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Bian Z, Zhang R, Yuan S, Fan R, Wang L, Larsson SC, Theodoratou E, Zhu Y, Wu S, Ding Y, Li X. Healthy lifestyle and cancer survival: A multinational cohort study. Int J Cancer 2024; 154:1709-1718. [PMID: 38230569 DOI: 10.1002/ijc.34846] [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: 07/06/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/18/2024]
Abstract
Lifestyle factors after a cancer diagnosis could influence the survival of cancer 60 survivors. To examine the independent and joint associations of healthy lifestyle factors with mortality outcomes among cancer survivors, four prospective cohorts (National Health and Nutrition Examination Survey [NHANES], National Health Interview Survey [NHIS], UK Biobank [UKB] and Kailuan study) across three countries. A healthy lifestyle score (HLS) was defined based on five common lifestyle factors (smoking, alcohol drinking, diet, physical activity and body mass index) that related to cancer survival. We used Cox proportional hazards regression to estimate the hazard ratios (HRs) for the associations of individual lifestyle factors and HLS with all-cause and cancer mortality among cancer survivors. During the follow-up period of 37,095 cancer survivors, 8927 all-cause mortality events were accrued in four cohorts and 4449 cancer death events were documented in the UK and US cohorts. Never smoking (adjusted HR = 0.77, 95% CI: 0.69-0.86), light alcohol consumption (adjusted HR = 0.86, 95% CI: 0.82-0.90), adequate physical activity (adjusted HR = 0.90, 95% CI: 0.85-0.94), a healthy diet (adjusted HR = 0.69, 95% CI: 0.61-0.78) and optimal BMI (adjusted HR = 0.89, 95% CI: 0.85-0.93) were significantly associated with a lower risk of all-cause mortality. In the joint analyses of HLS, the HR of all-cause and cancer mortality for cancer survivors with a favorable HLS (4 and 5 healthy lifestyle factors) were 0.55 (95% CI 0.42-0.64) and 0.57 (95% CI 0.44-0.72), respectively. This multicohort study of cancer survivors from the United States, the United Kingdom and China found that greater adherence to a healthy lifestyle might be beneficial in improving cancer prognosis.
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Affiliation(s)
- Zilong Bian
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Rongqi Zhang
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Rong Fan
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lijuan Wang
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Evropi Theodoratou
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, Medical Research Council Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Yimin Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yuan Ding
- Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xue Li
- Department of Big Data in Health Science, School of Public Health and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK
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Parera Roig M, Colomé DC, Colomer GB, Sardo EG, Tournour MA, Fernández SG, Ominetti AI, Juvanteny EP, Polo JLM, Jobal DB, Espejo-Herrera N. Evolution of Diagnoses, Survival, and Costs of Oncological Medical Treatment for Non-Small-Cell Lung Cancer over 20 Years in Osona, Catalonia. Curr Oncol 2024; 31:2145-2157. [PMID: 38668062 PMCID: PMC11049066 DOI: 10.3390/curroncol31040159] [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: 03/11/2024] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
Non-small-cell lung cancer (NSCLC) has experienced several diagnostic and therapeutic changes over the past two decades. However, there are few studies conducted with real-world data regarding the evolution of the cost of these new drugs and the corresponding changes in the survival of these patients. We collected data on patients diagnosed with NSCLC from the tumor registry of the University Hospital of Vic from 2002 to 2021. We analyzed the epidemiological and pathological characteristics of these patients, the diverse oncological treatments administered, and the survival outcomes extending at least 18 months post-diagnosis. We also collected data on pharmacological costs, aligning them with the treatments received by each patient to determine the cost associated with individualized treatments. Our study included 905 patients diagnosed with NSCLC. We observed a dynamic shift in histopathological subtypes from squamous carcinoma in the initial years to adenocarcinoma. Regarding the treatment approach, the use of chemotherapy declined over time, replaced by immunotherapy, while molecular therapy showed relative stability. An increase in survival at 18 months after diagnosis was observed in patients with advanced stages over the most recent years of this study, along with the advent of immunotherapy. Mean treatment costs per patient ranged from EUR 1413.16 to EUR 22,029.87 and reached a peak of EUR 48,283.80 in 2017 after the advent of immunotherapy. This retrospective study, based on real-world data, documents the evolution of pathological characteristics, survival rates, and medical treatment costs for NSCLC over the last two decades. After the introduction of immunotherapy, patients in advanced stages showed an improvement in survival at 18 months, coupled with an increase in treatment costs.
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Affiliation(s)
- Marta Parera Roig
- Oncohematology Unit, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain; (E.G.S.); (M.A.T.); (S.G.F.); (A.I.O.)
- School of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain; (D.B.J.); (N.E.-H.)
- Doctoral College, Medicine and Biomedical Sciences, University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
- Mechanisms of Disease Laboratory Research Group (MoD Lab), IRIS-CC, University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - David Compte Colomé
- Planning and Information Systems Department, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain;
| | - Gemma Basagaña Colomer
- Pharmacy Department, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain;
| | - Emilia Gabriela Sardo
- Oncohematology Unit, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain; (E.G.S.); (M.A.T.); (S.G.F.); (A.I.O.)
- School of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain; (D.B.J.); (N.E.-H.)
| | - Mauricio Alejandro Tournour
- Oncohematology Unit, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain; (E.G.S.); (M.A.T.); (S.G.F.); (A.I.O.)
| | - Silvia Griñó Fernández
- Oncohematology Unit, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain; (E.G.S.); (M.A.T.); (S.G.F.); (A.I.O.)
| | - Arturo Ivan Ominetti
- Oncohematology Unit, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain; (E.G.S.); (M.A.T.); (S.G.F.); (A.I.O.)
| | - Emma Puigoriol Juvanteny
- Epidemiology Department, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain;
- Multidisciplinary Inflammation Research Group (MIRG), IRIS-CC, 08500 Vic, Spain
| | - José Luis Molinero Polo
- Pathology Department, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain;
| | - Daniel Badia Jobal
- School of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain; (D.B.J.); (N.E.-H.)
- Pathology Department, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain;
| | - Nadia Espejo-Herrera
- School of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain; (D.B.J.); (N.E.-H.)
- Multidisciplinary Inflammation Research Group (MIRG), IRIS-CC, 08500 Vic, Spain
- Pathology Department, Consorci Hospitalari de Vic (University Hospital of Vic), 08500 Vic, Spain;
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Said SA, Perlmutter BC, Wehrle CJ, Chang J, Hossain MS, Naffouje S, Joyce D, Simon R, Walsh RM, Augustin T. Tumor Size Combined With CA-19 Level Improves Prediction of Survival of Patients With Pancreatic Adenocarcinoma Undergoing Perioperative Chemotherapy and Resection. Am Surg 2024:31348241241738. [PMID: 38513242 DOI: 10.1177/00031348241241738] [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: 03/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Five-year survival in pancreatic adenocarcinoma is less than 20%. While previous studies have postulated that a carbohydrate antigen 19-9 (CA19-9) threshold could predict outcome of resection, the role for CA19-9 in decision-making remains unclear. This study aims to assess whether CA19-9 levels combined with tumor size improve prediction of post-resection survival. METHOD A retrospective analysis was conducted on 109 patients with pancreatic adenocarcinoma who underwent perioperative chemotherapy followed by resection. The primary outcome of mortality was, divided into short (<1 year) or prolonged (>2 years). Univariate and multivariable analyses compared the tumor size-adjusted CA19-9 between the outcome groups. RESULTS Twenty-seven (24.78%) and eighty-two (75.23%) patients were in the short survival and prolonged-survival groups, respectively. The mean CA19-9 was significantly greater in the short vs prolonged group (P < .001). Analyzing CA19-9 level by tumor size, the association of high CA19-9 and short survival was significant for small (≤2 cm) and large tumor (>4 cm), but not for intermediate-size tumors (2-4 cm). Adjusting for preoperative variable did not change this association. CONCLUSION CA 19-9 in combination with tumor size better identifies patients with prolonged post-resection survival. This prediction is most accurate in patients with either small (≤2 cms) or large (>4 cms) tumors compared to intermediate-size tumors.
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Affiliation(s)
- Sayf A Said
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | | | - Chase J Wehrle
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Jenny Chang
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | | | - Samer Naffouje
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Daniel Joyce
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Robert Simon
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - R Matthew Walsh
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Toms Augustin
- Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA
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Afshar N, Dashti SG, Mar V, Te Marvelde L, Evans S, Milne RL, English DR. Do age at diagnosis, tumour thickness and tumour site explain sex differences in melanoma survival? A causal mediation analysis using cancer registry data. Int J Cancer 2024; 154:793-800. [PMID: 37823184 DOI: 10.1002/ijc.34752] [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: 06/19/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
Women diagnosed with melanoma have better survival than men, but little is known about potential intervention targets to reduce this survival gap by sex. We conducted a population-based study using Victorian Cancer Registry data including 5833 women and 6780 men aged 15 to 70 years when diagnosed with first primary melanoma between 2007 and 2015. Deaths to the end of 2020 were identified through linkage to the Victorian and national death registries. We estimated the effect of age at diagnosis, tumour thickness and tumour site on reducing the melanoma-specific survival gap by sex (ie, interventional indirect effects [IIEs]) on risk difference (RD) scale. Compared to women, there were 211 (95% CI: 145-278) additional deaths per 10 000 in men within 5 years following diagnosis. We estimated that 44% of this gap would be reduced by a hypothetical intervention shifting the distribution of melanoma thickness in men to be the same as that observed for women (IIEthickness RD 93 [95% CI: 75-118] per 10 000) and 20% by an intervention on tumour site (head and neck/trunk vs upper limb/lower limb; IIEsite RD 42 [95% CI: 15-72] per 10 000), while an intervention on age at diagnosis would have a negligible effect. Tumour thickness, tumour site and age at diagnosis mediated 65% of the effect of sex on 5-year melanoma survival in Victoria. Of these factors, tumour thickness had the most considerable mediating effect, suggesting that effective promotion of earlier detection of melanoma in men could potentially nearly halve the gap in melanoma-specific survival by sex.
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Affiliation(s)
- Nina Afshar
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - S Ghazaleh Dashti
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Clinical Epidemiology and Biostatistics Unit, Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Victoria Mar
- Victorian Melanoma Service, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Luc Te Marvelde
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sue Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Tupper CJ, Reeson EA, Burdyny MR, Eaton VP, Silberstein PT. Extent of Surgery and Survival of Osteosarcoma: A Retrospective Population-Based Study. Cureus 2024; 16:e56030. [PMID: 38606239 PMCID: PMC11008610 DOI: 10.7759/cureus.56030] [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] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
Background Osteosarcoma (OSC) is the most common primary bone tumor and is often managed surgically. Few prior investigations have assessed differences in OSC survival by specific surgical techniques at a national registry level. We sought to compare survival based on surgical subtypes for OSC patients in the Surveillance, Epidemiology, and End Results (SEER) database. Methodology We searched the SEER database for malignant OSCs diagnosed between 2000 and 2019 which were surgically managed. Separate survival comparisons were made for one and five years for wide excision (local tumor destruction or resection versus partial resection) and radical excision (radical resection with limb-sparing versus limb amputation with or without girdle resection). Results A total of 4,303 patients were included, of whom 3,587 were surgically managed. There were no survival differences between local destruction and partial resection (hazard ratio = 0.826, p = 0.303). However, younger age, lower staging, and management without radiation were associated with improved survival. The radical excision comparison showed limb amputation was associated with worse survival than limb-sparing surgery (hazard ratio = 1.531, p < 0.001). Younger age, female sex, lower stage, receipt of chemotherapy, and neoadjuvant plus adjuvant chemotherapy were associated with improved survival while Black and American Indian or Alaska Native were associated with worse survival. Conclusions Our findings show that patients managed with limb-sparing radical resection survived significantly compared to limb amputation. There were no differences in survival for wide excision surgeries. The use of a combination of neoadjuvant and adjuvant chemotherapy also yields improved survival. OSC survival may be optimized with limb-sparing surgery with a combination of neoadjuvant and adjuvant chemotherapy.
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Affiliation(s)
- Connor J Tupper
- Department of Orthopaedics, Creighton University School of Medicine, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Emily A Reeson
- Department of Orthopaedics, Creighton University School of Medicine, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Michael R Burdyny
- Department of Orthopaedics, Creighton University School of Medicine, Omaha, USA
| | - Vincent P Eaton
- Department of Orthopaedics, Creighton University School of Medicine, Omaha, USA
| | - Peter T Silberstein
- Department of Hematology and Oncology, Creighton University School of Medicine, Omaha, USA
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Kryzauskas M, Bausys A, Abeciunas V, Degutyte AE, Bickaite K, Bausys R, Poskus T. Achieving Textbook Outcomes in Colorectal Cancer Surgery Is Associated with Improved Long-Term Survival: Results of the Multicenter Prospective Cohort Study. J Clin Med 2024; 13:1304. [PMID: 38592180 PMCID: PMC10931839 DOI: 10.3390/jcm13051304] [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: 01/19/2024] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 04/10/2024] Open
Abstract
Background: The outcomes of patients with colorectal cancer greatly depend on the quality of their surgical care. However, relying solely on a single quality indicator does not adequately capture the multifaceted nature of modern perioperative care. A new tool-"Textbook Outcome" (TO)-has been suggested to provide a comprehensive evaluation of surgical quality. This study aims to examine how TO affects the long-term outcomes of colorectal cancer patients who are scheduled for surgery. Methods: The data of all patients undergoing elective colorectal cancer resection with primary anastomosis at two major cancer treatment centers in Lithuania-Vilnius University Hospital Santaros Klinikos and National Cancer Institute-between 2014 and 2018 were entered into the prospectively maintained database. The study defined TO as a composite quality indicator that incorporated seven parameters: R0 resection, retrieval of ≥12 lymph nodes, absence of postoperative complications during the intrahospital period, hospital stay duration of fewer than 14 days, no readmission within 90 days after surgery, no reinterventions within 30 days after surgery, and no 30-day mortality. Long-term outcomes between patients who achieved TO and those who did not were compared. Factors associated with failure to achieve TO were identified. Results: Of the 1524 patients included in the study, TO was achieved by 795 (52.2%). Patients with a higher ASA score (III-IV) were identified to have higher odds of failure to achieve TO (OR 1.497, 95% CI 1.203-1.863), while those who underwent minimally invasive surgery had lower odds for similar failure (OR 0.570, 95% CI 0.460-0.706). TO resulted in improved 5-year overall-(80.2% vs. 65.5%, p = 0.001) and disease-free survival (76.6% vs. 62.6%; p = 0.001) rates. Conclusions: Elective colorectal resections result in successful TO for 52.5% of patients. The likelihood of failure to achieve TO is increased in patients with a high ASA score, while minimally invasive surgery is associated with higher TO rates. Patients who fail to achieve successful surgical outcomes experience reduced long-term outcomes.
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Affiliation(s)
- Marius Kryzauskas
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania;
| | - Augustinas Bausys
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania;
- Department of Abdominal Surgery and Oncology, National Cancer Institute, 08660 Vilnius, Lithuania;
| | - Vilius Abeciunas
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (V.A.); (A.E.D.); (K.B.)
| | | | - Klaudija Bickaite
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (V.A.); (A.E.D.); (K.B.)
| | - Rimantas Bausys
- Department of Abdominal Surgery and Oncology, National Cancer Institute, 08660 Vilnius, Lithuania;
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania; (V.A.); (A.E.D.); (K.B.)
| | - Tomas Poskus
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania;
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Daniels J, Asante K, Tackie JNO, Kyei KA. Survival rate of cervical cancer: a five year review at a Major Teaching Hospital in Ghana, West Africa. Ecancermedicalscience 2024; 18:1663. [PMID: 38439806 PMCID: PMC10911670 DOI: 10.3332/ecancer.2024.1663] [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: 08/18/2023] [Indexed: 03/06/2024] Open
Abstract
Cervical cancer (CC) is one of the leading causes of cancer-related deaths among females in Ghana. Despite the magnitude of the public health challenge posed by CC in Ghana, survival data as well as reported incidence and mortality rates are primarily based on studies conducted in the capital city of the country. Even though age at diagnosis is known to affect the overall survival of CC patients, the role of this factor in the prognosis of CC patients in Ghana has not been sufficiently explored. The aim of this study was to determine the 5-year survival rate of Ghanaian woman treated for CC at a large tertiary healthcare facility in Ghana. This research was a single-institution-based quantitative retrospective cohort study conducted among patients with histopathologically confirmed CC. Clinical and socio-demographic data were retrieved from patients' medical records. Data analysis was done using the Statistical Package for the Social Sciences software version 23. Kaplan Meier curves were used to present the survival rates and median survival time. The peak age at diagnosis was between 45 and 80 years with the modal age group of patients between 75 and 80 years. The mean age at diagnosis was 63.3 ± 15.7 years ranging from 27 to 104 years. The overall survival rates at 1, 3 and 5 years were 76.5%, 51.5% and 32.4%, respectively. The median survival time was 65.8 months. Age < 50 years was associated with higher survival estimates than age >50 years. The 5-year overall survival rate of CC patients reported in this study (32.4%) is relatively low compared with countries in the developed world but like previous reports at other healthcare facilities in Ghana as well as in other underdeveloped countries.
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Affiliation(s)
- Joseph Daniels
- National Radiotherapy, Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
- https://orcid.org/0000-0002-1466-150X
| | - Kwesi Asante
- National Radiotherapy, Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Judith Naa Odey Tackie
- National Radiotherapy, Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Kofi Adesi Kyei
- National Radiotherapy, Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Radiography, University of Ghana, Accra, Ghana
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Li M, Sara G, Roder D, O'Brien TA. Mental Health Service Contact Following Cancer Diagnosis and Associations with Cancer Mortality: Results from a Linked Population-Based Study of Adolescents and Young Adults in New South Wales. J Adolesc Young Adult Oncol 2024. [PMID: 38261413 DOI: 10.1089/jayao.2023.0127] [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: 01/25/2024] Open
Abstract
Purpose: To assess the mental health conditions, as indicated by mental health service contact in adolescents and young adults (AYAs) diagnosed with cancer in New South Wales (NSW) and associations with cancer mortality. Methods: In 3998 NSW AYAs diagnosed with cancer in 2005-2017, mental health service contacts were obtained from hospital inpatient records and specified medical and pharmaceutical insurance claims. Odds of postcancer mental health contact were assessed by precancer mental contacts using logistic regression adjusted for sociodemographic and cancer characteristics. The risk of cancer-specific mortality related to postcancer mental health contacts was estimated using competing risk regression. Results: The prevalence of mental health service contacts in the 5 years postcancer diagnosis was 27.0%, higher than the corresponding precancer prevalence of 21.4%. The most common mental health conditions were depression and anxiety. The odds of having a mental health contact postcancer diagnosis were higher in patients with a precancer mental health service contact (adjusted odds ratio 5.69, confidence intervals [95% CIs]: 4.90-6.75). The 5-year cancer-specific survival was 87.9% (95% CI: 85.8-89.8) for patients with a mental health service contact postcancer, which was lower than the 93.9% (95% CI: 93.0-94.7) for patients without this contact. The subhazard ratio (SHR) for cancer mortality in patients having mental health service contact postcancer diagnosis was 1.67 (95% CI: 1.29-2.15), adjusted for sociodemographic characteristics, cancer stage, and precancer mental health status. Conclusion: The prevalence of mental health service contact increased after a cancer diagnosis. Mental health care should be a continued priority for AYA cancer patients, particularly for high-risk groups.
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Affiliation(s)
- Ming Li
- Cancer Institute, NSW Cancer Institute, Eveleigh, Australia
- University of South Australia, Cancer Epidemiology and Population Health, Adelaide, Australia
| | - Grant Sara
- NSW Ministry of Health, System Information and Analytics Branch, Sydney, Australia
- University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - David Roder
- Cancer Institute, NSW Cancer Institute, Eveleigh, Australia
- University of South Australia, Cancer Epidemiology and Population Health, Adelaide, Australia
| | - Tracey A O'Brien
- Cancer Institute, NSW Cancer Institute, Eveleigh, Australia
- University of NSW, Faculty of Medicine and Health, Sydney, Australia
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Mincuzzi A, Carone S, Galluzzo C, Tanzarella M, Lagravinese GM, Bruni A, Rashid I, Bisceglia L, Sardone R, Addabbo F, Minerba S, Giannico OV. Gender differences, environmental pressures, tumor characteristics, and death rate in a lung cancer cohort: a seven-years Bayesian survival analysis using cancer registry data from a contaminated area in Italy. Front Public Health 2024; 11:1278416. [PMID: 38269375 PMCID: PMC10806087 DOI: 10.3389/fpubh.2023.1278416] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/09/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction In Taranto, Southern Italy, adverse impacts on the environment and human health due to industrial installations have been studied. In the literature, associations have been reported between gender, environmental factors, and lung cancer mortality in women and men. The aim of this study was to investigate the relationships between gender, residence in areas with high environmental pressures, bronchus/lung cancer characteristics, and death rate. Methods Data from the Taranto Cancer Registry were used, including all women and men with invasive bronchus/lung cancer diagnosed between 1 January 2016 and 31 December 2020 and with follow-up to 31 December 2022. Bayesian mixed effects logistic and Cox regression models were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and disease characteristics. Results A total of 2,535 person-years were observed. Male gender was associated with a higher prevalence of histological grade 3 (OR 2.45, 95% CrI 1.35-4.43) and lung squamous-cell carcinoma (OR 3.04, 95% CrI 1.97-4.69). Variables associated with higher death rate were male gender (HR 1.24, 95% CrI 1.07-1.43), pathological/clinical stage II (HR 2.49, 95% CrI 1.63-3.79), III (HR 3.40, 95% CrI 2.33-4.97), and IV (HR 8.21, 95% CrI 5.95-11.34), histological grade 3 (HR 1.80, 95% CrI 1.25-2.59), lung squamous-cell carcinoma (HR 1.18, 95% CrI 1.00-1.39), and small-cell lung cancer (HR 1.62, 95% CrI 1.31-1.99). Variables associated with lower death rate were other-type lung cancer (HR 0.65, 95% CrI 0.44-0.95), high immune checkpoint ligand expression (HR 0.75, 95% CrI 0.59-0.95), lung localization (HR 0.73, 95% CrI 0.62-0.86), and left localization (HR 0.85, 95% CrI 0.75-0.95). Discussion The results among patients with lung cancer did not show an association between residence in the contaminated site of national interest (SIN) and the prevalence of the above mentioned prognostic factors, nor between residence in SIN and death rate. The findings confirmed the independent prognostic values of different lung cancer characteristics. Even after adjusting for patients and disease characteristics, male gender appeared to be associated with a higher prevalence of poorly differentiated cancer and squamous-cell carcinoma, and with an increased death rate.
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Affiliation(s)
- Antonia Mincuzzi
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Simona Carone
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Claudia Galluzzo
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Margherita Tanzarella
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | | | - Antonella Bruni
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Ivan Rashid
- Coordination Center of the Apulia Cancer Registry, Strategic Regional Agency for Health and Social Care of Apulia, Bari, Italy
| | - Lucia Bisceglia
- Coordination Center of the Apulia Cancer Registry, Strategic Regional Agency for Health and Social Care of Apulia, Bari, Italy
| | - Rodolfo Sardone
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Francesco Addabbo
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Sante Minerba
- Healthcare Management, Local Health Authority of Taranto, Taranto, Italy
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Giannico OV, Carone S, Tanzarella M, Galluzzo C, Bruni A, Lagravinese GM, Rashid I, Bisceglia L, Sardone R, Addabbo F, Minerba S, Mincuzzi A. Environmental pressures, tumor characteristics, and death rate in a female breast cancer cohort: a seven-years Bayesian survival analysis using cancer registry data from a contaminated area in Italy. Front Public Health 2024; 11:1310823. [PMID: 38264246 PMCID: PMC10805021 DOI: 10.3389/fpubh.2023.1310823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction In Taranto, Southern Italy, adverse impacts on the environment and human health due to industrial installations have been studied. In the literature, few associations have been reported between environmental factors and breast cancer mortality in women. The aim of this study was to investigate the relationships between residence in areas with high environmental pressures, female breast cancer characteristics, and death rate. Methods Data from the Taranto Cancer Registry were used, including all women with invasive breast cancer diagnosed between 01 January 2015 and 31 December 2020 and with follow-up to 31 December 2021. Bayesian mixed effects logistic and Cox regression models were fitted with the approach of integrated nested Laplace approximation, adjusting for patients and disease characteristics. Results A total of 10,445 person-years were observed. Variables associated with higher death rate were residence in the contaminated site of national interest (SIN) (HR 1.22, 95% CrI 1.01-1.48), pathological/clinical stage III (HR 2.77, 95% CrI 1.93-3.97) and IV (HR 17.05, 95% CrI 11.94-24.34), histological grade 3 (HR 2.50, 95% CrI 1.20-5.23), Ki-67 proliferation index of 21-50% (HR 1.42, 95% CrI 1.10-1.83) and > 50% (HR 1.81, 95% CrI 1.29-2.55), and bilateral localization (HR 1.65, 95% CrI 1.01-2.68). Variables associated with lower death rate were estrogen and/or progesterone receptor positivity (HR 0.61, 95% CrI 0.45-0.81) and HER2/neu oncogene positivity (HR 0.59, 95% CrI 0.44-0.79). Discussion The findings confirmed the independent prognostic values of different female breast cancer characteristics. Even after adjusting for patients and disease characteristics, residence in the SIN of Taranto appeared to be associated with an increased death rate.
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Affiliation(s)
| | - Simona Carone
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Margherita Tanzarella
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Claudia Galluzzo
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Antonella Bruni
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | | | - Ivan Rashid
- Coordination Center of the Apulia Cancer Registry, Strategic Regional Agency for Health and Social Care of Apulia, Bari, Italy
| | - Lucia Bisceglia
- Coordination Center of the Apulia Cancer Registry, Strategic Regional Agency for Health and Social Care of Apulia, Bari, Italy
| | - Rodolfo Sardone
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Francesco Addabbo
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
| | - Sante Minerba
- Healthcare Management, Local Health Authority of Taranto, Taranto, Italy
| | - Antonia Mincuzzi
- Unit of Statistics and Epidemiology, Local Health Authority of Taranto, Taranto, Italy
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Pandey M, Rajput M, Singh P, Shukla M, Zhu B, Koshiol J. Aspirin and Cancer Survival: An Analysis of Molecular Mechanisms. Cancers (Basel) 2024; 16:223. [PMID: 38201650 PMCID: PMC10778469 DOI: 10.3390/cancers16010223] [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: 10/07/2023] [Revised: 12/25/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
The benefit of aspirin on cancer survival is debated. Data from randomized clinical trials and cohort studies are discordant, although a meta-analysis shows a clear survival advantage when aspirin is added to the standard of care. However, the mechanism by which aspirin improves cancer survival is not clear. A PubMed search was carried out to identify articles reporting genes and pathways that are associated with aspirin and cancer survival. Gene ontology and pathway enrichment analysis was carried out using web-based tools. Gene-gene and protein-protein interactions were evaluated. Crosstalk between pathways was identified and plotted. Forty-one genes were identified and classified into primary genes (PTGS2 and PTGES2), genes regulating cellular proliferation, interleukin and cytokine genes, and DNA repair genes. The network analysis showed a rich gene-gene and protein-protein interaction between these genes and proteins. Pathway enrichment showed the interleukin and cellular transduction pathways as the main pathways involved in aspirin-related survival, in addition to DNA repair, autophagy, extracellular matrix, and apoptosis pathways. Crosstalk of PTGS2 with EGFR, JAK/AKT, TP53, interleukin/TNFα/NFκB, GSK3B/BRCA/PARP, CXCR/MUC1, and WNT/CTNNB pathways was identified. The results of the present study demonstrate that aspirin improves cancer survival by the interplay of 41 genes through a complex mechanism. PTGS2 is the primary target of aspirin and impacts cancer survival through six primary pathways: the interleukin pathway, extracellular matrix pathway, signal transduction pathway, apoptosis pathway, autophagy pathway, and DNA repair pathway.
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Affiliation(s)
- Manoj Pandey
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India; (M.R.)
| | - Monika Rajput
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India; (M.R.)
| | - Pooja Singh
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India; (M.R.)
| | - Mridula Shukla
- RRL, Dr. Lalpath Labs Ltd., Shivpur, Varanasi 221003, India
| | - Bin Zhu
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, RM 6-E212, Rockville, MD 20850, USA (J.K.)
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics (DCEG), National Cancer Institute (NCI), National Institutes of Health (NIH), 9609 Medical Center Drive, RM 6-E212, Rockville, MD 20850, USA (J.K.)
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12
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Haffner MR, Saiz AM, Darrow MA, Judge SJ, Laun T, Arora A, Taylor SL, Randall RL, Alvarez EM, Thorpe SW. Effect of ALDH1A1 and CD44 on Survival and Disease Recurrence in Patients With Osteosarcoma. Cureus 2024; 16:e52404. [PMID: 38371078 PMCID: PMC10869251 DOI: 10.7759/cureus.52404] [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] [Accepted: 01/15/2024] [Indexed: 02/20/2024] Open
Abstract
PURPOSE Emerging evidence suggests that osteosarcoma stem cells (OSCs) may be responsible for tumor initiation propagation, recurrence, and resistance to therapy. We set out to evaluate the relationship between the abundance of ALDH1A1 and CD44-positive cells in biopsy and resection samples on disease recurrence and overall survival. METHODS A retrospective review of 20 patients, including biopsy and resection samples, was performed at a comprehensive cancer center. Additionally, we queried the publicly available TARGET dataset of osteosarcoma patients. RESULTS Neither the percentages of ALDH1A1-positive cells nor CD44-positive cells were significantly associated with overall mortality or disease recurrence in either biopsy or resection samples. Unlike our institutional data, overall survival was significantly correlated to higher ALDH1A1 expression in the TARGET dataset both in univariate and age-adjusted analyses. CONCLUSIONS ADLH1 and CD44, potential markers of OSCs, were not found to be reliable clinical immunohistochemical prognostic markers for osteosarcoma patient survival, specifically disease-free survival. Osteosarcoma patients with high ALDH1A1 RNA expression showed improved overall survival in examining a national genomic database of osteosarcoma patients but again no association with disease-free survival. The potential of CD44 and ALDH1A1 as cellular-specific prognostic markers of survival, and as possible molecular targets, may be limited in osteosarcoma.
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Affiliation(s)
- Max R Haffner
- Orthopedic Surgery, UC (University of California) Davis Health, Sacramento, USA
| | - Augustine M Saiz
- Orthopedic Surgery, UC (University of California) Davis Health, Sacramento, USA
| | - Morgan A Darrow
- Pathology and Laboratory Medicine, UC (University of California) Davis Health, Sacramento, USA
| | - Sean J Judge
- Surgery, UC (University of California) Davis Health, Sacramento, USA
| | - Tammy Laun
- Medicine, Oakland University William Beaumont School of Medicine, Auburn Hills, USA
| | - Aman Arora
- Urology, UC (University of California) Davis School of Medicine, Sacramento, USA
| | - Sandra L Taylor
- Division of Biostatistics, Public Health Sciences, Sacramento, USA
| | - R Lor Randall
- Orthopedic Surgery, UC (University of California) Davis Health, Sacramento, USA
| | - Elysia M Alvarez
- Pediatric Hematology and Oncology, UC (University of California) Davis Health, Sacramento, USA
| | - Steven W Thorpe
- Orthopedic Surgery, UC (University of California) Davis Health, Sacramento, USA
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Zhang L, He J, Yu X, Zhang D. Prognostic Factors in Pediatric Alveolar Rhabdomyosarcoma: SEER Analysis of 277 Cases. Clin Pediatr (Phila) 2023:99228231220236. [PMID: 38153032 DOI: 10.1177/00099228231220236] [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] [Indexed: 12/29/2023]
Abstract
Alveolar rhabdomyosarcoma (ARMS) is a rare but highly aggressive cancer predominantly affecting children and adolescents. This study explores prognostic factors for pediatric and adolescent ARMS, using the Surveillance, Epidemiology, and End Results (SEER) database. Leveraging SEER data (2000-2019), we analyzed 277 cases. Employing Kaplan-Meier survival analysis and Cox proportional hazards models, we identified significant prognostic factors. Gender distribution was nearly equal (56.0% boys, 44.0% girls), with the majority (70.8%) from the white ethnic group. Primary tumors were predominantly in extremities (37.2%). Distant metastases significantly increased mortality risk (hazard ratio [HR], 3.13; 95% CI: 2.14-4.58) and regional lymph node involvement raised mortality risk (HR, 1.36; 95% CI: 0.96-1.92). Chemotherapy-only treatment had higher mortality risk than chemoradiotherapy (HR, 1.16; 95% CI: 0.97-2.67). Conclusively, our study identifies distant metastases, regional lymph node involvement, and treatment modality as crucial predictors of overall survival in pediatric ARMS.
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Affiliation(s)
- Li Zhang
- Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jiali He
- Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xianhai Yu
- Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Deying Zhang
- Children's Hospital of Chongqing Medical University, Chongqing, China
- National Clinical Research Center for Child Health and Disorders, Chongqing, China
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Jajal V, Nekarakanti PK, K S, Nag H. Effects of Cystic Duct Margin Involvement on the Survival Rates of Patients With Gallbladder Cancer: A Propensity Score-Matched Case-Control Study. Cureus 2023; 15:e50585. [PMID: 38226074 PMCID: PMC10788702 DOI: 10.7759/cureus.50585] [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] [Accepted: 12/14/2023] [Indexed: 01/17/2024] Open
Abstract
Background In gallbladder cancer (GBC), extrahepatic bile duct (EHBD) resection is selectively performed if gross direct extension or microscopic involvement of the cystic duct margin (CDM) is detected. Although CDM is usually sent for frozen biopsy intraoperatively in most centers, there are no studies regarding the routine use of CDM frozen biopsy irrespective of the tumor location and paucity of literature regarding the impact of CDM status on recurrence-free and overall survival in GBC. The presence of obstructive jaundice in GBC usually indicates the involvement of EHBD or cystic duct-bile duct junction. The present study aimed to analyze the necessity of routine CDM frozen biopsy in patients with resectable GBC without jaundice, regardless of the tumor location. The impact of positive CDM on survival was also evaluated. Methods This retrospective observational case-control study was conducted from May 2009 to March 2021 and included 105 patients with resectable GBC without macroscopic EHBD infiltration and jaundice. Patients were divided into CDM-negative (n=91) and CDM-positive (n=14) groups. Propensity score matching was performed for variables such as performance status, tumor size, tumor-node-metastasis (TNM) stage, and adjuvant chemotherapy. After propensity score matching, 27 patients (CDM-negative=13, CDM-positive=14) were included. The primary outcome was to analyze the role of routine CDM frozen biopsy regardless of tumor location, and secondary outcomes were to study the impact of positive CDM status on survival and evaluate predictive factors for CDM positivity. A subgroup analysis was conducted to assess clinicopathologic characteristics and outcomes of the anatomical location of the tumor. Results Of 105 patients, 91 had negative CDM, and 14 had positive CDM. Among 14 patients with positive CDM, only one patient had a tumor in the fundus/body, and the remaining had a tumor involving the neck. All CDM-positive patients underwent bile duct excision with hepaticojejunostomy. Common bile duct (CBD) involvement was present in 50% of patients with positive CDM in the final histopathological examination. In the matched population, patients with positive CDM had a significantly higher rate of neck tumors (p=0.001). Recurrence-free survival (24 vs. 12 months, p=0.30) and overall survival (24.5 vs. 20 months, p=0.417) were comparable between CDM-negative and CDM-positive groups, respectively. On multivariate analysis, preoperative and intraoperative tumor location were independent predictive factors for CDM positivity. On subgroup analysis, 30 patients had tumor involving the neck of the gallbladder, and the remaining 75 had at the fundus and body of the gallbladder. Neck tumors had inferior recurrence-free survival (17 vs. 30 months, p=0.012) and overall survival (24 vs. 36 months, p=0.048) compared to non-neck tumors. Conclusions Routine use of CDM frozen analysis in patients with resectable GBC without jaundice, regardless of tumor location, can be avoided. It can be selectively preferred in patients with GBC involving the neck since tumor location is found to be an independent predictive factor for CDM positivity. Positive CDM has comparable survival outcomes to negative CDM, providing a similar R0 resection rate and tumor stage. However, neck tumors have a worse prognosis than non-neck tumors.
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Affiliation(s)
- Vasistha Jajal
- Surgical Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, IND
| | - Phani K Nekarakanti
- Surgical Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, IND
| | - Sugumaran K
- Surgical Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, IND
| | - Hirdaya Nag
- Surgical Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, IND
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Brenner DR, Carbonell C, O’Sullivan DE, Ruan Y, Basmadjian RB, Bu V, Farah E, Loewen SK, Bond TR, Estey A, Pujadas Botey A, Robson PJ. Exploring the Future of Cancer Impact in Alberta: Projections and Trends 2020-2040. Curr Oncol 2023; 30:9981-9995. [PMID: 37999145 PMCID: PMC10670527 DOI: 10.3390/curroncol30110725] [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: 10/04/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
The impact of cancer in Alberta is expected to grow considerably, largely driven by population growth and aging. The Future of Cancer Impact (FOCI) initiative offers an overview of the present state of cancer care in Alberta and highlights potential opportunities for research and innovation across the continuum. In this paper, we present a series of detailed projections and analyses regarding cancer epidemiological estimates in Alberta, Canada. Data on cancer incidence and mortality in Alberta (1998-2018) and limited-duration cancer prevalence in Alberta (2000-2019) were collected from the Alberta Cancer Registry. We used the Canproj package in the R software to project these epidemiological estimates up to the year 2040. To estimate the direct management costs, we ran a series of microsimulations using the OncoSim All Cancers Model. Our findings indicate that from 2020, the total number of annual new cancer cases and cancer-related deaths are projected to increase by 56% and 49% by 2040, respectively. From 2019, the five-year prevalence of all cancers in Alberta is projected to increase by 86% by 2040. In line with these trends, the overall direct cost of cancer management is estimated to increase by 53% in 2040. These estimates and projections are integral to future strategic planning and investment.
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Affiliation(s)
- Darren R. Brenner
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N1, Canada
| | | | | | - Yibing Ruan
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N1, Canada
| | | | - Vickey Bu
- Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada
| | - Eliya Farah
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Shaun K. Loewen
- Division of Radiation Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB T2N 4N2, Canada
| | - Tara R. Bond
- Cancer Strategic Clinical Network, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Angela Estey
- Cancer Strategic Clinical Network, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Anna Pujadas Botey
- Cancer Strategic Clinical Network, Alberta Health Services, Calgary, AB T2S 3C3, Canada
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Paula J. Robson
- Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3H1, Canada
- Cancer Strategic Clinical Network, Alberta Health Services, Calgary, AB T2S 3C3, Canada
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
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Murillo-Maldonado MA, Galván PG, Ortega IP, Morales FG, Villegas LJ, Acosta ED. Long-term experience in treatment of acute promyelocytic leukemia in Mexican children in a tertiary care hospital. Front Oncol 2023; 13:1286106. [PMID: 38023223 PMCID: PMC10661391 DOI: 10.3389/fonc.2023.1286106] [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: 08/30/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Acute promyelocytic leukemia (APL) is a rare myeloid leukemia subtype affecting adult and pediatric populations. APL constitutes 15-20% of all childhood AML in Latin America, compared to 7% in the non-Latino population. This leukemia has unique characteristics, such as its association with chromosomal translocations involving the retinoid acid receptor α (RARA) gene on chromosome 17. In addition, APL is also distinct from other AML subtypes due to its response to all-trans-retinoic acid (ATRA), which induces terminal granulocytic differentiation of blasts. Overall 5-year survival rates are generally reported to be greater than 80%. Materials and methods A study was conducted from January 2008 to December 2022 applying the IC-APL 2006 treatment protocol. This case series reports the clinical results of 22 children with APL. In all cases, the diagnosis was made by bone marrow aspiration and evaluation of the t(15:17) or t(11:17) transcripts. Results We identified 22 patients with APL, of whom 10 were female and 12 were male. Twelve patients debuted with coagulation abnormalities. The doses of anthracyclines varied according to the risk, with an average of 496.8 mgm2. The cardiological assessment was performed before and after chemotherapy, finding 2/22 patients with moderate sisto-diastolic dysfunction and one with mild pulmonary insufficiency at the end of treatment. There were 6/22 patients with complications related to ATRA treatment, the most frequent being pseudotumor cerebri. All complications were transitory and treated immediately without complications. In this series of cases, an overall survival of 90.6% and a relapse-free survival of 90.6% were recorded. The follow-up mean was 9.1 ± 3.8 years. Conclusion APL is a highly curable disease when combined with ATRA and anthracyclines. In this series of cases, good long-term results were observed with the IC-APL 2006 protocol. However, in Latin America, the availability of drugs such as arsenic trioxide as the first line of treatment is an unresolved challenge.
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Affiliation(s)
| | | | - Israel Parra Ortega
- Laboratory of Molecular Biology, Federico Gómez, Children’s Hospital of Mexico Federico Gómez, Mexico City, Mexico
| | - Félix Gaytán Morales
- Myeloid Leukemia Clinic, Federico Gómez, Children’s Hospital of Mexico, Mexico City, Mexico
- Hematopoietic Stem Cell Transplant Unit, Federico Gómez, Children’s Hospital of Mexico Federico Gómez, Mexico City, Mexico
| | - Luis Juárez Villegas
- Department of Hemato-Oncology, Federico Gómez, Children’s Hospital of Mexico Federico Gómez, Mexico City, Mexico
| | - Elisa Dorantes Acosta
- Myeloid Leukemia Clinic, Federico Gómez, Children’s Hospital of Mexico, Mexico City, Mexico
- Leukemia Cell Research Biobank, Federico, Gómez Children’s Hospital of Mexico, Mexico City, Mexico
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Pendl‐Robinson E, Calkins KL, Simon SE, Barrett K, Poznyak D. The reliability and validity of lung cancer and melanoma clinical quality survival measures. Health Serv Res 2023; 58:1131-1140. [PMID: 37669902 PMCID: PMC10480076 DOI: 10.1111/1475-6773.14164] [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] [Indexed: 09/07/2023] Open
Abstract
OBJECTIVE To develop a risk adjustment approach and test reliability and validity for oncology survival measures. DATA SOURCES AND STUDY SETTING We used the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2010 to 2013, with mortality data through 2015. STUDY DESIGN We developed 2-year risk-standardized survival rates (RSSR) for melanoma, non-small cell lung cancer (NSCLC), and small cell lung cancer (SCLC). Patients were attributed to group practices based on the plurality of visits. We identified the risk-adjustment variables via bootstrap and calculated the RSSRs. Reliability was tested via three approaches: (1) signal-to-noise ratio (SNR) reliability, (2) split-half, and (3) test-retest using bootstrap. We tested known group validity by stage at diagnosis using Cohen's d. DATA COLLECTION/EXTRACTION METHODS We selected all patients enrolled in Medicare and linked to SEER during the measurement period with an incident first primary diagnosis of stage I-IV melanoma, NSCLC, or SCLC. We excluded patients with missing data on month and/or stage of diagnosis. PRINCIPAL FINDINGS Results are based on patients with melanoma (n = 4344); NSCLC (n = 16,080); and SCLC (n = 2807) diagnosed between 2012 and 2013. The median (interquartile range) for the RSSRs at the group practice-level were 0.89 (0.83-0.87) for melanoma, 0.37 (0.30-0.43) for NSCLC, and 0.19 (0.11-0.25) for SCLC. C-statistics for the models ranged from 0.725 to 0.825. The reliability varied by approach with median SNR 0.20, 0.25, and 0.13; median test-retest 0.59, 0.57, and 0.56; median split-half reliability 0.21, 0.29, and 0.29 for melanoma, NSCLC, and SCLC, respectively. Cohen's d for stage I-IIIa and IIIb+ was 1.27, 0.86, 0.60 for melanoma, NSCLC, and SCLC, respectively. CONCLUSIONS Our results suggest that these cancer survival measures demonstrated adequate test-retest reliability and expected findings for the known-group validity analysis. If data limitations and feasibility challenges can be addressed, implementation of these quality measures may provide a survival metric used for oncology quality improvement efforts.
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Wijeratne Y, Hapuachchige C. Surgical Outcomes in Early-Stage Cervical Cancer Following Radical Hysterectomy in a Resource-Limited Setting: The Experience of the National Cancer Institute (Apeksha Hospital, Maharagama), Sri Lanka. Cureus 2023; 15:e47744. [PMID: 38022125 PMCID: PMC10676234 DOI: 10.7759/cureus.47744] [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] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Cervical carcinoma is the commonest gynecological malignancy in Sri Lanka, and this incidence is rising. Radical hysterectomy is the preferred treatment for stages IB1, IB2, and selected cases of stages IIA1. Although surgery is feasible unless the parametrium is involved, careful patient selection is crucial in order to prevent the patient from receiving a dual mode of radical treatment (surgery and radiotherapy). Pre-operative imaging with MRI and PET-CT can accurately determine the tumor size and the lymph node metastasis. In a resource-limited setting, management is challenging as access to MRI and PET-CT is limited. This study was carried out to evaluate the surgical outcomes, five-year survival, and disease-free survival following radical hysterectomies at the National Cancer Institute, Sri Lanka, which performs the largest number of radical hysterectomies annually in the country. Methods Seventy-four patients who underwent radical hysterectomy, along with pelvic lymphadenectomy, between July 2015 to January 2017 at the National Cancer Institute, Sri Lanka (Apeksha Hospital Maharagama), were reviewed retrospectively, analyzing their clinical data and histopathological findings. Univariate analysis was performed to identify associated factors and mean survival. The Kaplan-Meier method was used for survival analysis. Results With a median follow-up of 63.5 months, five-year disease-free survival was 94.5%, and the five-year overall survival was 95.9%. There is a statistically significant association between mean survival and the cell type, presence of LVSI, and residual tumor on the hysterectomy specimen. Only four patients developed recurrences and four patients died during the follow-up. Eighteen (24.3%) patients needed blood transfusion postoperatively and no cases of bladder or bowel dysfunction in the one year post-operatively. Thirty patients (40.5%) required postoperative adjuvant treatment. Conclusions This analysis shows excellent surgical and oncological outcomes following radical hysterectomy as a primary treatment and comparable five-year disease-free survival with available global figures, despite the multiple scarcity of resources. Further studies are needed to assess the national-level status, and limited access to imaging during surgical planning poses a risk for patients receiving dual modes of radical treatment.
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Affiliation(s)
- Yapa Wijeratne
- Gynecological Oncology, Apeksha Hospital, Maharagama, LKA
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19
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Karczewski D, Gonzalez MR, Bedi A, Ready JE, Anderson ME, Lozano-Calderon SA. Giant cell-rich osteosarcoma: A match pair analysis of 11 new cases and literature review of 56 patients. J Surg Oncol 2023; 128:877-890. [PMID: 37292033 DOI: 10.1002/jso.27368] [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: 02/20/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Limited remains known on giant cell-rich osteosarcoma (GCRO) with current studies being case reports or smaller series. This investigation compared GCRO and conventional osteoblastic osteosarcoma (OOS) with regard to demographics and survival. METHODS An institutional tumor registry was used to identify 11 patients (six males) treated for GCRO. Mean age was 43 years. Staging showed American Joint Committee on Cancer (AJCC) stages IIA in four and IIB in seven patients. Mean follow-up was 14 years. Study initiatives were: (1) Comparison of demographics between GCRO and 167 OOS from our institutional registry, (2) Differences in survival between GCRO and 33 OOS case controls (based on sex and AJCC stage), as well as 10 OOS using an age-based propensity match, and (3) Summary of all GCRO cases reported in the literature. RESULTS (1) Sex (p = 0.53), grading (p = 0.56), AJCC stage (p = 0.42), and chemotherapeutic response rate (p = 0.67) did not differ between groups. Age was significantly increased in GCRO (p = 0.001). (2) Case-control and propensity-matched groups revealed no difference in disease-free survival, local recurrence, and distant disease-free survival at 2 years (p > 0.05). (3) Mean age of 56 patients (50% males) reported in the literature was 26 years. After merging with our 11 cases, the 2-year disease-free survival was 66%. CONCLUSIONS GCRO remains a rare disease with high short-term mortality. Although affecting older patients more than conventional osteosarcoma, GCRO should not be viewed as a predictor of survival compared to OOS.
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Affiliation(s)
- Daniel Karczewski
- Department of Orthopedic Surgery, Musculoskeletal Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Marcos R Gonzalez
- Department of Orthopedic Surgery, Musculoskeletal Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Angad Bedi
- Department of Orthopedic Surgery, Musculoskeletal Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Orthopaedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - John E Ready
- Department of Orthopedic Surgery, Musculoskeletal Oncology Service, Massachusetts General Brigham Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Megan E Anderson
- Department of Orthopedic Surgery, Musculoskeletal Oncology Service, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Santiago A Lozano-Calderon
- Department of Orthopedic Surgery, Musculoskeletal Oncology Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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20
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Kuo CW, Lin CY, Wei SH, Chou YT, Chen CW, Tsai JS, Su PL, Lin CC. Navigating the challenges of invasive pulmonary aspergillosis in lung cancer treatment: a propensity score study. Ther Adv Med Oncol 2023; 15:17588359231198454. [PMID: 37720497 PMCID: PMC10503299 DOI: 10.1177/17588359231198454] [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: 04/21/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Background Invasive pulmonary aspergillosis (IPA) can negatively impact cancer patients' survival. It remains uncertain whether IPA's impact on patient outcomes varies by treatment approach in advanced lung cancer. Objectives To explore the association between IPA and outcomes in patients with advanced lung cancer receiving different treatments. Design A retrospective cohort study. Methods We enrolled patients with advanced-stage lung cancer between 2013 and 2021 at a college hospital in Taiwan and used the 2021 European Organization for Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium consensus for IPA diagnosis. Multivariable logistic regression was used to identify the IPA risk factors. We compared overall survival (OS) and postgalactomannan (GM) test survival between the IPA and control groups using multivariable Cox proportional hazards regression and the Kaplan-Meier method with propensity score matching (PSM). Results Among 2543 patients with advanced-stage lung cancer, 290 underwent a GM test, of which 34 (11.7%) were diagnosed with IPA. Patients undergoing chemotherapy (HR = 4.02, p = 0.027) and immunotherapy [hazard ratio (HR) = 3.41, p = 0.076] tended to have IPA. Compared to the control group, the IPA group had shorter median OS (14.4 versus 9.9 months, p = 0.030) and post-GM test survival (4.5 versus 1.9 months, p = 0.003). IPA was associated with shorter OS (log-rank p = 0.014 and 0.018 before and after PSM, respectively) and shorter 1-year and 2-year survival post-GM test (HR = 1.65 and 1.66, respectively). Patients receiving chemotherapy or immunotherapy had a shorter post-GM test survival if they had IPA. Conclusions IPA tended to be diagnosed more frequently in patients receiving chemotherapy or immune checkpoint inhibitors. Patients diagnosed with IPA are associated with shorter survival. Larger cohort studies are needed to verify the observations.
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Affiliation(s)
- Chin-Wei Kuo
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Chien-Yu Lin
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Sheng-Huan Wei
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Yun-Tse Chou
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Chian-Wei Chen
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Jeng-Shiuan Tsai
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Po-Lan Su
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Chien-Chung Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan
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Koru-Sengul T, Pinheiro PS, Zhao W, Hernandez MN, Hernandez DR, Maggioni A, Kobetz EN, Caban-Martinez AJ, Lee DJ. Lung cancer survival among Florida male firefighters. Front Oncol 2023; 13:1155650. [PMID: 37664012 PMCID: PMC10473410 DOI: 10.3389/fonc.2023.1155650] [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: 01/31/2023] [Accepted: 04/27/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Lung cancer is a leading cause of cancer incidence and death in the United States. Although most firefighters are fit and do not smoke, they are exposed to many known carcinogens during and in the aftermath of firefighting activities. Comprehensive epidemiologic investigations on lung cancer survival for both career and volunteer firefighters have not been undertaken. Methods Data from the Florida Cancer Data System (1981-2014) were linked with firefighter certification records from the Florida State Fire Marshal's Office to identify all patients of this occupational group; lung cancer cause-specific survival data were compared with other occupational groups using Cox regression models with occupation as the main effect. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were calculated. Results Out of 210,541 male lung cancer cases diagnosed in Florida (1981-2014), 761 were firefighters (604 career, 157 volunteer). Lung cancer death was similar between volunteer (75.2%) and career firefighters (74.0%) but lower than non-firefighters (80.0%). Survival at 5 years was higher among firefighters (29.7%; career: 30.3%; volunteer: 27.4%) than non-firefighters (23.8%). In a multivariable model, compared with non-firefighters, firefighters have significantly higher cause-specific survival (aHR = 0.84; 95% CI: 0.77-0.91; p < 0.001). However, there were no significant survival differences between career and volunteer firefighters (1.14; 0.93-1.39; p = 0.213). In a separate multivariable model with firefighters as the comparator, other broad occupational groups had significantly lower cause-specific survival [white collar: 1.11 (1.02-1.21); blue collar: 1.15 (1.05-1.25); service: 1.13 (1.03-1.25); others/unknown: 1.21 (1.12-1.32); all p-values < 0.02]. Conclusion Lung cancer survival is significantly higher among firefighters compared with non-firefighters, but there is no significant difference between career and volunteer firefighters. Improved survival for firefighters might be due to a healthy worker effect, lower smoking prevalence relative to other worker groups, and possibly superior treatment adherence and compliance. Many firefighters are cross-trained as EMTs/paramedics and possess a level of medical knowledge that may favorably impact treatment engagement and better navigation of complex cancer care.
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Affiliation(s)
- Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Paulo S. Pinheiro
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Wei Zhao
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Monique N. Hernandez
- Florida Cancer Data System, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Diana R. Hernandez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Alessandra Maggioni
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Erin N. Kobetz
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Department of Medicine, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Department of Physical Medicine and Rehabilitation, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
| | - David J. Lee
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
- Florida Cancer Data System, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, United States
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22
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Fiol G, Lete I, Nieto L, Santaballa A, Pla MJ, Baquedano L, Calaf J, Coronado P, de la Viuda E, Llaneza P, Otero B, Sánchez-Méndez S, Ramírez I, Mendoza N. Associations between Menopausal Hormone Therapy and Colorectal, Lung, or Melanoma Cancer Recurrence and Mortality: A Narrative Review. J Clin Med 2023; 12:5263. [PMID: 37629305 PMCID: PMC10455141 DOI: 10.3390/jcm12165263] [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: 06/20/2023] [Revised: 07/31/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Objective: to develop eligibility criteria for use in non-gynecological cancer patients. Methods: We searched all the articles published in peer-reviewed journals up to March 2021. We utilized the PICOS standards and the following selection criteria: menopausal women with a history of non-gynecological and non-breast cancer who underwent hormone replacement therapy (HRT) using various preparations (oestrogens alone or in combination with a progestogen, tibolone, or tissue selective oestrogen complex) and different routes of administration (including oral, transdermal, vaginal, or intra-nasal). We focused on randomized controlled trials as well as relevant extension studies or follow-up reports, specifically examining recurrence and mortality outcomes. Results: Women colorectal cancer survivors who use MHT have a lower risk of death from any cause than those survivors who do not use MHT. Women who are skin melanoma survivors using MHT have a longer survival rate than non-MHT survivors. There is no evidence that women lung cancer survivors who use MHT have a different survival rate than those who do not use MHT. Conclusions: MHT is safe for women who have a history of colorectal, lung, or skin melanoma cancers.
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Affiliation(s)
- Gabriel Fiol
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Iñaki Lete
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Laura Nieto
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Ana Santaballa
- Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica), 28001 Madrid, Spain;
| | - María Jesús Pla
- Gynecological Oncology Section of the Spanish Society of Gynecology and Obstetrics (Sección de Oncología Ginecológica de la Sociedad Española de Ginecología y Obstetricia), 28036 Madrid, Spain;
| | - Laura Baquedano
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Joaquín Calaf
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Pluvio Coronado
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Esther de la Viuda
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Plácido Llaneza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Borja Otero
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Sonia Sánchez-Méndez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Isabel Ramírez
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
| | - Nicolas Mendoza
- Spanish Menopause Society (Asociación Española para el Estudio de la Menopausia—AEEM), 28036 Madrid, Spain; (I.L.); (L.N.); (L.B.); (J.C.); (P.C.); (E.d.l.V.); (P.L.); (B.O.); (S.S.-M.); (I.R.); (N.M.)
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Tan GSQ, Botteri E, Wood S, Sloan EK, Ilomäki J. Using administrative healthcare data to evaluate drug repurposing opportunities for cancer: the possibility of using beta-blockers to treat breast cancer. Front Pharmacol 2023; 14:1227330. [PMID: 37637417 PMCID: PMC10448902 DOI: 10.3389/fphar.2023.1227330] [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: 05/23/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction: Cancer registries and hospital electronic medical records are commonly used to investigate drug repurposing candidates for cancer. However, administrative data are often more accessible than data from cancer registries and medical records. Therefore, we evaluated if administrative data could be used to evaluate drug repurposing for cancer by conducting an example study on the association between beta-blocker use and breast cancer mortality. Methods: A retrospective cohort study of women aged ≥50 years with incident breast cancer was conducted using a linked dataset with statewide hospital admission data and nationwide medication claims data. Women receiving beta blockers and first-line anti-hypertensives prior to and at diagnosis were compared. Breast cancer molecular subtypes and metastasis status were inferred by algorithms from commonly prescribed breast cancer antineoplastics and hospitalization diagnosis codes, respectively. Subdistribution hazard ratios (sHR) and corresponding 95% confidence intervals (CIs) for breast cancer mortality were estimated using Fine and Gray's competing risk models adjusted for age, Charlson comorbidity index, congestive heart failure, myocardial infraction, molecular subtype, presence of metastasis at diagnosis, and breast cancer surgery. Results: 2,758 women were hospitalized for incident breast cancer. 604 received beta-blockers and 1,387 received first-line antihypertensives. In total, 154 breast cancer deaths were identified over a median follow-up time of 2.7 years. We found no significant association between use of any beta-blocker and breast-cancer mortality (sHR 0.86, 95%CI 0.58-1.28), or when stratified by beta-blocker type (non-selective, sHR 0.42, 95%CI 0.14-1.25; selective, sHR 0.95, 95%CI 0.63-1.43). Results were not significant when stratified by molecular subtypes (e.g., triple negative breast cancer (TNBC), any beta blocker, sHR 0.16, 95%CI 0.02-1.51). Discussion: It is possible to use administrative data to explore drug repurposing opportunities. Although non-significant, an indication of an association was found for the TNBC subtype, which aligns with previous studies using registry data. Future studies with larger sample size, longer follow-up are required to confirm the association, and linkage to clinical data sources are required to validate our methodologies.
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Affiliation(s)
- George S. Q. Tan
- Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia
| | - Edoardo Botteri
- Section for Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
- Research Department, Cancer Registry of Norway, Oslo, Norway
| | - Stephen Wood
- Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia
| | - Erica K. Sloan
- Monash Institute of Pharmaceutical Sciences, Drug Discovery Biology Theme, Monash University, Parkville, VIC, Australia
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Jenni Ilomäki
- Centre for Medicine Use and Safety, Monash University, Parkville, VIC, Australia
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Debelius JW, Engstrand L, Matussek A, Brusselaers N, Morton JT, Stenmarker M, Olsen RS. The Local Tumor Microbiome Is Associated with Survival in Late-Stage Colorectal Cancer Patients. Microbiol Spectr 2023; 11:e0506622. [PMID: 37042765 PMCID: PMC10269740 DOI: 10.1128/spectrum.05066-22] [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: 12/09/2022] [Accepted: 03/27/2023] [Indexed: 04/13/2023] Open
Abstract
The gut microbiome is associated with survival in colorectal cancer. Single organisms have been identified as markers of poor prognosis. However, in situ imaging of tumors demonstrate a polymicrobial tumor-associated community. To understand the role of these polymicrobial communities in survival, we conducted a nested case-control study in late-stage cancer patients undergoing resection for primary adenocarcinoma. The microbiome of paired tumor and adjacent normal tissue samples was profiled using 16S rRNA sequencing. We found a consistent difference in the microbiome between paired tumor and adjacent tissue, despite strong individual microbial identities. Furthermore, a larger difference between normal and tumor tissue was associated with prognosis: patients with shorter survival had a larger difference between normal and tumor tissue. Within the tumor tissue, we identified a 39-member community statistic associated with survival; for every log2-fold increase in this value, an individual's odds of survival increased by 20% (odds ratio survival 1.20; 95% confidence interval = 1.04 to 1.33). Our results suggest that a polymicrobial tumor-specific microbiome is associated with survival in late-stage colorectal cancer patients. IMPORTANCE Microbiome studies in colorectal cancer (CRC) have primarily focused on the role of single organisms in cancer progression. Recent work has identified specific organisms throughout the intestinal tract, which may affect survival; however, the results are inconsistent. We found differences between the tumor microbiome and the microbiome of the rest of the intestine in patients, and the magnitude of this difference was associated with survival, or, the more like a healthy gut a tumor looked, the better a patient's prognosis. Our results suggest that future microbiome-based interventions to affect survival in CRC will need to target the tumor community.
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Affiliation(s)
- Justine W. Debelius
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Solna, Sweden
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lars Engstrand
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Andreas Matussek
- Laboratory Medicine, Jönköping Region County, Department of Clinical and Experimental Medicine, Linköping University, Jönköping, Sweden
- Division of Laboratory Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology, Division of Laboratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Nele Brusselaers
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Solna, Sweden
- Global Health Institute, Antwerp University, Antwerp, Belgium
- Department of Head and Skin, Ghent University, Ghent, Belgium
| | - James T. Morton
- Biostatistics and Bioinformatics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA
| | - Margaretha Stenmarker
- Futurum/Department of Pediatrics, Jönköping Region County, Jönköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Institute of Clinical Sciences, Department of Paediatrics, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Renate S. Olsen
- Centre for Translational Microbiome Research, Department of Microbiology, Tumor, and Cell Biology, Karolinska Institutet, Solna, Sweden
- Pathology Laboratory, Department of Laboratory Medicine, Jönköping Region County, Jönköping, Sweden
- Department of Pathology, Division of Laboratory Medicine, Oslo University Hospital, Norwegian Radium Hospital, Oslo, Norway
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25
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Oberije CJG, Sharma N, James JJ, Ng AY, Nash J, Kecskemethy PD. Comparing Prognostic Factors of Cancers Identified by Artificial Intelligence (AI) and Human Readers in Breast Cancer Screening. Cancers (Basel) 2023; 15:3069. [PMID: 37370680 DOI: 10.3390/cancers15123069] [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: 03/28/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Invasiveness status, histological grade, lymph node stage, and tumour size are important prognostic factors for breast cancer survival. This evaluation aims to compare these features for cancers detected by AI and human readers using digital mammography. Women diagnosed with breast cancer between 2009 and 2019 from three UK double-reading sites were included in this retrospective cohort evaluation. Differences in prognostic features of cancers detected by AI and the first human reader (R1) were assessed using chi-square tests, with significance at p < 0.05. From 1718 screen-detected cancers (SDCs) and 293 interval cancers (ICs), AI flagged 85.9% and 31.7%, respectively. R1 detected 90.8% of SDCs and 7.2% of ICs. Of the screen-detected cancers detected by the AI, 82.5% had an invasive component, compared to 81.1% for R1 (p-0.374). For the ICs, this was 91.5% and 93.8% for AI and R1, respectively (p = 0.829). For the invasive tumours, no differences were found for histological grade, tumour size, or lymph node stage. The AI detected more ICs. In summary, no differences in prognostic factors were found comparing SDC and ICs identified by AI or human readers. These findings support a potential role for AI in the double-reading workflow.
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Affiliation(s)
- Cary J G Oberije
- Kheiron Medical Technologies, 112-116 Old St., London EC1V 9BG, UK
| | - Nisha Sharma
- Breast Screening Unit, Leeds Teaching Hospital NHS Trust, Leeds LS14 6UH, UK
| | - Jonathan J James
- Nottingham Breast Institute, City Hospital, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK
| | - Annie Y Ng
- Kheiron Medical Technologies, 112-116 Old St., London EC1V 9BG, UK
| | - Jonathan Nash
- Kheiron Medical Technologies, 112-116 Old St., London EC1V 9BG, UK
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Kim H, Yuan C, Nguyen LH, Ng K, Giovannucci EL. Prediagnostic Vitamin D Status and Colorectal Cancer Survival by Vitamin D Binding Protein Isoforms in US Cohorts. J Clin Endocrinol Metab 2023; 108:e223-e229. [PMID: 36550068 PMCID: PMC10188303 DOI: 10.1210/clinem/dgac742] [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: 10/10/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT Lower 25-hydroxyvitamin D (25(OH)D) levels have consistently been associated with higher mortality among participants with colorectal cancer (CRC). OBJECTIVE To investigate whether the association between 25(OH)D and CRC mortality differs according to vitamin D binding protein (also known as Gc) isoforms. METHODS We examined the association between prediagnostic 25(OH)D levels and overall and CRC-specific mortality among participants with CRC within 2 prospective US cohorts. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) and 95% CIs. RESULTS 588 participants with CRC were observed until the date of death or last follow-up (2018), whichever came first. Deficient vs sufficient 25(OH)D concentrations (<30 vs ≥50 nmol/L) were associated with higher overall mortality (HR 2.06; 95% CI 1.34-3.18) but not with CRC-specific mortality (HR 1.51; 95% CI 0.75-3.07). The HRs for overall mortality comparing deficient vs sufficient concentrations were 2.43 (95% CI 1.26-4.70) for those with the Gc1-1 isoform (rs4588 CC) and 1.63 (95% CI 0.88-3.02) for those with the Gc1-2 or Gc2-2 (rs4588 CA or AA) isoform (P for interaction = .54). The HRs for CRC-specific mortality were 1.18 (95% CI 0.27-5.14) for those with the Gc1-1 isoform and 1.41 (95% CI 0.62-3.24) for those with the Gc1-2 or Gc2-2 isoform (P for interaction = .94). CONCLUSION In these 2 US cohorts, we found that lower 25(OH)D levels were associated with higher overall mortality, but this association did not differ by Gc isoforms.
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Affiliation(s)
- Hanseul Kim
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Chen Yuan
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA
| | - Long H Nguyen
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Kimmie Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Dutra MP, Rodrigues CM, Peretz-Soroka H, Ribeiro M, Shultz D, Hodgson D, Tsang DS, Gupta AA. Radiation-induced sarcomas following childhood cancer - A Canadian Sarcoma Research and Clinical Collaboration Study (CanSaRCC). Cancer Rep (Hoboken) 2023:e1834. [PMID: 37178052 DOI: 10.1002/cnr2.1834] [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: 03/22/2023] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Radiation-induced sarcoma (RIS) is a late toxicity of radiation therapy (RT) usually associated with poor prognosis. Due to ongoing improvements in childhood cancer treatment and patient outcomes, RIS may become more prevalent notwithstanding evolving indications for RT. Due to limited reported studies, we sought to review our experience with RIS in survivors of pediatric cancer. METHODOLOGY Data were collected on RIS patients following treatment for childhood cancer (initial diagnosis <18 years) identified in the CanSaRCC database. Additionally, details on the protocol guidance at time of treatment were compared with current guidelines for the same disease. RESULTS Among 12 RIS identified, median age at initial diagnosis was 3.5 years (range 0.16-14) and the latency from RT to RIS diagnosis was 24.5 (range 5.4-46.2) years. Initial diagnoses included neuroblastoma, rhabdomyosarcoma, Ewing sarcoma, Wilms tumor, retinoblastoma and Hodgkin's Lymphoma. RIS histologies included osteosarcoma and soft tissue sarcomas. In comparison to protocols followed at time of diagnosis to current ones (2022), 7/12 (58%) patients would have required RT. RIS treatment included chemotherapy, radiation and surgery in 3/11 (27%), 10/11 (90%), and 7/11 (63%) patients, respectively. With a median follow-up time of 4.7 years from diagnosis of RIS, 8 (66%) patients were alive and 4 (33%) had died of progressive RIS. CONCLUSION RIS is a serious late effect of radiotherapy in childhood cancer; however, radiation remains an integral component of primary tumor management and requires participation from a specialized multi-disciplinary team, aiming to mitigate RIS and other potential late effects.
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Affiliation(s)
- Marina Parisi Dutra
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Caroline Mary Rodrigues
- Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Hagit Peretz-Soroka
- Canadian Sarcoma Research and Clinical Collaboration, CanSaRCC, Toronto, Ontario, Canada
| | - Mauricio Ribeiro
- Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Shultz
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Hodgson
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Derek S Tsang
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Abha A Gupta
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
- Canadian Sarcoma Research and Clinical Collaboration, CanSaRCC, Toronto, Ontario, Canada
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Konishi K, Kuwahara H, Morita D, Imai S, Nagata K. Prolonged Survival in a Patient With Extensive-Stage Small Cell Lung Cancer in Spite of Discontinued Immunotherapy With Atezolizumab. Cureus 2023; 15:e37757. [PMID: 37213944 PMCID: PMC10198584 DOI: 10.7759/cureus.37757] [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] [Accepted: 04/12/2023] [Indexed: 05/23/2023] Open
Abstract
A 64-year-old man was referred from a local clinic with a chief complaint of cough. Computed tomography (CT) revealed a mass comprising a tumor in the right lower lobe and enlarged mediastinal lymph nodes, and a whole-body workup with positron emission tomography-CT showed bilateral lymph node enlargement and cancerous pericarditis. Biopsy with bronchoscopy of the right lower lobe tumor and mediastinal lymph node confirmed the histological findings of small cell lung carcinoma. The clinical diagnosis of extensive-stage small cell lung cancer (ES-SCLC) was confirmed, and first-line treatment with carboplatin, etoposide, and atezolizumab was initiated, followed by tri-weekly atezolizumab thrice. The patient experienced worsening pleural effusion treated with thoracentesis, pleural drainage, and pleurodesis. He also experienced several recurrences, which were managed with second and third-line chemotherapy with nogitecan and amrubicin. He has been receiving third-line therapy for over 30 months since his initial visit and remains stable as of today. The patient experienced an exceptional treatment outcome considering that the prognosis of ES-SCLC remains poor, with a median survival of approximately 10 months with conventional chemotherapies using cytotoxic agents. The use of immune checkpoint inhibitors (ICI) for ES-SCLC as first-line treatment may demonstrate a persistent antitumor effect, and result in improved survival following discontinuation. In conclusion, therapy including ICI for patients with ES-SCLC is a treatment option that shows possibilities in improving survival even after discontinuation.
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Affiliation(s)
- Kazuhisa Konishi
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
| | - Hiroomi Kuwahara
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
| | - Daiki Morita
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
| | - Shunsuke Imai
- Department of Pathology, Koseikai Takeda Hospital, Kyoto, JPN
| | - Kazuhiro Nagata
- Department of Respiratory Medicine, Koseikai Takeda Hospital, Kyoto, JPN
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Engholm G, Lundberg FE, Kønig SM, Ólafsdóttir E, Johannesen TB, Pettersson D, Mørch LS, Johansson ALV, Friis S. Influence of various assumptions for the individual TNM components on the TNM stage using Nordic cancer registry data. Acta Oncol 2023; 62:215-222. [PMID: 36961761 DOI: 10.1080/0284186x.2023.2189528] [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] [Indexed: 03/25/2023]
Abstract
BACKGROUND The stage at diagnosis is one of the most important predictors for cancer survival. TNM stage is constructed from T (tumor size), N (nodal spread), and M (distant metastasis) components. In many notifications to cancer registries, TNM information is incomplete with unknown N and/or M. We aimed to evaluate the influence of various assumptions for recoding missing N (NX) and M (MX) as N0 and M0 on the proportion with available TNM stage, stage-distribution, and stage-specific relative survival. MATERIAL AND METHODS We identified 140,201 patients diagnosed with incident cancer of the colon, rectum, lung, breast, or kidney during 2014-2016 in Denmark, Norway, Sweden, or Iceland. Information on TNM were obtained from cancer registry records used for an update of the Nordic cancer statistics database NORDCAN. Patients were followed for death or emigration through 2017. We calculated proportions of available TNM stage, stage distribution, and stage-specific relative survival under different approaches for each cancer site and country. RESULTS Application of the assumptions yielded higher numbers of cases with available TNM stage for stages 0-I, II, and III. We observed only minor differences in stage-specific one-year relative survival when applying N0M0 for missing N and M, especially for high completeness of TNM registrations, whereas relative survival for remaining cases with missing TNM stage declined substantially. CONCLUSION We found no major changes in stage-specific one-year relative survival applying N0M0 for NXMX. We conclude that complete TNM information is preferable to making assumptions, but it seems reasonable to consider assuming N0M0 for missing N and M in future studies based on the Nordic cancer registries. An automatic algorithm, though, is not recommended without considering potential area-specific reasons for frequent use of NX and MX. Clinicians should be urged to report complete TNM information to improve surveillance of the TNM stage.
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Affiliation(s)
- Gerda Engholm
- Danish Cancer Society Research Center, Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Frida E Lundberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Simon M Kønig
- Danish Cancer Society Research Center, Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society, Copenhagen, Denmark
| | | | | | - David Pettersson
- Swedish Cancer Registry, National Board of Health and Welfare, Stockholm, Sweden
| | - Lina S Mørch
- Danish Cancer Society Research Center, Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Anna L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Cancer Registry of Norway, Oslo, Norway
| | - Søren Friis
- Danish Cancer Society Research Center, Cancer Surveillance and Pharmacoepidemiology, Danish Cancer Society, Copenhagen, Denmark
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Ebia MI, Sankar K, Osipov A, Hendifar AE, Gong J. TOPAZ-1: a new standard of care for advanced biliary tract cancers? Immunotherapy 2023; 15:473-476. [PMID: 36950948 DOI: 10.2217/imt-2022-0269] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Affiliation(s)
- Matthew I Ebia
- Department of Medicine, Division of Hematology & Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Kamya Sankar
- Department of Medicine, Division of Hematology & Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA
| | - Arsen Osipov
- Department of Medicine, Division of Hematology & Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA
| | - Andrew E Hendifar
- Department of Medicine, Division of Hematology & Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA
| | - Jun Gong
- Department of Medicine, Division of Hematology & Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA 90048, USA
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Nash SH, Wahlen MM, Meisner ALW, Morawski BM. Choice of Survival Metric and Its Impacts on Cancer Survival Estimates for American Indian and Alaska Native People. Cancer Epidemiol Biomarkers Prev 2023; 32:398-405. [PMID: 36723409 PMCID: PMC9992150 DOI: 10.1158/1055-9965.epi-22-1059] [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: 10/03/2022] [Revised: 12/08/2022] [Accepted: 01/09/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Different survival metrics have different applicability to clinical practice and research. We evaluated how choice of survival metric influences assessment of cancer survival among American Indian and Alaska Native (AIAN) people relative to non-Hispanic Whites (NHW). A secondary objective was to present variations in survival among AIAN people by age, sex, stage, and Indian Health Service (IHS) region. METHODS Five-year survival was calculated using the North American Association of Central Cancer Registries Cancer in North America dataset. We calculated survival among AIAN people, compared with NHW using four approaches: (i) observed (crude) survival, (ii) cause-specific survival, (iii) relative survival using age- and sex-adjusted lifetables, and (iv) relative survival using lifetables additionally adjusted for race, geography, and socioeconomic status. For AIAN people, we evaluated how survival varied by age, stage at diagnosis, and IHS region. RESULTS Observed survival methods produced the lowest estimates, and-excepting prostate cancer-cause-specific methods produced the highest survival estimates. Survival was lower among AIAN people than NHW for all methods. Among AIAN people, survival was higher among those 20-64 years, females, and tumors diagnosed at local stage. Survival varied by IHS region and cancer sites. CONCLUSIONS These results support the assertion that using the same methodology to compare survival estimates between racial and ethnic groups is of paramount importance, but that the choice of metric requires careful consideration of study objectives. IMPACT These findings have the potential to impact choice of survival metric to explore disparities among AIAN people.
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Affiliation(s)
- Sarah H Nash
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
- State Health Registry of Iowa, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Madison M Wahlen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Angela L W Meisner
- New Mexico Tumor Registry, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Bożena M Morawski
- Cancer Data Registry of Idaho, Idaho Hospital Association, Boise, Idaho
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Odani S, Tabuchi T, Nakaya T, Morishima T, Nakata K, Kuwabara Y, Saito MK, Ma C, Miyashiro I. Socioeconomic disparities in cancer survival: Relation to stage at diagnosis, treatment, and centralization of patients to accredited hospitals, 2005-2014, Japan. Cancer Med 2023; 12:6077-6091. [PMID: 36229942 PMCID: PMC10028172 DOI: 10.1002/cam4.5332] [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: 04/04/2022] [Revised: 09/09/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Cancer survival varies by socioeconomic status in Japan. We examined the extent to which survival disparities are explained by factors relevant to cancer control measures (promoting early-stage detection, standardizing treatment, and centralizing patients to government-accredited cancer hospitals [ACHs]). METHODS From the Osaka Cancer Registry, patients diagnosed with solid malignant tumors during 2005-2014 and aged 15-84 years (N = 376,077) were classified into quartiles using the Area Deprivation Index (ADI). Trends in inequalities were assessed for potentially associated factors: early-stage detection, treatment modality, and utilization of ACH (for first contact/diagnosis/treatment). 3-year all-cause survival was computed by the ADI quartile. Multivariable Cox regression models were used to assess survival disparities and their trends through a series of adjustment for the potentially associated factors. RESULTS During 2005-2014, the most deprived ADI quartile had lower rates than the least deprived quartile for early-stage detection (42.6% vs. 48.7%); receipt of surgery (58.1% vs. 64.1%); and utilization of ACH (83.5% vs. 88.4%). While rate differences decreased for receipt of surgery and utilization of ACH (Annual Percent Change = -3.2 and - 11.9, respectively) over time, it remained unchanged for early-stage detection. During 2012-2014, the most deprived ADI quartile had lower 3-year survival than the least deprived (59.0% vs. 69.4%) and higher mortality (Hazard Ratio [HR] = 1.32, adjusted for case-mix): this attenuated with additional adjustment for stage at diagnosis (HR = 1.23); treatment modality (HR = 1.20); and utilization of ACH (HR = 1.19) CONCLUSIONS: Despite improvements in equalizing access to quality cancer care during 2005-2014, survival disparities remained. Interventions to reduce inequalities in early-stage detection could ameliorate such gaps.
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Affiliation(s)
- Satomi Odani
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- Department of Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | | | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Yoshihiro Kuwabara
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Chaochen Ma
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- Department of Oncology, Osaka University Graduate School of Medicine, Suita, Japan
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Ramkumar SP, Simpson MC, Adjei Boakye E, Bukatko AR, Antisdel JL, Massa ST, Osazuwa-Peters N. High-risk human papillomavirus 16/18 associated with improved survival in sinonasal squamous cell carcinoma. Cancer 2023; 129:1372-1383. [PMID: 36808090 DOI: 10.1002/cncr.34690] [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: 11/16/2022] [Revised: 12/21/2022] [Accepted: 01/15/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND There has been conflicting evidence on the independent prognostic role of human papillomavirus (HPV) status in sinonasal cancer. The objective of this study was to assess whether the survival of patients with sinonasal cancer differs based on various HPV statuses, including HPV-negative, positive for the high-risk HPV-16 and HPV-18 (HPV16/18) subtypes, and positive for other high-risk and low-risk HPV subtypes. METHODS In this retrospective cohort study, data from the National Cancer Database were extracted from the years 2010-2017 for patients who had primary sinonasal cancer (N = 12,009). The outcome of interest was overall survival based on HPV tumor status. RESULTS Study included an analytic cohort of 1070 patients with sinonasal cancer who had confirmed HPV tumor status (732 [68.4%] HPV-negative; 280 [26.2%] HPV16/18-positive; 40 [3.7%] positive for other high-risk HPV; and 18 [1.7%] positive for low-risk HPV). HPV-negative patients had the lowest all-cause survival probability at 5 years postdiagnosis (0.50). After controlling for covariates, HPV16/18-positive patients had a 37% lower mortality hazard than HPV-negative patients (adjusted hazard ratio, 0.63; 95% confidence interval [CI], 0.48-0.82). Patients aged 64-72 years (crude prevalence ratio, 0.66; 95% CI, 0.51-0.86) and 73 years and older (crude prevalence ratio, 0.43; 95% CI, 0.31-0.59) presented with lower rates of HPV16/18-positive sinonasal cancer than those aged 40-54 years. In addition, Hispanic patients had a 2.36 times higher prevalence of non-HPV16/18 sinonasal cancer than non-Hispanic White patients. CONCLUSIONS These data suggest that, for patients with sinonasal cancer, HPV16/18-positive disease may confer a significant survival advantage compared with HPV-negative disease. Other high-risk and low-risk HPV subtypes have survival rates similar to the rates for HPV-negative disease. HPV status might be an important independent prognostic factor in sinonasal cancer that could be used in patient selection and clinical decisions.
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Affiliation(s)
- Shreya P Ramkumar
- St Louis University School of Medicine, St Louis, Missouri, USA.,Department of Otolaryngology Head and Neck Surgery, St Louis University School of Medicine, St Louis, Missouri, USA
| | - Matthew C Simpson
- Department of Otolaryngology Head and Neck Surgery, St Louis University School of Medicine, St Louis, Missouri, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA.,Department of Otolaryngology Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA
| | | | - Jastin L Antisdel
- Department of Otolaryngology Head and Neck Surgery, St Louis University School of Medicine, St Louis, Missouri, USA
| | - Sean T Massa
- Department of Otolaryngology Head and Neck Surgery, St Louis University School of Medicine, St Louis, Missouri, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina, USA.,Duke Cancer Institute, Duke University, Durham, North Carolina, USA
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Chat V, Dagayev S, Moran U, Snuderl M, Weber J, Ferguson R, Osman I, Kirchhoff T. A genome-wide association study of germline variation and melanoma prognosis. Front Oncol 2023; 12:1050741. [PMID: 36741706 PMCID: PMC9894711 DOI: 10.3389/fonc.2022.1050741] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/22/2022] [Accepted: 12/23/2022] [Indexed: 01/20/2023] Open
Abstract
Background The high mortality of cutaneous melanoma (CM) is partly due to unpredictable patterns of disease progression in patients with early-stage lesions. The reliable prediction of advanced disease risk from early-stage CM, is an urgent clinical need, especially given the recent expansion of immune checkpoint inhibitor therapy to the adjuvant setting. In our study, we comprehensively investigated the role of germline variants as CM prognostic markers. Methods We performed a genome-wide association analysis in two independent cohorts of N=551 (discovery), and N=550 (validation) early-stage immunotherapy-naïve melanoma patients. A multivariable Cox proportional hazard regression model was used to identify associations with overall survival in the discovery group, followed by a validation analysis. Transcriptomic profiling and survival analysis were used to elucidate the biological relevance of candidate genes associated with CM progression. Results We found two independent associations of germline variants with melanoma prognosis. The alternate alleles of these two SNPs were both associated with an increased risk of death [rs60970102 in MELK: HR=3.14 (2.05-4.81), p=1.48×10-7; and rs77480547 in SH3BP4: HR=3.02 (2.02-4.52), p=7.58×10-8, both in the pooled cohort]. The addition of the combined risk alleles (CRA) of the identified variants into the prognostic model improved the predictive power, as opposed to a model of clinical covariates alone. Conclusions Our study provides suggestive evidence of novel melanoma germline prognostic markers, implicating two candidate genes: an oncogene MELK and a tumor suppressor SH3BP4, both previously suggested to affect CM progression. Pending further validation, these findings suggest that the genetic factors may improve the prognostic stratification of high-risk early-stage CM patients, and propose putative biological insights for potential therapeutic investigation of these targets to prevent aggressive outcome from early-stage melanoma.
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Affiliation(s)
- Vylyny Chat
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States,Department of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States,The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
| | - Sasha Dagayev
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States,Department of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States,The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
| | - Una Moran
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States,The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
| | - Matija Snuderl
- Department of Pathology, New York University School of Medicine, New York, NY, United States
| | - Jeffrey Weber
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States,The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
| | - Robert Ferguson
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States,Department of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States,The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States,*Correspondence: Tomas Kirchhoff, ; Robert Ferguson,
| | - Iman Osman
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States,The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States,Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, NY, United States
| | - Tomas Kirchhoff
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States,Department of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States,The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States,*Correspondence: Tomas Kirchhoff, ; Robert Ferguson,
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Frontiers Production Office. Erratum: Wnt-pathway inhibitors with selective activity against triple-negative breast cancer: From thienopyrimidine to quinazoline inhibitors. Front Pharmacol 2023; 14:1173490. [PMID: 36959854 PMCID: PMC10027792 DOI: 10.3389/fphar.2023.1173490] [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: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fphar.2022.1045102.].
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Xu B, Shi J, Lu W, Wu Y, Dong X. Elderly Pancreatic Adenocarcinoma Cancer Patients Could Benefit From Postoperative Chemotherapy. Pancreas 2023; 52:e37-e44. [PMID: 37165831 PMCID: PMC10317297 DOI: 10.1097/mpa.0000000000002214] [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: 12/19/2021] [Accepted: 02/15/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES The study aim to investigate whether elderly patients with resectable pancreatic ductal adenocarcinoma (PDAC) could benefit from postoperative chemotherapy. METHODS This study selects the data of PDAC patients who were diagnosed between 2004 and 2014 from the Surveillance, Epidemiology, and End Results program. Median overall survival (mOS) is determined by Kaplan-Meier survival curves. Multivariate logistic regression analysis and hazard ratio are employed to assess the association among potential prognostic factors. Propensity score matching evaluation is used to reduce bias. RESULTS In total, there are 11,865 PDAC patients selected from the Surveillance, Epidemiology, and End Results database. Elderly PDAC patients have poor prognoses compared with younger (mOS, 15 vs 21 months). The possible reason might be that the elderly patients are less likely to receive postoperative chemotherapy. After propensity score matching, it is found that, for those who receive postoperative chemotherapy, although the mOS of older group is not as good as that of the younger group (mOS, 20 vs 23 months; 18-month survival rate: 53.4% vs 61.3%), the mOS of older group prolonged by postoperative chemotherapy is similar to that of younger group (9 vs 9 months). CONCLUSIONS Elderly PDAC patients (≥70 years) might benefit from the currently used postoperative chemotherapy regimens.
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Affiliation(s)
- Bin Xu
- From the Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinbo Shi
- From the Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Wenjie Lu
- From the Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yulian Wu
- From the Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Dong
- From the Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Cooper RM, Chao C, Mukherjee A, Zhuang Z, Haque R. Influence of Comorbidity Burden, Socioeconomic Status, and Race and Ethnicity on Survival Disparities in Patients With Cancer. Cancer Control 2023; 30:10732748231204474. [PMID: 37771179 PMCID: PMC10542233 DOI: 10.1177/10732748231204474] [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: 05/16/2023] [Revised: 07/21/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023] Open
Abstract
PURPOSE The purpose of this study was to assess the association of comorbidity burden with overall survival, accounting for racial/ethnic and socioeconomic differences in patients with cancer. METHODS In this retrospective cohort study, patients newly diagnosed with cancer between 2010 and 2018 were identified from a large health plan in southern California. Cancer registry data were linked with electronic health records (EHR). Comorbidity burden was defined by the Elixhauser comorbidity index (ECI). Patients were followed through December 2019 to assess all-cause mortality. Association of comorbidity burden with all-cause mortality was evaluated using Cox proportional hazards model. Crude and adjusted hazard ratio (HR, 95%CI) were determined. RESULTS Of 153,270 patients included in the analysis, 29% died during the ensuing 10-year follow-up. Nearly 49% were patients of color, and 32% had an ECI > 4. After adjusting for age, sex, race/ethnicity, cancer stage, smoking status, insurance payor, medical center, year of cancer diagnosis, and cancer treatments, we observed a trend demonstrating higher mortality risk by decreasing socioeconomic status (SES) (P-trend<.05). Compared to patients in the highest SES quintile, patients in the lowest, second lowest, middle, and second highest quintiles had 25%, 21%, 18%, and 11% higher risk of mortality, respectively [(HR, 95%CI): 1.25 (1.21-1.29), 1.21 (1.18-1.25), 1.18 (1.15-1.22), and 1.11 (1.07-1.14), respectively]. When we additionally adjusted for ECI, the adjusted HRs for SES were slightly attenuated; however, the trend persisted. Patients with higher comorbidity burden had higher mortality risk compared to patients with ECI score = 0 in the adjusted model [(HR, 95%CI): 1.22 (1.17-1.28), 1.48 (1.42-1.55), 1.80 (1.72-1.89), 2.24 (2.14-2.34), and 3.39 (3.25-3.53) for ECI = 1, 2, 3, 4, and >5, respectively]. CONCLUSIONS Comorbidity burden affects overall survival in cancer patients irrespective of racial/ethnic and SES differences. Reducing comorbidity burden can reduce some, but not all, of the mortality risk associated with lower SES.
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Affiliation(s)
- Robert M. Cooper
- Pediatric Oncology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Chun Chao
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Amrita Mukherjee
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Zimin Zhuang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Reina Haque
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
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Yu U, Xu H, Chen S, Yi M, Liu C, Zhang X, Wang C, Song J, Gan Y, Wang J, Wang Y, Zhang Q, Sun J, Xia B, Zhang G, Li C, Wen F, Liu S, Yuan X. A Retrospective Analysis of the Therapeutic Outcomes of 117 Neuroblastoma Patients Treated at a Single Pediatric Oncology Center in China. Cancer Control 2023; 30:10732748231187837. [PMID: 37575028 PMCID: PMC10426302 DOI: 10.1177/10732748231187837] [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: 02/16/2023] [Revised: 05/31/2023] [Accepted: 06/20/2023] [Indexed: 08/15/2023] Open
Abstract
OBJECTIVE Recent therapeutic advances have greatly enhanced the survival rates of patients with neuroblastoma (NB). However, the outcomes of neuroblastoma patients in China, particularly those with high-risk (HR) NB, remain limited. METHOD We retrospectively analyzed the clinical data and outcomes of NB patients who were treated at a tertiary pediatric cancer facility in China between January 2013 and October 2021. RESULTS A total of 117 NB patients were recruited. Patients with very low-risk (VLR), low-risk (LR), intermediate-risk (IR), and HR-NB patients made up 4%, 27%, 15%, and 54% of total patient population, respectively. Patients diagnosed between 2013 and 2018 were treated according to the protocol of Sun Yat-Sen University Cancer Center and those diagnosed between 2019 and 2021 were treated according to the COG ANBL0531 or ANBL0532 protocol with or without autologous stem cell transplantation (ASCT). The 5-year EFS and OS of all risk groups of patients were 67.29% and 77.90%, respectively. EFS and OS were significantly decreased in patients with higher risk classifications (EFS: VLR/LR vs IR vs HR: 97.22% vs 67.28% vs 51.83%; ***P = .001; OS: VLR/LR vs IR vs HR: 97.06% vs 94.12% vs 64.38%; *P = .046). In HR-NB patients treated according to the COG protocol between 2019 and 2021, the 3-year OS of patients who received tandem ASCT was significantly greater than those who did not receive ASCT (93.33% % vs 47.41%; *P = .046; log-rank test). EFS was not significantly different between patients with and without ASCT (72.16% vs 60.32%). CONCLUSION Our findings show that patients with lower risk classification have a positive prognosis for survival. The prognosis of patients with HR-NB remains in need of improvement. ASCT may enhance OS in HR-NB patients; however, protocol adjustment may be necessary to increase EFS in these patients.
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Affiliation(s)
- Uet Yu
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Huanli Xu
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Senmin Chen
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Meng Yi
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Chao Liu
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Xiaoling Zhang
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Chunjing Wang
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Jianming Song
- Department of Pathology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Yungen Gan
- Department of Radiology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Jianyao Wang
- Department of General Surgery, Shenzhen Children’s Hospital, Shenzhen, China
| | - Yuanxiang Wang
- Department of Thoracic Surgery, Shenzhen Children’s Hospital, Shenzhen, China
| | - Qing Zhang
- Department of Thoracic Surgery, Shenzhen Children’s Hospital, Shenzhen, China
| | - Junjie Sun
- Department of Urology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Bei Xia
- Department of Ultrasound, Shenzhen Children’s Hospital, Shenzhen, China
| | - Gongwei Zhang
- Department of Radiology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Changgang Li
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Feiqiu Wen
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Sixi Liu
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Xiuli Yuan
- Department of Hematology and Oncology, Shenzhen Children’s Hospital, Shenzhen, China
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Xu Y, Wei M, Cheng X, Li X. Chemotherapy-Induced Neutropenia as a Prognostic Factor in Patients With Advanced Epithelial Ovarian Carcinoma. Cancer Control 2023; 30:10732748231183496. [PMID: 37394868 DOI: 10.1177/10732748231183496] [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] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND To evaluate the prognostic value of chemotherapy-induced neutropenia (CIN) in epithelial ovarian carcinoma (EOC) treated with primary surgery followed by platinum-based chemotherapy. METHODS The records of primary EOC treated between Jan 1st 2002 and Dec 31st 2016 were reviewed according to the including and excluding criteria. CIN was defined as absolute neutrophil count (ANC) after chemotherapy <2.0 × 109/L. Patients with CIN were further divided into mild and severe CIN (ANC <1.0 × 109/L), early-onset and late-onset (>3 cycles) CIN. Clinical characteristic was compared by chi-square test. Overall survival (OS) and progression-free survival (PFS) were compared using Kaplan-Meier analysis, univariate and multivariate Cox regression models. RESULTS Among 735 EOC patients enrolled, no significant differences of the prognosis were found between patients with and without CIN, early and late CIN, mild and severe CIN. However, Kaplan-Meier curve (65 vs 42 months for CIN vs non-CIN, P = .007) and Cox regression analysis (HR 1.499, 95% CI 1.142-1.966; P = .004) both revealed that CIN was significantly related with better OS in advanced EOC patients, but not for PFS. So, subgroup analysis was further conducted and date suggested that CIN was an independent predictor of better survival in advanced EOC with suboptimal surgery (PFS: 18 vs 14 months, P = .013, HR 1.526, 95% CI 1.072-2.171, P = .019; OS: 37 vs 27 months, P = .013, HR 1.455, 95% CI 1.004-2.108; P = .048). CONCLUSIONS CIN might be used as an independent prognostic indicator of advanced EOC, especially for those patients with suboptimal surgery.
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Affiliation(s)
- Yaping Xu
- Department of Gynecologic Oncology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
- Hangzhou Red Cross Hospital, Hangzhou, China
| | - Mingjing Wei
- Department of Gynecologic Oncology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
| | - Xiaodong Cheng
- Department of Gynecologic Oncology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, China
| | - Xiao Li
- Department of Gynecologic Oncology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, Zhejiang, China
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Abstract
INTRODUCTION There is limited availability of self-management interventions for oesophageal cancer survivors at present. This study examined the feasibility of OptiMal, a six-week, self-management programme to improve fatigue, mood and health-related quality of life for oesophageal cancer survivors. METHODS A mixed methods design was used to evaluate the feasibility of OptiMal. The quantitative arm of the study examined changes in the Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and the EQ-5D-3L, administered prior to OptiMal (T1), immediately following completion of OptiMal (T2), and three months following completion (T3). Qualitative inquiry in the study was guided by a qualitative descriptive approach through focus groups investigating the experiences of group participants, and individual semi-structured interviews at T3. Qualitative data were analysed using thematic analysis. RESULTS Two OptiMal programmes were delivered over a six-month period with a total of fourteen individuals who had finished treatment for oesophageal cancer. The attendance rate was 89.3%. Statistically significant reductions were observed in fatigue, difficulty performing usual activities, anxiety and depression at three-month follow-up. Qualitative findings identified acceptability of the content and delivery format of OptiMal. Participants reported applying self-management strategies acquired through OptiMal to increase participation in daily activities and improve their health and well-being. CONCLUSIONS This feasibility study yielded promising results in terms of self-management outcomes for oesophageal cancer survivors following attendance of OptiMal. Larger scale research studies with control groups are warranted to examine the outcomes in a robust manner.
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Affiliation(s)
- Eilish King
- Discipline of Occupational Therapy, School of Medicine, Trinity College, Dublin, Ireland
| | - Naomi Algeo
- Discipline of Occupational Therapy, School of Medicine, Trinity College, Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, School of Medicine, Trinity College, Dublin, Ireland
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Chen Y, Qian FJ, Ye ZQ, Xie WX, He YD, Huang JR, Tian L, Gu DN. Anticancer Benefit of Metformin in Patients With Early-Stage Pancreatic Cancer: A Retrospective Cohort Study. Technol Cancer Res Treat 2022; 21:15330338221138208. [PMID: 36583563 PMCID: PMC9806383 DOI: 10.1177/15330338221138208] [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] [Indexed: 12/31/2022] Open
Abstract
Background: Epidemiologic studies have produced conflicting results on the effects of metformin on pancreatic cancer. This study aimed to observe and analyze whether metformin use is associated with better prognosis in pancreatic cancer. Materials and Methods: In this retrospective cohort study, all baseline data were retrieved from The Chinese Medicine Information Retrieval System (https://dc.wzhospital.cn/vpn/index.html) of The First Affiliated Hospital of Wenzhou Medical University. Survival data were collected by follow-up visits and medical records. Overall survival was the primary endpoint, while progression-free survival and disease-free survival were secondary endpoints. Progression or recurrence was assessed with radiologic images. Results: Seventy-six metformin users and 92 metformin nonusers diagnosed with pancreatic cancer from 2012 to 2020 in this hospital were enrolled. The adjusted hazard ratio for overall survival for metformin users was 0.50 (95% confidence interval = 0.33-0.76), where median overall survival was 16.0 months for metformin users versus 11.5 months for metformin nonusers. The protective effect was also found by analyzing progression-free survival (adjusted hazard ratio = 0.39, 95% confidence interval = 0.18-0.86) and disease-free survival (adjusted hazard ratio = 0.30, 95% confidence interval = 0.14-0.68). In the subgroup analysis, metformin use had a statistically significant association with prolongation of survival in stage I to II pancreatic cancer patients (hazard ratio = 0.47, 95% confidence interval = 0.25-0.91), but not for advanced tumor stage (hazard ratio for IV stage = 0.62, 95% confidence interval = 0.33-1.19), after adjustment for other risk factors. Conclusion: Metformin use is related to favorable survival outcomes of pancreatic cancer, especially in early tumor stage.
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Affiliation(s)
- Yang Chen
- Wenzhou Medical University, Wenzhou, China
| | | | - Zhi-qiang Ye
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | | | - You-di He
- Wenzhou Medical University, Wenzhou, China
| | | | - Ling Tian
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,Ling Tian, Department of Central Laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
Dian-na Gu, Department of Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
| | - Dian-na Gu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Sato Y, Kaneko R, Yano Y, Kamada K, Kishimoto Y, Ikehara T, Sato Y, Matsuda T, Igarashi Y. Volume-Outcome Relationship in Cancer Survival Rates: Analysis of a Regional Population-Based Cancer Registry in Japan. Healthcare (Basel) 2022; 11:healthcare11010016. [PMID: 36611476 PMCID: PMC9819082 DOI: 10.3390/healthcare11010016] [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: 10/31/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is limited data on the relationship between hospital volumes and outcomes with respect to cancer survival in Japan. The primary objective of this study was to evaluate the effect of hospital volume on cancer survival rate using a population-based cohort database. METHODS Using the Kanagawa cancer registry, propensity score matching was employed to create a dataset for each cancer type by selecting 1:1 matches for cases from high- and other-volume hospitals. The 5-year survival rate was estimated and the hazard ratio (HR) for hospital volume was calculated using a Cox proportional hazard model. Additional analyses were performed limited to cancer patients who underwent surgical operation, chemotherapy, and other treatments in each tumor stage and at the time of diagnosis. RESULTS The number of cases with complete data, defined as common cancers (prostate, kidney, bladder, esophagus, stomach, liver, pancreas, colon, breast, and lung), was 181,039. Adjusted HR differed significantly among hospital volume categories for the most common cancers except bladder, and the trends varied according to cancer type. The HR ranged from 0.76 (95%CI, 0.74-0.79) for stomach cancer to 0.85 (0.81-0.90) for colon cancer. CONCLUSIONS This study revealed that a relationship may exist between hospital volume and cancer survival in Japan.
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Affiliation(s)
- Yoichiro Sato
- Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Kanagawa 211-8510, Japan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo 143-8541, Japan
| | - Rena Kaneko
- Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Kanagawa 211-8510, Japan
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
- Correspondence: ; Tel.: +81-44-433-3150
| | - Yuichiro Yano
- Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Kanagawa 211-8510, Japan
| | - Kentaro Kamada
- Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Kanagawa 211-8510, Japan
| | - Yuui Kishimoto
- Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Kanagawa 211-8510, Japan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo 143-8541, Japan
| | - Takashi Ikehara
- Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Kanagawa 211-8510, Japan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo 143-8541, Japan
| | - Yuzuru Sato
- Department of Gastroenterology and Hepatology, Kanto Rosai Hospital, Kanagawa 211-8510, Japan
| | - Takahisa Matsuda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo 143-8541, Japan
| | - Yoshinori Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo 143-8541, Japan
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Muacevic A, Adler JR, Nassri RB, Alabdaljabar MS, Hashmi S, Muhsen IN. Quality of Life in Hematologic Malignancy in the Eastern Mediterranean Region: A Systematic Review. Cureus 2022; 14:e32436. [PMID: 36644089 PMCID: PMC9833332 DOI: 10.7759/cureus.32436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/14/2022] Open
Abstract
Health-related quality of life (HRQoL) indicates patients' overall health and is an essential aspect of cancer care. Although multiple studies have addressed the various aspects of HRQoL in cancer patients, few studies have investigated HRQoL in hematologic malignancy patients in the Eastern Mediterranean region (EMR). This review conducted an electronic search using OVID-Medline to identify HRQoL-related articles involving hematologic malignancy patients in the EMR. Eight studies met the inclusion criteria. Two studies validated translated QoL psychometric instruments, three were observational studies, and three were interventional studies. Except for the validation studies, all studies discussed HRQoL in leukemia patients. Our review highlighted a scarcity in the number of studies focusing on patients with hematological malignancies in this region. The included studies demonstrated the negative impact of hematological malignancies and therapies on patients' HRQoL. In addition, the studies displayed the association between physical symptoms and QoL of cancer patients, necessitating the importance of addressing these symptoms. The studies were limited by publication year, the number of patients, geographical locations, and disease entities. Future studies in this area are encouraged to help understand factors affecting HRQoL in the EMR region and ways to improve it. Consequently, further research is needed to establish translated and validated QoL assessment instruments that target patients in the EMR using the most common tools including the Short-Form 36-item Health Survey and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire.
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Nik Ab Kadir MN, Yaacob NM, Yusof SN, Ab Hadi IS, Musa KI, Mohd Isa SA, Bahtiar B, Adam F, Yahya MM, Hairon SM. Development of Predictive Models for Survival among Women with Breast Cancer in Malaysia. Int J Environ Res Public Health 2022; 19:15335. [PMID: 36430052 PMCID: PMC9690612 DOI: 10.3390/ijerph192215335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
Prediction of survival probabilities based on models developed by other countries has shown inconsistent findings among Malaysian patients. This study aimed to develop predictive models for survival among women with breast cancer in Malaysia. A retrospective cohort study was conducted involving patients who were diagnosed between 2012 and 2016 in seven breast cancer centres, where their survival status was followed until 31 December 2021. A total of 13 predictors were selected to model five-year survival probabilities by applying Cox proportional hazards (PH), artificial neural networks (ANN), and decision tree (DT) classification analysis. The random-split dataset strategy was used to develop and measure the models' performance. Among 1006 patients, the majority were Malay, with ductal carcinoma, hormone-sensitive, HER2-negative, at T2-, N1-stage, without metastasis, received surgery and chemotherapy. The estimated five-year survival rate was 60.5% (95% CI: 57.6, 63.6). For Cox PH, the c-index was 0.82 for model derivation and 0.81 for validation. The model was well-calibrated. The Cox PH model outperformed the DT and ANN models in most performance indices, with the Cox PH model having the highest accuracy of 0.841. The accuracies of the DT and ANN models were 0.811 and 0.821, respectively. The Cox PH model is more useful for survival prediction in this study's setting.
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Affiliation(s)
- Mohd Nasrullah Nik Ab Kadir
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Najib Majdi Yaacob
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Siti Norbayah Yusof
- Malaysian National Cancer Registry Department, National Cancer Institute, Ministry of Health Malaysia, Putrajaya 62250, Federal Territory of Putrajaya, Malaysia
| | - Imi Sairi Ab Hadi
- Breast and Endocrine Surgery Unit, Department of Surgery, Hospital Raja Perempuan Zainab II, Ministry of Health Malaysia, Kota Bharu 15586, Kelantan, Malaysia
| | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Seoparjoo Azmel Mohd Isa
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Balqis Bahtiar
- Malaysian National Cancer Registry Department, National Cancer Institute, Ministry of Health Malaysia, Putrajaya 62250, Federal Territory of Putrajaya, Malaysia
| | - Farzaana Adam
- Public Health Division, Penang State Health Department, Ministry of Health Malaysia, Georgetown 10590, Penang, Malaysia
| | - Maya Mazuwin Yahya
- Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Sun Y, Fowke JH, Liang X, Mozhui K, Sen S, Bao W, Liu B, Snetselaar LG, Wallace RB, Shadyab AH, Saquib N, Cheng TYD, Johnson KC. Changes in Dietary Intake of Methionine, Folate/Folic Acid and Vitamin B12 and Survival in Postmenopausal Women with Breast Cancer: A Prospective Cohort Study. Nutrients 2022; 14:nu14224747. [PMID: 36432434 PMCID: PMC9699275 DOI: 10.3390/nu14224747] [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: 09/23/2022] [Revised: 10/20/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous experimental studies showed that limiting methionine in the diet of animals or in cell culture media suppresses mammary cancer cell proliferation or metastasis. However, no previous study has investigated the associations of changes in methionine intake with survival among breast cancer survivors. We aimed to examine the association between changes in dietary intake of methionine, folate/folic acid, and vitamin B12 from before to after diagnosis of breast cancer, and mortality among breast cancer survivors. METHODS We included 1553 postmenopausal women from the Women's Health Initiative who were diagnosed with invasive breast cancer and completed a food frequency questionnaire both before and after breast cancer diagnosis. Multivariable Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence (CIs) of all-cause and breast cancer mortality associated with changes in methionine intake and changes in folate/folic acid and vitamin B12 intake. RESULTS Relative to pre-diagnosis, 28% of women decreased methionine intake by ≥20%, 30% of women increased methionine intake by ≥20%, and 42% of women had a relatively stable methionine intake (±19.9%) following breast cancer diagnosis. During a mean 16.1 years of follow up, there were 772 deaths in total, including 195 deaths from breast cancer. Compared to women with relatively stable methionine intake, women with decreased methionine intake had lower risks of all-cause (HR 0.78, 95% CI 0.62-0.97) and breast cancer mortality (HR 0.58, 95% CI 0.37-0.91) in fully adjusted models. In contrast, increased methionine intake or changes in folate/folic acid or vitamin B12 intake were not associated with all-cause or breast cancer mortality. CONCLUSIONS Among breast cancer survivors, decreased methionine intake after breast cancer diagnosis was associated with lower risk of all-cause and breast cancer mortality.
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Affiliation(s)
- Yangbo Sun
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163, USA
- Correspondence: ; Tel.: +1-901-448-3923; Fax: +1-901-448-7041
| | - Jay H. Fowke
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163, USA
| | - Xiaoyu Liang
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163, USA
| | - Khyobeni Mozhui
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163, USA
| | - Saunak Sen
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163, USA
| | - Wei Bao
- Institute of Public Health, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
- Department of Endocrinology, Division of Life Sciences and Medicine, First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei 230026, China
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - Linda G. Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - Robert B. Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukayriah 51941, Saudi Arabia
| | - Ting-Yuan David Cheng
- College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA
| | - Karen C. Johnson
- Department of Preventive Medicine, College of Medicine, The University of Tennessee Health Science Center, 66 N. Pauline Street, Memphis, TN 38163, USA
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Ling S, Sweeting M, Zaccardi F, Adlam D, Kadam UT. Glycosylated haemoglobin and prognosis in 10,536 people with cancer and pre-existing diabetes: a meta-analysis with dose-response analysis. BMC Cancer 2022; 22:1048. [PMID: 36203139 PMCID: PMC9535893 DOI: 10.1186/s12885-022-10144-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 09/29/2022] [Indexed: 11/10/2022] Open
Abstract
AIMS To assess whether glycaemic control is associated with prognosis in people with cancer and pre-existing diabetes. METHODS In this pre-registered systematic review (PROSPERO: CRD42020223956), PubMed and Web of Science were searched on 25th Nov 2021 for studies investigating associations between glycosylated haemoglobin (HbA1c) and prognosis in people with diabetes and cancer. Summary relative risks (RRs) and 95% Confidence Intervals (CIs) for associations between poorly controlled HbA1c or per 1-unit HbA1c increment and cancer outcomes were estimated using a random-effects meta-analysis. We also investigated the impact of potential small-study effects using the trim-and-fill method and potential sources of heterogeneity using subgroup analyses. RESULTS Fifteen eligible observational studies, reporting data on 10,536 patients with cancer and pre-existing diabetes, were included. Random-effects meta-analyses indicated that HbA1c ≥ 7% (53 mmol/mol) was associated with increased risks of: all-cause mortality (14 studies; RR: 1.14 [95% CI: 1.03-1.27]; p-value: 0.012), cancer-specific mortality (5; 1.68 [1.13-2.49]; p-value: 0.011) and cancer recurrence (8; 1.68 [1.18-2.38; p-value: 0.004]), with moderate to high heterogeneity. Dose-response meta-analyses indicated that 1-unit increment of HbA1c (%) was associated with increased risks of all-cause mortality (13 studies; 1.04 [1.01-1.08]; p-value: 0.016) and cancer-specific mortality (4; 1.11 [1.04-1.20]; p-value: 0.003). All RRs were attenuated in trim-and-fill analyses. CONCLUSIONS Our findings suggested that glycaemic control might be a modifiable risk factor for mortality and cancer recurrence in people with cancer and pre-existing diabetes. High-quality studies with a larger sample size are warranted to confirm these findings due to heterogeneity and potential small-study effects. In the interim, it makes clinical sense to recommend continued optimal glycaemic control.
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Affiliation(s)
- Suping Ling
- Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK.
- Present address: Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
| | - Michael Sweeting
- Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | - Francesco Zaccardi
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester, UK
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - David Adlam
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Umesh T Kadam
- Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
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Muacevic A, Adler JR. Metastatic Breast Cancer Presenting as Acute Appendicitis. Cureus 2022; 14:e30456. [PMID: 36415432 PMCID: PMC9674045 DOI: 10.7759/cureus.30456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 01/25/2023] Open
Abstract
Breast cancer is one of the most commonly diagnosed cancers in Australia. With the development in screening, diagnosis, and treatment, people are living longer with metastatic disease of the breast. This malignancy commonly metastasizes to the lung, brain, bone, and liver. However, due to the increased survival of patients living with breast cancer, metastases may present with complications that have not been seen before. We describe a case of a 55-year-old female with a background of metastatic breast cancer to the brain who presented to the emergency department with acute appendicitis. At surgery, a malignant mass was found in the cecum obstructing the appendix, and histopathology revealed metastatic breast cancer.
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Ravaioli A, Crocetti E, Bucchi L, Guzzinati S, Casella C, Falcini F, Ferretti S, Giuliani O, Mancini S, Puppo A, Toffolutti F, Zamagni F, Zorzi M, Dal Maso L, Serraino D. [Update of survival of cancer patients in Italy: geographical comparisons and focus on patients with cancers targeted by screening programmes, childhood cancers, and smoking-associated cancers]. Epidemiol Prev 2022; 46:356-366. [PMID: 36458516 DOI: 10.19191/ep22.5-6.a489.095] [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] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES to update the Italian estimates of survival for patients with a paediatric cancer, tobacco smoke-associated cancers, and cancers targeted by screening; to assess geographical differences. DESIGN population-based descriptive study. SETTING AND PARTICIPANTS incident cancer cases diagnosed in 2010-2014, with follow-up to 2018, from 17 Italian cancer registries (covering 31% of the national population; 43% of the population residing in the North-Centre of the country and 8% of the population living in the South and Islands). MAIN OUTCOME MEASURES age-standardized 5-year net survival (NS) by cancer site or type, sex, age, and geographical area. RESULTS NS of patients aged ≥15 years with breast, prostate, colorectal, and lung cancers was higher in the North-Centre than in the South and Islands. The overall survival of people diagnosed with cancer in childhood (0-14 years) was 84.3%, with similar values among the geographical macro-areas and between males and females. Women with breast cancer within the current target age of the screening programmes and those in the younger age groups (45-49 years) show similar survival values; the same is true for women with colorectal cancer. In both cases, survival decreased in the age groups after the age of cessation of screening programmes. Survival of patients with tobacco smoke-associated cancers varies according to cancer site (from 11.1% for patients with pancreatic cancer to 79.7% for those with bladder cancer). For most cancer sites, women have higher survival than men. CONCLUSIONS for adults, a geographical survival gap persists. The results may contribute to the debate on extending the target age for screening programmes and to support initiatives to encourage tobacco smoking cessation even after cancer diagnosis. For patients who receive a cancer diagnosis in childhood, survival similar to highest values internationally.
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Affiliation(s)
- Alessandra Ravaioli
- Registro tumori della Regione Emilia-Romagna, Unità funzionale della Romagna, IRCCS Istituto romagnolo per lo studio dei tumori (IRST) "Dino Amadori", Meldola (FC)
| | - Emanuele Crocetti
- Registro tumori della Regione Emilia-Romagna, Unità funzionale della Romagna, IRCCS Istituto romagnolo per lo studio dei tumori (IRST) "Dino Amadori", Meldola (FC)
| | - Lauro Bucchi
- Registro tumori della Regione Emilia-Romagna, Unità funzionale della Romagna, IRCCS Istituto romagnolo per lo studio dei tumori (IRST) "Dino Amadori", Meldola (FC)
| | | | | | - Fabio Falcini
- Registro tumori della Regione Emilia-Romagna, Unità funzionale della Romagna, IRCCS Istituto romagnolo per lo studio dei tumori (IRST) "Dino Amadori", Meldola (FC).,Azienda USL della Romagna, Forlì
| | - Stefano Ferretti
- Registro tumori dell'Emilia-Romagna, Unità funzionale di Ferrara, Università di Ferrara, Azienda USL Ferrara
| | - Orietta Giuliani
- Registro tumori della Regione Emilia-Romagna, Unità funzionale della Romagna, IRCCS Istituto romagnolo per lo studio dei tumori (IRST) "Dino Amadori", Meldola (FC)
| | - Silvia Mancini
- Registro tumori della Regione Emilia-Romagna, Unità funzionale della Romagna, IRCCS Istituto romagnolo per lo studio dei tumori (IRST) "Dino Amadori", Meldola (FC)
| | | | - Federica Toffolutti
- SOC Epidemiologia oncologica, Centro di riferimento oncologico di Aviano (CRO) IRCCS, Aviano (PN)
| | - Federica Zamagni
- Registro tumori della Regione Emilia-Romagna, Unità funzionale della Romagna, IRCCS Istituto romagnolo per lo studio dei tumori (IRST) "Dino Amadori", Meldola (FC)
| | - Manuel Zorzi
- Registro tumori del Veneto, Azienda Zero, Padova
| | - Luigino Dal Maso
- SOC Epidemiologia oncologica, Centro di riferimento oncologico di Aviano (CRO) IRCCS, Aviano (PN);
| | - Diego Serraino
- SOC Epidemiologia oncologica, Centro di riferimento oncologico di Aviano (CRO) IRCCS, Aviano (PN)
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Nagamine CML, de Goulart BNG, Ziegelmann PK. Net Survival in Survival Analyses for Patients with Cancer: A Scoping Review. Cancers (Basel) 2022; 14:3304. [PMID: 35884365 DOI: 10.3390/cancers14143304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/07/2022] [Accepted: 06/25/2022] [Indexed: 12/07/2022] Open
Abstract
Population-based net survival is an important tool for assessing prognostic advances. The unbiased Pohar Perme Estimator (PPE) was suggested in 2012 and soon established itself as the gold standard for estimating net survival. This scoping review aims to know in which context this estimator is being used in the oncology area, what the authors point out as a justification for its use, and the limitations found. We searched PubMed, and the grey literature to answer the question: Have studies involving patients diagnosed with cancer used the PPE to estimate cancer-specific survival? How do they justify the use of the PPE and what are the limitations pointed out? Out of 295 screened, 85 studies were included in this review. The two main characteristics of the PPE mentioned by the studies as justification were the fact that it is an unbiased estimator (83.5%) and that it produces comparable estimates among populations with different mortality rates from causes other than cancer (36.47%). No study pointed to a limitation due to the use of PPE. As a conclusion, the Pohar Perme Estimator is the gold standard for estimating net survival and should be more used in oncology, especially when dealing with population-based studies where the follow-up time is long, making high the probability of death from causes other than cancer.
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Sorice KA, Fang CY, Wiese D, Ortiz A, Chen Y, Henry KA, Lynch SM. Systematic review of neighborhood socioeconomic indices studied across the cancer control continuum. Cancer Med 2022; 11:2125-2144. [PMID: 35166051 PMCID: PMC9119356 DOI: 10.1002/cam4.4601] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/03/2021] [Accepted: 12/28/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND There is extensive interest in understanding how neighborhood socioeconomic status (nSES) may affect cancer incidence or survival. However, variability regarding items included and approaches used to form a composite nSES index presents challenges in summarizing overall associations with cancer. Given recent calls for standardized measures of neighborhood sociodemographic effects in cancer disparity research, the objective of this systematic review was to identify and compare existing nSES indices studied across the cancer continuum (incidence, screening, diagnosis, treatment, survival/mortality) and summarize associations by race/ethnicity and cancer site to inform future cancer disparity studies. METHODS Using PRISMA guidelines, peer-reviewed articles published between 2010 and 2019 containing keywords related to nSES and cancer were identified in PubMed. RESULTS Twenty-four nSES indices were identified from 75 studies. In general, findings indicated a significant association between nSES and cancer outcomes (n = 64/75 studies; 85.33%), with 42/64 (65.63%) adjusting for highly-correlated individual SES factors (e.g., education). However, the direction of association differed by cancer site, race/ethnicity, and nSES index. CONCLUSIONS This review highlights several methodologic and conceptual issues surrounding nSES measurement and potential associations with cancer disparities. Recommendations pertaining to the selection of nSES measures are provided, which may help inform disparity-related disease processes and improve the identification of vulnerable populations in need of intervention.
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Affiliation(s)
- Kristen A. Sorice
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Carolyn Y. Fang
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Daniel Wiese
- Geography and Urban StudiesTemple UniversityPhiladelphiaPAUSA
| | - Angel Ortiz
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Yuku Chen
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
| | - Kevin A. Henry
- Geography and Urban StudiesTemple UniversityPhiladelphiaPAUSA
| | - Shannon M. Lynch
- Cancer Prevention and ControlFox Chase Cancer CenterPhiladelphiaPAUSA
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