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Bennett D, Murray I, Mitchell H, Gavin A, Donnelly D. Impact of COVID-19 on cancer incidence, presentation, diagnosis, treatment and survival in Northern Ireland. Int J Cancer 2024; 154:1731-1744. [PMID: 38268160 DOI: 10.1002/ijc.34847] [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: 10/23/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024]
Abstract
The COVID-19 pandemic had a major impact on cancer patients and services but has been difficult to quantify. We examined how the entire cancer pathway-from incidence, presentation, diagnosis, stage, treatment and survival-was affected in Northern Ireland during April-December 2020 compared to equivalent 2018-2019 periods using retrospective, observational cancer registry data from the Northern Ireland Cancer Registry (NICR). There were 6748 cancer cases in April-December 2020 and an average 7724 patients in April-December 2018-2019. Incident cases decreased by 13% (almost 1000). Significant differences were found across age cohorts and deprivation quintiles, with reductions greatest for younger people (<55 years; 19% decrease) and less deprived (22% decrease). A higher proportion had emergency admission (16%-to-20%) with lower proportions diagnosed pathologically (85%-to-83%). There was a significant stage shift, with lower proportions of early stage (29%-to-25%) and higher late-stage (21%-to-23%). Lower proportions received surgery (41%-to-38%) and radiotherapy (24%-to-22%) with a higher proportion not receiving treatment (29%-to-33%). One-year observed-survival decreased from 73.7% to 69.8% and 1-year net-survival decreased from 76.1% to 72.9%, with differences driven by five tumours; Lung (40.3%-to-35.0%), Head-and-Neck (77.4%-to-68.4%), Oesophageal (53.5%-to-42.3%), Lymphoma (81.1%-to-75.2%) and Uterine cancer (87.4%-to-80.4%). Our study reveals profound adverse impact of COVID-19 on the entire cancer patient pathway, with 13% fewer cases, greater emergency admissions and significant stage-shift from early to more advanced-stage disease. There was major treatment impact with lower rates of surgery and radiotherapy and higher proportions receiving no treatment. There were significant reductions in 1-year survival. Our study will support service recovery and protect cancer services in future pandemics or disruptions.
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Affiliation(s)
- Damien Bennett
- Northern Ireland Cancer Registry, Centre for Public Health, Belfast, Northern Ireland
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Inez Murray
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Helen Mitchell
- Northern Ireland Cancer Registry, Centre for Public Health, Belfast, Northern Ireland
| | - Anna Gavin
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - David Donnelly
- Northern Ireland Cancer Registry, Centre for Public Health, Belfast, Northern Ireland
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Holtfreter B, Kuhr K, Borof K, Tonetti MS, Sanz M, Kornman K, Jepsen S, Aarabi G, Völzke H, Kocher T, Krois J, Papapanou PN. ACES: A new framework for the application of the 2018 periodontal status classification scheme to epidemiological survey data. J Clin Periodontol 2024; 51:512-521. [PMID: 38385950 DOI: 10.1111/jcpe.13965] [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: 06/07/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/23/2024]
Abstract
AIM To propose a framework for consistently applying the 2018 periodontal status classification scheme to epidemiological surveys (Application of the 2018 periodontal status Classification to Epidemiological Survey data, ACES). PROPOSED FRAMEWORK We specified data requirements and workflows for either completed or planned epidemiological surveys, utilizing commonly collected measures of periodontal status (clinical attachment levels [CAL], probing depths, bleeding on probing), as well as additional necessary variables for the implementation of the 2018 periodontal status classification (tooth loss due to periodontitis and complexity factors). Following detailed instructions and flowcharts, survey participants are classified as having periodontal health, gingivitis or periodontitis. Rates of edentulism must also be reported. In cases of periodontitis, instructions on how to compute the stage and extent are provided. Assessment of grade can be derived from CAL measurements (or from radiographic alveolar bone loss data) in relation to root length and the participant's age. CONCLUSIONS ACES is a framework to be used in epidemiological studies of periodontal status that (i) have been completed, and in which stage and grade according to the 2018 classification are inferred retroactively, or (ii) are being planned. Consistent use of the proposed comprehensive approach will facilitate the comparability of periodontitis prevalence estimates across studies.
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Affiliation(s)
- Birte Holtfreter
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Kuhr
- Health Care Research and Epidemiology, Institute of German Dentists (IDZ), Cologne, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maurizio S Tonetti
- Shanghai PerioImplant Innovation Centre, Department of Oral and Maxillofacial Implantology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, National Centre for Stomatology, Shanghai, China
- National Clinical Research Centre for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Mariano Sanz
- Department of Dental Clinical Specialties, ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Kenneth Kornman
- Department of Periodontics and Oral Medicine, The University of Michigan-School of Dentistry, Ann Arbor, Michigan, USA
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Joachim Krois
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
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Businge L, Hagenimana M, Motlhale M, Bardot A, Liu B, Anastos K, Castle PE, Murenzi G, Claire K, Sabushimike D, Cyuzuzo C, Kubwimana G, Maniragaba T, Uwinkindi F, Paczkowski M, Soerjomataram I, Parkin DM. Stage at diagnosis and survival by stage for the leading childhood cancers in Rwanda. Pediatr Blood Cancer 2024:e31020. [PMID: 38668553 DOI: 10.1002/pbc.31020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND The lack of accurate population-based information on childhood cancer stage and survival in low-income countries is a barrier to improving childhood cancer outcomes. METHODS In this study, data from the Rwanda National Cancer Registry (RNCR) were examined for children aged 0-14 diagnosed in 2013-2017 for the eight most commonly occurring childhood cancers: acute lymphoblastic leukaemia, Hodgkin lymphoma (HL), Burkitt lymphoma (BL), non-Hodgkin lymphoma excluding BL, retinoblastoma, Wilms tumour, osteosarcoma and rhabdomyosarcoma. Utilising the Toronto Childhood Cancer Stage Guidelines Tier 1, the study assigned stage at diagnosis to all, except HL, and conducted active follow-ups to calculate 1-, 3- and 5-year observed and relative survival by cancer type and stage at diagnosis. RESULTS The cohort comprised 412 children, of whom 49% (n = 202) died within 5 years of diagnosis. Five-year survival ranged from 28% (95% confidence interval [CI]: 12.5%-45.6%) for BL to 68% (CI: 55%-78%) for retinoblastoma. For the cancers for which staging was carried out, it was assigned for 83% patients (n = 301 of 362), with over half (58%) having limited or localised stage at diagnosis. Stage was a strong predictor of survival; for example, 3-year survival was 70% (95% CI: 45.1%-85.3%) and 11.8% (2.0%-31.2%) for limited and advanced non-HL, respectively (p < .001). CONCLUSION This study is only the second to report on stage distribution and stage-specific survival for childhood cancers in sub-Saharan Africa. It demonstrates the feasibility of the Toronto Stage Guidelines in a low-resource setting, and highlights the value of population-based cancer registries in aiding our understanding of the poor outcomes experienced by this population.
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Affiliation(s)
- Lydia Businge
- Rwanda Biomedical Centre (RBC), Kigali, Rwanda
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | | | - Melitah Motlhale
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - Aude Bardot
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Biying Liu
- African Cancer Registry Network, Prama House, Oxford, UK
| | - Kathryn Anastos
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
- Departments of Medicine and of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Philip E Castle
- Divisions of Cancer Prevention and Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Gad Murenzi
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | | | | | | | - Gallican Kubwimana
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | - Theoneste Maniragaba
- Rwanda Biomedical Centre (RBC), Kigali, Rwanda
- Rwanda Military Hospital, Kigali, Rwanda
| | | | | | | | - Donald Maxwell Parkin
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
- African Cancer Registry Network, Prama House, Oxford, UK
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Al-Zubi M, Al-Shami K, Sawalha L, Alguzo HM, Al Demour S, Al-Mnayyis AM, Alazab R, Al-Rawashdah SF, Alzoubi LT, Al-khawaldeh SR. Can We Predict the Grade of Clear Cell Renal Cell Carcinoma from Houns-Field Unit of Renal Lesion on Computerized Tomography Scan, a Retrospective Cross-Sectional Study. Int J Gen Med 2024; 17:1571-1577. [PMID: 38680191 PMCID: PMC11055518 DOI: 10.2147/ijgm.s452754] [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: 01/18/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Renal cell carcinoma (RCC) is a type of urological malignancy that affects approximately 2% of the global population. Imaging modalities, especially computed tomography (CT) scanning, play a critical role in diagnosing RCC. In this study, we investigated whether there is a relationship between tumour grade of clear cell RCC and HU values of renal lesions on CT scan performed before operation. Materials and Methods We conducted a retrospective analysis of 123 patients who underwent radical or partial (open or laparoscopic) nephrectomy for clear cell RCC between January 2017 and January 2021. Post-operation histopathological grades were recorded according to World Health Organization (WHO)/International Society of Urological Pathology (ISUP) 2016 grading system and divided into low grade (includes grade 1 and 2) and high grade (grade 3 and 4), and their links to age, sex, smoking habits, tumour size, and HUs of renal lesions were evaluated. Results The mean age of the patients studied was 63.02 years old. About 56.9% of the patients were low grade (grade 1 or grade 2), while 43.1% were high grade (grade 3 or 4). The mean tumour size was 6.31 cm. There were no significant differences in tumour grade according to age, sex, or smoking habits. We found a significant relation between tumour grade and HU in the pre-contrast and nephrogenic phases, with p values of 0.001 and 0.037, respectively. On the other hand, there was no significant relation linking the tumour grade to the difference in HU between these phases, where there was a p value of 0.641. Conclusion HU in the pre-contrast and nephrogenic phases in addition to tumour size on CT scan have a significant relation to clear cell RCC grade.
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Affiliation(s)
- Mohammad Al-Zubi
- Department of Surgery, Division of Urology, Yarmouk University MEdical SChool, Irbid, 21110, Jodan
| | - Khayry Al-Shami
- Department of Clinical Medical Sciences, Yarmouk University Medical school, Irbid, Jordan
| | - Leen Sawalha
- Department of Clinical Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Heyam Mahmoud Alguzo
- Department of Clinical Medical Sciences, Yarmouk University Medical school, Irbid, Jordan
| | - Saddam Al Demour
- Department of Special Surgery, Division of Urology, the University of Jordan medical School, Amman, 11972, Jordan
| | | | - Rami Alazab
- Department of Surgery & Urology, Jordan University of Science & Technology, Irbid, 21110, Jordan
| | - Samer Fathi Al-Rawashdah
- Department of Special Surgery, School of Medicine, Mutah University medical School, Karak, 61710, Jordan
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5
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Wu Y, Tian Q, Wang S, Li K, Feng D, Cai Q. Hemorrhagic cerebral venous infarction after vein injury during intraoperative lesion resection: incidence, hemorrhagic stages, risk factors and prognosis. Front Neurol 2024; 15:1371184. [PMID: 38651110 PMCID: PMC11034368 DOI: 10.3389/fneur.2024.1371184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 04/25/2024] Open
Abstract
Objective Cerebral venous infarction (CVI) after vein injury during intraoperative lesion resection is associated with intracranial hemorrhage. We conducted this study to identify the incidence, clinical and imaging features, and prognosis of hemorrhage CVI. Methods We performed a retrospective analysis of patients with confirmed CVI after vein injury who underwent craniotomy in our hospital. Postoperative clinical symptoms were observed, and imaging features were compared between patients with and without intracranial hemorrhages through CT examination. Variables were analyzed using univariate and multivariate regression analyses. Results Among 2,767 patients who underwent craniotomy, 93 cases of injured veins were identified intraoperatively. Hemorrhagic CVI was found in 38% (35/93). Multivariate analysis revealed that midline approach, meningioma, postoperative seizures, disorders of consciousness and interval in hours < 72 h were identified as predictors of hemorrhagic CVI. After 3 months of follow-up, the prognosis was poor in 15 cases (16%, 15/93), including death (two cases), vegetative survival (four cases), and severe disability (nine cases). Conclusions Hemorrhagic CVI, as a critical complication after venous injury, can have disastrous consequences. Do not injure known veins intraoperatively. In case of injury, requisite remedial measures should be adopted during and after surgery.
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Affiliation(s)
| | | | | | | | - Dayun Feng
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shanxi, China
| | - Qing Cai
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shanxi, China
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Komiyama S, Okusaka T, Maruki Y, Ohba A, Nagashio Y, Kondo S, Hijioka S, Morizane C, Ueno H, Sukeda A, Mizui T, Takamoto T, Nara S, Ban D, Esaki M, Hiraoka N, Shimada K. Clinicopathological Findings and Treatment Outcomes of Patients with Primary Hepatobiliary Neuroendocrine Neoplasms: A Retrospective Single-institution Analysis. Intern Med 2024; 63:891-901. [PMID: 37612088 PMCID: PMC11045373 DOI: 10.2169/internalmedicine.2016-23] [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: 03/31/2023] [Accepted: 07/11/2023] [Indexed: 08/25/2023] Open
Abstract
Objective Primary hepatobiliary neuroendocrine neoplasms (NENs) are rare tumors exhibiting several morphological and behavioral characteristics. Considering the lack of relevant data on this topic, we evaluated the clinicopathological features and treatment outcomes of patients with primary hepatobiliary NENs. Methods/Patients We examined 43 consecutive patients treated at the National Cancer Center Hospital with pathological diagnoses of primary hepatobiliary NEN between 1980 and 2016. Results Nine patients were diagnosed with neuroendocrine tumor (NET) G1, 9 with NET G2, and 25 with neuroendocrine carcinoma (NEC) based on the World Health Organization 2019 classification. Patients with NEC had primary sites across the hepatobiliary organs, although sites in patients with NET G1 and NET G2 only included the liver and ampulla of Vater. Patients with primary extrahepatic bile duct or ampulla of Vater NENs tended to be diagnosed earlier than patients with primary gallbladder NENs. The median survival times in the NET G1, NET G2, and NEC groups were 167.9, 97.4, and 11.1 months, respectively. A good performance status, absence of distant metastases, and low tumor grade were identified as independent predictors of a favorable prognosis. Conclusion The NET-to-NEC ratio and tumor stage distribution at the diagnosis differed depending on the primary site. Patients with G1 and G2 NETs who underwent surgical resection had good prognoses, whereas those with NEC exhibited more advanced disease and poorer prognoses. The performance status, staging classification, and tumor grade are important factors to consider when devising an appropriate treatment strategy and predicting the prognoses of patients with primary hepatobiliary NEN.
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Affiliation(s)
- Satoshi Komiyama
- Chemotherapy Department, Yokohama City University Medical Center, Japan
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Yuta Maruki
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Akihiro Ohba
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Yoshikuni Nagashio
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Shunsuke Kondo
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Susumu Hijioka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Chigusa Morizane
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Hideki Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Aoi Sukeda
- Pathology and Clinical Laboratories, National Cancer Center Hospital, Japan
- Department of Anatomic Pathology, Tokyo Medical University, Japan
| | - Takahiro Mizui
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Japan
| | - Takeshi Takamoto
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Japan
| | - Satoshi Nara
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Japan
| | - Daisuke Ban
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Japan
| | - Minoru Esaki
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Japan
| | - Nobuyoshi Hiraoka
- Pathology and Clinical Laboratories, National Cancer Center Hospital, Japan
| | - Kazuaki Shimada
- Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Japan
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Gendreau JL, Kuo CC, Patel NA, Brown NJ, Pennington Z, Bui NE, Reardon T, Lien BV, Prevedello DM, Kuan EC, Hsu FP, Mohyeldin A. Staged Resection of Difficult-to-Treat Intracranial Meningiomas: A Systematic Review of the Indications, Surgical Approaches, and Postoperative Outcomes. J Neurol Surg B Skull Base 2024; 85:131-144. [PMID: 38449578 PMCID: PMC10914469 DOI: 10.1055/a-2015-8238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023] Open
Abstract
Introduction Meningiomas-the most common extra-axial tumors-are benign, slow-growing dural-based lesions that can involve multiple cranial fossae and can progress insidiously for years until coming to clinical attention secondary to compression of adjacent neurovascular structures. For complex, multicompartmental lesions, multistaged surgeries have been increasingly shown to enhance maximal safe resection while minimizing adverse sequela. Here, we systematically review the extant literature to highlight the merits of staged resection. Methods PubMed, Scopus, and Web of Science databases were queried to identify articles reporting resections of intracranial meningiomas using a multistaged approach, and articles were screened for possible inclusion in a systematic process performed by two authors. Results Of 118 identified studies, 36 describing 169 patients (mean age 42.6 ± 21.3 years) met inclusion/exclusion criteria. Petroclival lesions comprised 57% of cases, with the most common indications for a multistaged approach being large size, close approximation of critical neurovascular structures, minimization of brain retraction, identification and ligation of deep vessels feeding the tumor, and resection of residual tumor found on postoperative imaging. Most second-stage surgeries occurred within 3 months of the index surgery. Few complications were reported and multistaged resections appeared to be well tolerated overall. Conclusions Current literature suggests multistaged approaches for meningioma resection are well-tolerated. However, there is insufficient comparative evidence to draw definitive conclusions about its advantages over an unstaged approach. There are similarly insufficient data to generate an evidence-based decision-making framework for when a staged approach should be employed. This highlights the need for collaborative efforts among skull base surgeons to establish an evidentiary to support the use of staged approaches and to outline those indications that merit such an approach.
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Affiliation(s)
- Julian L. Gendreau
- Department of Biomedical Engineering, Johns Hopkins Whiting School of Engineering, Baltimore, Maryland, United States
| | - Cathleen C. Kuo
- Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, New York, United States
| | - Neal A. Patel
- School of Medicine, Mercer University School of Medicine, Savannah, Georgia, United States
| | - Nolan J. Brown
- Department of Neurosurgery, University of California, Irvine, Orange, California, United States
| | - Zach Pennington
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Nicholas E. Bui
- Loma Linda University School of Medicine, Loma Linda, California, United States
| | - Taylor Reardon
- Kentucky College of Osteopathic Medicine, University of Pikeville, Pikeville, Kentucky, United States
| | - Brian V. Lien
- Department of Neurosurgery, University of California, Irvine, Orange, California, United States
| | - Daniel M. Prevedello
- Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
| | - Edward C. Kuan
- Department of Neurosurgery, University of California, Irvine, Orange, California, United States
- Department of Otolaryngology, University of California, Irvine, Orange, California, United States
| | - Frank P.K. Hsu
- Department of Neurosurgery, University of California, Irvine, Orange, California, United States
| | - Ahmed Mohyeldin
- Department of Neurosurgery, University of California, Irvine, Orange, California, United States
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8
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Kim DY, Dee EC, Cheng I, Hartman RI. Advanced melanoma presentation and disease-specific survival disparities among disaggregated Asian American, Native Hawaiian, and Pacific Islander populations. J Am Acad Dermatol 2024; 90:623-626. [PMID: 37923219 DOI: 10.1016/j.jaad.2023.10.052] [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] [Received: 02/06/2023] [Revised: 09/21/2023] [Accepted: 10/22/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Daniel Y Kim
- Harvard-MIT Health Sciences and Technology Program, Harvard Medical School, Boston, Massachusetts
| | - Edward C Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California
| | - Rebecca I Hartman
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Dermatology Section, VA Integrated Service Network 1 (VISN-1), Jamaica Plain, Massachusetts.
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9
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Wei MX, Yang Z, Wang PP, Zhao XK, Song X, Xu RH, Hu JF, Zhong K, Lei LL, Han WL, Yang MM, Zhou FY, Han XN, Fan ZM, Li J, Wang R, Li B, Wang LD. Novel metabolic biomarker for early detection and diagnosis to the patients with gastric cardia adenocarcinoma. Cancer Med 2024; 13:e7015. [PMID: 38491808 PMCID: PMC10943274 DOI: 10.1002/cam4.7015] [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: 11/06/2023] [Revised: 01/10/2024] [Accepted: 01/31/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Gastric cardia adenocarcinoma (GCA) is classified as Siewert type II adenocarcinoma at the esophagogastric junction in Western countries. The majority of GCA patients do not exhibit early warning symptoms, leading to over 90% of diagnoses at an advanced stage, resulting in a grim prognosis, with less than a 20% 5-year survival rate. METHOD Metabolic features of 276 GCA and 588 healthy controls were characterized through a widely-targeted metabolomics by UPLC-MS/MS analysis. This study encompasses a joint pathway analysis utilizing identified metabolites, survival analysis in both early and advanced stages, as well as high and negative and low expression of HER2 immunohistochemistry staining. Machine learning techniques and Cox regression models were employed to construct a diagnostic panel. RESULTS A total of 25 differential metabolites were consistently identified in both discovery and validation sets based on criteria of p < 0.05, (VIP) ≥ 1, and FC ≥ 2 or FC ≤ 0.5. Early-stage GCA patients exhibited a more favorable prognosis compared to those in advanced stages. HER2 overexpression was associated with a more positive outcome compared to the negative and low expression groups. Metabolite panel demonstrated a robust diagnostic performance with AUC of 0.869 in discovery set and 0.900 in validation set. CONCLUSIONS A total of 25 common and stable differential metabolites may hold promise as liquid non-invasive indicators for GCA diagnosis. HER2 may function as a tumor suppressor gene in GCA, as its overexpression is associated with improved survival. The downregulation of bile acid metabolism in GCA may offer valuable theoretical insights and innovative approaches for precision-targeted treatments in GCA patients.
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Affiliation(s)
- Meng Xia Wei
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Zheng Yang
- School of Life ScienceZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Pan Pan Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Xue Ke Zhao
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Xin Song
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Rui Hua Xu
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Jing Feng Hu
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Kan Zhong
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Ling Ling Lei
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Wen Li Han
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Miao Miao Yang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Fu You Zhou
- Department of Thoracic SurgeryAnyang Tumor HospitalAnyangHenan ProvincePR China
| | - Xue Na Han
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Zong Min Fan
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Jia Li
- Department of LanguageZhengzhou White Gown Translation Co., Ltd.ZhengzhouPR China
| | - Ran Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Bei Li
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
| | - Li Dong Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouHenan ProvincePR China
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Segel JE, Wong WG, Kaag M, Joshi M, Warrick J, Lengerich EJ, Shen C. Relationship Between Availability of Urologists and Primary Care Providers and Stage of Diagnosis for Invasive Urinary Bladder Cancer. Urol Pract 2024; 11:339-346. [PMID: 38305777 DOI: 10.1097/upj.0000000000000503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/13/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION With no recommended screening approach, urinary bladder cancer patients rely on referral to urologists to ensure timely diagnosis of bladder cancer. This requires coordination between primary and specialty care. We provide estimates of the relative association between primary care physician and urologist density on stage of urinary bladder cancer diagnosis. METHODS We used 2010 to 2016 Pennsylvania Cancer Registry data to identify all adult patients diagnosed with bladder cancer. Our primary outcome was locoregional stage of diagnosis, since treatment modality changes and prognosis worsens beyond this stage. Based on patient's residential location at the time of diagnosis we defined both density of urologists and number of primary care providers (defined as providers per population) within the patient's county. We used univariate and multivariate logistic regression to estimate the association between provider density and likelihood of locoregional stage of diagnosis. We also controlled for age, sex, race/ethnicity, insurance type, and year. RESULTS Our sample included 11,771 urinary bladder cancer patients with 10,607 diagnosed at locoregional stage and 1164 at distant stage. Multivariate regression results show primary care density was associated with significantly higher odds of locoregional stage of diagnosis (odds ratio of 1.05 [95% CI: 1.02-1.08]) while urologist density was associated with significantly lower odds of locoregional stage (odds ratio of 0.65 [95% CI: 0.48-0.89]). CONCLUSIONS We found primary care density but not urologist density was associated with earlier stage of diagnosis, highlighting the importance of access to primary care and need for timely referral to urologic care.
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Affiliation(s)
- Joel E Segel
- Department of Health Policy and Administration, Penn State University, University Park, Pennsylvania
- Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State University, Hershey, Pennsylvania
| | - William G Wong
- Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania
| | - Matthew Kaag
- Department of Urology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Monika Joshi
- Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Medicine, Division of Hematology-Oncology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Joshua Warrick
- Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Urology, Penn State College of Medicine, Hershey, Pennsylvania
- Department of Pathology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Eugene J Lengerich
- Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State University, Hershey, Pennsylvania
| | - Chan Shen
- Penn State Cancer Institute, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State University, Hershey, Pennsylvania
- Department of Surgery, Penn State College of Medicine, Hershey, Pennsylvania
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Lu X, Wang G, Feng L, Kan Y, Wang W, Yang J, Zhang M. Preoperative metabolic parameters of 18F-FDG PET/CT are associated with TNM stage and prognosis of colorectal cancer patients. Quant Imaging Med Surg 2024; 14:462-475. [PMID: 38223114 PMCID: PMC10784033 DOI: 10.21037/qims-23-966] [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: 07/03/2023] [Accepted: 10/24/2023] [Indexed: 01/16/2024]
Abstract
Background Colorectal cancer (CRC) is the third most frequent cause of cancer-related death, while tumor/node/metastasis (TNM) stage of American Joint Committee on Cancer is the guideline of making treatment strategy and predicting survival. The aim of this study is to investigate the association of preoperative 2-deoxy-2[18F]fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT), TNM stage, and prognosis of patients with CRC. Methods From September 2016 to August 2022, a total of 132 patients were retrospectively and consecutively enrolled in this cross-sectional study, who were diagnosed as CRC by histopathology and received preoperative 18F-FDG PET/CT. Firstly, the correlation between the metabolic parameters and clinicopathological features of the primary tumors was investigated. Secondly, univariate and multivariate logistic regression analyses were used to estimate the odds ratio of the association between the clinical and metabolic parameters and the advanced TNM stage (stage III-IV). Thirdly, progression-free survival (PFS) was analyzed using Kaplan-Meier curves and Log-rank test. Results The results revealed that the metabolic tumor volume (MTV) >6.6 cm3 and serum carcinoembryonic antigen (CEA) >5.84 ng/mL were independently associated with advanced TNM stage (P=0.0009, 0.0011, respectively). Larger tumor size, higher tumor-to-liver standardized uptake value ratio, MTV, and total lesion glycolysis (TLG) were significantly correlated with advanced pT stage (stage 4), and higher TLG and MTV were significantly correlated with advanced pN stage (stage 1-2) (P<0.05), while no metabolic parameters were significantly correlated with metastasis status (P>0.05). Higher serum CEA and carbohydrate antigen 19-9 levels were significantly correlated with advanced pT, pN stage, and metastasis status (P<0.05). Patients were followed up for at least 1 year. The MTV >6.6 cm3 was significantly associated with worse PFS (P=0.032). Conclusions 18F-FDG PET-CT can serve as a noninvasive tool for preoperatively staging CRC. The MTV >6.6 cm3 might be associated with advanced TNM stage and worse PFS.
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Affiliation(s)
- Xia Lu
- Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Guanyun Wang
- Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lijuan Feng
- Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ying Kan
- Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jigang Yang
- Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Mingyu Zhang
- Nuclear Medicine Department, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Sara G, Lambeth C, Burgess P, Curtis J, Walton R, Currow D. Breast screening participation and degree of spread of invasive breast cancer at diagnosis in mental health service users: A population linkage study. Cancer 2024; 130:77-85. [PMID: 37632356 DOI: 10.1002/cncr.35002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/28/2023] [Accepted: 07/24/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Women living with mental health conditions may not have shared in improvements in breast cancer screening and care. No studies have directly examined the link between reduced screening participation and breast cancer spread in women using mental health (MH) services. METHODS Population-wide linkage of a population cancer register, BreastScreen register, and mental health service data set in women aged 50 to 74 years in New South Wales, Australia, from 2008 to 2017. Incident invasive breast cancers were identified. Predictors of degree of spread (local, regional, metastatic) at diagnosis were examined using partial proportional odds regression, adjusting for age, socioeconomic status, rurality, and patterns of screening participation. RESULTS A total of 29 966 incident cancers were identified and included 686 (2.4%) in women with MH service before cancer diagnoses. More than half of MH service users had regional or metastatic spread at diagnosis (adjusted odds ratio, 1.63; 95% CI, 1.41-1.89). MH service users had lower screening participation; however, advanced cancer was more common even when adjusting for screening status (adjusted odds ratio, 1.53; 95% CI, 1.32-1.77). Advanced cancer was more common in women with severe or persistent MH conditions. CONCLUSIONS Low screening participation rates explain only small part of the risk of more advanced breast cancer in women who use MH services. More study is needed to understand possible mechanisms contributing to more advanced breast cancer in women living with MH conditions. Health systems need strategies to ensure that women living with MH conditions enjoy population gains in breast cancer outcomes.
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Affiliation(s)
- Grant Sara
- System Information and Analytics Branch, NSW Ministry of Health, Sydney, Australia
- Faculty of Medicine and Health, University of NSW, Sydney, Australia
| | - Chris Lambeth
- NSW Biostatistics Training Program, NSW Ministry of Health, Sydney, Australia
| | - Philip Burgess
- Faculty of Public Health, University of Queensland, Brisbane, Australia
| | - Jackie Curtis
- Faculty of Medicine and Health, University of NSW, Sydney, Australia
| | | | - David Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
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Jung HS, Kim S, Chung BM, Lee HI, Lee JS. Magnetic resonance imaging analysis of the distribution of cartilage damage in scaphoid nonunion. J Hand Surg Eur Vol 2024; 49:54-59. [PMID: 37728770 DOI: 10.1177/17531934231193281] [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: 09/21/2023]
Abstract
This study aimed to evaluate the distribution and severity of cartilage damage using magnetic resonance imaging in patients with scaphoid nonunion without advanced wrist arthritis. We retrospectively analysed MRI of patients who underwent osteosynthesis for scaphoid nonunion. Cartilage damage was assessed in eight wrist regions using a modified Whole-Organ Magnetic Resonance Imaging Score. The frequencies of regions affected by any cartilage damage (Score ≥2.5) depicted on MRI were analysed. The study included 32 patients (31 men and one woman), with a mean age of 32 years (SD 11). The distal radioscaphoid (29/32), scaphotrapeziotrapezoid (STT) (22/32), proximal radioscaphoid (14/32) and scaphocapitate (11/32) joints were most commonly affected by degenerative cartilage damage. The STT and proximal radioscaphoid joint were especially likely to be involved in early-stage scaphoid nonunion advanced collapse. We recommend that surgeons should investigate the cartilage status of these joints during decision-making for scaphoid nonunion surgery.Level of evidence: III.
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Affiliation(s)
- Hyoung Seok Jung
- Department of Orthopaedic Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea
| | - Sujin Kim
- Department of Radiology, Hospital of Chung-Ang University of Medicine, Seoul, Republic of Korea
| | - Bo Mi Chung
- Department of Radiology, Hospital of Chung-Ang University of Medicine, Seoul, Republic of Korea
| | - Hyun Il Lee
- Department of Orthopaedic Surgery, Ilsan-Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Jae-Sung Lee
- Department of Orthopaedic Surgery, Hospital of Chung-Ang University of Medicine, Seoul, Republic of Korea
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Modin C, Rinon CD, Faham A, Gustafsson A, Yucel-Lindberg T, Jansson L. Periodontitis in young individuals: Important factors for disease progression. J Clin Periodontol 2024; 51:74-85. [PMID: 37803906 DOI: 10.1111/jcpe.13884] [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: 01/18/2023] [Revised: 08/11/2023] [Accepted: 09/16/2023] [Indexed: 10/08/2023]
Abstract
AIM To investigate the progression of periodontitis in young individuals and identify factors that contribute to progression rate and whether periodontitis stage and grade have an impact on disease progression. MATERIALS AND METHODS This retrospective cohort study was based on patients younger than 36 years at two periodontal clinics between 2003 and 2009. At least 10 years later, a clinical and radiographic examination was performed on 215 patients. The marginal bone loss between baseline and follow-up for the tooth with the most severe bone loss at follow-up was estimated by radiographic measurements. Linear regression analysis was used to investigate the influence of potential risk indicators on periodontitis progression. RESULTS Most patients (83%) were classified as periodontitis stage III at baseline. At follow-up, 70% of these patients remained in stage III. The frequency of patients with grade C decreased from 79% to 17% at follow-up. The median (Q25%; Q75%) of the longitudinal marginal bone loss was 0.5 mm (0.0; 2.0). High bleeding on probing (BOP) index at baseline, smoking and interruption of periodontal treatment were found to significantly increase longitudinal bone loss. CONCLUSIONS High levels of BOP at baseline, smoking and interruption of periodontal treatment increased the risk of marginal bone loss. The stage and grade at baseline had no significant impact on disease progression.
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Affiliation(s)
- Carolina Modin
- Department of Periodontology, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Caroline Dolk Rinon
- Department of Periodontology, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, Sweden
| | - Ali Faham
- Department of Periodontology, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, Sweden
| | - Anders Gustafsson
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Tülay Yucel-Lindberg
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Leif Jansson
- Department of Periodontology, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, Sweden
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Mangone L, Marinelli F, Bisceglia I, Braghiroli MB, Mastrofilippo V, Pezzarossi A, Morabito F, Aguzzoli L, Mandato VD. Optimizing Outcomes through a Multidisciplinary Team Approach in Endometrial Cancer. Healthcare (Basel) 2023; 12:64. [PMID: 38200970 PMCID: PMC10778853 DOI: 10.3390/healthcare12010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to assess the impact of a multidisciplinary team (MDT) approach on outcomes with endometrial cancer (EC) patients, utilizing 2013-2020 data from the Reggio Emilia Cancer Registry. Recurrence rate, treatments, and outcome indicators were compared between the MDT (319 cases) and non-MDT (324 cases) groups. Among 643 cases, 52.4% were over 65 years old, 98% had microscopic confirmation, and 73% were in stage I. Surgery was performed in 89%, with 41% receiving adjuvant therapies. Recurrence rates (10%) were similar between the two groups, but MDT patients who were older and predominantly in stage I exhibited 79% recurrence within one year (21% in the non-MDT group). Disease-free survival (DFS) showed no significant difference [HR 1.1; 95% CI 0.7-1.6], while differences in overall survival (OS) were notable [HR 1.5; 95% CI 1.0-2.4]. The 5-year OS rates were 87% and 79% in the MDT and non-MDT groups. Comparing the 2013-2015 to 2016-2020 study periods, a shift towards caring for older women, more advanced-stage patients, and those residing outside the metropolitan area, along with a greater number of relapsed cases (from 16% to 76%), were accounted for. These findings underscore the impact of an MDT on EC outcomes, highlighting the evolving patient demographics over time.
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Affiliation(s)
- Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Francesco Marinelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Isabella Bisceglia
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Maria Barbara Braghiroli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | - Valentina Mastrofilippo
- Unit of Obstetrics and Gynaecology, Azienda USL—IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (V.M.); (L.A.); (V.D.M.)
| | - Annamaria Pezzarossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.M.); (I.B.); (M.B.B.); (A.P.)
| | | | - Lorenzo Aguzzoli
- Unit of Obstetrics and Gynaecology, Azienda USL—IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (V.M.); (L.A.); (V.D.M.)
| | - Vincenzo Dario Mandato
- Unit of Obstetrics and Gynaecology, Azienda USL—IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (V.M.); (L.A.); (V.D.M.)
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Wang B, Xu L, Fang M, Zheng B, Yan W. Establishment of a staging system for visceral sarcoma. Cancer Med 2023; 13:e6791. [PMID: 38102873 PMCID: PMC10807571 DOI: 10.1002/cam4.6791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/22/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Visceral sarcoma is a rare malignancy with a poor prognosis. However, there is no recommended prognostic staging system for the malignant disease. METHOD We analyzed the data of patients diagnosed with primary soft tissue sarcoma (STS) of the abdomen and thoracic visceral organs between 2006 and 2017 at our hospital. Prognostic factors (size, tumor grade, and lymph node metastasis) were analyzed in our cohort (n = 203) and the SEER validation cohort (n = 5826). RESULTS Tumor size, grade, and lymph node metastasis were important prognostic factors for visceral sarcoma in both our and the SEER cohorts. Based on these prognostic factors, we established a new staging system for visceral sarcoma, by which patients could be stratified into clinically meaningful and non-overlapping stages in both our cohort and the SEER validation series. Moreover, the area under the curve (AUC) value of the staging system for 5-year survival was 0.84 (95% CI: 0.78-0.89) in our series and 0.80 (95% CI: 0.79-0.81) in SEER series, respectively. In addition, compared with the widely used FIGO staging system for female genital sarcoma, the visceral sarcoma staging system could more effectively and reliably stratify patients into four different prognostic groups. CONCLUSIONS The visceral sarcoma staging system is applicable for STS of the abdomen and thoracic visceral organs and is better than the current FIGO staging system for female genital sarcoma and should be incorporated into the AJCC Cancer Staging Manual.
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Affiliation(s)
- Bingnan Wang
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Lun Xu
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Meng Fang
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Biqiang Zheng
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
| | - Wangjun Yan
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
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de Vries E, Uribe C, Beltrán Rodríguez CC, Caparros A, Meza E, Gil F. Descriptive Epidemiology of Melanoma Diagnosed between 2010 and 2014 in a Colombian Cancer Registry and a Call for Improving Available Data on Melanoma in Latin America. Cancers (Basel) 2023; 15:5848. [PMID: 38136393 PMCID: PMC10741499 DOI: 10.3390/cancers15245848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
We aimed to improve the available information on morphology and stage for cutaneous melanoma in the population-based cancer registry of the Bucaramanga Metropolitan Area in Colombia. The incidence and survival rates and the distribution of melanoma patients by age, gender, anatomical subsite, and histological subtype were calculated. All 113 melanoma patients (median age 61) were followed up (median time 7.4 years). This exercise (filling in missing information in the registry by manual search of patient clinical record and other available information) yielded more identified invasive melanomas and cases with complete information on anatomical localization and stage. Age-standardized incidence and mortality rates were 1.86 and 1.08, being slightly higher for males. Most melanomas were localized on the lower limbs, followed by the trunk. For 35% of all melanomas, the morphological subtype remained unknown. Most of the remaining melanomas were nodular and acral lentiginous melanomas. Overall global and relative 5-year survival was 61.6% and 71.3%, respectively, with poorer survival for males than females. Melanomas on the head and neck and unspecified anatomical sites had the worst survival. Patients without stage information in their medical files had excellent survival, unlike patients for whom medical files were no longer available. This study shows the possibility of improving data availability and the importance of good quality population-based data.
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Affiliation(s)
- Esther de Vries
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicina, Pontificia Universidad Javeriana, Ed. Hospital Universitario San Ignacio, Carrera 7 N° 40–62–piso 2, Bogotá 110231, Colombia;
| | - Claudia Uribe
- Population Based Cancer Registry of Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Calle 157 #14 55, Floridablanca 68276, Colombia; (C.U.); (E.M.)
| | | | - Alfredo Caparros
- MSD Medical Affairs Latin America, Cazadores de Coquimbo 2841/57, Munro, Vicente López, Buenos Aires B1605AZE, Argentina
| | - Erika Meza
- Population Based Cancer Registry of Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Calle 157 #14 55, Floridablanca 68276, Colombia; (C.U.); (E.M.)
| | - Fabian Gil
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicina, Pontificia Universidad Javeriana, Ed. Hospital Universitario San Ignacio, Carrera 7 N° 40–62–piso 2, Bogotá 110231, Colombia;
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Malmgren JA, Atwood MK, Kaplan HG. Persistence of patient-detected breast cancer over time: 1990-2019. Cancer 2023; 129:3862-3872. [PMID: 37552155 DOI: 10.1002/cncr.34973] [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: 04/07/2023] [Revised: 06/03/2023] [Accepted: 07/10/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND The continued presentation of patient-detected breast cancer (BC) and associated characteristics over time is understudied. METHODS In a large institutional cohort of first primary stage 0-IV patients with BC in 1990-2019 (n = 15,827), diagnostic method (patient-detected [PtDBC] [n = 5844]; mammography-detected [MamDBC] [nondiagnostic] [n = 9248]; and physician-detected [PhysDBC] [n = 736]) and patient and tumor characteristics including age, race, TNM stage, and hormone-receptor status were reviewed. Pearson χ2 tests for bivariate comparisons and logistic regression for patient detection-associated factors were used. RESULTS In a cohort from 1990 to 2019, the proportion aged 50-74 years (55%-63%; p < .001) and non-White race (9%-37%; p < .001) increased over time. Percentage PtDBC decreased over time but case numbers increased (1990-1999: 44% [n = 1399]; 2010-2019: 34% [n = 2349]; p < .001). Excluding stage 0, PtDBC declined from 47% to 41% over time (p < .001). In 2010-2019, 21% of cases were stage 0, 91% of which were mammography detected (n = 1439). Seventy percent of patient-detected cases were stage II-IV (stage II, 44%; stage III, 20%; stage IV, 6%; p < .001). In adjusted logistic regression, the odds of PtDBC decreased over time (2000-2009: odds ratio [OR], .65 [95% CI, .58-.72]; 2010-2019: OR, .54 [95% CI, .49-.60]), with age <40 years OR, 15.81, and Black and non-White other at 50% increased risk. CONCLUSIONS The relative proportion of PtDBC decreased to a constant 34%-40% of total cases after 1990-1999. PtDBC case numbers increased in subsequent years (2000-2019), and were consistently higher stage. Interval cancers, mammography-screening uptake, breast health awareness of age groups outside screening guidelines, and underserved socioeconomic groups may be related to the continued significant PtDBC incidence. PLAIN LANGUAGE SUMMARY After decades of mammography-screening availability, symptomatic patient-detected breast cancer declined over time from 44% to a persistent rate of 34% in our institutional cohort. The persistence of patient-detected breast cancer over time presents a difficult situation for patients and care givers without clear diagnosis pathways for younger and older women outside recommended screening guidelines, who often present with higher stage and more lethal characteristics. More timely diagnosis and treatment including breast health awareness, prompt presentation of breast problems, outreach to younger age and minority groups, and provision of specialized training and care delivery for symptomatic patient-detected breast cancer are needed.
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Affiliation(s)
- Judith A Malmgren
- HealthStat Consulting, Inc., Seattle, Washington, USA
- School of Public Health, University of Washington, Seattle, Washington, USA
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Aytekin O, Yüksel D, Oktar O, Çakır C, Kimyon Cömert G, Korkmaz V, Engin-Üstün Y, Turan T. The surgical and clinicopathological characteristics of primary mucinous ovarian cancer: a single institution 30-year retrospective analysis. J Turk Ger Gynecol Assoc 2023; 24:252-260. [PMID: 38054417 DOI: 10.4274/jtgga.galenos.2023.2022-8-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Objective To evaluate the clinicopathological characteristics of primary mucinous ovarian carcinoma (MOC) and define oncologic outcomes. Material and Methods This retrospective study reviewed patients diagnosed with primary MOC at a single institution and underwent primary treatment between 1990 and 2019. The clinicopathological factors affecting oncological outcomes and treatment response were evaluated. The Kaplan-Meier method was used to evaluate survival outcomes. Survival curves were compared using the log-rank test. Results The cohort's (n=92) median (range) age was 48 (15-82) years. Seventy-five (81.5%) patients were in the International Federation of Gynecology and Obstetrics stage I-II. Forty patients received platinum-based adjuvant chemotherapy. The 5-year progression-free survival was 98% in stage I-II and 17% for stage III-IV (p<0.001). In multivariate analysis, the only independent risk factor for disease failure was stage (hazard ratio: 6.838, 95% confidence interval: 1,358-34,415; p=0.020). Conclusion Advanced stage was an independent poor prognostic factor for recurrence in patient with MOC.
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Affiliation(s)
- Okan Aytekin
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - Dilek Yüksel
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Okan Oktar
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Caner Çakır
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Günsu Kimyon Cömert
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Vakkas Korkmaz
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Yaprak Engin-Üstün
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health and Research Center, Ankara, Turkey
| | - Taner Turan
- Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
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Santos‐García D, de Deus Fonticoba T, Cores Bartolomé C, Feal Painceiras MJ, García Díaz I, Alvarado MCÍ, Paz JM, Jesús S, Cosgaya M, Caldentey JG, Caballol N, Legarda I, Hernández Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Gómez Mayordomo V, Nogueira V, Dotor García‐Soto J, Borrué C, Solano Vila B, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Mendoza Z, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Kulisevsky J, Seijo M, Valero C, Alonso Redondo R, Buongiorno MT, Ordás C, Menéndez‐González M, McAfee D, Martinez‐Martin P, Mir P. Staging Parkinson's disease according to the MNCD classification correlates with caregiver burden. Brain Behav 2023; 13:e3295. [PMID: 37939322 PMCID: PMC10726881 DOI: 10.1002/brb3.3295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/08/2023] [Accepted: 10/12/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Recently, we demonstrated that staging Parkinson's disease (PD) with a novel simple classification called MNCD, based on four axes (motor, non-motor, cognition, and dependency) and five stages, correlated with disease severity and patients' quality of life. Here, we analyzed the correlation of MNCD staging with PD caregiver's status. PATIENTS AND METHODS Data from the baseline visit of PD patients and their principal caregiver recruited from 35 centers in Spain from the COPPADIS cohort from January 2016 to November 2017 were used to apply the MNCD total score (from 0 to 12) and MNCD stages (from 1 to 5) in this cross-sectional analysis. Caregivers completed the Zarit Caregiver Burden Inventory (ZCBI), Caregiver Strain Index (CSI), Beck Depression Inventory-II (BDI-II), PQ-10, and EUROHIS-QOL 8-item index (EUROHIS-QOL8). RESULTS Two hundred and twenty-four PD patients (63 ± 9.6 years old; 61.2% males) and their caregivers (58.5 ± 12.1 years old; 67.9% females) were included. The frequency of MNCD stages was 1, 7.6%; 2, 58.9%; 3, 31.3%; and 4-5, 2.2%. A more advanced MNCD stage was associated with a higher score on the ZCBI (p < .0001) and CSI (p < .0001), and a lower score on the PQ-10 (p = .001), but no significant differences were observed in the BDI-II (p = .310) and EUROHIS-QOL8 (p = .133). Moderate correlations were observed between the MNCD total score and the ZCBI (r = .496; p < .0001), CSI (r = .433; p < .0001), and BDI-II (r = .306; p < .0001) in caregivers. CONCLUSION Staging PD according to the MNCD classification is correlated with caregivers' strain and burden.
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Affiliation(s)
- Diego Santos‐García
- Department of Neurology, CHUACComplejo Hospitalario Universitario de A CoruñaA CoruñaSpain
| | | | - Carlos Cores Bartolomé
- Department of Neurology, CHUACComplejo Hospitalario Universitario de A CoruñaA CoruñaSpain
| | | | - Iago García Díaz
- Department of Neurology, CHUACComplejo Hospitalario Universitario de A CoruñaA CoruñaSpain
| | | | - Jose Manuel Paz
- Department of Neurology, CHUACComplejo Hospitalario Universitario de A CoruñaA CoruñaSpain
| | - Silvia Jesús
- Department of Neurology, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de SevillaHospital Universitario Virgen del Rocío/CSIC/Universidad de SevillaSevilleSpain
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas)MadridSpain
| | - Marina Cosgaya
- Department of NeurologyHospital Clínic de BarcelonaBarcelonaSpain
| | | | - Nuria Caballol
- Department of Neurology, Consorci Sanitari IntegralHospital Moisés BroggiSant Joan DespíBarcelonaSpain
| | - Ines Legarda
- Department of NeurologyHospital Universitario Son EspasesPalma de MallorcaSpain
| | - Jorge Hernández Vara
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas)MadridSpain
- Department of NeurologyHospital Universitario Vall d´HebronBarcelonaSpain
| | - Iria Cabo
- Department of NeurologyComplejo Hospitalario Universitario de Pontevedra (CHOP)PontevedraSpain
| | | | - Isabel González Aramburu
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas)MadridSpain
- Department of NeurologyHospital Universitario Marqués de Valdecilla – IDIVALSantanderSpain
| | - Maria A. Ávila Rivera
- Department of Neurology, Consorci Sanitari IntegralHospital General de L´Hospitalet, L´Hospitalet de LlobregatBarcelonaSpain
| | - Víctor Gómez Mayordomo
- Department of Neurology, Institute of NeuroscienceVithas Madrid La Milagrosa University Hospital, Vithas Hospital GroupMadridSpain
| | - Víctor Nogueira
- Department of NeurologyHospital Universitario Lucus AugustiLugoSpain
| | | | - Carmen Borrué
- Department of NeurologyHospital Infanta SofíaMadridSpain
| | - Berta Solano Vila
- Department of NeurologyInstitut d'Assistència Sanitària (IAS) – Institut Català de la SalutGironaSpain
| | | | - Lydia Vela
- Department of NeurologyFundación Hospital de AlcorcónMadridSpain
| | - Sonia Escalante
- Department of NeurologyHospital de Tortosa Verge de la Cinta (HTVC)TortosaTarragonaSpain
| | - Esther Cubo
- Department of NeurologyComplejo Asistencial Universitario de BurgosBurgosSpain
| | - Zebenzui Mendoza
- Department of NeurologyHospital Universitario de CanariasSan Cristóbal de la LagunaSanta Cruz de TenerifeSpain
| | | | | | - Maria G. Alonso Losada
- Department of NeurologyHospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI)VigoSpain
| | | | - Itziar Gastón
- Department of NeurologyComplejo Hospitalario de NavarraPamplonaSpain
| | - Jaime Kulisevsky
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas)MadridSpain
- Department of NeurologyHospital de Sant PauBarcelonaSpain
| | - Manuel Seijo
- Department of NeurologyComplejo Hospitalario Universitario de Pontevedra (CHOP)PontevedraSpain
| | - Caridad Valero
- Department of NeurologyHospital Arnau de VilanovaValenciaSpain
| | | | | | - Carlos Ordás
- Department of NeurologyHospital Rey Juan CarlosMadridSpain
| | | | - Darrian McAfee
- University of Maryland School of MedicineBaltimoreMarylandUSA
| | - Pablo Martinez‐Martin
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas)MadridSpain
| | - Pablo Mir
- Department of Neurology, Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de SevillaHospital Universitario Virgen del Rocío/CSIC/Universidad de SevillaSevilleSpain
- CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas)MadridSpain
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Wei S, Yi T, OuYang Z, Wu J. Association between ABO blood type and type I endometrial cancer: a retrospective study. J OBSTET GYNAECOL 2023; 43:2153026. [PMID: 36606697 DOI: 10.1080/01443615.2022.2153026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study aimed to assess the association between ABO blood type and incident of type I endometrial cancer (EC), as well as the stage and differentiation. 213 patients with type I EC and 300 healthy controls were included. As a result, the frequencies of A, B, O, and AB blood types among patients with type I EC were 51 (23.9%), 59 (27.7%), 93 (43.7%) and 10 (4.7%), respectively. There were no significant differences in age, body mass index, and other baseline covariates between groups of ABO blood types (p > .05). Logistic regression model showed that women with blood type O was more likely to develop type I EC than those with type A (odds ratio (OR): 1.66, 95% confidence interval (CI): 1.05-2.63). However, there was no significant association of ABO blood type with stage and differentiation of type I EC (p > .05). In conclusion, blood type O was the most prevalent ABO blood type among patients with type I EC and was associated with increased risk of type I EC, while ABO blood type was not significantly associated with stage or differentiation of type I EC.IMPACT STATEMENTWhat is already known on this subject? Previous studies have produced inconsistent findings on association of ABO blood type with EC. Those studies also did not explore the relationship between ABO blood type and stage or differentiation of type I EC.What the results of this study add? The present study showed that women with blood type O was more likely to develop type I EC than those with type A and there was no significant association of ABO blood type with stage or differentiation of type I EC.What the implications are of these findings for clinical practice and/or further research? Gynaecologists should pay more attention to women with blood type O, who should undergo more active EC screening.
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Affiliation(s)
- Shiyuan Wei
- The Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Tingting Yi
- Department of Hematology, The First Affiliated Hospital of Shaoyang University, Shaoyang, China
| | - Zhenbo OuYang
- The Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jiawen Wu
- The Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
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22
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Chen C, Justo M, Gangi A. Hyperthermic intraperitoneal chemotherapy for gastric cancer: a narrative review. Chin Clin Oncol 2023; 12:68. [PMID: 38195075 DOI: 10.21037/cco-23-90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/08/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND AND OBJECTIVE Gastric cancer (GC) is the 5th most common malignancy globally, and although there have been modest gains in improving survival rates, it remains a leading cause of death. A component contributing to the poor survival rates includes advanced disease stage at presentation. Approximately 30-40% of GC patients present with metastases at diagnosis, with poorer outcomes when peritoneal metastases are present. However, recent studies have demonstrated potential utility of hyperthermic intraperitoneal chemotherapy (HIPEC) for GC with peritoneal carcinomatosis (GCPC) and for prevention of peritoneal carcinomatosis in high-risk patients. HIPEC for GC is highly debated. It is currently not recommended as part of standard of care for GC. The objective of this study is to discuss the various factors influencing the success of HIPEC, current intraperitoneal (IP) chemotherapy treatment regimens, timing of HIPEC administration, major randomized controlled trials (RCTs) and non-RCTs (NRCTs), and meta-analyses in GC patients. METHODS A review of the Library of Congress, the Cochrane Review, Google Scholar, PubMed, and ClinicalTrials.gov was performed. All articles and trials with available data in English with full text were considered. Necessary keywords used to search included "gastric cancer" and/or "HIPEC". Included articles were independently reviewed by authors. KEY CONTENT AND FINDINGS Optimal HIPEC administration timing is unclear, but many utilize it in a neoadjuvant or prophylactic setting. Signet ring pathology and epithelial mesenchymal transition (EMT) cell histologic subtypes may have more aggressive pathology, limiting HIPEC success rates. Patients who receive complete cytoreduction and have low peritoneal carcinomatosis index (PCI) burden have been shown to have improved median overall survival (OS) after HIPEC. The data suggests in GCPC, HIPEC can modestly improve recurrence-free and OS. The data regarding benefits of prophylactic HIPEC in advanced GC (AGC) remains mixed. CONCLUSIONS HIPEC for GC is controversial. Much of the literature is exploratory in nature or difficult to compare, as many outcomes are novel/not cross validated against substantial preceding data, with highly variable patient populations and study designs. However, in certain clinical scenarios in high volume centers, some patients with non-metastatic or low burden disease who undergo prophylactic or intraoperative HIPEC may benefit with improved overall and recurrence free survival (RFS).
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Affiliation(s)
- Courtney Chen
- Department of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Monica Justo
- Department of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alexandra Gangi
- Department of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Mallon B, Kaboré R, Couitchere L, Akonde FB, Narison MLR, Budiongo A, Dackono TA, Pondy A, Diedhiou F, Patte C, Steliarova-Foucher E, Clavel J. The feasibility of implementing Toronto childhood cancer stage guidelines and estimating the impact on outcome for childhood cancers in seven pediatric oncology units in sub-Saharan Africa. A study from the Franco-African Pediatric Oncology Group. Pediatr Blood Cancer 2023; 70:e30664. [PMID: 37732944 DOI: 10.1002/pbc.30664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The improvement of childhood cancer outcome is determined by early diagnosis, effective treatment, supportive care, and adequate medical follow-up. Stage at diagnosis may reflect timeliness of diagnosis, therefore standardized registration of stage is essential for interpretation of regional differences and time trends in survival. Here, we describe the feasibility of implementing the Toronto Childhood Cancer Stage Guidelines (hereafter Toronto Guidelines [TG]) in the hospital-based cancer registry of the Franco-African Pediatric Oncology Group (GFAOP), and assess the impact of TG stage on outcome in pediatric oncology units (POUs) in seven low- and middle-income countries in sub-Saharan Africa (SSA). METHODS All cancer patients diagnosed before 15 years of age with one of the 15 cancer types defined in TG, resident in one of the participating countries, and attending one of the selected POUs in 2017-2019 were included. Stage was assigned according to TG. Patients were followed-up for vital status for at least 12 months post diagnosis. Survival at 3, 6, and 12 months was calculated using Kaplan-Meier method and compared between POUs and tumor groups using log-rank test. RESULTS TG stage was assigned to 1772 of 2446 (89%) cases diagnosed with one of 11 cancer types. It was not possible to assign TG stage to acute lymphoblastic leukemia (ALL) and the three types of the central nervous system tumors included in the TG. One-year overall survival (OS) was 58% [95% confidence interval: 55-60] and varied between POUs. Survival declined with increasing stage for four tumor types and was statistically significant for two. CONCLUSION Except for ALL and brain tumors, we demonstrated feasibility of TG implementation for childhood solid cancers in participating POUs in SSA, and provided a baseline assessment of childhood cancer outcomes against which future stage distribution and survival can be measured as timelines of diagnosis improve over time within the GFAOP network.
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Affiliation(s)
- Brenda Mallon
- Groupe Franco-Africain d'Oncologie Pédiatrique (GFAOP) Gustave Roussy Villejuif, Villejuif, France
| | - Rolande Kaboré
- Service d'oncologie pédiatrique, Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Line Couitchere
- Unité d'oncologie pédiatrique, Hôpital de Treichville, Abidjan, Ivory Coast
| | | | | | - Aléine Budiongo
- Unité d'oncologie pédiatrique, Cliniques Universitaires de Kinshasa, Kinshasa, Congo
| | | | - Angel Pondy
- Centre Mère et Enfant de la Fondation Chantal Biya, Yaoundé, Cameroun
| | - Francis Diedhiou
- Groupe Franco-Africain d'Oncologie Pédiatrique (GFAOP) Gustave Roussy Villejuif, Villejuif, France
| | - Catherine Patte
- Groupe Franco-Africain d'Oncologie Pédiatrique (GFAOP) Gustave Roussy Villejuif, Villejuif, France
| | - Eva Steliarova-Foucher
- Cancer Surveillance Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Jacqueline Clavel
- INSERM UMRS-1153 - EPICEA Epidémiologie des Cancers de l'Enfant et de l'Adolescent, Paris, France
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McCluggage WG, Bosse T, Gilks CB, Howitt BE, McAlpine JN, Nucci MR, Rabban JT, Singh N, Talia KL, Parra-Herran C. FIGO 2023 endometrial cancer staging: too much, too soon? Int J Gynecol Cancer 2023:ijgc-2023-004981. [PMID: 37935523 DOI: 10.1136/ijgc-2023-004981] [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: 11/09/2023] Open
Abstract
An updated International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial carcinoma was introduced in June 2023. The new system represents a significant departure from traditional endometrial and other gynecological carcinoma staging systems which are agnostic of parameters such as tumor type, tumor grade, lymphovascular space invasion, and molecular alterations. The updated system, which incorporates all of these 'non-anatomical' parameters, is an attempt to make staging more personalized and relevant to patient prognostication and management, and to align with the European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) risk stratification. Herein, we present a critical review of the new staging system and discuss its advantages and disadvantages. The authors propose that the new FIGO staging system should be first appraised at a multi-institutional and global level with the input of all relevant societies (gynecology, pathology, gynecologic oncology, medical oncology, radiation oncology) to understand the impact, scope, and supporting evidence of the proposed changes. Such a process is fundamental to produce a robust system that pathologists and treating clinicians can adopt.
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Affiliation(s)
- W Glenn McCluggage
- Department of Pathology, HCS Belfast Health and Social Care Trust, Belfast, UK
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - C Blake Gilks
- Department of Pathology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Brooke E Howitt
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Jessica N McAlpine
- Gynecology and Obstetrics; Division Gynecologic Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marisa R Nucci
- Women's and Perinatal Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Naveena Singh
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Karen L Talia
- Pathology, Royal Women's Hospital and Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Carlos Parra-Herran
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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25
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Wen W, Mumma M, Zheng W. Temporal Trends of Stages and Survival of Biliary Tract Cancers in the United States and Associations with Demographic Factors. Cancer Epidemiol Biomarkers Prev 2023; 32:1660-1667. [PMID: 37606709 PMCID: PMC10840886 DOI: 10.1158/1055-9965.epi-23-0562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The incidence of cholangiocarcinoma and gallbladder cancer has been increasing and decreasing respectively in the United States, whereas their mortality has been declining since 1980, which suggests improved overall survival of biliary tract cancers (BTC). We aimed to investigate temporal trends of BTC stages and survival and their associations with demographic factors. METHODS A total of 55,163 patients with BTC collected from 2000 to 2018 from the NCI Surveillance, Epidemiology, and End Results 18 registry were included in this study. We assessed the temporal trend of BTC stages with diagnosis years using the annual percentage of change (APC) in the proportion of the stages. We estimated the association of BTC survival and stages with diagnosis years and demographic factors using the Cox regression models. RESULTS While localized BTC proportion remained little changed from 2006 to 2018, the proportion of regional and distant BTCs significantly decreased (APC = -2.3%) and increased (APC = 2.7%), respectively, through the years. The overall and cancer-specific survival increased from 41.0% and 47.3% in 2000 to 2004 to 51.2% and 53.8% in 2015 to 2018, respectively. Patients with BTC who were older, Black, unmarried, or had lower socioeconomic status (SES) had significantly poorer overall survival. CONCLUSIONS We found that distant and regional BTC significantly increased and decreased, respectively, and the BTC survival significantly improved over time. Age, sex, race, SES, and marital status were significantly associated with overall survival and less evidently with cancer-specific survival of patients with BTC. IMPACT Our findings suggest that demographic factors were associated with BTC stages and BTC survival.
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Affiliation(s)
- Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Michael Mumma
- International Epidemiology Field Station, Vanderbilt University Medical Center, Nashville, TN
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
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Conroy S, Catto JWF, Bex A, Brown JE, Cartledge J, Fielding A, Jones RJ, Khoo V, Nicol D, Stewart GD, Sullivan M, Tran MGB, Woodward R, Cumberbatch MG. Diagnosis, treatment, and survival from kidney cancer: real-world National Health Service England data between 2013 and 2019. BJU Int 2023; 132:541-553. [PMID: 37436368 DOI: 10.1111/bju.16128] [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: 07/13/2023]
Abstract
OBJECTIVES To report the NHS Digital (NHSD) data for patients diagnosed with kidney cancer (KC) in England. We explore the incidence, route to diagnosis (RTD), treatment, and survival patterns from 2013 to 2019. MATERIALS AND METHODS Data was extracted from the Cancer Data NHSD portal for International Classification of Diseases, 10th edition coded KC; this included Cancer Registry data, Hospital Episode Statistics, and cancer waiting times data. RESULTS Registrations included 66 696 individuals with KC. Incidence of new KC diagnoses increased (8998 in 2013, to 10 232 in 2019), but the age-standardised rates were stable (18.7-19.4/100 000 population). Almost half of patients (30 340 [45.5%]) were aged 0-70 years and the cohort were most frequently diagnosed with Stage 1-2 KC (n = 26 297 [39.4%]). Most patients were diagnosed through non-urgent general practitioner referrals (n = 16 814 [30.4%]), followed by 2-week-wait (n = 15 472 [28.0%]) and emergency routes (n = 11 796 [21.3%]), with older patients (aged ≥70 years), Stage 4 KCs, and patients with non-specified renal cell carcinoma being significantly more likely to present through the emergency route (all P < 0.001). Invasive treatment (surgery or ablation), radiotherapy, or systemic anti-cancer therapy use varied with disease stage, patient factors, and treatment network (Cancer Alliance). Survival outcomes differed by Stage, histological subtype, and social deprivation class (P < 0.001). Age-standardised mortality rates did not change over the study duration, although immunotherapy usage is likely not captured in this study timeline. CONCLUSION The NHSD resource provides useful insight about the incidence, diagnostic pathways, treatment, and survival of patients with KC in England and a useful benchmark for the upcoming commissioned National Kidney Cancer Audit. The RTD data may be limited by incidental diagnoses, which could confound the high proportion of 'emergency' diagnoses. Importantly, survival outcomes remained relatively unchanged.
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Affiliation(s)
- Samantha Conroy
- Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
- Academic Unit of Urology, Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - James W F Catto
- Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
- Academic Unit of Urology, Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - Axel Bex
- Royal Free NHS Foundation Trust, Specialist Centre for Kidney Cancer, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Janet E Brown
- Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
- Academic Unit of Clinical Oncology, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | | | - Alison Fielding
- Bladder and Renal Cancer Clinical Studies Group, National Cancer Research Institute, London, UK
| | - Rob J Jones
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Vincent Khoo
- Royal Marsden NHS Foundation Trust, London, UK
- Institute of Cancer Research, London, UK
| | - David Nicol
- Royal Marsden NHS Foundation Trust, London, UK
- Institute of Cancer Research, London, UK
| | - Grant D Stewart
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Mark Sullivan
- Department of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
| | - Maxine G B Tran
- Royal Free NHS Foundation Trust, Specialist Centre for Kidney Cancer, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Rose Woodward
- Action Kidney Cancer, Manchester, UK
- International Kidney Cancer Coalition, UK
| | - Marcus G Cumberbatch
- Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
- Academic Unit of Urology, Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
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Maloney NJ, Zacher NC, Aasi SZ, Hirotsu KE, Zaba LC, Kibbi N. Association of histopathologic grade with stage and survival in sebaceous carcinoma: A retrospective cohort study in the National Cancer Database. J Am Acad Dermatol 2023; 89:1080-1083. [PMID: 37532139 DOI: 10.1016/j.jaad.2023.07.1013] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 06/20/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Nolan J Maloney
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California; Veterans Affairs Palo Alto Healthcare System, Palo Alto, California
| | - Natasha C Zacher
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California; Veterans Affairs Palo Alto Healthcare System, Palo Alto, California
| | - Sumaira Z Aasi
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California
| | - Kelsey E Hirotsu
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California
| | - Lisa C Zaba
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California; Veterans Affairs Palo Alto Healthcare System, Palo Alto, California
| | - Nour Kibbi
- Department of Dermatology, Stanford University School of Medicine, Palo Alto, California.
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Zhao Z, Wang H, Liu Y, Li M, Li M. Abdominal lymph node metastasis in non-surgical esophageal squamous cell carcinoma: prognostic significance and a novel staging strategy. Front Oncol 2023; 13:1234426. [PMID: 37876971 PMCID: PMC10591313 DOI: 10.3389/fonc.2023.1234426] [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: 06/04/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose This study aimed to evaluate the feasibility of a combination of abdominal lymph node (LN) metastasis and the number of LNs in esophageal squamous cell carcinoma (ESCC) patients to optimize its clinical nodal staging. Methods A retrospective study, including a total of 707 ESCC patients treated with definitive radiotherapy, was conducted at two participating institutes. Different combinations of LN variables, including abdominal LN metastasis (R1: no-abdominal LN metastasis; R2: abdominal LN metastasis), were further analyzed to propose a potential revised nodal (rN) staging. Results The multivariate analyses showed that the number of metastatic LN and abdominal LN metastasis were independent prognostic factors for the overall survival (OS). The results showed no significant differences in the OS between the N2 patients with abdominal LN metastasis and N3 patients. The OS of the stage III patients with abdominal LN metastasis was not significantly different from those with stage IVa. The N3R1 and N1-2R2 had similar hazard ratios (HRs). The N1R1 subset was defined as rN1, the N2R1 subset was defined as rN2, and the N3R1-2 and N1-2R2 subsets were defined as rN3. The HRs of OS of the rN2 and rN3 groups increased subsequently. The rN stage could identify the differences in the OS times of each subgroup based on the 8th AJCC cN staging or the 11th JES N staging. Conclusions The rN staging, including the number of metastatic LNs and abdominal LN metastasis, might serve as a potential prognostic predictor for non-surgical patients with ESCC.
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Affiliation(s)
- Zongxing Zhao
- Department of Radiation Oncology, Liaocheng People’s Hospital, Shandong First Medical University, Liaocheng, Shandong, China
| | - Hongmin Wang
- Joint Laboratory for Translational Medicine Research, Liaocheng People’s Hospital, Shandong First Medical University, Liaocheng, Shandong, China
| | - Yajing Liu
- Clinical Laboratory, Liaocheng Third People’s Hospital, Liaocheng, Shandong, China
| | - Minghuan Li
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Mingjun Li
- Department of Radiation Oncology, Liaocheng People’s Hospital, Shandong First Medical University, Liaocheng, Shandong, China
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29
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Petit G. [Internship in a private practice: Added value to initial nursing training]. Rev Infirm 2023; 72:39-41. [PMID: 37838371 DOI: 10.1016/j.revinf.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
For a nursing student, an internship in a private practice enriches the discovery of nursing practice, so different is it from in-hospital practice. Having completed an internship in a private practice as part of her clinical training, Gwenaëlle, a 3rd-year nursing student, shares her questions with us and highlights the specific features of this practice by comparing her experience with her previous internship.
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Affiliation(s)
- Gwenaëlle Petit
- Institut de formation interhospitalière ThéodoreSimon, 19 avenue de Maison-Blanche, 93330 Neuilly-sur-Marne, France.
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30
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Zhang C, Zhao S, Wang X, Wen D. A new lymph node ratio-based staging system for rectosigmoid cancer: a retrospective study with external validation. Int J Surg 2023; 109:3087-3096. [PMID: 37462992 PMCID: PMC10583910 DOI: 10.1097/js9.0000000000000546] [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: 03/06/2023] [Accepted: 06/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND This study evaluated the clinical value of a new American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) staging prediction model based on lymph node ratio (LNR) in rectosigmoid cancer (RSC). METHODS The analysis included 1444 patients with nonmetastatic RSC diagnosed pathologically between 2010 and 2016 who were collected from the National Cancer Institute Surveillance, Epidemiology, and Results database. The AJCC N-stage was redefined according to the LNR cutoff point, and the ability of the new staging system to predict prognosis was compared with that of the AJCC TNM staging system. Data from 739 patients from our hospital were used for external validation. RESULTS According to the number of examined lymph nodes and LNR, the N stage was divided into five groups (LNR0-5). The 5-year OS of patients divided according to the new T lymph node ratio M (TLNRM) staging into stage I (T1LNR1, T1LNR2), IIA (T1LNR3, T2LNR1, T2LNR2, T2LNR3, T1LNR4, T3LNR1), IIB (T2LNR4), IIC (T3LNR2, T4a LNR1, T1LNR5), IIIA (T3LNR3, T2LNR5, T4b LNR1, T4a LNR2, T3LNR4), IIIB (T3LNR5, T4a LNR3, T4a LNR4, T4b LNR2), and IIIC (T4b LNR3, T4a LNR5, T4b LNR4, T4b LNR5) was significantly different ( P <0.05). Decision curve analysis showed that the net income of the new TLNRM staging system for different decision thresholds was higher than the prediction line of the traditional eighth TNM staging system. The smaller Akaike information criterion and Bayesian information suggested that the new staging system had a higher sensitivity for predicting prognosis than the traditional staging system. TLNRM II and III patients benefited from adjuvant chemotherapy, while adjuvant chemotherapy did not improve the prognosis of TNM II patients. These findings were confirmed by the external validation data. CONCLUSION The new TLNRM staging system was superior to the eighth edition AJCC staging system for staging and predicting the prognosis of patients with RSC and may become an effective tool in clinical practice.
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Affiliation(s)
| | | | | | - Dacheng Wen
- Department of Gastrointestinal Nutrition and Hernia Surgery, The Second Hospital of Jilin University, Changchun, People’s Republic of China
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Lu N, Guan X, Zhu J, Li Y, Zhang J. A Contrast-Enhanced CT-Based Deep Learning System for Preoperative Prediction of Colorectal Cancer Staging and RAS Mutation. Cancers (Basel) 2023; 15:4497. [PMID: 37760468 PMCID: PMC10526233 DOI: 10.3390/cancers15184497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE This study aimed to build a deep learning system using enhanced computed tomography (CT) portal-phase images for predicting colorectal cancer patients' preoperative staging and RAS gene mutation status. METHODS The contrast-enhanced CT image dataset comprises the CT portal-phase images from a retrospective cohort of 231 colorectal cancer patients. The deep learning system was developed via migration learning for colorectal cancer detection, staging, and RAS gene mutation status prediction. This study used pre-trained Yolov7, vision transformer (VIT), swin transformer (SWT), EfficientNetV2, and ConvNeXt. 4620, and contrast-enhanced CT images and annotated tumor bounding boxes were included in the tumor identification and staging dataset. A total of 19,700 contrast-enhanced CT images comprise the RAS gene mutation status prediction dataset. RESULTS In the validation cohort, the Yolov7-based detection model detected and staged tumors with a mean accuracy precision (IoU = 0.5) (mAP_0.5) of 0.98. The area under the receiver operating characteristic curve (AUC) in the test set and validation set for the VIT-based prediction model in predicting the mutation status of the RAS genes was 0.9591 and 0.9554, respectively. The detection network and prediction network of the deep learning system demonstrated great performance in explaining contrast-enhanced CT images. CONCLUSION In this study, a deep learning system was created based on the foundation of contrast-enhanced CT portal-phase imaging to preoperatively predict the stage and RAS mutation status of colorectal cancer patients. This system will help clinicians choose the best treatment option to increase colorectal cancer patients' chances of survival and quality of life.
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Affiliation(s)
- Na Lu
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, No. 121, Jiangjiayuan Road, Nanjing 210011, China (X.G.)
| | - Xiao Guan
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, No. 121, Jiangjiayuan Road, Nanjing 210011, China (X.G.)
| | - Jianguo Zhu
- Department of Radiology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China;
| | - Yuan Li
- Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China;
| | - Jianping Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, No. 121, Jiangjiayuan Road, Nanjing 210011, China (X.G.)
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Kuzuu K, Misawa N, Ashikari K, Tamura S, Kato S, Hosono K, Yoneda M, Nonaka T, Matsushima S, Komatsu T, Nakajima A, Higurashi T. Changes in the Number of Gastrointestinal Cancers and Stage at Diagnosis with COVID-19 Pandemic in Japan: A Multicenter Cohort Study. Cancers (Basel) 2023; 15:4410. [PMID: 37686686 PMCID: PMC10487252 DOI: 10.3390/cancers15174410] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/09/2023] [Revised: 08/13/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
This retrospective cohort study compared the number of newly diagnosed patients, stage at diagnosis, and detection process of gastrointestinal cancers based on hospital-based cancer registry data at two tertiary Japanese hospitals. The pre-COVID-19 period was from January 2017 to February 2020, with phase 1 (midst of COVID-19 pandemic) from March to December 2020 and phase 2 (the transition period to the "new normal") from January to December 2021. Each month, the number of patients diagnosed with esophageal, gastric, colorectal, pancreatic, liver, and biliary tract cancers were aggregated, classified by stage and detection process, and compared, including a total of 6453 patients. The number of colorectal Stage 0-II patients decreased significantly in phase 1 and increased in phase 2. The total number of colorectal cancer patients returned to pre-COVID-19 levels (mean monthly patients [SD]: 41.61 [6.81] vs. 36.00 [6.72] vs. 46.00 [11.32]). The number of patients with gastric cancer Stage I significantly decreased in phase 2 following phase 1. The number of gastric cancer patients decreased significantly from pre-COVID-19 levels (30.63 [6.62] vs. 22.40 [5.85] vs. 24.50 [4.15]). During phase 2, the number of patients diagnosed after screening with colorectal cancer increased significantly, whereas that with gastric cancer remained considerably lower. The number of Stage III colorectal and gastric cancer patients increased significantly from the pre-COVID-19 levels. Thus, gastric cancer may not be optimally screened during phases 1 and 2. There was a significant increase in patients with Stage III colorectal and gastric cancers from the pre-COVID-19 period; hence, the stage at diagnosis may have progressed.
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Affiliation(s)
- Kento Kuzuu
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Noboru Misawa
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Keiichi Ashikari
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Shigeki Tamura
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Shingo Kato
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Kunihiro Hosono
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Masato Yoneda
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Takashi Nonaka
- National Hospital Organization Yokohama Medical Center, 3-60-2 Harazyuku, Totuka-ku, Yokohama 245-8575, Japan; (T.N.); (S.M.); (T.K.)
| | - Shozo Matsushima
- National Hospital Organization Yokohama Medical Center, 3-60-2 Harazyuku, Totuka-ku, Yokohama 245-8575, Japan; (T.N.); (S.M.); (T.K.)
| | - Tatsuji Komatsu
- National Hospital Organization Yokohama Medical Center, 3-60-2 Harazyuku, Totuka-ku, Yokohama 245-8575, Japan; (T.N.); (S.M.); (T.K.)
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
| | - Takuma Higurashi
- Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (K.K.); (N.M.); (K.A.); (S.T.); (S.K.); (K.H.); (M.Y.); (A.N.)
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Fane LS, Wei AH, Tripathi R, Bordeaux JS. Asian American and Pacific Islander patients with melanoma have increased odds of treatment delays: A cross-sectional study. J Am Acad Dermatol 2023; 89:529-536. [PMID: 37224968 DOI: 10.1016/j.jaad.2023.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/26/2023] [Accepted: 05/06/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Asian American and Pacific Islander (AAPI) melanoma patients have higher mortality than non-Hispanic White (NHW) patients. Treatment delays may contribute, but whether AAPI patients have longer time from diagnosis to definitive surgery (TTDS) is unknown. OBJECTIVES Investigate TTDS differences between AAPI and NHW melanoma patients. METHODS Retrospective review of AAPI and NHW melanoma patients in the National Cancer Database (NCD) (2004-2020). The association of race with TTDS was evaluated by multivariable logistic regression, controlling for sociodemographic characteristics. RESULTS Of 354,943 AAPI and NHW melanoma patients identified, 1155 (0.33%) were AAPI. AAPI patients had longer TTDS for stage I, II, and III melanoma (P < .05 for all). Adjusting for sociodemographic factors, AAPI patients had 1.5 times the odds of a TTDS between 61 and 90 days and twice the odds of a TTDS >90 days. Racial differences in TTDS persisted in Medicare and private insurance types. Uninsured AAPI patients had the longest TTDS (mean, 53.26 days), while those with private insurance had the shortest TTDS (mean, 34.92 days; P < .001 for both). LIMITATION AAPI patients comprised 0.33% of the sample. CONCLUSIONS AAPI melanoma patients have increased odds of treatment delays. Associated socioeconomic differences should inform efforts to reduce disparities in treatment and survival.
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Affiliation(s)
- Lauren S Fane
- School of Medicine, Case Western Reserve University, Cleveland, Ohio.
| | - Angela H Wei
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Raghav Tripathi
- Department of Dermatology, Johns Hopkins, Baltimore, Maryland
| | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Kwon W, Heo JS, Han IW, Kang CM, Hwang HK, Kim SC, Park SJ, Yoon YS, Kim YH, Lim CS, Lee SY, Park T, Takami H, Watanabe N, Shimizu Y, Okuno M, Yamaue H, Kawai M, Seiko H, Nagakawa Y, Osakabe H, Sugiura T, Toyama H, Ohtsuka M, Unno M, Endo I, Kitago M, Jang JY. Features of T1 pancreatic cancer and validation of the eighth edition AJCC staging system definition using a Korean-Japanese joint cohort and the SEER database. J Hepatobiliary Pancreat Sci 2023; 30:1129-1140. [PMID: 36734142 DOI: 10.1002/jhbp.1316] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/23/2022] [Accepted: 01/20/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND/PURPOSE Little is known about the features of T1 pancreatic ductal adenocarcinoma (PDAC) and its definition in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system needs validation. The aims were to analyze the clinicopathologic features of T1 PDAC and investigate the validity of its definition. METHOD Data from 1506 patients with confirmed T1 PDAC between 2000 and 2019 were collected and analyzed. The results were validated using 3092 T1 PDAC patients from the Surveillance, Epidemiology, and End Results (SEER) database. RESULTS The median survival duration of patients was 50 months, and the 5-year survival rate was 45.1%. R0 resection was unachievable in 10.0% of patients, the nodal metastasis rate was 40.0%, and recurrence occurred in 55.2%. The current T1 subcategorization was not feasible for PDAC, tumors with extrapancreatic extension (72.8%) had worse outcomes than those without extrapancreatic extension (median survival 107 vs. 39 months, p < .001). Extrapancreatic extension was an independent prognostic factor whereas the current T1 subcategorization was not. The results of this study were reproducible with data from the SEER database. CONCLUSION Despite its small size, T1 PDAC displayed aggressive behavior warranting active local and systemic treatment. The subcategorization by the eighth edition of the AJCC staging system was not adequate for PDAC, and better subcategorization methods need to be explored. In addition, the role of extrapancreatic extension in the staging system should be reconsidered.
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Affiliation(s)
- Wooil Kwon
- Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jin Seok Heo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - In Woong Han
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chang Moo Kang
- Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho Kyoung Hwang
- Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Song Cheol Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sang-Jae Park
- Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, South Korea
| | - Yoo-Seok Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Sungnam, South Korea
| | - Yong Hoon Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Hospital, Daegu, South Korea
| | - Chang-Sup Lim
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Seung Yeoun Lee
- Department of Mathematics and Statistics, Sejong University College of Natural Sciences, Seoul, South Korea
| | - Taesung Park
- Department of Statistics and Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, South Korea
| | - Hideki Takami
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Watanabe
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masataka Okuno
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Manabu Kawai
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hirono Seiko
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yuichi Nagakawa
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hiroaki Osakabe
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Teiichi Sugiura
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Japan, Shizuoka, Japan
| | - Hirochika Toyama
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masayuki Ohtsuka
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Minoru Kitago
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Jin-Young Jang
- Department of Surgery, College of Medicine, Seoul National University, Seoul, South Korea
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Eickholz P, Koch R, Göde M, Nickles K, Kocher T, Lorenz K, Kim TS, Meyle J, Kaner D, Schlagenhauf U, Harks I, Ehmke B. Clinical benefits of systemic amoxicillin/metronidazole may depend on periodontitis stage and grade: An exploratory sub-analysis of the ABPARO trial. J Clin Periodontol 2023; 50:1239-1252. [PMID: 37293896 DOI: 10.1111/jcpe.13838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
AIM Assessment of treatment response after systemic amoxicillin/metronidazole adjunctive to subgingival instrumentation (SI) according to stages and grades of the 2018 classification of periodontal diseases. MATERIALS AND METHODS We carried out exploratory re-analysis of the placebo-controlled, multi-centre ABPARO trial (52; 45/60 years of age; 205 males, 114 active smokers). Patients were randomized to SI with systemic amoxicillin 500 mg/metronidazole 400 mg (three times a day for 7 days, n = 205; ANTI) or placebo (n = 200; PLAC) and maintenance therapy every 3 months. Patients were reclassified according to the 2018 classification (stage/extent/grade). Treatment effect was the percentage of sites per patient with new attachment loss ≥1.3 mm (PSAL ≥ 1.3 mm) at 27.5 months post-baseline/randomization. RESULTS All patients were assigned according to the stage (n = 49 localized stage III, n = 206 generalized stage III, n = 150 stage IV). Because of missing radiographs, only 222 patients were assigned to grades (n = 73 B, n = 149 C). Treatment (PLAC/ANTI) resulted in PSAL ≥ 1.3 mm (median; lower/upper quartile) in localized stage III (PLAC: 5.7; 3.3/8.4% vs. ANTI: 4.9; 3.0/8.3%; p = .749), generalized stage III (8.0; 4.5/14.3% vs. 4.7; 2.4/9.0%; p < .001), stage IV (8.5; 5.1/14.4% vs. 5.7; 3.3/10.6%; p = .008), grade B (4.4; 2.4/6.7% vs. 3.6; 1.9/4.7%; p = .151) and grade C (9.4; 5.3/14.3% vs. 4.8; 2.5/9.4%; p < .001). CONCLUSIONS In generalized periodontitis stage III/grade C, a clinically relevant lower percentage of disease progression after adjunctive systemic amoxicillin/metronidazole was observed compared to placebo (PLAC: 9.7; 5.8/14.3% vs. ANTI: 4.7; 2.4/9.0%; p < .001).
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Affiliation(s)
- Peter Eickholz
- Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Moritz Göde
- Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Katrin Nickles
- Department of Periodontology, Johann Wolfgang Goethe-University Frankfurt am Main, Frankfurt am Main, Deutschland
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Katrin Lorenz
- Department of Periodontology, TU Dresden, Dresden, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, University Hospital Heidelberg, Heidelberg, Germany
| | - Jörg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
| | - Doğan Kaner
- Department of Periodontology, Dental School, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Schlagenhauf
- Department of Periodontology, University Hospital Würzburg, Würzburg, Germany
| | - Inga Harks
- Department of Periodontology, University Hospital Münster, Münster, Germany
| | - Benjamin Ehmke
- Department of Periodontology, University Hospital Münster, Münster, Germany
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Kim DY, Behbahani S, Hartman RI. Impact of COVID-19 pandemic on melanoma presentation by facility type and region in the United States. J Am Acad Dermatol 2023; 89:175-178. [PMID: 36898529 PMCID: PMC9995293 DOI: 10.1016/j.jaad.2023.02.046] [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] [Received: 12/14/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/11/2023]
Affiliation(s)
- Daniel Y Kim
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sara Behbahani
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Rebecca I Hartman
- Harvard Medical School, Boston, Massachusetts; Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts; Dermatology Section, VA Integrated Service Network 1 (VISN-1), Jamaica Plain, Massachusetts.
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Karaağaç M, Geredeli Ç, Yıldırım MS, Altınok T, Dede İ, İnal A, Zamani AG, Kaya B, Demirkazık A, Artaç M. The XRCC1 and TP53 gene polymorphisms are associated with advanced- stage disease and early distant metastasis at diagnosis in non-small cell lung cancer. J Cancer Res Ther 2023; 19:1248-1254. [PMID: 37787291 DOI: 10.4103/jcrt.jcrt_1657_21] [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: 10/04/2023]
Abstract
Background Studies on single nucleotide polymorphisms (SNPs) in non-small cell lung cancer (NSCLC) suggest that DNA repair capacity may have prognostic implications for disease recurrence and survival. However, there is no study investigating the relationship between SNPs and the risk of metastasis at the time of initial diagnosis in patients with NSCLC. Objective This study aimed to investigate the potential predictive value of SNPs in detecting the risk of metastasis at the time of initial diagnosis and poor prognosis in patients with NSCLC. Material and Methods In this prospective cohort study, we evaluated 275 patients with NSCLC. Analysis of SNPs from peripheral blood cells was performed by a polymerase chain reaction. Excision repair cross-complementing group 1 (ERCC1)- Asn118Asn, excision repair cross-complementing group 2 (ERCC2)-Lys751Gln, X-ray repair cross-complementing group 1 (XRCC1)-Arg399Gln, and tumor protein 53 (TP53)-Arg72Pro polymorphisms were evaluated in conjunction with the development of metastasis. Results The ERCC1 normal genotype, ERCC2 heterozygote genotype, XRCC1 normal genotype, and TP53 normal genotype were associated with a higher stage and more advanced-stage disease at the time of initial diagnosis (P = 0.027, 0.005, <0.001, and 0.006, respectively). Also, XRCC1 normal genotype and TP53 normal genotype were associated with the risk of metastasis at the time of initial diagnosis (P = <0.001 and 0.002, respectively). Moreover, the XRCC1 normal genotype was associated with the risk of brain metastasis at the time of initial diagnosis (P = 0.031). Conclusions We showed that SNPs are related to a higher stage and more advanced-stage disease at the time of initial diagnosis in patients with NSCLC, and XRCC1 and TP53 gene polymorphisms are associated with the risk of metastasis. These results may contribute to the identification of high-risk groups and may help to earlier diagnosis and treatment in patients with NSCLC.
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Affiliation(s)
- Mustafa Karaağaç
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Çağlayan Geredeli
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Mahmut Selman Yıldırım
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Tamer Altınok
- Department of Thoracic Surgery, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - İsa Dede
- Department of Medical Oncology, Medical Faculty, Ankara University, Ankara, Turkey
| | - Ali İnal
- Department of Medical Oncology, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Ayşe Gül Zamani
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Buğra Kaya
- Department of Nuclear Medicine, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Ahmet Demirkazık
- Department of Medical Oncology, Medical Faculty, Ankara University, Ankara, Turkey
| | - Mehmet Artaç
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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Jiang W, Wang Y, Yu C, Sui D, Du G, Li Y. Prognostic Analysis and Biomarkers Identification of Immune Infiltration in Early and Late Stage Hepatocellular Carcinoma Based on TCGA Data. Int J Gen Med 2023; 16:2519-2530. [PMID: 37346812 PMCID: PMC10281275 DOI: 10.2147/ijgm.s420458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
Background Hepatocellular carcinoma (HCC) is a major cause of cancer death in the world. The aim of this study was to establish a new model to predict the prognosis of HCC. Materials and Methods The mRNA, miRNA and lncRNA expression profiles of early (stage I-II) and late (stage III-IV) stage HCC patients were acquired from The Cancer Genome Atlas (TCGA) database. The differentially expressed mRNAs (DEmRNAs), miRNAs (DEmiRNAs) and lncRNAs (DElncRNAs) were identified between early and late stage HCC. Key molecules associated with the prognosis, and important immune cell types in HCC were identified. The nomogram based on incorporating age, gender, stage, and all important factors was constructed to predict the survival of HCC. Results A total of 1516 DEmRNAs, 97 DEmiRNAs and 87 DElncRNAs were identified. A DElncRNA-DEmiRNA-DEmRNA regulatory network including 78 mRNAs, 50 miRNAs and 1 lncRNA was established. Among the regulatory network, 11 molecules were significantly correlated with the prognosis of HCC based on Lasso regression analysis. Then, Preadipocytes and 3 survival-associated DEmRNAs were identified as crucial biomarkers. Subsequently, a nomogram with a differentiation degree of 0.758, including 1 immune cell, 11 mRNAs and 3 miRNAs, was generated. Conclusion Our study constructed a model by incorporating clinical information, significant biomarkers and immune cells to predict the survival of HCC, which achieved a good performance.
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Affiliation(s)
- Wenying Jiang
- Department of General Surgery, The Second People’s Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng, Shandong, People’s Republic of China
| | - Yunxing Wang
- Department of General Surgery, The Second People’s Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng, Shandong, People’s Republic of China
| | - Changtao Yu
- Department of General Surgery, The Second People’s Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng, Shandong, People’s Republic of China
| | - Deling Sui
- Department of General Surgery, The Second People’s Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng, Shandong, People’s Republic of China
| | - Gang Du
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China
| | - Youchun Li
- Department of General Surgery, The Second People’s Hospital of Liaocheng Affiliated to Shandong First Medical University, Liaocheng, Shandong, People’s Republic of China
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Bastos M, Ode S, Silva C. [Evolution of tutoring in an orthopaedic surgery department: feedback]. Rev Infirm 2023; 72:35-36. [PMID: 37364975 DOI: 10.1016/j.revinf.2023.05.009] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Tutoring involves a commitment on the part of tutors to welcoming, teaching and supporting student nurses. Tutoring plays a central role in our orthopedic surgery department, and we make it a priority. Its operation evolves according to needs, changes in tutors, student levels and the expectations of the nursing training institute. Our constant commitment to tutoring reflects our awareness of the need to support our future colleagues. Drawing on our various backgrounds and experiences, we felt it necessary to review the way we supervise ISTs and carry out our role as tutors.
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Affiliation(s)
- Marina Bastos
- Service de chirurgie orthopédique et traumatologique, DMU CHIR, Hôpital universitaire Pitié Salpêtrière, AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France.
| | - Steeve Ode
- Service de chirurgie orthopédique et traumatologique, DMU CHIR, Hôpital universitaire Pitié Salpêtrière, AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France
| | - Céline Silva
- Service de chirurgie orthopédique et traumatologique, DMU CHIR, Hôpital universitaire Pitié Salpêtrière, AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France
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Mandato VD, Torricelli F, Mastrofilippo V, Palicelli A, Costagliola L, Aguzzoli L. Primary Ovarian Leiomyosarcoma Is a Very Rare Entity: A Narrative Review of the Literature. Cancers (Basel) 2023; 15:cancers15112953. [PMID: 37296915 DOI: 10.3390/cancers15112953] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Primary ovarian leiomyosarcoma is a very rare malignancy characterized by unclear management and poor survival. We reviewed all the cases of primary ovarian leiomyosarcoma to identify prognostic factors and the best treatment. METHODS We collected and analyzed the articles published in the English literature regarding primary ovarian leiomyosarcoma from January 1951 to September 2022, using PubMed research. Clinical and pathological characteristics, different treatments and outcomes were analyzed. RESULTS 113 cases of primary ovarian leiomyosarcoma were included. Most patients received surgical resection, associated with lymphadenectomy in 12.5% of cases. About 40% of patients received chemotherapy. Follow-up information was available for 100/113 (88.5%) patients. Stage and mitotic count were confirmed to affect survival, and lymphadenectomy and chemotherapy were associated with a better survival rate. A total of 43.4% of patients relapsed, and their mean disease-free survival was 12.5 months. CONCLUSIONS Primary ovarian leiomyosarcomas are more common in women in their 50s (mean age 53 years). Most of them are at an early stage at presentation. Advanced stage and mitotic count showed a detrimental effect on survival. Surgical excision associated with lymphadenectomy and chemotherapy are associated with increased survival. An international registry could help collect clear and reliable data to standardize the diagnosis and treatment.
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Affiliation(s)
- Vincenzo Dario Mandato
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Federica Torricelli
- Laboratory of Translational Research, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Valentina Mastrofilippo
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Andrea Palicelli
- Unit of Pathology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
| | - Luigi Costagliola
- Unit of Obstetrics and Gynecology, Santa Maria delle Grazie Hospital, 80100 Naples, Italy
| | - Lorenzo Aguzzoli
- Unit of Obstetrics and Oncological Gynecology, Azienda USL-IRCCS di, 42122 Reggio Emilia, Italy
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Fortner RT, Trewin-Nybråten CB, Paulsen T, Langseth H. Characterization of ovarian cancer survival by histotype and stage: A nationwide study in Norway. Int J Cancer 2023. [PMID: 37226635 DOI: 10.1002/ijc.34576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/02/2023] [Accepted: 05/10/2023] [Indexed: 05/26/2023]
Abstract
Contemporary population-based data on ovarian cancer survival using current subtype classifications and by surgical status are sparse. We evaluated 1-, 3-, 5- and 7-year relative (and overall) survival, and excess hazards in patients with borderline tumors or invasive epithelial ovarian cancer diagnosed 2012 to 2021 in a nationwide registry-based cohort in Norway. Outcomes were evaluated by histotype, FIGO stage, cytoreduction surgery and residual disease. Overall survival was evaluated for non-epithelial ovarian cancer. Survival of women with borderline ovarian tumors was excellent (≥98.0% 7-year relative survival). Across all evaluated invasive epithelial ovarian cancer histotypes, 7-year relative survival for cases diagnosed with stages I or II disease was ≥78.3% (stage II high-grade serous). Survival for ovarian cancers diagnosed at stage ≥III differed substantially by histotype and time since diagnosis (eg, stage III, 5-year relative survival from 27.7% [carcinosarcomas] to 76.2% [endometrioid]). Overall survival for non-epithelial cases was good (91.8% 5-year overall survival). Women diagnosed with stage III or IV invasive epithelial ovarian cancer and with residual disease following cytoreduction surgery had substantially better survival than women not operated. These findings were robust to restriction to women with high reported functional status scores. Patterns for overall survival were similar to those for relative survival. We observed relatively good survival with early stage at diagnosis even for the high grade serous histotype. Survival for patients diagnosed at stage ≥III invasive epithelial ovarian cancer was poor for all but endometrioid disease. There remains an urgent need for strategies for risk reduction and earlier detection, together with effective targeted treatments.
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Affiliation(s)
- Renée Turzanski Fortner
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | | | - Torbjørn Paulsen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
- Department of Gynecological Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Hilde Langseth
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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Petrelli A, German AJ, O'Connell EM, Silvestrini P. Serum insulin concentration in dogs with insulinoma as a clinical marker for presence of metastasis at the time of diagnosis. J Vet Intern Med 2023; 37:1139-1145. [PMID: 37194422 DOI: 10.1111/jvim.16720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 04/08/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Information regarding serum insulin concentration in dogs newly diagnosed with insulinoma and its association with clinical stage and survival time is lacking. OBJECTIVE Examine association between serum insulin concentration and survival and clinical disease stage in dogs with insulinoma. ANIMALS Fifty-nine client-owned dogs with a diagnosis of insulinoma from 2 referral hospitals. METHOD Retrospective observational study. The χ2 test was used to compare the proportion of dogs with increased insulin concentration in groups with or without metastasis at the time of diagnosis. Linear mixed-effect models were built to compare differences in insulin concentration between dogs with and without evidence of metastasis at the time of original diagnosis. Cox's proportional hazards regression and Kaplan-Meier graphs were used to evaluate the association between insulin concentration and insulin groups and survival. RESULTS Median serum insulin concentration was 33 mIU/L (range, 8-200 mIU/L) in dogs with World Health Organization (WHO) stage I disease and 45 mIU/L (range, 12-213 mIU/L) in dogs with WHO stage II and III disease. No difference was found in the proportion of dogs with increased insulin concentration with or without metastasis (P = .09). No association was identified between insulin concentration and survival (P = .63), and between dogs grouped by insulin concentration and survival (P = .51). CONCLUSIONS AND CLINICAL IMPORTANCE Serum insulin concentrations were not different between dogs with or without metastasis at diagnosis. The degree of insulinemia does not provide further information regarding the stage of the disease and is not associated with survival time in dogs with insulinoma.
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Affiliation(s)
- Andrea Petrelli
- Institute of Veterinary Science, University of Liverpool, Neston, UK
| | | | - Erin M O'Connell
- Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Paolo Silvestrini
- School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, Philadelphia, USA
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Karhan O, Secmeler Ş, Sezgin Y, Ileri S, Yerlikaya H. Are Syrian refugee breast cancer patients diagnosed at advanced stage and do they have treatment delays? Future Oncol 2023. [PMID: 37170860 DOI: 10.2217/fon-2022-1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
Aim: To compare the clinicopathological features and time to reach treatment of patients with breast cancer among Syrian refugees (SRs) and Turkish citizens (TCs). Methods: Retrospective data from 2014 to 2021 were extracted from the hospital database. Student's t-test, Mann-Whitney U test and χ2 test were used to compare the two groups. Results: Data of 88 SR and 402 TC patients were analyzed. The mean age was 45 years for SRs and 50 years for TCs. Breast cancer subtypes were similar in both groups. The de novo metastatic ratio was 23% in SRs and 21.3% in TCs and the time to reach treatment was similar between the two groups. Conclusion: Provided the absence of any obstacle in the healthcare system, SRs are diagnosed and treated like the citizens of their host nation.
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Affiliation(s)
- Ogur Karhan
- Mehmet Akif Inan Training & Research Hospital, Medical Oncology, Sanliurfa, 63040, Turkey
| | - Şaban Secmeler
- Mehmet Akif Inan Training & Research Hospital, Medical Oncology, Sanliurfa, 63040, Turkey
| | - Yasin Sezgin
- Siirt Training & Research Hospital, Medical Oncology, Siirt, 5600, Turkey
| | - Serdar Ileri
- Dicle University School of Medicine, Medical Oncology, Diyarbakır, 21280, Turkey
| | - Halis Yerlikaya
- Diyarbakır Memorial Hospital, Medical Oncology, Diyarbakır, 21070, Turkey
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Wang J, Peng J, Luo H, Song Y. Development and internal validation of a nomogram for predicting survival of nonoperative EGFR-positive locally advanced elderly esophageal cancers. Front Oncol 2023; 13:1097907. [PMID: 37251922 PMCID: PMC10213387 DOI: 10.3389/fonc.2023.1097907] [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: 11/14/2022] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Purpose This study aims to develop and validate a prediction model for non-operative, epidermal growth factor receptor (EGFR)-positive, locally advanced elderly esophageal cancer (LAEEC). Methods A total of 80 EGFR-positive LAEEC patients were included in the study. All patients underwent radiotherapy, while 41 cases received icotinib concurrent systemic therapy. A nomogram was established using univariable and multivariable Cox analyses. The model's efficacy was assessed through area under curve (AUC) values, receiver operating characteristic (ROC) curves at different time points, time-dependent AUC (tAUC), calibration curves, and clinical decision curves. Bootstrap resampling and out-of-bag (OOB) cross-validation methods were employed to verify the model's robustness. Subgroup survival analysis was also conducted. Results Univariable and multivariable Cox analyses revealed that icotinib, stage, and ECOG score were independent prognostic factors for LAEEC patients. The AUCs of model-based prediction scoring (PS) for 1-, 2-, and 3-year overall survival (OS) were 0.852, 0.827, and 0.792, respectively. Calibration curves demonstrated that the predicted mortality was consistent with the actual mortality. The time-dependent AUC of the model exceeded 0.75, and the internal cross-validation calibration curves showed good agreement between predicted and actual mortality. Clinical decision curves indicated that the model had a substantial net clinical benefit within a threshold probability range of 0.2 to 0.8. Model-based risk stratification analysis demonstrated the model's excellent ability to distinguish survival risk. Further subgroup analyses showed that icotinib significantly improved survival in patients with stage III and ECOG score of 1 (HR 0.122, P<0.001). Conclusions Our nomogram model effectively predicts the overall survival of LAEEC patients, and the benefits of icotinib were found in the clinical stage III population with good ECOG scores.
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Affiliation(s)
| | | | | | - Yaqi Song
- *Correspondence: Yaqi Song, ; Honglei Luo,
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Brige K, Rocher L. [The situation of students on placement, a real obstacle to the attractiveness of hospitals]. Soins 2023; 68:44-46. [PMID: 37321784 DOI: 10.1016/j.soin.2023.04.012] [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: 06/17/2023]
Abstract
Complementing theoretical courses, hospital internships are intended to encourage learners to apply their acquired knowledge while experiencing the field. In fact, this is becoming more and more complicated, and students are direct witnesses of the crisis affecting the hospital. The degraded working conditions of professionals do not allow them to properly supervise trainees, and even allow reprehensible behavior to flourish. Suffering on the job, the students desert the hospital after graduation.
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Affiliation(s)
- Kévin Brige
- Fédération nationale des étudiant(e)s en sciences infirmières (Fnesi), 79 rue Périer, 92120 Montrouge, France
| | - Lisa Rocher
- Fédération nationale des étudiant(e)s en sciences infirmières (Fnesi), 79 rue Périer, 92120 Montrouge, France.
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Heulin V. [A satisfied intern is a future professional ready to commit]. Soins 2023; 68:42-43. [PMID: 37321783 DOI: 10.1016/j.soin.2023.04.013] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Providing trainees with a caring and supportive environment that is tailored to their needs remains crucial. This allows them to learn and grow professionally, but not only. It motivates them, makes them want to continue and, why not, to join their internship field as professionals once they graduate. This is perfectly demonstrated by the testimony of Victoria Heulin, a second-year nursing student in Saint-Étienne.
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Affiliation(s)
- Victoria Heulin
- Institut régional de formation sanitaire et sociale Auvergne-Rhône-Alpes, 41 rue Montferré, 42100 Saint-Étienne, France.
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Neuman HB, Schumacher JR, Edge SB, Ruddy KJ, Partridge AH, Yu M, Vanness DJ, Hanlon BM, Le-Rademacher JG, Yang DY, Havlena J, Strand CA, Greenberg CC. The influence of anatomic stage and receptor status on first recurrence for breast cancer within 5 years (AFT-01). Cancer 2023; 129:1351-1360. [PMID: 36872873 PMCID: PMC10424512 DOI: 10.1002/cncr.34656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 03/07/2023]
Abstract
BACKGROUND Risk-stratified follow-up guidelines that account for the absolute risk and timing of recurrence may improve the quality and efficiency of breast cancer follow-up. The objective of this study was to assess the relationship of anatomic stage and receptor status with timing of the first recurrence for patients with local-regional breast cancer and generate risk-stratified follow-up recommendations. METHODS The authors conducted a secondary analysis of 8007 patients with stage I-III breast cancer who enrolled in nine Alliance legacy clinical trials from 1997 to 2013 (ClinicalTrials.gov identifier NCT02171078). Patients who received standard-of-care therapy were included. Patients who were missing stage or receptor status were excluded. The primary outcome was days from the earliest treatment start date to the date of first recurrence. The primary explanatory variable was anatomic stage. The analysis was stratified by receptor type. Cox proportional-hazards regression models produced cumulative probabilities of recurrence. A dynamic programming algorithm approach was used to optimize the timing of follow-up intervals based on the timing of recurrence events. RESULTS The time to first recurrence varied significantly between receptor types (p < .0001). Within each receptor type, stage influenced the time to recurrence (p < .0001). The risk of recurrence was highest and occurred earliest for estrogen receptor (ER)-negative/progesterone receptor (PR)-negative/Her2neu-negative tumors (stage III; 5-year probability of recurrence, 45.5%). The risk of recurrence was lower for ER-positive/PR-positive/Her2neu-positive tumors (stage III; 5-year probability of recurrence, 15.3%), with recurrences distributed over time. Model-generated follow-up recommendations by stage and receptor type were created. CONCLUSIONS This study supports considering both anatomic stage and receptor status in follow-up recommendations. The implementation of risk-stratified guidelines based on these data has the potential to improve the quality and efficiency of follow-up.
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Affiliation(s)
- Heather B. Neuman
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
| | - Jessica R. Schumacher
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
| | - Stephen B. Edge
- Departments of Surgical Oncology and Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | | | - Ann H. Partridge
- Department of Medical Oncology, Dana-Farber/Partners Cancer Care, Boston, Massachusetts, USA
| | - Menggang Yu
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
| | - David J. Vanness
- Department of Health Policy and Administration, Penn State College of Health and Human Development, Hershey, Pennsylvania, USA
| | - Bret M. Hanlon
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
| | | | - Dou-Yan Yang
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jeffrey Havlena
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Carrie A. Strand
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, Minnesota, USA
| | - Caprice C. Greenberg
- Department of Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
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Pinsky P, Miller E, Faris N, Osarogiagbon R. Pulmonary Nodules, Lung Cancer Screening, and Lung Cancer in the Medicare Population. Chest 2023; 163:1304-1313. [PMID: 36529155 PMCID: PMC10206506 DOI: 10.1016/j.chest.2022.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/22/2022] [Accepted: 12/08/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Early detection of lung cancer through management of pulmonary nodules (PNs) may reduce lung cancer mortality. We assessed the relationship between PNs and lung cancer. RESEARCH QUESTION How common are PNs in the Medicare population? What is the rate of lung cancer after detection of PNs? What is the relative proportion of early-stage lung cancer diagnosed after reporting of PNs vs through low-dose CT (LDCT) scan screening? STUDY DESIGN AND METHODS Using the Surveillance Epidemiology and End Results Program-Medicare database, we defined two cohorts: those in the 5% sample with ≥ 12 months of Medicare Parts A and B coverage from 2014 through 2019 (5% sample cohort) and those with a diagnosis of lung cancer from 2015 through 2017 with coverage for the prior 18-month period (lung cancer cohort). We defined PNs as chest CT scans with accompanying codes of 793.11 (International Classification of Diseases [ICD], Ninth Revision) or R91.1 (ICD, Tenth Revision) denoting a solitary PN. Patients in the lung cancer cohort were classified by whether they had undergone LDCT scan screening and whether they had a diagnosis of PN or neither (reference) within 18 months before diagnosis. We compared cancer stage and survival across groups. RESULTS Of 627,547 patients in the 5% sample cohort, 5.0% demonstrated PNs over median of 5.0 years of follow-up. Cumulative 1- and 2-year lung cancer rates after initial PN diagnosis were 3.2% and 4.7%, respectively. Of 44,194 patients in the lung cancer cohort, 15.7%, 2.9%, and 81.4% were in the PN, LDCT scan, and reference groups, respectively. Of patients in the PN, LDCT scan, and reference groups, 58.1%, 50.3%, and 24.4% respectively, had disease of a localized stage. Among all patients with localized disease, 30.0% and 4.9% were in the PN and LDCT scan and groups, respectively. Three-year lung cancer-specific survival rates were 75.0%, 75.6%, and 49.4% for the PN, LDCT scan, and reference groups. INTERPRETATION Patients with lung cancer who received a diagnosis after identification of PNs tended to have localized disease. Of all patients with localized disease, almost one-third had PNs that were diagnosed previously, compared with 5% of patients who had undergone LDCT scan screening. PNs represent a relatively common presentation of potentially curable lung cancer.
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Affiliation(s)
- Paul Pinsky
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD.
| | - Eric Miller
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD
| | - Nick Faris
- Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN
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Larpin F. [Clinical care and training of the medical electroradiology technician]. Rev Infirm 2023; 72:44-45. [PMID: 37247990 DOI: 10.1016/j.revinf.2023.04.013] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There are dozens of healthcare professions. All of them are involved in patient care and most of them work in multidisciplinary teams. In a world of health care in crisis, nurses and medical electroradiology manipulators (MERM) must work together more than ever to contribute to the optimization of care. This starts with the initial training of both in the training institutes and on the training grounds.
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Affiliation(s)
- Frédéric Larpin
- Centre de formation et du développement des compétences, IFMEM Campus Picpus, AP-HP, 33 boulevard de Picpus, 75012 Paris, France.
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Brige K. [Nursing students, the poor relation of the health care system]. Soins 2023; 68:37-39. [PMID: 37321781 DOI: 10.1016/j.soin.2023.04.010] [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: 06/17/2023]
Abstract
Even if nursing students have obtained social progress following different periods of mobilization and negotiations, we must admit that their situation remains worrying. Many of them live in precariousness and undergo very difficult training conditions. Instrumentalized, even mistreated, by caregivers who are at the end of their rope because they work in institutions that are in a critical situation, the students no longer learn and perform the tasks of the missing staff. The Covid-19 crisis is a striking example of this.
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Affiliation(s)
- Kévin Brige
- Fédération nationale des étudiant(e)s en sciences infirmières (Fnesi), 79, rue Périer, 92120 Montrouge, France.
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