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Naamala A, Eriksson LE, Orem J, Nalwadda GK, Kabir ZN, Wettergren L. Health-related quality of life among adult patients with cancer in Uganda - a cross-sectional study. Glob Health Action 2024; 17:2325728. [PMID: 38596846 PMCID: PMC11008308 DOI: 10.1080/16549716.2024.2325728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/27/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVES The study aimed to investigate the prevalence and factors associated with poor health-related quality of life in adults with cancer in Uganda. METHODS This cross-sectional study surveyed 385 adult patients (95% response rate) with various cancers at a specialised oncology facility in Uganda. Health-related quality of life was measured using the EORTC QLQ-C30 in the Luganda and English languages. Predetermined validated clinical thresholds were applied to the instrument in order to identify patients with poor health-related quality of life, that is, functional impairments or symptoms warranting concern. Multivariable logistic regression was used to identify factors associated with poor health-related quality of life in six subscales: Physical Function, Role Function, Emotional Function, Social Function, Pain and Fatigue. RESULTS The mean age of the patients was 48 years. The majority self-reported poor functioning ranging between 61% (Emotional Function) to 79% (Physical Function) and symptoms (Fatigue 63%, Pain 80%) at clinically concerning levels. These patients were more likely to be older, without formal education and not currently working. Being an inpatient at the facility and being diagnosed with cervical cancer or leukaemia was a predictor of poor health-related quality of life. CONCLUSION Improvement of cancer care in East Africa requires a comprehensive and integrated approach that addresses various challenges specific to the region. Such strategies include investment in healthcare infrastructure, for example, clinical guidelines to improve pain management, and patient education and support services.
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Affiliation(s)
- Allen Naamala
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Medical Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Lars E. Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- School of Health and Psychological Sciences, University of London, London, UK
- Medical Unit Infectious Diseases, Karolinska University Hospital, Huddinge, Sweden
| | - Jackson Orem
- Department of Medical Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Gorrette K. Nalwadda
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Zarina Nahar Kabir
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Lena Wettergren
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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O'Rorke M, Chrischilles E. Making progress against rare cancers: A case study on neuroendocrine tumors. Cancer 2024; 130:1568-1574. [PMID: 38244195 DOI: 10.1002/cncr.35184] [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: 01/22/2024]
Abstract
In April 2023, the National Cancer Institute offered a roadmap for cancer research to achieve Cancer Moonshot goals. To reach these goals requires making progress for all cancers, not just those that are most common. Achieving progress against rare cancers, as well as common cancers, requires involvement of large clinical research networks. In 2020, the Patient-Centered Outcomes Research Institute (PCORI) launched an initiative on Conducting Rare Disease Research using PCORnet, the National Patient-Centered Clinical Research Network. The purpose of this commentary is to introduce the broader community of cancer researchers to the PCORnet NET-PRO study (comparing the effects of different treatment approaches for neuroendocrine tumors on patient-reported outcomes) thereby demonstrating how researchers can use the PCORnet infrastructure to conduct large-scale patient-centered studies of rare cancers.
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Affiliation(s)
- Michael O'Rorke
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Elizabeth Chrischilles
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
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Ullman AJ, Larsen E, Gibson V, Binnewies S, Ohira R, Marsh N, Mcbride C, Winterbourn K, Boyte F, Cunninghame J, Dufficy M, Plummer K, Roberts N, Takashima M, Cooke M, Byrnes J, Rickard CM, Kleidon TM. An mHealth application for chronic vascular access: A multi-method evaluation. J Clin Nurs 2024; 33:1762-1776. [PMID: 38413831 DOI: 10.1111/jocn.17034] [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: 02/28/2023] [Revised: 12/13/2023] [Accepted: 01/07/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Healthcare consumers require diverse resources to assist their navigation of complex healthcare interactions, however, these resources need to be fit for purpose. AIM In this study, we evaluated the utility, usability and feasibility of children, families and adults requiring long-term intravenous therapy using a recently developed mobile health application (App), intravenous (IV) Passport. DESIGN Multi-site, parallel, multi-method, prospective cohort study. METHODS A multi-site, multi-method study was carried out in 2020-2021, with 46 participants (20 adults, 26 children/family) reporting on their experiences surrounding the use of the IV Passport for up to 6 months. RESULTS Overall, utility rates were acceptable, with 78.3% (N = 36) using the IV Passport over the follow-up period, with high rates of planned future use for those still active in the project (N = 21; 73%), especially in the child/family cohort (N = 13; 100%). Acceptability rates were high (9/10; IQR 6.5-10), with the IV Passport primarily used for documenting new devices and complications. Thematic analysis revealed three main themes (and multiple subthemes) in the qualitative data: Advocacy for healthcare needs, Complexity of healthcare and App design and functionality. CONCLUSION Several recommendations were made to improve the end-user experience including 'how to' instructions; and scheduling functionality for routine care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The IV Passport can be safely and appropriately integrated into healthcare, to support consumers. IMPACT Patient-/parent-reported feedback suggests the Intravenous Passport is a useful tool for record-keeping, and positive communication between patients/parents, and clinicians. REPORTING METHOD Not applicable. PATIENT CONTRIBUTION Consumers reported their experiences surrounding the use of the IV Passport for up to 6 months.
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Affiliation(s)
- Amanda J Ullman
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
| | - Emily Larsen
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
| | - Victoria Gibson
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Sebastian Binnewies
- School of Information and Communication Technology, Griffith University, Gold Coast, Queensland, Australia
| | - Ryoma Ohira
- School of Information and Communication Technology, Griffith University, Gold Coast, Queensland, Australia
| | - Nicole Marsh
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Craig Mcbride
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Karen Winterbourn
- Parenteral Nutrition Down Under, Randwick, New South Wales, Australia
| | - Francesca Boyte
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Jacqueline Cunninghame
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Mitchell Dufficy
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Karin Plummer
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
| | - Natasha Roberts
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Metro North Health Service, Herston, Queensland, Australia
| | - Mari Takashima
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Marie Cooke
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
| | - Joshua Byrnes
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
| | - Claire M Rickard
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
- Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Metro North Health Service, Herston, Queensland, Australia
| | - Tricia M Kleidon
- School of Nursing, Midwifery and Social Work, Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
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Lahaye MJ, Lambregts DMJ, Aalbers AGJ, Snaebjornsson P, Beets-Tan RGH, Kok NFM. Imaging in the era of risk-adapted treatment in Colon cancer. Br J Radiol 2024:tqae061. [PMID: 38648743 DOI: 10.1093/bjr/tqae061] [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: 10/27/2022] [Revised: 02/14/2024] [Accepted: 03/14/2024] [Indexed: 04/25/2024] Open
Abstract
The treatment landscape for patients with colon cancer is continuously evolving. Risk-adapted treatment strategies, including neoadjuvant chemotherapy and immunotherapy, are slowly finding their way into clinical practice and guidelines. Radiologists are pivotal in guiding clinicians toward the most optimal treatment for each colon cancer patient. This review provides an overview of recent and upcoming advances in the diagnostic management of colon cancer and the radiologist's role in the multidisciplinary approach to treating colon cancer.
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Affiliation(s)
- Max J Lahaye
- The Netherlands Cancer Institute, Department of Radiology, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Doenja M J Lambregts
- The Netherlands Cancer Institute, Department of Radiology, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Arend G J Aalbers
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
| | - Petur Snaebjornsson
- The Netherlands Cancer Institute, Department of Pathology, Amsterdam, The Netherlands
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - R G H Beets-Tan
- The Netherlands Cancer Institute, Department of Radiology, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University Medical Centre, Maastricht, The Netherlands
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Niels F M Kok
- The Netherlands Cancer Institute, Department of Surgery, Amsterdam, The Netherlands
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Tzoumpa S, Nuñez J, Postigo-Mac Dowall M, Lopez-Ilasaca M, Bejar C. Multiple enchondromas and hobnail hemangiomas revealing a rare type of Maffucci syndrome. Int J Dermatol 2024. [PMID: 38647156 DOI: 10.1111/ijd.17203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Sofia Tzoumpa
- Department of Dermatology, Avicenne University Hospital, AP-HP, Sorbonne-Paris-Nord University, Bobigny, France
| | - Jeanette Nuñez
- Department of Dermatology, Goyeneche Hospital, Arequipa, Peru
| | | | - Marco Lopez-Ilasaca
- Center for Molecular Diagnostics, Lima, Peru
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Claudia Bejar
- Department of Dermatology, Avicenne University Hospital, AP-HP, Sorbonne-Paris-Nord University, Bobigny, France
- Department of Dermatology, Goyeneche Hospital, Arequipa, Peru
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Harvey RD, Miller TM, Hurley PA, Thota R, Black LJ, Bruinooge SS, Boehmer LM, Fleury ME, Kamboj J, Rizvi MA, Symington BE, Tap WD, Waterhouse DM, Levit LA, Merrill JK, Prindiville SA, Pollastro T, Brewer JR, Byatt LP, Hamroun L, Kim ES, Holland N, Nowakowski GS. A call to action to advance patient-focused and decentralized clinical trials. Cancer 2024; 130:1193-1203. [PMID: 38193828 DOI: 10.1002/cncr.35145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
This commentary is a call to action for a concerted commitment and effort to transform clinical trials and enable people with cancer to participate in clinical trials closer to home. Three key strategies are identified to address major barriers: confront challenges with the interpretation of US Food and Drug Administration Form 1572 requirements (Statement of Investigator); broaden acceptance of local laboratories and imaging centers; and invest in the creation of effective, sustainable partnerships between research centers and local providers.
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Affiliation(s)
- R Donald Harvey
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Therica M Miller
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, USA
| | | | - Ramya Thota
- Intermountain Health, Salt Lake City, Utah, USA
| | | | | | - Leigh M Boehmer
- Association of Community Cancer Centers, Rockville, Maryland, USA
| | - Mark E Fleury
- American Cancer Society Cancer Action Network, Washington, District of Columbia, USA
| | | | | | | | - William D Tap
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Laura A Levit
- American Society of Clinical Oncology, Alexandria, Virginia, USA
| | | | - Sheila A Prindiville
- National Cancer Institute Coordinating Center for Clinical Trials, Bethesda, Maryland, USA
| | - Teri Pollastro
- Metastatic Breast Cancer Alliance, Mercer Island, Washington, USA
| | - Jamie R Brewer
- US Food and Drug Administration, Rockville, Maryland, USA
| | - Leslie P Byatt
- New Mexico Cancer Care Alliance, Albuquerque, New Mexico, USA
| | | | | | - Nicole Holland
- American Society of Clinical Oncology, Alexandria, Virginia, USA
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St-Laurent MP, Acland G, Hamilton SN, Hamm J, Sunderland K, Black PC, McKenzie M, Keyes M, Miller S, Gleave ME, Tyldesley S. Long Term Second Malignancies in Prostate Cancer Patients Treated with Low-Dose-Rate Brachytherapy and Radical Prostatectomy. J Urol 2024:101097JU0000000000003965. [PMID: 38603578 DOI: 10.1097/ju.0000000000003965] [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: 10/03/2023] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE Second malignancy is a rare but potentially lethal event after prostate brachytherapy, but data remain scarce on its long-term risk. The objective of this study is to estimate the number of pelvic second malignancies following brachytherapy compared to prostatectomy (RP). MATERIALS AND METHODS Retrospective review of patients treated with low dose 125I brachytherapy and prostatectomy in British Columbia from 1999 to 2010. Kaplan Meier (KM) estimates for pelvic (bladder and rectum), invasive pelvic, any second malignancy and death from any second malignancy were assessed. Cox multivariable analyses were performed adjusting for initial treatment type, age, post RP adjuvant/salvage EBRT status, and smoking history. RESULTS Two thousand three hndred seventy-eight brachytherapy and 9089 prostatectomy patients were included. Median age was 66 years (IQR 61-71) and 63 years (IQR 58-67), respectively. Median follow-up time to event or censured was 14 years (IQR 11.5-17.3). The KM estimates for pelvic second malignancy at 15 and 20 years were 6.4% and 9.8% after brachytherapy, and 3.2% and 4.2% after prostatectomy. Time to any second malignancy and time to death from any second malignancy were not significantly different (P > .05). On Cox-multivariable analysis, brachytherapy, compared to surgery, was an independent factor for pelvic (HR 1.81 [95% CI 1.45-2.26], P < .001) and invasive pelvic second malignancy (HR 2.13 [95% CI 1.61-2.83], P < .001). Increased age and smoking were also associated with higher estimates of events (P < .001). CONCLUSION After adjustment for age, post RP adjuvant/salvage EBRT status and smoking status, numerically higher long-term HRs of pelvic and invasive pelvic second malignancy in patients treated with brachytherapy compared to radical prostatectomy were noted.
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Affiliation(s)
- Marie-Pier St-Laurent
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Sarah N Hamilton
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeremy Hamm
- Data and Analytics, BC Cancer, Vancouver, British Columbia, Canada
| | | | - Peter C Black
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael McKenzie
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mira Keyes
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stacy Miller
- Department of Radiation Oncology, BC Cancer-Centre for the North, Prince George, British Columbia, Canada
| | - Martin E Gleave
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Tyldesley
- Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Cooper-Moss N, Bajpai A, Smith N, Merriel SWD, Chauhan U. Learning from new colorectal cancers: a qualitative synthesis of significant event reports. BJGP Open 2024:BJGPO.2023.0088. [PMID: 38097268 DOI: 10.3399/bjgpo.2023.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/07/2023] [Accepted: 10/11/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Colorectal cancer is the second leading cause of cancer-related mortality in the UK and a significant contributor to morbidity and mortality worldwide. Early diagnosis provides opportunities for intervention and improved survival. Significant event analysis (SEA) is a well-established quality improvement method for learning from new cancer diagnoses. AIM To provide additional insights into diagnostic processes for colorectal cancer and to identify areas for improvement in patient care pathways. DESIGN & SETTING Fifty-three general practices across Pennine Lancashire, England, submitted one or more SEA reports as part of an incentivised scheme. METHOD A standardised data collection form was used to collate learning points and recommendations for improvements. In total, 161 reports were analysed using an inductive framework analysis approach. RESULTS There was an overarching theme of building vigilance and collaboration between and within general practices and secondary care. The following four main sub-themes were also identified: education; individualised and flexible care; ownership and continuity; and communication. CONCLUSION These findings provide additional insights into colorectal cancer pathways from a primary care perspective. Practices should be supported in developing protocols for assessment and follow-up of patients with varying presentations. Screening and access to investigations are paramount for improving early diagnosis; however, a flexible diagnostic approach is required according to the individual circumstances of each patient.
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Affiliation(s)
- Nicola Cooper-Moss
- School of Medicine, Faculty of Health and Biomedical Sciences, University of Central Lancashire, Preston, UK
- Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK
| | - Achint Bajpai
- School of Medicine, Faculty of Health and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | - Neil Smith
- Lancashire and South Cumbria Cancer Alliance, Manchester, UK
| | | | - Umesh Chauhan
- School of Medicine, Faculty of Health and Biomedical Sciences, University of Central Lancashire, Preston, UK
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Amonkar MM, Abderhalden LA, Fox GE, Frederickson AM, Grira T, Gozman A, Malhotra U, Malbecq W, Akers KG. Clinical outcomes for previously treated patients with advanced biliary tract cancer: a meta-analysis. Future Oncol 2024; 20:863-876. [PMID: 38353044 DOI: 10.2217/fon-2023-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Aim: A systematic review and meta-analysis were performed to evaluate the efficacy of treatments for previously treated advanced biliary tract cancer (BTC) patients. Materials & methods: Databases were searched for studies evaluating treatments for advanced (unresectable and/or metastatic) BTC patients who progressed on prior therapy. Pooled estimates of objective response rate (ORR), median overall survival (OS) and median progression-free survival (PFS) were calculated using random effects meta-analysis. Results: Across 31 studies evaluating chemotherapy or targeted treatment regimens in an unselected advanced BTC patient population, pooled ORR was 6.9%, median OS was 6.6 months and median PFS was 3.2 months. Conclusion: The efficacy of conventional treatments for previously treated advanced BTC patients is poor and could be improved by novel therapies.
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Han MA, Kim SH, Hwang EC, Jung JH, Park SM. Population attributable fractions of modifiable cancer risk factors in Korea: A systematic review. Asia Pac J Clin Oncol 2024; 20:299-314. [PMID: 36899477 DOI: 10.1111/ajco.13950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES The population attributable fraction (PAF), an epidemiologic measure of exposures and health outcomes, can provide information on the public health impacts of exposures in populations. This study aimed to systematically summarize the PAF estimates of modifiable cancer risk factors in Korea. METHODS This review included studies that determined PAFs of modifiable risk factors for cancer in Korea. We performed systematic searches in EMBASE, MEDLINE, Cochrane library, and Korean databases for studies published up to July 2021. Two reviewers independently screened studies for eligibility, extracted data, and performed quality assessments of the included studies. Due to high variability among the data acquisition methods and PAF estimates, we presented the results qualitatively and did not perform quantitative data synthesis. RESULTS We reviewed 16 studies that reported the PAFs of risk factors for cancer, including smoking, alcohol consumption, obesity, and various cancer sites. We found considerable variability in the PAF estimates across exposure and cancer pairs. However, PAF estimates for smoking and respiratory cancer were consistently high in men. PAF estimates were higher in men than in women for smoking and alcohol consumption but higher in women for obesity. We found limited evidence for other exposures and cancers. CONCLUSION Our findings may be used to prioritize and plan strategies to reduce cancer burden. We encourage further and updated assessments of cancer risk factors, including those not addressed in the studies included in this review, and their potential contributions to cancer burden to better inform strategies for cancer control.
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Affiliation(s)
- Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, The Republic of Korea
| | - Seo-Hee Kim
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, The Republic of Korea
- Department of Public Health, Graduate School, Chosun University, Gwangju, The Republic of Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, The Republic of Korea
| | - Jae Hung Jung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, The Republic of Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, The Republic of Korea
| | - Sun Mi Park
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, The Republic of Korea
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Rabben J, Vivat B, Fossum M, Rohde GE. Shared decision-making in palliative cancer care: A systematic review and metasynthesis. Palliat Med 2024; 38:406-422. [PMID: 38481012 PMCID: PMC11025308 DOI: 10.1177/02692163241238384] [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] [Indexed: 04/19/2024]
Abstract
BACKGROUND Shared decision-making is a key element of person-centred care and promoted as the favoured model in preference-sensitive decision-making. Limitations to implementation have been observed, and barriers and limitations, both generally and in the palliative setting, have been highlighted. More knowledge about the process of shared decision-making in palliative cancer care would assist in addressing these limitations. AIM To identify and synthesise qualitative data on how people with cancer, informal carers and healthcare professionals experience and perceive shared decision-making in palliative cancer care. DESIGN A systematic review and metasynthesis of qualitative studies. We analysed data using inductive thematic analysis. DATA SOURCES We searched five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL and Scopus) from inception until June 2023, supplemented by backward searches. RESULTS We identified and included 23 studies, reported in 26 papers. Our analysis produced four analytical themes; (1) Overwhelming situation of 'no choice', (2) Processes vary depending on the timings and nature of the decisions involved, (3) Patient-physician dyad is central to decision-making, with surrounding support and (4) Level of involvement depends on interactions between individuals and systems. CONCLUSION Shared decision-making in palliative cancer care is a complex process of many decisions in a challenging, multifaceted and evolving situation where equipoise and choice are limited. Implications for practice: Implementing shared decision-making in clinical practice requires (1) clarifying conceptual confusion, (2) including members of the interprofessional team in the shared decision-making process and (3) adapting the approach to the ambiguous, existential situations which arise in palliative cancer care.
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Affiliation(s)
- Jannicke Rabben
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand/Grimstad, Vest-Agder, Norway
| | - Bella Vivat
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Mariann Fossum
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand/Grimstad, Vest-Agder, Norway
| | - Gudrun Elin Rohde
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand/Grimstad, Vest-Agder, Norway
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
- Department of Clinical Research, Sorlandet hospital, Kristiansand, Vest-Agder, Norway
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Chambers AJ, Enoch JF, Wong J, Spigelman A. When teams disagree: Investigating the incidence and causes of dissent occurring in cancer multidisciplinary team meetings. Asia Pac J Clin Oncol 2024; 20:234-239. [PMID: 36670329 DOI: 10.1111/ajco.13919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/05/2022] [Accepted: 12/26/2022] [Indexed: 01/22/2023]
Abstract
AIM Multidisciplinary teams (MDT) are commonly involved in the care of patients with cancer. How frequently dissent occurs within MDT has not been studied. This study aimed to determine how frequently dissent was documented in cancer MDT meetings at our institution, the reasons for this, and the opinions of MDT members on how dissent should be documented and communicated. METHODS A retrospective review of records from cancer MDT meetings at our institution from 2016 to 2020 was performed to identify cases where dissent was documented and the reasons for this. MDT members were invited to complete an online survey assessing their perceptions of how frequently dissent occurred, how comfortable they felt voicing dissenting opinions, and their opinions on how dissent should be documented and communicated. RESULTS Dissent was recorded in 30 of 7737 MDT case discussions (0.39%). The incidence of dissent varied from 0 to 1.2% between cancer streams. The most common reason for dissent involved the role of surgery. 27% of survey respondents felt either very or somewhat uncomfortable voicing dissenting opinions. Only 3% felt that dissent should not be documented, and none that it should not be communicated in some way, although there were wide ranging of views on how this should occur. CONCLUSION Dissent was rarely documented within cancer MDT meetings at our institution, likely due to underreporting. Measuring the incidence of dissent within an MDT may be a useful performance metric. MDT should develop policies for how dissent should be managed, documented, and communicated.
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Affiliation(s)
- Anthony J Chambers
- Department of Surgical Oncology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jade F Enoch
- Department of Surgical Oncology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
- School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jasmine Wong
- Department of Surgical Oncology, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia
| | - Allan Spigelman
- School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
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Liu W, Li C, Ma Z, Zhang G, Lubamba GP, Lian H, Zhang Z, Tang W. Reconstruction of Total Maxillectomy Defects Using Coronoid-Temporalis Pedicled Flap, Titanium Mesh, and Free Flap. Otolaryngol Head Neck Surg 2024; 170:1200-1203. [PMID: 38104317 DOI: 10.1002/ohn.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/26/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
The maxilla plays a crucial role in maintaining midfacial contour, supporting the globe and dentition and separating the oral and nasal cavity. Reconstruction of total maxillectomy defects has always been a challenge in head and neck surgery. In recent years, on the basis of existing methods, we have used the coronoid-temporalis pedicled flap combined with personalized titanium mesh and free flap to reconstruct total maxillectomy defects. This combination of multiple methods can restore the functional subunits of the maxilla. In this report, we introduce our surgical procedures in detail and assess the postoperative effects. Postoperative facial aesthetic outcomes were satisfactory in all 8 patients. None of the patients showed diplopia, oral-nasal reflux, hypernasality, titanium mesh exposure, or trismus. This new surgical procedure may be a simple and feasible option for the reconstruction of total maxillectomy defects.
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Affiliation(s)
- Wei Liu
- Department of Trauma and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chunjie Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhongkai Ma
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Gaowei Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Grace Paka Lubamba
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Haosen Lian
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhuoyuan Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Wei Tang
- Department of Trauma and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Liu X, Zhang X, Ruan G, Zheng X, Chen Y, Zhang X, Liu T, Ge Y, Shi H. Relationship between educational level and survival of patients with cancer: A multicentre cohort study. Cancer Med 2024; 13:e7141. [PMID: 38545856 PMCID: PMC10974719 DOI: 10.1002/cam4.7141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Although socioeconomic factors are important determinants of population mortality, the effect of educational level on the survival of patients with cancer in China is unclear. This study aimed to assess whether educational level is associated with the prognosis of patients with cancer and to explore the mediators of this association. METHODS This multicentre cohort study included 18,251 patients diagnosed with cancer between May 2013 and December 2018. The main parameters measured were overall survival (OS) and all-cause mortality. The relationship between educational level and all-cause mortality was assessed using multifactor-corrected Cox survival analysis. Logistic regression was used to analyze the association between educational level and patient-generated subjective global assessment (PG-SGA). RESULTS The mean age of the 18,251 participants (men, 9939 [54.4%]) was 57.37 ± 11.66 years. Multifactorial survival analysis showed that patients survived longer with increasing education (university and above vs. elementary school and below; p = p = <0.001, HR = 0.84, 95% CI: 0.77-0.92), and the differences were statistically significant in different subgroups. The potential impact factors included sex, age, TNM stage, and PG-SGA score. Logistic regression showed a significant negative association between educational level and the modifiable factor PG-SGA (secondary vs. primary and below; p = 0.004, HR = 0.90, 95% CI: 0.83-0.97; university and above vs. primary and below; p < 0.001, HR = 0.79, 95% CI: 0.71-0.88). CONCLUSIONS Educational level was a significant prognostic factor for patients with cancer, independent of other known prognostic factors. This association was further improved by modifying the nutritional status.
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Affiliation(s)
- Xiao‐Yue Liu
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Xi Zhang
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Guo‐Tian Ruan
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Xin Zheng
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Yue Chen
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Xiao‐Wei Zhang
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Tong Liu
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Yi‐Zhong Ge
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Han‐Ping Shi
- Department of Gastrointestinal SurgeryBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- Department of Clinical NutritionBeijing Shijitan Hospital, Capital Medical UniversityBeijingChina
- National Clinical Research Center for Geriatric DiseasesXuanwu Hospital, Capital Medical UniversityBeijingChina
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Akgul M, Sangoi AR, Williamson SR. GATA3 in Renal Neoplasms: Increased Utility and Potential Pitfalls. Int J Surg Pathol 2024; 32:365-367. [PMID: 37248558 DOI: 10.1177/10668969231177883] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Mahmut Akgul
- Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
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Müller E, Müller MJ, Boehlke C, Schäfer H, Quante M, Becker G. Screening for Palliative Care Need in Oncology: Validation of Patient-Reported Outcome Measures. J Pain Symptom Manage 2024; 67:279-289.e6. [PMID: 38154625 DOI: 10.1016/j.jpainsymman.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
CONTEXT Leading oncology societies recommend monitoring symptoms and support needs through patient-reported outcome measures (PROMs), but their use for assessing specialist palliative care (SPC) need has not yet been explored. Research on SPC integration has focused on staff-assessed screening tools, which are time-consuming. OBJECTIVES This study aimed to assess the diagnostic validity of the Integrated Palliative Outcome Scale (IPOS) and NCCN Distress Thermometer (NCCN DT) in identifying need for SPC in patients with incurable cancer. METHODS In a cross-sectional study, patients with incurable cancer (prognosis <2 years) completed PROMs. In an independent process, the palliative care consultation service (PCCS) assessed the need for SPC in each patient through multiprofessional case review, and this was used as the reference standard. ROC analyses were employed to determine diagnostic validity. RESULTS Of the 208 participants, 71 (34.1 %) were classified as having SPC need by the PCCS. Aiming for a minimum sensitivity of 80%, a cut-off of ≥2 items with high/very high burden in the IPOS resulted in a 90.2% sensitivity (specificity = 50; AUC = 0.791; CI 95%= 0.724-0.858). A cut-off of ≥5 resulted in a sensitivity of 80 % for NCCN DT (specificity = 49.5 %; AUC = 0.687; CI 95% = 0.596-0.777). CONCLUSION PROMs are useful for identifying SPC need in cancer patients. Their implementation might facilitate timely integration of SPC. Future research should focus on an integrated assessment approach with PROMs that combines the requirements of the different specialties to save patient and staff resources.
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Affiliation(s)
- Evelyn Müller
- Department of Palliative Medicine (E.M., M.J.M., G.B.), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Josef Müller
- Department of Palliative Medicine (E.M., M.J.M., G.B.), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Christopher Boehlke
- Department of Palliative Care (C.B.), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Henning Schäfer
- Department of Radiation Oncology (H.S.), Medical Center, Faculty of Medicine, University of Freiburg, German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ) Heidelberg, Freiburg, Germany
| | - Michael Quante
- Clinic for Internal Medicine II (M.Q.), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gerhild Becker
- Department of Palliative Medicine (E.M., M.J.M., G.B.), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Fleischer A, Humphrey C. Women's Experiences after Hormone Positive Breast Cancer: Beginning of Radiation to 3-4 Years Post-Radiation. Occup Ther Health Care 2024; 38:364-384. [PMID: 36112023 DOI: 10.1080/07380577.2022.2121991] [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: 01/06/2022] [Revised: 08/23/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
This study found that a breast cancer survivor cohort who were 3-4 years post-treatment returned to near baseline activity levels, and their important activity categories were nearly evenly distributed among instrumental activities of daily living, high-demand leisure, and social participation. When describing their experiences, three themes emerged: exercise is important physically and emotionally, participating in important activities feels good, and plans have been made to continue engaging in important activities. Further research is needed to compare activity resumption among those receiving or not receiving occupational therapy-at different timepoints-to understand when occupational therapy can make the greatest impact.
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Affiliation(s)
- Anne Fleischer
- Occupational Therapy Program, Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati
| | - Casey Humphrey
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University
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García de Herreros M, Laguna JC, Padrosa J, Barreto TD, Chicote M, Font C, Grafiá I, Llavata L, Seguí E, Tuca A, Viladot M, Zamora-Martínez C, Fernández-Méndez S, Téllez A, Nicolás JM, Prat A, Castro-Rebollo P, Marco-Hernández J. Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment. Diagnostics (Basel) 2024; 14:730. [PMID: 38611643 PMCID: PMC11011727 DOI: 10.3390/diagnostics14070730] [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: 02/16/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Despite the increasing number of ICU admissions among patients with solid tumours, there is a lack of tools with which to identify patients who may benefit from critical support. We aim to characterize the clinical profile and outcomes of patients with solid malignancies admitted to the ICU. METHODS Retrospective observational study of patients with cancer non-electively admitted to the ICU of the Hospital Clinic of Barcelona (Spain) between January 2019 and December 2019. Data regarding patient and neoplasm characteristics, ICU admission features and outcomes were collected from medical records. RESULTS 97 ICU admissions of 84 patients were analysed. Lung cancer (22.6%) was the most frequent neoplasm. Most of the patients had metastatic disease (79.5%) and were receiving oncological treatment (75%). The main reason for ICU admission was respiratory failure (38%). Intra-ICU and in-hospital mortality rates were 9.4% and 24%, respectively. Mortality rates at 1, 3 and 6 months were 19.6%, 36.1% and 53.6%. Liver metastasis, gastrointestinal cancer, hypoalbuminemia, elevated basal C-reactive protein, ECOG-PS greater than 2 at ICU admission, admission from ward and an APACHE II score over 14 were related to higher mortality. Functional status was severely affected at discharge, and oncological treatment was definitively discontinued in 40% of the patients. CONCLUSION Medium-term mortality and functional deterioration of patients with solid cancers non-electively admitted to the ICU are high. Surrogate markers of cachexia, liver metastasis and poor ECOG-PS at ICU admission are risk factors for mortality.
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Affiliation(s)
- Marta García de Herreros
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Juan Carlos Laguna
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Joan Padrosa
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
| | - Tanny Daniela Barreto
- Radiation Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain;
| | - Manoli Chicote
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
| | - Carme Font
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Ignacio Grafiá
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
| | - Lucía Llavata
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
| | - Elia Seguí
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Albert Tuca
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Margarita Viladot
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Carles Zamora-Martínez
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
| | - Sara Fernández-Méndez
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
| | - Adrián Téllez
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
| | - Josep Maria Nicolás
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
| | - Aleix Prat
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Translational Genomics and Targeted Therapies in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Pedro Castro-Rebollo
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
| | - Javier Marco-Hernández
- Medical Oncology Department, Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (M.G.d.H.); (J.C.L.); (J.P.); (M.C.); (C.F.); (I.G.); (L.L.); (E.S.); (A.T.); (M.V.); (C.Z.-M.); (A.P.)
- Medical Intensive Care Unit, Internal Medicine Department Hospital Clínic de Barcelona, C/Villarroel 170, 08036 Barcelona, Spain; (S.F.-M.); (A.T.); (J.M.N.); (P.C.-R.)
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Aldakkour JL, Newman-Caro AB, Henning A. An Unusual Case of Microcystic Serous Cystadenoma in a 19-Year-Old Male Patient. HCA Healthc J Med 2024; 5:35-37. [PMID: 38560389 PMCID: PMC10939088 DOI: 10.36518/2689-0216.1510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Introduction Microcystic serous cystadenomas are uncommon, benign neoplasms rarely known to progress to malignancy. They are typically asymptomatic and inadvertently discovered during imaging for another unrelated condition. When discovered, they are commonly found in females over 60 years of age. Case Presentation In this case report, we examine a unique presentation of a serous cystadenoma discovered when a 19-year-old male presented with symptoms of abdominal pain, nausea, and vomiting. Conclusion Previous studies on serous cystadenomas in a younger male demographic are rare. Therefore, this study will provide additional insight into the signs, symptoms, diagnosis, and management of cystadenomas in young patients.
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Chen Y, Jiao W, Wang Y, Liang Z, Wang L, Li D, Liang Y, Niu H. Microtubule interacting and trafficking domain containing 1 deficiency leads to poor survival via tissue factor-mediated coagulation in bladder cancer. J Thromb Haemost 2024:S1538-7836(24)00173-9. [PMID: 38554936 DOI: 10.1016/j.jtha.2024.03.015] [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: 12/05/2023] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Patients with cancer are at an increased risk of developing a hypercoagulative phenotype and venous thromboembolism. However, no clinical trial has yet confirmed that anticoagulant therapy improves cancer prognosis, and the mechanism underlying hypercoagulation in patients with bladder cancer is not well understood. OBJECTIVES We hypothesized that the prognostic genes affect tumor progression via tumor-mediated coagulation. METHODS We detected the most significant prognostic genes of bladder cancer with The Cancer Genome Atlas dataset and validated them in 2 Gene Expression Omnibus datasets and 1 ArrayExpress dataset. Immunohistochemical tests were performed on a cohort of 80 individuals to further examine the prognostic genes. For the most reliable prognostic gene, its influence on coagulation was evaluated with gene knockdown followed by next-generation sequencing and cellular and animal experiments. RESULTS Depletion of microtubule interacting and trafficking domain containing 1 (MITD1), a major prognostic gene of bladder cancer, significantly increased the tissue factor (TF) expression. MITD1 deficiency led to cytokinesis arrest, which, in turn, promoted the TF expression via unfolded protein response and c-Jun. The knockdown of IRE1, an essential kinase of unfolded protein response or the inactivation of c-Jun using c-Jun N-terminal kinase inhibitors weakened MITD1 deficiency- or dithiothreitol-induced TF upregulation. Cells lacking MITD1 promoted coagulation and metastasis in the experimental metastasis assay. CONCLUSION Our findings suggest the novel role of tumor prognostic genes upon the development of hypercoagulative phenotype and venous thromboembolism, thereby underlining the importance of anticoagulant therapy and shedding light on the therapeutic value of targeting MITD1 in bladder cancer.
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Affiliation(s)
- Yuanbin Chen
- Qingdao Clinical Medical Research Center for Urinary System Disease, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wei Jiao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yonghua Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhijuan Liang
- Qingdao Clinical Medical Research Center for Urinary System Disease, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Liping Wang
- Qingdao Clinical Medical Research Center for Urinary System Disease, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dan Li
- Qingdao Clinical Medical Research Center for Urinary System Disease, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ye Liang
- Qingdao Clinical Medical Research Center for Urinary System Disease, The Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Haitao Niu
- Qingdao Clinical Medical Research Center for Urinary System Disease, The Affiliated Hospital of Qingdao University, Qingdao, China; Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Hui D, Huang YT, Andersen C, Cassel B, Nortje N, George M, Bruera E. Cost of Hospitalization Associated with Inpatient Goals-of-Care Program Implementation at a Comprehensive Cancer Center: A Propensity Score Analysis. Cancers (Basel) 2024; 16:1316. [PMID: 38610994 PMCID: PMC11010830 DOI: 10.3390/cancers16071316] [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: 02/29/2024] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
The impact of goals-of-care programs on acute hospitalization costs is unclear. We compared the hospitalization cost in an 8-month period before implementation of a multimodal interdisciplinary goals-of-care program (1 May 2019 to 31 December 2019) to an 8-month period after program implementation (1 May 2020 to 31 December 2020). Propensity score weighting was used to adjust for differences in potential covariates. The primary outcome was total direct cost during the hospital stay for each index hospitalization. This analysis included 6977 patients in 2019 and 5964 patients in 2020. The total direct cost decreased by 3% in 2020 but was not statistically significant (ratio 0.97, 95% CI 0.92, 1.03). Under individual categories, there was a significant decrease in medical oncology (ratio 0.58, 95% CI 0.50, 0.68) and pharmacy costs (ratio 0.86, 95% CI 0.79, 0.96), and an increase in room and board (ratio 1.06, 95% CI 1.01, 1.10). In subgroup analysis, ICU patients had a significant reduction in total direct cost after program implementation (ratio 0.83, 95% CI 0.72, 0.94). After accounting for the length of ICU admission, we found that the total direct cost per hospital day was no longer different between 2019 and 2020 (ratio 0.986, 95% CI 0.92, 1.05), suggesting that shorter ICU admissions likely explained much of the observed cost savings. This study provides real-world data on how "in-the-moment" GOC conversations may contribute to reduced hospitalization costs among ICU patients.
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Affiliation(s)
- David Hui
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Yu-Ting Huang
- Cost Management and Decision Support, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Clark Andersen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Brian Cassel
- Hematology/Oncology & Palliative Care, Virginia Commonwealth University, Richmond, VA 22043, USA;
| | - Nico Nortje
- Section of Integrated Ethics, Department of Critical Care Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
- Department of Dietetics and Nutrition, University of the Western Cape, Bellville 7535, South Africa
| | - Marina George
- Department of Hospital Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
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22
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van der Velden NCA, Smets EMA, van Vliet LM, Brom L, van Laarhoven HWM, Henselmans I. Effects of prognostic communication strategies on emotions, coping, and appreciation of consultations: An experimental study in advanced cancer. Palliat Support Care 2024:1-13. [PMID: 38533613 DOI: 10.1017/s1478951524000403] [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: 03/28/2024]
Abstract
OBJECTIVES We aimed to investigate effects of prognostic communication strategies on emotions, coping, and appreciation of consultations in advanced cancer. METHODS For this experimental study, we created 8 videos of a scripted oncological consultation, only varying in prognostic communication strategies. Disease-naive individuals (n = 1036) completed surveys before and after watching 1 video, while imagining being the depicted cancer patient. We investigated effects of the type of disclosure (prognostic disclosure vs. communication of unpredictability vs. non-disclosure) and content of disclosure (standard vs. standard and best-case vs. standard, best- and worst-case survival scenarios; numerical vs. word-based estimates) on emotions, coping, and appreciation of consultations. Moderating effects of individual characteristics were tested. RESULTS Participants generally reported more satisfaction (p < .001) after prognostic disclosure versus communication of unpredictability and less uncertainty (p = .042), more satisfaction (p = .005), and more desirability (p = .016) regarding prognostic information after numerical versus word-based estimates. Effects of different survival scenarios were absent. Prognostic communication strategies lacked effects on emotions and coping. Significant moderators included prognostic information preference and uncertainty tolerance. SIGNIFICANCE OF RESULTS In an experimental setting, prognostic disclosure does not cause more negative emotions than non-disclosure and numerical estimates are more strongly appreciated than words. Oncologists' worries about harming patients should not preclude disclosing (precise) prognostic information, yet sensitivity to individual preferences and characteristics remains pivotal.
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Affiliation(s)
- Naomi C A van der Velden
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Liesbeth M van Vliet
- Department of Health, Medical and Neuropsychology, University of Leiden, Leiden, The Netherlands
| | - Linda Brom
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
- Department of Medical Oncology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Inge Henselmans
- Department of Medical Psychology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health, Amsterdam, The Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, The Netherlands
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23
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Ohyama H, Hirotsu Y, Amemiya K, Amano H, Hirose S, Oyama T, Iimuro Y, Kojima Y, Mikata R, Mochizuki H, Kato N, Omata M. Liquid biopsy of wash samples obtained via endoscopic ultrasound-guided fine-needle biopsy: Comparison with liquid biopsy of plasma in pancreatic cancer. Diagn Cytopathol 2024. [PMID: 38516904 DOI: 10.1002/dc.25306] [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: 02/17/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES Pancreatic cancer (PC) has a poor prognosis and limited treatment options. Liquid biopsy, which analyzes circulating tumor DNA (ctDNA) in blood, holds promise for precision medicine; however, low ctDNA detection rates pose challenges. This study aimed to investigate the utility of wash samples obtained via endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) as a liquid biopsy for PC. METHODS A total of 166 samples (42 formalin-fixed paraffin-embedded [FFPE] tissues, 80 wash samples, and 44 plasma samples) were collected from 48 patients with PC for genomic analysis. DNA was extracted and quantified, and 60 significantly mutated genes were sequenced. The genomic profiles of FFPE tissues, wash samples, and plasma samples were compared. Finally, the ability to detect druggable mutations in 80 wash samples and 44 plasma samples was investigated. RESULTS The amount of DNA was significantly lower in plasma samples than in wash samples. Genomic analysis revealed a higher detection rate of oncogenic mutations in FFPE tissues (98%) and wash samples (96%) than in plasma samples (18%) and a comparable detection rate in FFPE tissues and wash samples. Tumor-derived oncogenic mutations were detected more frequently in wash samples than in plasma samples. Furthermore, the oncogenic mutations detection rate remained high in wash samples at all PC stages but low in plasma samples even at advanced PC stages. Using wash samples was more sensitive than plasma samples for identifying oncogenic and druggable mutations. CONCLUSIONS The wash sample obtained via EUS-FNB is an ideal specimen for use as a liquid biopsy for PC.
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Affiliation(s)
- Hiroshi Ohyama
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
- Genome Analysis Center, Yamanashi Central Hospital, Yamanashi, Japan
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
| | - Yosuke Hirotsu
- Genome Analysis Center, Yamanashi Central Hospital, Yamanashi, Japan
| | - Kenji Amemiya
- Genome Analysis Center, Yamanashi Central Hospital, Yamanashi, Japan
| | - Hiroyuki Amano
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
| | - Sumio Hirose
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
| | - Toshio Oyama
- Department of Pathology, Yamanashi Central Hospital, Yamanashi, Japan
| | - Yuji Iimuro
- Department of Surgery, Yamanashi Central Hospital, Yamanashi, Japan
| | - Yuichiro Kojima
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
| | - Rintaro Mikata
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hitoshi Mochizuki
- Genome Analysis Center, Yamanashi Central Hospital, Yamanashi, Japan
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masao Omata
- Genome Analysis Center, Yamanashi Central Hospital, Yamanashi, Japan
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan
- University of Tokyo, Tokyo, Japan
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Mougel G, Mohamed A, Burnichon N, Giraud S, Pigny P, Bressac-de Paillerets B, Mirebeau-Prunier D, Buffet A, Savagner F, Romanet P, Arlot Y, Gardie B, Gimenez-Roqueplo AP, Beroud C, Richard S, Barlier A. Update of the UMD-VHL database: classification of 164 challenging variants based on genotype-phenotype correlation among 605 entries. J Med Genet 2024; 61:378-384. [PMID: 37979962 DOI: 10.1136/jmg-2023-109550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/28/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The von Hippel-Lindau (VHL) disease is a hereditary tumour syndrome caused by germline mutations in VHL tumour suppressor gene. The identification of VHL variants requires accurate classification which has an impact on patient management and genetic counselling. METHODS The TENGEN (French oncogenetics network of neuroendocrine tumors) and PREDIR (French National Cancer Institute network for Inherited predispositions to kidney cancer) networks have collected VHL genetic variants and clinical characteristics of all VHL-suspected patients analysed from 2003 to 2021 by one of the nine laboratories performing VHL genetic testing in France. Identified variants were registered in a locus-specific database, the Universal Mutation Database-VHL database (http://www.umd.be/VHL/). RESULTS Here we report the expert classification of 164 variants, including all missense variants (n=124), all difficult interpretation variants (n=40) and their associated phenotypes. After initial American College of Medical Genetics classification, first-round classification was performed by the VHL expert group followed by a second round for discordant and ambiguous cases. Overall, the VHL experts modified the classification of 87 variants including 30 variants of uncertain significance that were as (likely)pathogenic variants for 19, and as likely benign for 11. CONCLUSION Consequently, this work has allowed the diagnosis and influenced the genetic counselling of 45 VHL-suspected families and can benefit to the worldwide VHL community, through this review.
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Affiliation(s)
- Gregory Mougel
- Aix Marseille Univ, APHM, INSERM, MMG, U1251, GEnOPé Departement, M2GM, Timone Hospital, Marseille, France
| | - Amira Mohamed
- APHM, GEnOPé Department, M2GM, Timone Hospital, Marseille, France
| | - Nelly Burnichon
- Département de Médecine Génomique des Tumeurs et des Cancers, Hôpital européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université Paris Cité, Inserm, PARCC, Paris, France
| | - Sophie Giraud
- Genetics Department, Hospices Civils de Lyon (HCL), University Hospital, East Pathology Center, Lyon, France
| | - Pascal Pigny
- Service de Biochimie et Biologie Moléculaire « Hormonologie, Métabolisme-Nutrition, Oncologie », Centre de Biologie Pathologie, CHU Lille, Bd du Pr J Leclercq, Lille, France
| | - Brigitte Bressac-de Paillerets
- Service de Genetique, Département de Biologie et Pathologies Médicales, Gustave Roussy; INSERM U1279, Université Paris-Saclay, Villejuif Cedex, France
| | - Delphine Mirebeau-Prunier
- Département de Biochimie et Génétique, Service de Biochimie et Biologie Moléculaire, CHU d'Angers, University of Angers, INSERM, CNRS, MITOVASC, Equipe MitoLab, SFRICAT, Angers, France
| | - Alexandre Buffet
- Département de Médecine Génomique des Tumeurs et des Cancers, Hôpital européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université Paris Cité, Inserm, PARCC, Paris, France
| | - Frédérique Savagner
- Laboratoire de Biochimie, Institut Fédératif de Biologie, CHU Toulouse; Inserm UMR1297, I2MC, Toulouse, France
| | - Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, MMG, U1251, GEnOPé Departement, M2GM, Timone Hospital, Marseille, France
| | - Yannick Arlot
- CNRS UMR6290, Université Rennes 1, SFR-UMS CNRS 3480, INSERM 018, Rennes, France
| | - Betty Gardie
- Ecole Pratique des Hautes Etudes, EPHE, Université PSL; Université de Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
| | - Anne-Paule Gimenez-Roqueplo
- Département de Médecine Génomique des Tumeurs et des Cancers, Hôpital européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université Paris Cité, Inserm, PARCC, Paris, France
| | - Christophe Beroud
- Department of Genetics, M2GM, Timone Hospital, Aix Marseille Univ, APHM, INSERM, MMG, U1251 Bioinformatic Team, Marseille, France
| | - Stephane Richard
- Ecole Pratique des Hautes Etudes, EPHE, Université PSL, France, UMR 9019-CNRS, Gustave Roussy Cancer Campus, Villejuif, France et Service d'Urologie, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, Paris, France
- Réseau National pour Cancers rares de l'Adulte PREDIR labellisé par l'INCa, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Paris, France
| | - Anne Barlier
- Aix Marseille Univ, APHM, INSERM, MMG, U1251, GEnOPé Departement, M2GM, Timone Hospital, Marseille, France
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Ikawa T, Kuwabara Y, Nakata K, Kanayama N, Morimoto M, Miyashiro I, Konishi K. Risk of thoracic soft tissue sarcoma after breast cancer radiotherapy: a population-based cohort study in Osaka, Japan. J Radiat Res 2024:rrae010. [PMID: 38515338 DOI: 10.1093/jrr/rrae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/22/2024] [Indexed: 03/23/2024]
Abstract
Postoperative radiotherapy for breast cancer reportedly increases the risk of thoracic soft tissue sarcomas, particularly angiosarcomas; however, the risk in the Japanese population remains unknown. Therefore, this study aimed to investigate the incidence of thoracic soft tissue sarcoma among patients with breast cancer in Japan and determine its association with radiotherapy. This retrospective cohort study used data from the population-based cancer registry of the Osaka Prefecture. The inclusion criteria were female sex, age 20-84 years, diagnosis of breast cancer between 1990 and 2010, no supraclavicular lymph node or distant metastasis, underwent surgery and survived for at least 1 year. The primary outcome was the occurrence of thoracic soft tissue sarcomas 1 year or later after breast cancer diagnosis. Among the 13 762 patients who received radiotherapy, 15 developed thoracic soft tissue sarcomas (nine angiosarcomas and six other sarcomas), with a median time of 7.7 years (interquartile range, 4.0-8.6 years) after breast cancer diagnosis. Among the 27 658 patients who did not receive radiotherapy, four developed thoracic soft tissue sarcomas (three angiosarcomas and one other sarcoma), with a median time of 11.6 years after diagnosis. The 10-year cumulative incidence was higher in the radiotherapy cohort than in the non-radiotherapy cohort (0.087 vs. 0.0036%, P < 0.001). Poisson regression analysis revealed that radiotherapy increased the risk of thoracic soft tissue sarcoma (relative risk, 6.8; 95% confidence interval, 2.4-24.4). Thus, although rare, breast cancer radiotherapy is associated with an increased risk of thoracic soft tissue sarcoma in the Japanese population.
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Affiliation(s)
- Toshiki Ikawa
- Department of Radiation Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Yoshihiro Kuwabara
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Naoyuki Kanayama
- Department of Radiation Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Masahiro Morimoto
- Department of Radiation Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Koji Konishi
- Department of Radiation Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
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Chalcarz M, Grabarek BO, de Mezer M, Krokowicz P, Patera J, Czupryna K, Żurawski J. Serum Selenium Concentration as a Potential Diagnostic Marker for Early-Stage Colorectal Cancer: A Comparative Study. Med Sci Monit 2024; 30:e942882. [PMID: 38504430 PMCID: PMC10962284 DOI: 10.12659/msm.942882] [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: 10/16/2023] [Accepted: 01/24/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Selenium deficiency is an established risk factor for colorectal cancer. The aim of the present study was to determine selenium levels in blood samples obtained from colorectal cancer patients compared with the levels of this element in the blood of patients who had undergone hernia repair and cholecystectomy. MATERIAL AND METHODS The study group consisted of 49 patients diagnosed with colorectal cancer at our institution. The comparison group consisted of 29 and 26 patients undergoing hernia repair and cholecystectomy, respectively. The histological staging level was evaluated on a 4-grade scale. Serum selenium concentration was quantified by inductively coupled mass spectrometry using methane to reduce polyatomic interference. RESULTS Colorectal cancer patients had significantly lower serum selenium concentration than the comparison patients (67.24±15.55 μg/L vs 78.81±12.93 μg/L; P<0.001), and selenium concentration was below the reference range in a high percentage of colorectal cancer patients. However, among the colorectal cancer patients, no significant difference in cancer grading was observed according to selenium concentration (P=0.235). Serum selenium concentration in the patients was evaluated on the basis of 5 independent variables (R=0.6250): age (P=0.011), number of leukocytes (P=0.010), family history of cancer (P=0.045), dietary supplements (P=0.023), and exposure to chemical factors (P=0.057). CONCLUSIONS This study supports findings from previous studies that low serum selenium levels are associated with colorectal cancer and that selenium deficiency may be a risk factor for colorectal cancer.
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Affiliation(s)
| | | | - Mateusz de Mezer
- Department of Immunobiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Piotr Krokowicz
- Clinic of General and Colorectal Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - Janusz Patera
- Department of Medicine, University of Maria Skłodowska-Curie in Warsaw, Warsaw, Poland
| | | | - Jakub Żurawski
- Department of Immunobiology, Poznań University of Medical Science, Poznań, Poland
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Consolo L, Rusconi D, Colombo S, Basile I, Campa T, Pezzera D, Benenati S, Caraceni A, Lusignani M. Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study. Am J Hosp Palliat Care 2024:10499091241240667. [PMID: 38504550 DOI: 10.1177/10499091241240667] [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: 03/21/2024] Open
Abstract
INTRODUCTION Electronic patient-reported outcome measures (e-PROMs) offer advantages in palliative cancer care, including rapid completion, improved data quality and direct storage, improving clinical decision-making. The electronic Integrated Palliative Care Outcome Scale (e-IPOS) in this context enables thorough self-assessment by patients, enhancing symptom management and self-reflection of their current situation. AIM To evaluate the feasibility of implementing the e-IPOS in home palliative cancer care. OUTCOMES The primary outcomes included the enrollment consent rate, study retention rate, e-IPOS completion rate and response completeness, and the number of clinical assessments and interventions performed during home visits. The secondary outcomes were the number of unscheduled visits and patients' perceived quality of life. DESIGN A two-group quasiexperimental clinical pilot study. The control group received standard palliative care, the intervention group received standard care along with weekly e-IPOS completion during home visits. Both groups were enrolled for 4 weeks. SETTING/PARTICIPANTS Adults with advanced cancer from the home palliative care unit of the Istituto Nazionale dei Tumori of Milan. RESULTS Twenty-three patients were enrolled (74.19%), and 20 completed the study (drop-out: 13.04%). 82.5% of the expected e-IPOS responses were received, of which 96.9% were fully complete. In the intervention group, the Wilcoxon test showed an increase in identified needs and documented interventions (P < .05) and a decrease in unscheduled visits (P < .05). CONCLUSION It is feasible to recruit people via home palliative care for an e-IPOS implementation study. Future fully powered studies should investigate the feasibility and assess patients' perceptions of its use to better understand its clinical benefits.
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Affiliation(s)
- Letteria Consolo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- Bachelor School of Nursing, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy
| | - Daniele Rusconi
- Urologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Stella Colombo
- Intensive Care Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ilaria Basile
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy
| | - Tiziana Campa
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy
| | - Daniele Pezzera
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy
| | - Salvatore Benenati
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy
| | - Augusto Caraceni
- High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maura Lusignani
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Nishizaki D, Kurzrock R, Miyashita H, Adashek JJ, Lee S, Nikanjam M, Eskander RN, Patel H, Botta GP, Nesline MK, Pabla S, Conroy JM, DePietro P, Sicklick JK, Kato S. Viewing the immune checkpoint VISTA: landscape and outcomes across cancers. ESMO Open 2024; 9:102942. [PMID: 38503143 DOI: 10.1016/j.esmoop.2024.102942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/18/2023] [Accepted: 02/16/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Optimizing immune checkpoint inhibitor (ICI) therapy may require identification of co-targetable checkpoint pathways via immune profiling. Herein, we analyzed the transcriptomic expression and clinical correlates of V-domain immunoglobulin suppressor of T-cell activation (VISTA), a promising targetable checkpoint. PATIENTS AND METHODS RNA sequencing was carried out on 514 tissues reflecting diverse advanced/metastatic cancers. Expression of eight immune checkpoint markers [lymphocyte-activation gene 3 (LAG-3), tumor necrosis factor receptor superfamily 14 (TNFRSF14), programmed cell death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), programmed death-ligand 2 (PD-L2), B- and T-lymphocyte attenuator (BTLA), T-cell immunoglobulin and mucin domain-containing protein 3 (TIM-3), cytotoxic T-lymphocyte antigen 4 (CTLA-4)], in addition to VISTA, was analyzed, along with clinical outcomes. RESULTS High VISTA RNA expression was observed in 32% of tumors (66/514) and was the most common highly expressed checkpoint among the nine assessed. High VISTA expression was independently correlated with high BTLA, TIM-3, and TNFRSF14, and with a diagnosis of pancreatic, small intestine, and stomach cancer. VISTA transcript levels did not correlate with overall survival (OS) from metastatic/advanced disease in the pan-cancer cohort or with immunotherapy outcome (progression-free survival and OS from the start of ICI) in 217 ICI-treated patients. However, in ICI-treated pancreatic cancer patients (n = 16), median OS was significantly shorter (from immunotherapy initiation) for the high- versus not-high-VISTA groups (0.28 versus 1.21 years) (P = 0.047); in contrast, VISTA levels were not correlated with OS in 36 pancreatic cancer patients who did not receive ICI. CONCLUSION High VISTA expression correlates with high BTLA, TIM-3, and TNFRSF14 checkpoint-related molecules and with poorer post-immunotherapy survival in pancreatic cancer, consistent with prior literature indicating that VISTA is prominently expressed on CD68+ macrophages in pancreatic cancers and requiring validation in larger prospective studies. Immunomic analysis may be important for individualized precision immunotherapy.
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Affiliation(s)
- D Nishizaki
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla.
| | - R Kurzrock
- MCW Cancer Center and Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, USA; WIN Consortium, Paris, France
| | - H Miyashita
- Dartmouth Cancer Center, Hematology and Medical Oncology, Lebanon
| | - J J Adashek
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins Hospital, Baltimore
| | - S Lee
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla
| | - M Nikanjam
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla
| | - R N Eskander
- Center for Personalized Cancer Therapy and Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, Moores Cancer Center, La Jolla
| | - H Patel
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla
| | - G P Botta
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla
| | | | | | | | | | - J K Sicklick
- Division of Surgical Oncology, Department of Surgery, Center for Personalized Cancer Therapy, University of California San Diego, La Jolla, USA
| | - S Kato
- Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, University of California San Diego, Moores Cancer Center, La Jolla.
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Washimi K, Hiroshima Y, Sato S, Ueno M, Kobayashi S, Yamamoto N, Hasegawa C, Yoshioka E, Ono K, Okubo Y, Yokose T, Miyagi Y. Evaluation of pancreatic cancer specimens for comprehensive genomic profiling. Pathol Int 2024. [PMID: 38477638 DOI: 10.1111/pin.13416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/30/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024]
Abstract
Inadequate specimen quality or quantity hinders comprehensive genomic profiling in identifying actionable mutations and guiding treatment strategies. We investigated the optimal conditions for pancreatic cancer specimen selection for comprehensive genomic profiling. We retrospectively analyzed 213 pancreatic cancer cases ordered for comprehensive genomic profiling and compared results from pancreatic biopsy, liver biopsy of pancreatic cancer metastases, pancreatectomy, liquid, and nonliver metastatic organ specimens. We examined preanalytical conditions, including cellularity (tumor cell count/size). The successfully tested cases were those that underwent comprehensive genomic profiling tests without any issues. The successfully tested case ratio was 72.8%. Pancreatic biopsy had the highest successfully tested case ratio (87%), with a high tumor cell percentage, despite the small number of cells (median, 3425). Pancreatic biopsy, liver biopsy of pancreatic cancer metastases, and non-liver metastatic organ had higher successfully tested case ratios than that for pancreatectomy. Liver biopsy of pancreatic cancer metastases and pancreatectomy cases with tumor size (mm2 ) × tumor ratio (%) > 150 and >3000, respectively, had high successfully tested case ratios. The success of comprehensive genomic profiling is significantly influenced by the tumor cell ratio, and pancreatic biopsy is a potentially suitable specimen for comprehensive genomic profiling.
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Affiliation(s)
- Kota Washimi
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yukihiko Hiroshima
- Division of Advanced Cancer Therapeutics, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan
- Center for Cancer Genome Medicine, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Shinya Sato
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
- Division of Molecular Pathology and Genetics, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan
| | - Makoto Ueno
- Department of Gastoroenterology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Satoshi Kobayashi
- Department of Gastoroenterology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Naoto Yamamoto
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Chie Hasegawa
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Emi Yoshioka
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Kyoko Ono
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yoichiro Okubo
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yohei Miyagi
- Center for Cancer Genome Medicine, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
- Division of Molecular Pathology and Genetics, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa, Japan
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Boelhouwer IG, van Vuuren T. The association of fatigue and cognitive complaints with work-related outcomes and cancer-related anxiety among employees 2-10 years after cancer diagnosis. J Health Psychol 2024:13591053241234748. [PMID: 38433650 DOI: 10.1177/13591053241234748] [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: 03/05/2024] Open
Abstract
This study investigated the association of fatigue and cognitive complaints among employees post-cancer diagnosis, with work-related outcomes, and moderation by cancer-related anxiety. A survey was carried out among workers 2-10 years after cancer diagnosis. Employees without cancer recurrence or metastases were selected (N = 566). Self-reported fatigue and cognitive complaints were classified into three groups. ANOVA's and regression analyses were used, controlling for age. Group 1 (cognitive complaints, n = 25, 4.4%), group 2 (fatigue, n = 205, 36.2%), and group 3 (cognitive complaints and fatigue, n = 211, 37.3%) were associated with higher burnout complaints and lower work engagement, and group 2 and 3 with lower work ability. Cancer-related anxiety positively moderated the association of group 3 with higher burnout complaints. Employees with both fatigue and cognitive complaints report less favorable work functioning. Cancer-related anxiety needs attention in the context of burnout complaints.
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Affiliation(s)
| | - Tinka van Vuuren
- Open Universiteit, the Netherlands
- Loyalis Knowledge & Consult, the Netherlands
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31
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Takase E, Akamatsu H, Teraoka S, Nakaguchi K, Tanaka M, Kaki T, Furuta K, Sato K, Murakami E, Sugimoto T, Shibaki R, Fujimoto D, Hayata A, Tokudome N, Ozawa Y, Koh Y, Nakanishi M, Kanai K, Shimokawa T, Yamamoto N. A Phase II Study of High-Flow Nasal Cannula for Relieving Dyspnea in Advanced Cancer Patients. J Pain Symptom Manage 2024; 67:204-211.e1. [PMID: 37992848 DOI: 10.1016/j.jpainsymman.2023.11.009] [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: 08/10/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 11/24/2023]
Abstract
CONTEXT The efficacy and tolerability of high-flow nasal cannula (HFNC) for relieving dyspnea in advanced cancer patients with limited prognosis requires elucidation. OBJECTIVES The primary aim of this trial was to assess the efficacy and tolerability of HFNC regarding dyspnea including severe as well as moderate for longer durations in patients under palliative care. METHODS In this prospective study, hospitalized patients with advanced cancer who had dyspnea at rest (numeric rating scale, NRS≥3) and hypoxemia were enrolled. They were treated with HFNC for five days in the respiratory unit. Primary endpoint was mean change of modified Borg scale at 24 hours. Key secondary endpoints consisted of mean changes in modified Borg scale during the study period and feasibility (Trial Identifier, UMIN000035738). RESULTS Between February 2019 and February 2022, 25 patients were enrolled and 21 were analyzed. Twenty patients used inspired oxygen and the mean fraction of inspired oxygen (FiO2) was 0.34 (range, 0.21-1.0). At baseline, mean NRS (dyspnea) was 5.9 (range, 3-10). Median survival time was 19 days (range, 3-657). The mean change of modified Borg scale was 1.4 (80% confidence interval [CI]: 0.8-1.9) at 24 hours, 12 patients (57%) showed 1.0 points improvement of modified Borg scale. Within two hours, 15 patients showed 1.0 points improvement of modified Borg scale and such early responders were likely to maintain dyspnea improvement for 24 hours. Nineteen patients could continue HFNC for 24 hours and 11 patients completed five days of HFNC. CONCLUSION To our knowledge, this trial is the first prospective study to assess the five-day efficacy and tolerability of HFNC for dyspnea in patients under palliative care. Although this did not reach the prespecified endpoint, about half of the patients showed 1.0 point improvement, a minimally clinically important difference (MCID) in the chronic lung disease. HFNC can be a palliative treatment option in advanced cancer patients with dyspnea.
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Affiliation(s)
- Eri Takase
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Hiroaki Akamatsu
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan.
| | - Shunsuke Teraoka
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Keita Nakaguchi
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Masanori Tanaka
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Takahiro Kaki
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Katsuyuki Furuta
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Koichi Sato
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Eriko Murakami
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Takeya Sugimoto
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Ryota Shibaki
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Daichi Fujimoto
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Atsushi Hayata
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Nahomi Tokudome
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Yuichi Ozawa
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Yasuhiro Koh
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan; Center for Biomedical Sciences (Y.K.), Wakayama Medical University, Wakayama, Japan
| | - Masanori Nakanishi
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan
| | - Kuninobu Kanai
- Department of Respiratory Medicine (K.K.), Naga Municipal Hospital, Wakayama, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center (T.S.), Wakayama Medical University, Wakayama, Japan
| | - Nobuyuki Yamamoto
- Internal Medicine III (E.T., H.A., S.T., K.N., M.T., T.K., K.F., K.S., E.M., T.S., R.S., D.F., A.H., N.T., Y.O., Y.K., M.N., N.Y.), Wakayama Medical University, Wakayama, Japan; Center for Biomedical Sciences (Y.K.), Wakayama Medical University, Wakayama, Japan
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De Metz C, Hennart B, Aymes E, Cren P, Martignène N, Penel N, Barthoulot M, Carnot A. Complete DPYD genotyping combined with dihydropyrimidine dehydrogenase phenotyping to prevent fluoropyrimidine toxicity: A retrospective study. Cancer Med 2024; 13:e7066. [PMID: 38523525 PMCID: PMC10961597 DOI: 10.1002/cam4.7066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/19/2024] [Accepted: 02/18/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION In April 2019, French authorities mandated dihydropyrimidine dehydrogenase (DPD) screening, specifically testing uracilemia, to mitigate the risk of toxicity associated with fluoropyrimidine-based chemotherapy. However, this subject is still of debate as there is no consensus on a standardized DPD deficiency screening test. We conducted a real-life retrospective study with the aim of assessing the impact of DPD screening on the occurrence of severe toxicity and exploring the potential benefits of complete genotyping using next-generation sequencing. METHODS All adult patients consecutively treated with 5-fluorouracil (5-FU) or its oral prodrug at six cancer centers between March 2018 and February 2019 were considered for inclusion. Dihydropyrimidine dehydrogenase deficiency screening included gene encoding DPD (DPYD) genotyping using complete genome sequencing and DPD phenotyping (uracilemia or dihydrouracilemia/uracilemia ratio) or both tests. Associations between each DPD screening method and (i) severe (grade ≥3) early toxicity and (ii) fluoropyrimidine dose reduction in the second chemotherapy cycle were evaluated using multivariable logistic regression analysis. Furthermore, we assessed the concordance between DPD genotype and phenotype using Cohen's kappa. RESULTS A total of 551 patients were included. Most patients were tested for DPD deficiency (86%) including DPYD genotyping only (6%), DPD phenotyping only (8%), or both (72%). Complete DPD deficiency was not detected in the study population. Severe early toxicity events were observed in 73 patients (13%), with two patients (0.30%) presenting grade 5 toxicity. Despite the numerically higher toxicity rate in untested patients, the occurrence of severe toxicity was not significantly associated with the DPD screening method (p = 0.69). Concordance between the DPD genotype and phenotype was weak (Cohen's kappa of 0.14). CONCLUSION Due to insufficient numbers, our study was not able to demonstrate any added value of DPYD genotyping using complete genome sequencing to prevent 5-FU toxicity. The optimal strategy for DPD screening before fluoropyrimidine-based chemotherapy requires further clinical evaluation.
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Affiliation(s)
- Côme De Metz
- Department of Medical OncologyCentre Oscar LambretLilleFrance
| | - Benjamin Hennart
- Toxicology Unit, Biology and Pathology CentreLille University Medical CentreLilleFrance
| | - Estelle Aymes
- Department of BiostatisticsCentre Oscar LambretLilleFrance
| | - Pierre‐Yves Cren
- Department of Medical OncologyCentre Oscar LambretLilleFrance
- Department of BiostatisticsCentre Oscar LambretLilleFrance
| | | | - Nicolas Penel
- Department of Medical OncologyCentre Oscar LambretLilleFrance
- Univ. Lille, CHU Lille, ULR 2694 ‐ Metrics: Evaluation des technologies de santé et des pratiques médicalesLilleFrance
| | | | - Aurélien Carnot
- Department of Medical OncologyCentre Oscar LambretLilleFrance
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Díaz LA, Fuentes-López E, Idalsoaga F, Ayares G, Corsi O, Arnold J, Cannistra M, Vio D, Márquez-Lomas A, Ramirez-Cadiz C, Medel MP, Hernandez-Tejero M, Ferreccio C, Lazo M, Roblero JP, Cotter TG, Kulkarni AV, Kim W, Brahmania M, Louvet A, Tapper EB, Dunn W, Simonetto D, Shah VH, Kamath PS, Lazarus JV, Singal AK, Bataller R, Arrese M, Arab JP. Association between public health policies on alcohol and worldwide cancer, liver disease and cardiovascular disease outcomes. J Hepatol 2024; 80:409-418. [PMID: 37992972 DOI: 10.1016/j.jhep.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND & AIMS The long-term impact of alcohol-related public health policies (PHPs) on disease burden is unclear. We aimed to assess the association between alcohol-related PHPs and alcohol-related health consequences. METHODS We conducted an ecological multi-national study including 169 countries. We collected data on alcohol-related PHPs from the WHO Global Information System of Alcohol and Health 2010. Data on alcohol-related health consequences between 2010-2019 were obtained from the Global Burden of Disease database. We classified PHPs into five items, including criteria for low, moderate, and strong PHP establishment. We estimated an alcohol preparedness index (API) using multiple correspondence analysis (0 lowest and 100 highest establishment). We estimated an incidence rate ratio (IRR) for outcomes according to API using adjusted multilevel generalized linear models with a Poisson family distribution. RESULTS The median API in the 169 countries was 54 [IQR 34.9-76.8]. The API was inversely associated with alcohol use disorder (AUD) prevalence (IRR 0.13; 95% CI 0.03-0.60; p = 0.010), alcohol-associated liver disease (ALD) mortality (IRR 0.14; 95% CI 0.03-0.79; p = 0.025), mortality due to neoplasms (IRR 0.09; 95% CI 0.02-0.40; p = 0.002), alcohol-attributable hepatocellular carcinoma (HCC) (IRR 0.13; 95% CI 0.02-0.65; p = 0.014), and cardiovascular diseases (IRR 0.09; 95% CI 0.02-0.41; p = 0.002). The highest associations were observed in the Americas, Africa, and Europe. These associations became stronger over time, and AUD prevalence was significantly lower after 2 years, while ALD mortality and alcohol-attributable HCC incidence decreased after 4 and 8 years from baseline API assessment, respectively (p <0.05). CONCLUSIONS The API is a valuable instrument to quantify the robustness of alcohol-related PHP establishment. Lower AUD prevalence and lower mortality related to ALD, neoplasms, alcohol-attributable HCC, and cardiovascular diseases were observed in countries with a higher API. Our results encourage the development and strengthening of alcohol-related policies worldwide. IMPACT AND IMPLICATIONS We first developed an alcohol preparedness index, an instrument to assess the existence of alcohol-related public policies for each country. We then evaluated the long-term association of the country's alcohol preparedness index in 2010 with the burden of chronic liver disease, hepatocellular carcinoma, other neoplasms, and cardiovascular disease. The strengthening of alcohol-related public health policies could impact long-term mortality rates from cardiovascular disease, neoplasms, and liver disease. These conditions are the main contributors to the global burden of disease related to alcohol use. Over time, this association has not only persisted but also grown stronger. Our results expand the preliminary evidence regarding the importance of public health policies in controlling alcohol-related health consequences.
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Affiliation(s)
- Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Eduardo Fuentes-López
- Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile; Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Oscar Corsi
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Macarena Cannistra
- Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Danae Vio
- Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Carolina Ramirez-Cadiz
- Department of Anesthesiology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - María Paz Medel
- Departamento de Medicina Familiar, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Catterina Ferreccio
- Public Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; Advanced Center for Chronic Diseases, ACCDis, Santiago, Chile
| | - Mariana Lazo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA; Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Juan Pablo Roblero
- Sección Gastroenterología, Hospital Clínico Universidad de Chile, Escuela de Medicina Universidad de Chile, Santiago, Chile
| | - Thomas G Cotter
- Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Anand V Kulkarni
- Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Won Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Mayur Brahmania
- Univeristy of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Alexandre Louvet
- Hôpital Claude Huriez, Services des Maladies de l'Appareil Digestif, CHRU Lille, and Unité INSERM 995, Lille, France
| | - Elliot B Tapper
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA; Gastroenterology Section, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | | | - Douglas Simonetto
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Vijay H Shah
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Patrick S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey V Lazarus
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA; Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ashwani K Singal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | | | - Marco Arrese
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Observatorio Multicéntrico de Enfermedades Gastrointestinales, OMEGA, Santiago, Chile; Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada.
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Vielmo A, Santos IR, Piva MM, Bandinelli MB, Pavarini SP, Panziera W, Driemeier D. Histological and immunohistochemical features of carcinomas with pulmonary involvement in cattle. Vet Pathol 2024; 61:179-189. [PMID: 37638494 DOI: 10.1177/03009858231192373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Primary pulmonary neoplasms in cattle are rare. There are few studies on the pathological findings of these neoplasms in this species. This study aimed to describe the histological and immunohistochemical findings of primary and metastatic pulmonary carcinomas in cattle. We conducted a retrospective study of 19 cases of epithelial neoplasms with pulmonary involvement. Histologically, most of the neoplasms were classified as primary pulmonary neoplasms, including different adenocarcinoma subtypes (4/19, 21%) and adenosquamous carcinomas (3/19, 16%), followed by squamous cell carcinoma (6/19, 32%), metastatic uterine adenocarcinoma (4/19, 21%), metastatic hepatocellular carcinoma (1/19, 5%), and metastatic cholangiocarcinoma (1/19, 5%). By immunohistochemistry, all neoplasms were positive for pancytokeratin, and 4/19 (21%) were positive for vimentin. Primary pulmonary neoplasms had immunoreactivity for thyroid transcription factor-1 (6/7), while only 2 of these cases were positive for napsin A. All cases with squamous differentiation (9/9) had immunoreactivity for cytokeratin (CK) 5/6, while only 7 of these cases were positive for p40. CK20, CK7, and CK8/18 showed varied immunoreactivity in the primary and metastatic pulmonary carcinomas but were important markers to confirm the diagnosis of primary mucinous adenocarcinoma and metastatic cholangiocarcinoma. HepPar-1 was only positive in the metastatic hepatocellular carcinoma. The limited number of cases of metastatic uterine adenocarcinomas in this study precluded identification of a specific immunophenotype for this tumor. Immunohistochemistry proved to be an important tool to confirm the proper classification of these neoplasms.
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Affiliation(s)
- Andréia Vielmo
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | - Welden Panziera
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - David Driemeier
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Virgilsen LF, Jensen H, Falborg AZ, Prior A, Pedersen AF, Vedsted P. Psychiatric disorders and the cancer diagnostic process in general practice: a combined questionnaire and register study exploring the patients' experiences in Denmark. Scand J Prim Health Care 2024; 42:156-169. [PMID: 38149909 PMCID: PMC10851816 DOI: 10.1080/02813432.2023.2296944] [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: 06/29/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVE Patients with psychiatric disorders are at risk of experiencing suboptimal cancer diagnostics and treatment. This study investigates how this patient group perceives the cancer diagnostic process in general practice. DESIGN Cross-sectional study using questionnaire and register data. SETTING General practice in Denmark. SUBJECTS Patients diagnosed with cancer in late 2016 completed a questionnaire about their experiences with their general practitioner (GP) in the cancer diagnostic process (n = 3411). Information on pre-existing psychiatric disorders was obtained from register data on psychiatric hospital contacts and primary care treated psychiatric disorders through psychotropic medications. Logistic regression was used to analyse the association between psychiatric disorders and the patients' experiences. MAIN OUTCOME MEASURES Patients' experiences, including cancer worry, feeling being taken seriously, and the perceived time between booking an appointment and the first GP consultation.[Box: see text]. RESULTS A total of 13% of patients had an indication of a psychiatric disorder. This group more often perceived the time interval as too short between the first booking of a consultation and the first GP consultation. Patients with primary care treated psychiatric disorders were more likely to worry about cancer at the first presentation and to share this concern with their GP compared with patients without psychiatric disorders. We observed no statistically significant association between patients with psychiatric disorders and perceiving the waiting time to referral from general practice, being taken seriously, trust in the GP's abilities, and the patients' knowledge of the process following the GP referral. CONCLUSION The patients' experiences with the cancer diagnostic process in general practice did not vary largely between patients with and without psychiatric disorders. Worrying about cancer may be a particular concern for patients with primary care treated psychiatric disorders.
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Affiliation(s)
| | - Henry Jensen
- Research Unit for General Practice, Aarhus C, Denmark
| | | | - Anders Prior
- Research Unit for General Practice, Aarhus C, Denmark
| | - Anette Fischer Pedersen
- Research Unit for General Practice, Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
| | - Peter Vedsted
- Research Unit for General Practice, Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
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Cerdà G, Julià-Torras J, González-Barboteo J, Romeo M, Calsina-Berna A. Polypharmacy and Reversible Drug Induced QT Prolongation in a Patient with Advanced Cancer: Case Report. J Pain Palliat Care Pharmacother 2024; 38:33-37. [PMID: 38180376 DOI: 10.1080/15360288.2023.2297218] [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: 03/31/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
QT prolongation is related to the development of ventricular arrhythmias such as Torsade de Pointes (TdP) that can lead to sudden cardiac death. Several drugs used in the treatment of patients with advanced cancer may induce QT prolongation due to their interference with cardiac ion channels. Some patients may be at higher risk if predisposing factors are present. Herein we present the case of a patient with advanced cancer under anti-tumor treatment with radical intention that developed a reversible drug-induced QT prolongation when simultaneously treated with methadone, haloperidol and fluoxetine that presented with chest pain and bradycardia. An approach to cancer patients at risk for drug-induced QT prolongation is discussed highlighting the need of a thorough medication review with a special focus in the patient with polypharmacy.
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Affiliation(s)
- Gabriela Cerdà
- Medical Oncology Department, Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | | | - Margarita Romeo
- is with Medical Oncology Department, Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Agnès Calsina-Berna
- Research and Knowledge Group in Palliative Care of Institut Català d'Oncologia (GRICOPAL)
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37
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Cheong MA, Leader A. Cancer and arterial thrombosis: therapeutic options. Res Pract Thromb Haemost 2024; 8:102393. [PMID: 38660456 PMCID: PMC11039399 DOI: 10.1016/j.rpth.2024.102393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
A State of the Art lecture titled "Cancer and Arterial Thrombosis: Therapeutic Options" was presented at the International Society on Thrombosis and Haemostasis Congress in 2023. This State of the Art review delves into the complex relationship between cancer and arterial thromboembolism (ATE), encompassing acute coronary syndrome, ischemic strokes, and peripheral arterial disease. The burden of cancer-associated ATE is not well defined, but studies indicate elevated risks, particularly in the 6 months after a cancer diagnosis. Incidence varies among cancer subtypes, with lung cancer displaying the highest rates. Additionally, the pathophysiology of cancer-associated ATE involves a multifaceted interplay of cancer-induced hypercoagulopathy, cancer therapy-related thrombosis, and personal risk factor contributors. ATEs are clinically heterogeneous and in the context of cancer have particular mechanistic differences compared with ATE patients without cancer. This requires modifications in approach and tailored management considerations. Specific etiologies contributing to ATE, such as coronary vasospasm and non-bacterial-thrombotic endocarditis, need to be considered. The diagnosis of cancer alone usually does not contraindicate patients to standard guideline-based therapies for the management of ATE, although nuances in treatment may need to be considered in light of the underlying cancer. Atrial fibrillation in cancer patients further complicates the thrombotic landscape. Cancer patients with atrial fibrillation are at a higher risk of ATE, necessitating careful consideration of anticoagulation therapy as clinical benefits and bleeding risks need to be weighed. ATE may also be a presenting sign of underlying malignancy, which requires increased awareness and focused clinical evaluation for cancer in selected cases. Finally, we summarize relevant new data on this topic presented during the 2023 International Society on Thrombosis and Haemostasis Congress.
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Affiliation(s)
- May Anne Cheong
- Department of Haematology, Singapore General Hospital, Singapore
| | - Avi Leader
- Department of Medicine, Hematology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Manzari‐Tavakoli A, Babajani A, Tavakoli MM, Safaeinejad F, Jafari A. Integrating natural compounds and nanoparticle-based drug delivery systems: A novel strategy for enhanced efficacy and selectivity in cancer therapy. Cancer Med 2024; 13:e7010. [PMID: 38491817 PMCID: PMC10943377 DOI: 10.1002/cam4.7010] [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: 10/24/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 03/18/2024] Open
Abstract
Cancer remains a leading cause of death worldwide, necessitating the development of innovative and more effective treatment strategies. Conventional cancer treatments often suffer from limitations such as systemic toxicity, poor pharmacokinetics, and drug resistance. Recently, there has been growing attention to utilizing natural compounds derived from various sources as possible cancer therapeutics. Natural compounds have demonstrated diverse bioactive properties, including antioxidant, anti-inflammatory, and antitumor effects, making them attractive candidates for cancer treatment. However, their limited solubility and bioavailability present challenges for effective delivery to cancer cells. To overcome these limitations, researchers have turned to nanotechnology-based drug delivery systems. Nanoparticles, with their small size and unique properties, can encapsulate therapeutic agents and offer benefits such as improved solubility, prolonged drug release, enhanced cellular uptake, and targeted delivery. Functionalizing nanoparticles with specific ligands further enhances their precision in recognizing and binding to cancer cells. Combining natural compounds with nanotechnology holds great promise in achieving efficient and safe cancer treatments by enhancing bioavailability, pharmacokinetics, and selectivity toward cancer cells. This review article provides an overview of the advancements in utilizing natural substances and nanotechnology-based drug delivery systems for cancer treatment. It discusses the benefits and drawbacks of various types of nanoparticles, as well as the characteristics of natural compounds that make them appealing for cancer therapy. Additionally, current research on natural substances and nanoparticles in preclinical and clinical settings is highlighted. Finally, the challenges and future perspectives in developing natural compound-nanoparticle-based cancer therapies are discussed.
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Affiliation(s)
| | - Amirhesam Babajani
- Oncopathology Research Center, Department of Molecular Medicine, School of MedicineIran University of Medical SciencesTehranIran
| | - Maryam Manzari Tavakoli
- Department of PhytochemistryMedicinal Plants and Drugs Research Institute, Shahid Beheshti UniversityTehranIran
| | - Fahimeh Safaeinejad
- Traditional Medicine and Materia Medica Research CenterShahid Beheshti University of Medical SciencesTehranIran
| | - Ameneh Jafari
- Chronic Respiratory Diseases Research Center, NRITLDShahid Beheshti University of Medical SciencesTehranIran
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Cominacini M, De Marchi S, Tosi F, Piccinno E, Dal Corso A, Dalla Grana E, Stefani F, Dalle Carbonare L. Incidence and clinical progression of asymptomatic peripherally inserted central catheter -related thrombosis in solid neoplasm patients: ultrasound insights from a prospective cohort study. Res Pract Thromb Haemost 2024; 8:102391. [PMID: 38660454 PMCID: PMC11039392 DOI: 10.1016/j.rpth.2024.102391] [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: 03/11/2024] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Background Managing central venous catheters in patients with neoplasms is challenging, and peripherally inserted central catheter PORT (PICC-PORT) has emerged as a promising option for safety and efficacy. However, understanding the clinical progression of catheter-related thrombosis (CRT) in cancer patients with central venous catheters remains limited, especially in certain neoplasm types associated with a higher risk of venous thrombosis. Objectives This study aims to assess the effectiveness of ultrasound-guided management in detecting and treating asymptomatic CRT in cancer patients with PICC. Methods In this prospective cohort study of 120 patients with solid neoplasms receiving chemotherapy, we investigated the incidence of isolated upper-extremity superficial vein thrombosis, upper-extremity deep vein thrombosis, and fibrin sheath formation through ultrasound follow-up at 30 and 90 days after catheter insertion. We analyzed risk factors associated with CRT and compared incidence rates between PICC-PORT and traditional PICC. Results Among the cohort, 69 patients (57.5%) had high-risk thromboembolic neoplasm, and 31 cases (25.8%) of CRT were observed, mostly within 30 days, with only 7 cases (22.6%) showing symptoms. Traditional PICC use (odds ratio, 5.86; 95% CI, 1.14-30) and high-risk thromboembolic neoplasm (odds ratio, 4.46; 95% CI, 1.26-15.81) were identified as independent risk factors for CRT. Conclusion The majority of CRT present asymptomatically within the first 30 days of venous catheter insertion in patients with solid neoplasms. Ultrasound follow-up is valuable for detecting asymptomatic CRT. The risk of CRT was lower with PICC-PORT than with PICC. Additionally, the risk of CRT was found to be higher in patients with high-risk thromboembolic neoplasms. It is crucial for larger studies to confirm the utility of treating asymptomatic thromboses and isolated superficial thrombosis.
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Affiliation(s)
- Mattia Cominacini
- Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - Sergio De Marchi
- Department of Angiology, Integrated University Hospital of Verona, Verona, Italy
| | - Federica Tosi
- Department of Emergency Medicine, Integrated University Hospital of Verona, Verona, Italy
| | - Elia Piccinno
- Department of Emergency Medicine, Integrated University Hospital of Verona, Verona, Italy
| | - Alessandro Dal Corso
- Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - Elisa Dalla Grana
- Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
| | - Francesca Stefani
- Department of Emergency Medicine, Integrated University Hospital of Verona, Verona, Italy
| | - Luca Dalle Carbonare
- Department of Engineering for Innovative Medicine, University of Verona, Verona, Italy
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Bayrak Durmaz MS, Unutmaz DG, Demir M, Goksel O, Dursun AB, Bavbek S. Hypersensitivity Reactions to Taxanes: A Multicenter Study for Outcomes and Safety of Rapid Drug Desensitization. Allergy Asthma Immunol Res 2024; 16:142-153. [PMID: 38528382 DOI: 10.4168/aair.2024.16.2.142] [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] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/28/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE Taxanes can cause hypersensitivity reactions (HSRs), which pose a significant challenge in the treatment of malignancies. Patients who are eligible for rapid drug desensitization (RDD) can continue treatment; however, some patients experience breakthrough reactions (BTRs). Data about risk factors for BTRs during RDDs in patients with HSRs to taxanes are limited. METHODS This was a multicenter, retrospective study of patients with immediate-HSRs to taxanes. Initial HSRs were classified as grade 1, 2, or 3 based on severity. Prick/intradermal skin tests were performed with implicated taxanes. A 12-step protocol was used during RDD. RESULTS The study comprised 75 patients (F/M: 63/12, mean age 49.92 ± 11.72 years, 43 HSRs to paclitaxel, 32 HSRs to docetaxel). The majority of reactions (86.7%) occurred during the first or second exposure. The prevalence of drug allergy history was higher in patients with paclitaxel HSR than in those with docetaxel HSR, although it was not statistically significant (23.3% vs. 6.3%). The initial HSRs were mostly grade 2 (n = 50, 66.7%) or grade 3 (n = 22, 29.3%). Skin tests with implicated taxanes were done on 48 patients, and the rate of positive response in patients with grade 1, 2, and 3 initial HSRs were 50%, 17.6%, and 16.7%, respectively. . A total of 255 RDDs were completely performed, although BTRs occurred in 27 (grade 1, 55.6%; grade 2, 40.7%; grade 3, 3.7%). There were no statistically significant correlations between the risk of BTR and age, drug cycle, gender, positivity of skin test or atopy. The step reduction was successfully done on 9 eligible patients with mild or moderate HSRs during the 12-step RDDs. CONCLUSIONS Our experience demonstrates a 100% success rate in completing the 255 RDDs for taxanes, affirming the safety and efficacy of the RDD within the study population.
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Affiliation(s)
- Makbule Seda Bayrak Durmaz
- Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Done Gulcin Unutmaz
- Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Meryem Demir
- Division of Immunology and Allergy, Department of Chest Diseases, Ege University School of Medicine, Izmir, Turkey
| | - Ozlem Goksel
- Division of Immunology and Allergy, Department of Chest Diseases, Ege University School of Medicine, Izmir, Turkey
| | - Adile Berna Dursun
- Division of Immunology and Allergy, Department of Chest Diseases, Memorial Ankara Hospital, Ankara, Turkey
- Division of Immunology and Allergy, Department of Chest Diseases, Lokman Hekim University Hospital School of Medicine, Ankara, Turkey
| | - Sevim Bavbek
- Division of Immunology and Allergy, Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey.
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He MJ, Wang YJ, Ran DL, Fu DS, He Q, Zhang HY, Mao Y, Zhao PY, Yu JB, Zhang JA. Relationship between bullous pemphigoid and malignancy: A Mendelian randomization study. J Dermatol 2024; 51:403-408. [PMID: 38212903 DOI: 10.1111/1346-8138.17100] [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: 10/18/2023] [Revised: 12/03/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
Bullous pemphigoid (BP) is the most common autoimmune blistering disease, which primarily affects the elderly. However, the relationship between BP and malignancy remains controversial in traditional observational studies. The aim of this study, which included only European populations, was to assess the potential causative link between BP and 13 types of malignant tumors in a two-sample Mendelian randomization (MR) study. BP was not associated with an increased risk of developing 13 types of malignant tumors. This study did not find a causal relationship between BP and malignant tumors. However, further research is warranted to examine the generalizability of this conclusion in non-European populations.
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Affiliation(s)
- Ming-Jie He
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yu-Jia Wang
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - De-Long Ran
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - De-Shuang Fu
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qing He
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Han-Yin Zhang
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yu Mao
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Peng-Yuan Zhao
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jian-Bin Yu
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jiang-An Zhang
- Department of Dermatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Abdoli Shadbad M, Derogar R, Shekarchi AA, Akbari F, Jafari Shobeiri M. Mature cystic ovarian teratoma with squamous cell carcinoma transformation: a case report and literature review. Horm Mol Biol Clin Investig 2024; 45:35-39. [PMID: 38282269 DOI: 10.1515/hmbci-2023-0001] [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: 01/05/2023] [Accepted: 01/03/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVES Cancerous transformation in mature cystic ovarian teratoma is rare. Herein, we reported a case of squamous cell carcinoma transformation in mature cystic ovarian teratoma and performed an in-depth literature review to highlight the risk factors, prognosis, and suggested treatment for these patients. CASE PRESENTATION We report a 66-years old postmenopausal woman diagnosed with a 120×90 (mm) mass at the left adnexa compatible with mature cystic ovarian teratoma. Following resection, the histopathological investigations showed malignant transformation in her mature cystic ovarian teratoma, and the immunohistochemistry for cytokeratin (CK) 5/6 and tumor protein 63 (P63) indicated squamous cell carcinoma transformation. She has been observed for her stage IA tumor and has been cancer-free for 6 months. CONCLUSIONS Although malignant transformation in mature cystic ovarian teratoma is rare, it should be suspected if certain risk factors, e.g., elderly and high tumor size, exist. Stage IA patients' prognosis is favorable, and chemotherapy is not recommended.
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Affiliation(s)
| | - Roghaiyeh Derogar
- Fellowship in Gynecologic Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Akbar Shekarchi
- Department of Pathology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farideh Akbari
- Fellowship in Gynecologic Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehri Jafari Shobeiri
- Fellowship in Gynecologic Oncology, Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Nakabayashi A, Tsujii A, Kim D, Tamada T, Yoshimura M, Isoda K, Ohshima S. Ultrasound and magnetic resonance image findings in a patient with a subungual abscess: A case report. Clin Case Rep 2024; 12:e8593. [PMID: 38444921 PMCID: PMC10912096 DOI: 10.1002/ccr3.8593] [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: 07/14/2023] [Revised: 10/04/2023] [Accepted: 01/04/2024] [Indexed: 03/07/2024] Open
Abstract
Subungual abscesses are rare, and information about them through imaging findings is lacking. Carbon dioxide laser drainage and antibiotics are effective treatment strategies for subungual abscesses. We report a case of a 47-year-old male healthcare worker with a subungual abscess that improved after manual drainage alone. Ultrasound and magnetic resonance images showed a tumor (with blood flow) between the nail plate and distal phalanx. Culture tests revealed Staphylococcus aureus. The patient's symptoms resolved quickly and the nail returned to normal after 4 months. This is possibly the first report of a subungual abscess with ultrasound and magnetic resonance imaging findings.
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Affiliation(s)
- Akihiko Nakabayashi
- Department of RheumatologyNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
| | - Atsuko Tsujii
- Department of RheumatologyNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
| | - Dong‐seop Kim
- Department of RheumatologyNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
| | - Tatsuya Tamada
- Department of RheumatologyNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
| | - Maiko Yoshimura
- Department of RheumatologyNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
| | - Kentaro Isoda
- Department of RheumatologyNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
- Department of Clinical ResearchNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
| | - Shiro Ohshima
- Department of RheumatologyNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
- Department of Clinical ResearchNational Hospital Organization Osaka Minami Medical CenterOsakaJapan
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van der Velden NCA, Smets EMA, van Vliet LM, Brom L, van Laarhoven HWM, Henselmans I. Effects of Prognostic Communication Strategies on Prognostic Perceptions, Treatment Decisions and End-Of-Life Anticipation in Advanced Cancer: An Experimental Study among Analogue Patients. J Pain Symptom Manage 2024:S0885-3924(24)00647-X. [PMID: 38428696 DOI: 10.1016/j.jpainsymman.2024.02.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/15/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
CONTEXT Evidence-based guidance for oncologists on how to communicate prognosis is scarce. OBJECTIVES To investigate the effects of prognostic communication strategies (prognostic disclosure vs. communication of unpredictability vs. non-disclosure; standard vs. standard and best-case vs. standard, best- and worst-case survival scenarios; numerical vs. word-based estimates) on prognostic perceptions, treatment decision-making and end-of-life anticipation in advanced cancer. METHODS This experimental study used eight videos of a scripted oncological consultation, varying only in prognostic communication strategies. Cancer-naive individuals, who imagined being the depicted patient, completed surveys before and after watching one video (n = 1036). RESULTS Individuals generally perceived dying within 1 year as more likely after prognostic disclosure, compared to communication of unpredictability or non-disclosure (P < 0.001), and after numerical versus word-based estimates (P < 0.001). Individuals felt better informed about prognosis to decide about treatment after prognostic disclosure, compared to communication of unpredictability or non-disclosure (P < 0.001); after communication of unpredictability versus non-disclosure (P < 0.001); and after numerical versus word-based estimates (P = 0.017). Chemotherapy was more often favored after prognostic disclosure versus non-disclosure (P = 0.010), but less often after numerical versus word-based estimates (P < 0.001). Individuals felt more certain about the treatment decision after prognostic disclosure, compared to communication of unpredictability or non-disclosure (P < 0.001). Effects of different survival scenarios were absent. No effects on end-of-life anticipation were observed. Evidence for moderating individual characteristics was limited. CONCLUSION If and how oncologists discuss prognosis can influence how individuals perceive prognosis, which treatment they prefer, and how they feel about treatment decisions. Communicating numerical estimates may stimulate prognostic understanding and informed treatment decision-making.
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Affiliation(s)
- Naomi C A van der Velden
- Department of Medical Psychology (N.C.A.V., E.M.A.S., I.H.), Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health (N.C.A.V., E.M.A.S., I.H.), Quality of Care, Amsterdam, The Netherlands; Cancer Center Amsterdam (N.C.A.V., E.M.A.S., I.H., H.W.M.L.), Cancer Treatment and Quality of Life, Amsterdam, The Netherlands.
| | - Ellen M A Smets
- Department of Medical Psychology (N.C.A.V., E.M.A.S., I.H.), Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health (N.C.A.V., E.M.A.S., I.H.), Quality of Care, Amsterdam, The Netherlands; Cancer Center Amsterdam (N.C.A.V., E.M.A.S., I.H., H.W.M.L.), Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - Liesbeth M van Vliet
- Department of Health, Medical and Neuropsychology (L.M.V.), University of Leiden, Leiden, The Netherlands
| | - Linda Brom
- Department of Research and Development (L.B.), Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Netherlands Association for Palliative Care (PZNL) (L.B.), Utrecht, The Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam (N.C.A.V., E.M.A.S., I.H., H.W.M.L.), Cancer Treatment and Quality of Life, Amsterdam, The Netherlands; Department of Medical Oncology (H.W.M.L.), Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Inge Henselmans
- Department of Medical Psychology (N.C.A.V., E.M.A.S., I.H.), Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health (N.C.A.V., E.M.A.S., I.H.), Quality of Care, Amsterdam, The Netherlands; Cancer Center Amsterdam (N.C.A.V., E.M.A.S., I.H., H.W.M.L.), Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
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45
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Fournel J, Hermier M, Martin A, Gamondès D, Tommasino E, Broussolle T, Morgado A, Baassiri W, Cotton F, Berthezène Y, Bani-Sadr A. It Looks Like a Spinal Cord Tumor but It Is Not. Cancers (Basel) 2024; 16:1004. [PMID: 38473365 DOI: 10.3390/cancers16051004] [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: 02/07/2024] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
Differentiating neoplastic from non-neoplastic spinal cord pathologies may be challenging due to overlapping clinical and radiological features. Spinal cord tumors, which comprise only 2-4% of central nervous system tumors, are rarer than non-tumoral myelopathies of inflammatory, vascular, or infectious origins. The risk of neurological deterioration and the high rate of false negatives or misdiagnoses associated with spinal cord biopsies require a cautious approach. Facing a spinal cord lesion, prioritizing more common non-surgical myelopathies in differential diagnoses is essential. A comprehensive radiological diagnostic approach is mandatory to identify spinal cord tumor mimics. The diagnostic process involves a multi-step approach: detecting lesions primarily using MRI techniques, precise localization of lesions, assessing lesion signal intensity characteristics, and searching for potentially associated anomalies at spinal cord and cerebral MRI. This review aims to delineate the radiological diagnostic approach for spinal cord lesions that may mimic tumors and briefly highlight the primary pathologies behind these lesions.
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Affiliation(s)
- Julien Fournel
- Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Marc Hermier
- Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Anna Martin
- Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Delphine Gamondès
- Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Emanuele Tommasino
- Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Théo Broussolle
- Department of Spine and Spinal Cord Neurosurgery, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Alexis Morgado
- Department of Spine and Spinal Cord Neurosurgery, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Wassim Baassiri
- Department of Spine and Spinal Cord Neurosurgery, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
| | - Francois Cotton
- CREATIS Laboratory, CNRS UMR 5220, INSERM U1294, Claude Bernard Lyon I University, 7 Avenue Jean Capelle, 69100 Villeurbanne, France
- Department of Radiology, South Lyon Hospital, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69495 Pierre-Bénite, France
| | - Yves Berthezène
- Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
- CREATIS Laboratory, CNRS UMR 5220, INSERM U1294, Claude Bernard Lyon I University, 7 Avenue Jean Capelle, 69100 Villeurbanne, France
| | - Alexandre Bani-Sadr
- Department of Neuroradiology, East Group Hospital, Hospices Civils de Lyon, 59 Bd Pinel, 69500 Bron, France
- CREATIS Laboratory, CNRS UMR 5220, INSERM U1294, Claude Bernard Lyon I University, 7 Avenue Jean Capelle, 69100 Villeurbanne, France
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Ma'rifah AR, Afiyanti Y, Djatmiko W, Ruwaida I, Milanti A. Gender role conflicts experienced by Indonesian women with gynecological cancer: A phenomenological study. Belitung Nurs J 2024; 10:78-86. [PMID: 38425683 PMCID: PMC10900052 DOI: 10.33546/bnj.3064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/27/2023] [Accepted: 01/13/2024] [Indexed: 03/02/2024] Open
Abstract
Background Gynecological cancer and its treatments can lead to sexual problems, potentially disrupting the gender role performance of women. Sexuality and gender roles are context-specific, yet these issues remain unexplored in the Indonesian context. Objective This study aimed to explore the gender role conflicts experienced by Indonesian women having gynecological cancer. Method A qualitative design with a phenomenology approach was utilized in this study. Data were collected through individualized, face-to-face, in-depth interviews conducted from 1 April to 30 December 2022 with 22 women diagnosed with gynecological cancer who had undergone treatments at the Dharmais Cancer Hospital, Jakarta, Indonesia. Data were analyzed using thematic analysis. Results Three themes were developed: 1) challenges in fulfilling female gender roles after having cancer diagnosis and therapies, 2) emotional struggles related to gender role conflicts, and 3) efforts to cope with gender role conflicts. Conclusion The study sheds light on how sexual complications due to gynecological cancer and its treatments extend beyond physical issues. A deeper layer of problems around sexual dysfunctions among gynecological cancer survivors is often rooted in traditional gender-role expectations. Nurses should have a comprehensive and contextual understanding of the unique experiences of women living with gynecological cancer to facilitate a positive adaptation to their cancer journey.
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Affiliation(s)
- Atun Raudotul Ma'rifah
- Faculty of Nursing, Universitas Indonesia, 16424 Depok, Indonesia
- Faculty of Health, Harapan Bangsa University, Purwokerto, Indonesia
| | - Yati Afiyanti
- Faculty of Nursing, Universitas Indonesia, 16424 Depok, Indonesia
| | - Wisnu Djatmiko
- Faculty of Computer Science, Universitas Indonesia, 16424 Depok, Indonesia
| | - Ida Ruwaida
- Faculty of Social and Political Science, Universitas Indonesia, 16424 Depok, Indonesia
| | - Ariesta Milanti
- Faculty of Nursing and Midwifery, Binawan University, 13630 Jakarta, Indonesia
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Lopes-Santos G, Marques NGDO, Tjioe KC, Oliveira DT. Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review. Acta Cir Bras 2024; 39:e390824. [PMID: 38422328 PMCID: PMC10911496 DOI: 10.1590/acb390824] [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: 10/19/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024] Open
Abstract
PURPOSE This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. METHODS Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. RESULTS Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. CONCLUSIONS The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.
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Affiliation(s)
- Gabriela Lopes-Santos
- Universidade de São Paulo – Faculdade de Odontologia de Bauru – Departamento de Cirurgia, Estomatologia, Patologia e Radiologia – Bauru (SP) – Brazil
| | - Najara Gomes de Oliveira Marques
- Universidade de São Paulo – Faculdade de Odontologia de Bauru – Departamento de Cirurgia, Estomatologia, Patologia e Radiologia – Bauru (SP) – Brazil
| | - Kellen Cristine Tjioe
- Augusta University – Georgia Cancer Center – Augusta (GA) – United States of America
| | - Denise Tostes Oliveira
- Universidade de São Paulo – Faculdade de Odontologia de Bauru – Departamento de Cirurgia, Estomatologia, Patologia e Radiologia – Bauru (SP) – Brazil
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48
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Kwon H, Han KD, Moon SJ, Park SE, Rhee EJ, Lee WY. Nonalcoholic Fatty Liver Disease and the Risk of Thyroid Cancer Among Young Adults in South Korea. J Clin Endocrinol Metab 2024; 109:e1095-e1104. [PMID: 37921093 DOI: 10.1210/clinem/dgad575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Indexed: 11/04/2023]
Abstract
CONTEXT Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. Obesity and metabolic syndrome are known risk factors for thyroid cancer. OBJECTIVE We investigated the association between NAFLD and thyroid cancer risk in young adults. METHODS This nationwide cohort study included 1 135 967 participants aged 20 to 39 years who underwent 4 consecutive health screenings in South Korea. NAFLD was categorized using the fatty liver index (FLI), as follows: ≥60, 30 to 60, and <30. The cumulative FLI points were defined as the number of times participants had a FLI of ≥30 (0-4). RESULTS During a median follow-up of 5.2 years, 4126 participants (0.36%) were newly diagnosed with thyroid cancer. Compared with the participants with an FLI of <30, those with an FLI of 30 to 60 (men: hazard ratio [HR] 1.36 [95% CI, 1.22-1.51] and women: HR 1.44 [1.21-1.70]) and those with an FLI of ≥60 (men: HR 1.71 [1.53-1.92] and women: HR 1.81 [1.46-2.25]) had a significantly higher risk of thyroid cancer. Participants with higher cumulative FLI points had a higher risk of thyroid cancer compared to those with a cumulative FLI point of 0 (P < .001). During the follow-up period, the participants with an increased FLI exhibited an increased risk of thyroid cancer. CONCLUSION NAFLD was associated with an increased risk of thyroid cancer in young adults. Repeatedly elevated FLI and progression of NAFLD were associated with an increased risk of thyroid cancer in this study.
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Affiliation(s)
- Hyemi Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea
| | - Sun Joon Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Se Eun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Eun-Jung Rhee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Won-Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
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Poon IO, Ajewole V, Braun UK. A Review of Olanzapine in the Treatment of Cancer Anorexia-Cachexia Syndrome. Pharmacy (Basel) 2024; 12:34. [PMID: 38392941 PMCID: PMC10893239 DOI: 10.3390/pharmacy12010034] [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: 12/07/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Cancer anorexia-cachexia syndrome (CAS) is a multifactorial condition that is highly prevalent in advanced cancer patients and associated with significant reduction in functional performance, reduction in quality of life, and increased mortality. Currently, no medications are approved for this indication. Recently, the American Society of Clinical Oncology (ASCO) released a rapid recommendation suggesting that low-dose olanzapine once daily may be used to treat cancer cachexia. Many questions still exist on how to use olanzapine for this indication in clinical practice. The objective of this review is to identify existing knowledge on the use of olanzapine for CAS. METHODS A comprehensive search was conducted to identify the primary literature that involved olanzapine for anorexia and cachexia in cancer patients between 2000 and 2023. RESULTS Seven articles were identified and are discussed here, including two randomized double-blinded placebo-controlled studies, one randomized comparative study, two prospective open-label studies, one retrospective chart review, and one case report. CONCLUSIONS Low dose olanzapine (2.5-5 mg once daily) may be useful in the treatment of CAS for increasing appetite, reducing nausea and vomiting, and promoting weight gain. Further large-scale multi-center randomized placebo-controlled studies will be needed to investigate the impact of olanzapine on weight change in CAS patients.
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Affiliation(s)
- Ivy O. Poon
- Department of Pharmacy Practice, Texas Southern University, Houston, TX 77004, USA; (I.O.P.); (V.A.)
| | - Veronica Ajewole
- Department of Pharmacy Practice, Texas Southern University, Houston, TX 77004, USA; (I.O.P.); (V.A.)
- Pharmacy Department, Houston Methodist Hospital, Houston, TX 77004, USA
| | - Ursula K. Braun
- Rehabilitation & Extended Care Line, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Section of Geriatrics & Palliative Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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50
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Beserra VDS, Brito C. [Difficult situations and feelings in palliative oncology care]. CAD SAUDE PUBLICA 2024; 40:e00116823. [PMID: 38359275 PMCID: PMC10876151 DOI: 10.1590/0102-311xpt116823] [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: 06/26/2023] [Revised: 08/28/2023] [Accepted: 09/29/2023] [Indexed: 02/17/2024] Open
Abstract
The act of caring for people in pain, shortness of breath, and imminent death on a daily basis can intensify difficult situations for health professionals. However, difficult situations are rarely discussed in the services and in the professional training process. This study aimed to analyze difficult situations and feelings that emerge from healthcare. This is a phenomenological and qualitative study based on 30 difficult situations of health professionals who work exclusively in palliative oncological care. The interviews were conducted from August to February 2020. The results show that the main difficulties were motivated by identification (when the professional recognizes similarities in the patient they are caring for), a bad death (with suffering), caring for young patients, the death of a mother with a small child, and when there was a divergence between what the professional proposed and the patient's choice. There was a relationship between types of difficult situations and professional category. The professionals expressed both unpleasant feelings (sadness, impotence, anguish, fear) and pleasant feelings (compassion, gratitude). The results show that the concealment of the dying process throughout the societies' development turned it into a taboo, causing distress even in those who work in palliative care. They also show an important subjective dimension of care, usually neglected, which generates suffering, but also resignification. To properly provide care, health professionals must find meaning in the work, made possible by the modification of the their internal mindset via experience, which generates transformation, new meaning, and knowledge from praxis.
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Affiliation(s)
| | - Claudia Brito
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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