Sa1336 PREOPERATIVE CHOLANGITIS IN PATIENTS WITH PANCREATIC HEAD ADENOCARCINOMA IS ASSOCIATED WITH AN INCREASED RISK OF CANCER RECURRENCE AFTER PANCREATICODUODENECTOMY

2019 ◽  
Vol 89 (6) ◽  
pp. AB214
Author(s):  
Thomas J. Wang ◽  
Eli P. Darnell ◽  
Melissa A. Lumish ◽  
Yasmin G. Hernandez-Barco ◽  
Maximilian Weniger ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Cancer Recurrence ◽  
Increased Risk ◽  
Risk Of Cancer

scholarly journals Rapidly Shifting Concepts Regarding Androgens and Prostate Cancer

2009 ◽  
Vol 9 ◽  
pp. 685-690 ◽  
Author(s):  
Abraham Morgentaler
Keyword(s):  
Prostate Cancer ◽  
Cancer Recurrence ◽  
Serum Testosterone ◽  
High Serum ◽  
Prior History ◽  
Minimal Risk ◽  
Increased Risk ◽  
History Of ◽  
Dramatic Shift ◽  
Risk Of Cancer

There has been a recent dramatic shift in our understanding of the relationship between androgens and prostate cancer (PCa). Whereas for several decades it had been assumed that higher serum testosterone (T) concentrations would lead to ever-greater PCa growth, current literature indicates that PCa growth is unaffected by changes in serum T throughout most of the naturally occurring range. A Saturation Model has been proposed to explain how prostate tissue can be exquisitely sensitive to changes in serum T at the very low end of the concentration range, but appears indifferent to such changes above the near-castrate range. This has special applicability to T-deficient men, since this means that T therapy may not be nearly as risky as once assumed. Indeed, one of the more interesting changes over the last several years has been the growing acceptance of the use of T therapy in men with a prior history of PCa, with early data indicating minimal risk of cancer recurrence or progression. Provocative new evidence suggests that it is not high serum T that is problematic for PCa, butlowserum T that is associated with worrisome cancer features and outcomes, such as high Gleason score, advanced stage of presentation, and increased risk of biochemical recurrence after surgery. It will be interesting to see what changes will occur in this rapidly changing field over the next several years.

scholarly journals Obesity and cancer

2020 ◽  
Vol 48 (2-3) ◽  
pp. 89-102
Author(s):  
Franjo Cmrečak ◽  
◽  
Iva Andrašek ◽  
Višnja Gregov ◽  
Lidija Beketić-Orešković
Keyword(s):  
Intracellular Signaling ◽  
Cancer Recurrence ◽  
Epidemiological Data ◽  
Cancer Development ◽  
Malignant Diseases ◽  
Insulin Metabolism ◽  
Beneficial Effects ◽  
Increased Risk ◽  
After Cancer ◽  
Risk Of Cancer

For the past several decades, we have witnessed the emergence of the obesity pandemic worldwide and, simultaneously, the increase of incidence of malignant diseases. The effects of obesity and overweight on cancer incidence, morbidity, and mortality started to be meticulously researched only recently. According to the epidemiological data analysis, the connection between obesity and increased risk of numerous cancers has been established. Estimations are that a change in lifestyle and diet can prevent 30-50% of malignant diseases. After smoking, obesity is the second largest preventable cause of cancer. Obesity affects the quality of life and increases the risk of cancer recurrence and cancer-related mortality. By reducing body mass and avoiding gaining weight during adulthood, the risk of getting cancer is lowered. Numerous studies have shown the beneficial effects of physical activity during and after cancer treatment. Obesity influences cancer development; however, the mechanisms responsible for it are still unclear. It is considered that chronic inflammation, caused by the overabundance of nutrients, increases the levels of inflammatory cytokines and immune cells. It has been discovered that adipocytes have an important endocrine role; they synthesize numerous hormones and adipocytokines, such as leptin and adiponectin. High levels of leptons and low levels of adiponectin can activate intracellular signaling pathways involving malignant cells’ development. An important part of cancer development can be attributed to insulin metabolism, insulin-like growth factors, and sex hormones.

Is there value to routine oncologic surveillance after radical cystectomy? Comparative outcomes of symptomatic versus asymptomatic recurrence.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 421-421
Author(s):  
Abhinav Khanna ◽  
Andrew Zganjar ◽  
Paras Shah ◽  
Matthew K. Tollefson ◽  
Vidit Sharma ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Gastrointestinal Symptoms ◽  
Cancer Recurrence ◽  
Patients With Cancer ◽  
Presenting Symptoms ◽  
Voiding Symptoms ◽  
Routine Surveillance ◽  
Increased Risk ◽  
Risk Of Cancer

421 Background: Reported rates of adherence to post-radical cystectomy (RC) surveillance guidelines in real-world practice have been as low as 9%, in part reflecting a nihilistic view held by many of the value of routine follow-up. Indeed, conflicting data exist regarding the outcomes of patients with cancer recurrence detected by scheduled surveillance versus symptom-directed evaluation. Herein, we assessed comparative outcomes of patients with symptomatic recurrence (SR) versus asymptomatic recurrence (AR) after RC. Methods: We reviewed our Institutional Registry of RC patients to identify patients with cancer recurrence following RC. Presenting symptoms in the SR cohort included pain, constitutional symptoms, gastrointestinal symptoms, and hematuria/voiding symptoms, whereas AR was defined as recurrence detected on routine surveillance in the absence of symptoms. Baseline demographic and clinical characteristics were compared between study groups using chi-square and t-test. Kaplan-Meier and Cox survival analyses were performed to compare cancer-specific survival (CSS) and overall survival (OS) between AR and SR groups. Results: Of 3822 patients who underwent RC from 1980-2018 (with a median follow-up after RC of 2.4 years (IQR 1.1,5.5), a total of 1100 were subsequently diagnosed with recurrence, including 311 (28.3%) with AR and 789 (71.7%) with SR. Median time from RC to recurrence was longer in the AR group (13.2 months) than in the SR group (10.8 months; p = 0.01). Presenting symptoms included pain (70.2%), constitutional symptoms (50.7%), gastrointestinal symptoms (23.3%), and urinary symptoms (23.3%). Median follow-up after recurrence was 2.4 years (IQR 1.1-5.5), during which time 997 patients died, including 840 who died of bladder cancer. Compared to patients with SR, patients with AR had a longer median CSS (54.5 months vs 27.3 months, p < 0.001) and OS (43.0 months vs 25.8 months, p < 0.001). On multivariable Cox proportional hazards models adjusting for demographic and clinical factors, SR was associated with a significantly increased risk of cancer-specific (hazard ratio [HR] 1.66 [95% confidence interval 1.41-1.96], p < 0.0001) and all-cause mortality (HR 1.48 [1.23-1.71], p < 0.0001). Conclusions: SR after RC is associated with worse oncologic outcomes than post-RC recurrence detected by routine surveillance. As such, continued surveillance is warranted, while further study is needed to determine the optimal follow-up regimen balancing patient and disease risks.

scholarly journals Anaesthetic challenges in cancer patients: current therapies and pain management

2017 ◽  
Vol 24 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Jūratė Gudaitytė ◽  
Dominykas Dvylys ◽  
Indrė Šimeliūnaitė
Keyword(s):  
Pain Management ◽  
Cancer Patients ◽  
Cancer Recurrence ◽  
Anaesthetic Techniques ◽  
Organ Systems ◽  
Platinum Based Chemotherapy ◽  
Increased Risk ◽  
Pulmonary Damage ◽  
Chemotherapy Agents ◽  
Risk Of Cancer

The objective. The  aim is to present the  major effects of cancer treatment (chemotherapy, radiotherapy, surgery) that the  anaesthesiologist should consider preoperatively, and to review techniques of the analgesic management of the disease. Materials and Methods. To summarize the  major challenges that cancer patients present for the  anaesthesiologists, a  literature review was conducted. Articles presenting evidence or reviewing the  possible effects of anaesthetics on  cancer  cells were also included. Online databases of Science Direct, PubMed, and ELSEVIER, as well as reference lists of included studies were searched. Articles published from 2005 to 2016 were selected. Results. Anaesthesiologists should pay attention to patients receiving chemotherapy and its side effects on organ systems. Bleomycin causes pulmonary damage, anthracyclines are cardiotoxic, and platinum-based chemotherapy agents are nephrotoxic. A lot of chemotherapy agents lead to abnormal liver function, vomiting, diarrhoea, etc. Surgery itself is suspected to be associated with an increased risk of metastasis and recurrence of cancer. Regional anaesthesia and general anaesthesia with propofol should be used and volatile agents should be avoided to prevent cancer patients from perioperative immunosuppression that leads to increased risk of cancer recurrence. Pain management for palliative patients remains a major problem. Conclusions. To provide the best treatment for cancer patients, cooperation of anaesthesiologists with oncologists and surgeons becomes imperative. It has been established that anaesthetic techniques and drugs could minimize the perioperative inflammation. However, further research of the perioperative “onco-anaesthetic” is needed.

Prostate brachytherapy: the impact of smoking on recurrence and overall survival of localized prostate cancer

2013 ◽  
Vol 2 (1) ◽  
pp. 58-72
Author(s):  
Edwin Cohen ◽  
Justin Robinson ◽  
Paul Margolis ◽  
Marcia Gaut ◽  
Amie Alperson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Locally Advanced ◽  
Cancer Recurrence ◽  
Localized Prostate Cancer ◽  
Smoking History ◽  
Prostate Brachytherapy ◽  
Cost Effective Treatment ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
The Impact

Brachytherapy has been shown to be an efficacious and cost-effective treatment among patients with localized prostate cancer. In this study, we examined the effects of smoking on prostate cancer recurrence and mortality in patients undergoing brachytherapy for locally advanced prostate cancer. The study population consisted of 405 patients with an average age of 73.4 years. Smoking history included 88 (21.7%) patients with no history of smoking, 108(26.6%) patients with one to twenty pack-years, and 209 (51.7%) patients with twenty-one or more pack-years. The impact of smoking history on OS relative to nonsmokers was hazards ratio 1.39 (CI: 0.81-2.64; P<0.05). In conclusion, the era of brachytherapy dose and treatment intensification strategies to improve upon prostate cancer outcomes, our study showed that smoking increases the risk of cancer recurrence and mortality. Patients who have smoked a higher number of pack-years are at increased risk of recurrence and mortality compared to those who smoked less.

scholarly journals A randomized trial of a clinic-based weight loss intervention in cancer survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 167-167
Author(s):  
Rachel Lynn Yung ◽  
Anita Giobbie-Hurder ◽  
Laura Shockro ◽  
Keelin O'Connor ◽  
Nancy Campbell ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Cancer Survivors ◽  
Physical Functioning ◽  
Intervention Group ◽  
Cancer Recurrence ◽  
Weight Loss Intervention ◽  
Increased Risk ◽  
Risk Of Cancer ◽  
The Impact

167 Background: Evidence increasingly links obesity to increased risk of cancer recurrence and mortality in breast and other cancers, but few studies have evaluated weight loss interventions in cancer patients. We evaluated the impact of a group-based weight loss intervention implemented through an oncology clinic on weight and other outcomes in a mixed population of cancer survivors. Methods: Overweight and obese cancer survivors were randomized 1:1 to immediate or delayed participation in a 15-week group-based weight loss program focused on calorie restriction and increased physical activity. Weight, body composition, physical activity, fitness and quality of life were assessed at baseline and 15 weeks. Changes in measurements between baseline and 15 weeks were compared using Wilcoxon rank sum tests. The primary outcome was change in weight between baseline and 15 weeks between groups. Results: 60 participants were randomized; 30 to intervention and 30 to control. Median age was 52, average BMI was 31.8 kg/m2, 97% of participants were women, and 80% had breast cancer. Intervention participants lost 5.3% of baseline weight at 15 weeks vs 0.2% weight gain in controls (P < 0.001) (Table). Improvements in fitness (6-minute walk test) and physical functioning (EORTC QLQ C30) were also observed in the intervention group vs. controls. Conclusions: We found thatparticipation in a 15-week group-based intervention resulted in weight loss and improvements in fitness and physical functioning in overweight and obese cancer survivors. More work is needed to evaluate the feasibility and sustainability of weight loss programs implemented through oncology practices. Clinical trial information: NCT01978899. [Table: see text]

scholarly journals The role of genetic polymorphisms in endolysosomal ion channels TPC2 and P2RX4 in cancer pathogenesis, prognosis, and diagnosis: a genetic association in the UK Biobank

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Abeer F. Alharbi ◽  
John Parrington
Keyword(s):  
Prostate Cancer ◽  
Ion Channels ◽  
Genetic Variants ◽  
Cancer Recurrence ◽  
Malignant Neoplasms ◽  
Uk Biobank ◽  
Cancer Subtypes ◽  
Increased Risk ◽  
The Uk ◽  
Risk Of Cancer

AbstractRecent studies have implicated important roles for endolysosomal ion channels in cancer biology. We used UK Biobank data to characterise the relationships between genetic variants in two genes coding for endolysosomal ion channels—i.e. TPCN2 and P2RX4—and cancer in terms of the definition of tumour types, susceptibility, and prognosis. We investigated these relationships at both global and local levels with regard to specific types of cancer, including malignant neoplasms of the brain, breast, bronchus, lung, colon, lymphoid and haematopoietic systems, skin, ovary, prostate, rectum, thyroid gland, lip, oral cavity, pharynx, and urinary tract. Apart from rs3829241 (p value < 0.05), all the genetic variants were in Hardy–Weinberg equilibrium. We included 468,436 subjects in the analysis and stratified them into two major cohorts: cancer-free controls (385,253) and cancer cases (83,183). For the first time, we report novel associations between genetic variants of TPCN2 and P2RX4 and cancer/cancer subtypes in the UK Biobank’s population. Genotype GG in TPCN2 rs3750965 was significantly associated with a decreased risk of cancer and an increased risk of lip, oral cavity, and pharynx cancer and cancer recurrence in patients with prostate cancer, and genotypes GA/GG were associated with a significantly lower risk of developing various malignant neoplasms (involving melanoma, prostate, mesothelial, and soft tissues). rs35264875:TA was associated with a high risk of cancer at the global level, with subtypes of cancer at the local level (including breast, colon, prostate, and stated or presumed primary cancer of lymphoid, haematopoietic, and related tissue), and with a significantly low risk of cancer metastasis. rs72932540:GA was associated with a higher incidence of cancer/cancer subtypes (including breast, melanoma, and rectal cancer), and genotypes GA/GG were associated with an increased risk of prostate cancer. The P2RX4 rs25644 allele GG was associated with a high risk of prostate cancer, whereas it was associated with a low risk of cancer recurrence in patients with prostate cancer. Genotypes GA/GG in rs28360472 were associated with an increased risk of breast, mesothelial, and soft tissue cancers but with a decreased risk of colon cancer. We also provide insights into the pathophysiological contributions made by these significant polymorphisms to cancer/cancer subtypes and their effects on expression or channel activity. Further investigations of these genetic variants could help identify novel cancer biomarkers and facilitate the development of new diagnostic and therapeutic strategies. This would constitute a further step towards personalised cancer care.

Programmed Death-Ligand 1 Expression in a Large Cohort of Pediatric Patients With Solid Tumor and Association With Clinicopathologic Features in Neuroblastoma

2017 ◽  
pp. 1-12 ◽  
Author(s):  
Federica Saletta ◽  
Ricardo E. Vilain ◽  
Aditya Kumar Gupta ◽  
Sumanth Nagabushan ◽  
Aysen Yuksel ◽  
...  
Keyword(s):  
Cancer Recurrence ◽  
Predictive Biomarker ◽  
Immune Checkpoint Blockade ◽  
Mycn Amplification ◽  
Positive Staining ◽  
Programmed Death Ligand 1 ◽  
Weak Intensity ◽  
Programmed Death ◽  
Increased Risk ◽  
Risk Of Cancer

Purpose Programmed death-ligand 1 (PD-L1) expression represents a potential predictive biomarker of immune checkpoint blockade response. However, literature about the prevalence of PD-L1 expression in the pediatric cancer setting is discordant. Methods PD-L1 expression was analyzed using immunohistochemistry in 500 pediatric tumors (including neuroblastoma, sarcomas, and brain cancers). Tumors with ≥ 1% cells showing PD-L1 membrane staining of any intensity were scored as positive. Positive cases were further characterized, with cases with weak intensity PD-L1 staining reported as having low PD-L1 expression and cases with a moderate or strong intensity of staining considered to have high PD-L1 expression. Results PD-L1–positive staining was identified in 13% of cases, whereas high PD-L1 expression was found in 3% of cases. Neuroblastoma (n = 254) showed PD-L1 expression of any intensity in 18.9% of cases and was associated with longer overall survival ( P = .045). However, high PD-L1 expression in neuroblastoma (3.1%) was significantly associated with an increased risk of relapse ( P = .002). Positive PD-L1 staining was observed more frequently in low- and intermediate-risk patients ( P = .037) and in cases lacking MYCN amplification ( P = .002). Conclusion In summary, high PD-L1 expression in patients with neuroblastoma may represent an unfavorable prognostic factor associated with a higher risk of cancer relapse. This work proposes PD-L1 immunohistochemical assessment as a novel parameter for identifying patients with an increased likelihood of cancer recurrence.

Sign in / Sign up

Export Citation Format

Share Document