Does Distance to Treatment Affect Mortality Rate for Surgical Oncology Patients?

2020 ◽  
Vol 86 (9) ◽  
pp. 1129-1134
Author(s):  
Meghan Garstka ◽  
Dominique Monlezun ◽  
Emad Kandil
Keyword(s):  
Positive Margin ◽  
Surgical Oncology ◽  
Tumor Stage ◽  
Mortality Trends ◽  
Multiple Tumor ◽  
Income Insurance ◽  
Oncology Care ◽  
Tumor Types ◽  
Distance To Care ◽  
Relationship Of

Introduction Using the National Cancer Database (NCDB), we seek to analyze the relationship of patient distance to hospital of treatment on mortality trends after surgery, since patients often travel large distances to referral centers. Methods A retrospective cohort study of the NCDB from 2004 to 2013 was performed, and patients with gastrointestinal, melanoma, and head and neck primary site tumors who underwent surgery were included. We excluded cases with no recorded mortality status or distance from the hospital. A multivariable logistic regression was conducted with adjustments for population density, treating facility location, age, race, gender, education, income, insurance, comorbidities (Charlson-Deyo score), days from diagnosis to treatment, positive margin, tumor stage and grade, and lymph or vascular invasion. Results A total of 1 424 482 patients were included. Overall median distance to hospital was 9.7 miles (range 4.2-23.7 miles); 696 647 (48.91%) of the sample traveled a distance greater than 10 miles to the institution where the procedure was performed. The multivariable regression analysis demonstrated overall lower mortality for those patients travelling a longer distance to care for multiple tumor types, including: liver (OR .87, .77-.99, P = .032), pancreas (OR .82, .76-.89, P < .001), colon (OR .92, .89-.95, P < .001), rectum (OR .90, .83-.96, P = .003), melanoma (OR .83, .79-.88, P < .001), and tumors of the larynx (OR .80, .69-.94, P = .005). Discussion Increased distance traveled for surgical treatment has a significant correlation with decreased odds of mortality for multiple cancers, highlighting the importance of centralized referral patterns for oncology care.

Key determinants of patient experience in oncology: Results from a national online survey.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17502-e17502
Author(s):  
Christopher G. Lis ◽  
Steve Wood ◽  
Mark Rodeghier ◽  
Harold Taylor ◽  
James F. Grutsch ◽  
...  
Keyword(s):  
Patient Experience ◽  
Online Survey ◽  
Age Distribution ◽  
Hospital Setting ◽  
Tumor Stage ◽  
National Sample ◽  
Care Providers ◽  
Oncology Care ◽  
Patient’S Perception ◽  
Tumor Types

e17502 Background: Evaluation of patient experience provides important data on the patient’s perception of the quality of care and treatment delivered by physicians, paramedical staff and the hospital as a whole. There are limited data on the most significant determinants of patient experience in the oncology setting. In a national sample of cancer patients, we investigated the key self-reported factors influencing overall patient experience. Methods: A national random sample of 724 patients undergoing treatment for cancer in a hospital setting between Jan 2009 and Dec 2011. Using a combination of professional and scholarly literature and focus groups, the survey instrument was developed employing an identified set of 13 patient experience factors, an overall patient experience measure and relevant demographic variables. Patients were invited via messages appearing randomly on oncology-oriented physician profile pages, content pages and hospital profile pages from the Healthgrades web properties. Patients were asked to rate their cancer treatment experience on a 5-point scale from “very poor” to “very good” on the 13 patient experience factors. Participants were also asked to identify factors that contributed the most to their overall patient experience. Results: 181 were males and 543 were females. Age distribution was 5-24 (n=8), 25-44 (n=95), 45-54 (n=197), 55-64 (n=259) and 65+ (n=159). Top 5 tumor types were breast (n=284), gynecological (n=78), colorectal (n=47), lung (n=34) and prostate (n=28). Tumor stage at the time of receiving care was I, 210; II, 149; III, 133; IV, 128; and unknown, 104.481 (66.4%) patients were “very satisfied” with their overall experience. The three most important determinants of patient experience as reported by patients were "a compassionate team of care providers" (49.2%), "a knowledgeable, competent physician” (48.9%) and "treatment as a human being and not just a person with a disease" (28.3%). Conclusions: We identified three key determinants of overall patient experience in oncology. Oncology care providers can use data on patient experience to design and track quality improvement over time as well as recognize and expeditiously resolve unmet needs of patients in real-time.

scholarly journals Targeting AURKA in Cancer: molecular mechanisms and opportunities for Cancer therapy

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ruijuan Du ◽  
Chuntian Huang ◽  
Kangdong Liu ◽  
Xiang Li ◽  
Zigang Dong
Keyword(s):  
Cancer Therapy ◽  
Molecular Mechanisms ◽  
Aurora Kinase ◽  
Interacting Proteins ◽  
Multiple Tumor ◽  
Oncogenic Pathways ◽  
Wide Range ◽  
The Family ◽  
Tumor Types ◽  
Cancer Tissues

AbstractAurora kinase A (AURKA) belongs to the family of serine/threonine kinases, whose activation is necessary for cell division processes via regulation of mitosis. AURKA shows significantly higher expression in cancer tissues than in normal control tissues for multiple tumor types according to the TCGA database. Activation of AURKA has been demonstrated to play an important role in a wide range of cancers, and numerous AURKA substrates have been identified. AURKA-mediated phosphorylation can regulate the functions of AURKA substrates, some of which are mitosis regulators, tumor suppressors or oncogenes. In addition, enrichment of AURKA-interacting proteins with KEGG pathway and GO analysis have demonstrated that these proteins are involved in classic oncogenic pathways. All of this evidence favors the idea of AURKA as a target for cancer therapy, and some small molecules targeting AURKA have been discovered. These AURKA inhibitors (AKIs) have been tested in preclinical studies, and some of them have been subjected to clinical trials as monotherapies or in combination with classic chemotherapy or other targeted therapies.

scholarly journals Enhance the Immune Checkpoint Inhibitors Efficacy with Radiotherapy Induced Immunogenic Cell Death: A Comprehensive Review and Latest Developments

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 678 ◽  
Author(s):  
Adrien Procureur ◽  
Audrey Simonaggio ◽  
Jean-Emmanuel Bibault ◽  
Stéphane Oudard ◽  
Yann-Alexandre Vano
Keyword(s):  
Cell Death ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Tumor Antigens ◽  
Checkpoint Inhibitors ◽  
Mitotic Cell ◽  
Immunogenic Cell Death ◽  
Dna Damages ◽  
Multiple Tumor ◽  
Tumor Types

The immunogenic cell death (ICD) is defined as a regulated cell death able to induce an adaptive immunity. It depends on different parameters including sufficient antigenicity, adjuvanticity and favorable microenvironment conditions. Radiation therapy (RT), a pillar of modern cancer treatment, is being used in many tumor types in curative, (neo) adjuvant, as well as metastatic settings. The anti-tumor effects of RT have been traditionally attributed to the mitotic cell death resulting from the DNA damages triggered by the release of reactive oxygen species. Recent evidence suggests that RT may also exert its anti-tumor effect by recruiting tumor-specific immunity. RT is able to induce the release of tumor antigens, to act as an immune adjuvant and thus to synergize with the anti-tumor immunity. The advent of new efficient immunotherapeutic agents, such as immune checkpoint inhibitors (ICI), in multiple tumor types sheds new light on the opportunity of combining RT and ICI. Here, we will describe the biological and radiobiological rationale of the RT-induced ICD. We will then focus on the interest to combine RT and ICI, from bench to bedside, and summarize the clinical data existing with this combination. Finally, RT technical adaptations to optimize the ICD induction will be discussed.

scholarly journals Larinksin Skuamöz Hücreli Karsinomunda LGALS3 Gen Varyasyonlarıyla Histopatolojik Kriterler Arasında Bir İlişki Var Mı ?

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Cem Horozoglu ◽  
Seyda Demirkol ◽  
Aysegul Verim ◽  
Dilara Sonmez ◽  
Saime Sürmen ◽  
...  
Keyword(s):  
Positive Family History ◽  
Treatment Resistance ◽  
Tumor Stage ◽  
Dynamic Factor ◽  
Solid Organ ◽  
Advanced Tumor Stage ◽  
Multiple Tumor ◽  
Advanced Tumor ◽  
Galectin 3 ◽  
Statistical Relationships

Abstract Objectives Genetic variations of LGALS3 (Galectin-3) were found to be associated with treatment resistance, mortality, recurrence, high tumor volume and multiple tumor involvement in solid organ cancers. The modulators of extracellular matrix (ECM), which is a dynamic factor in the larynx tissue with high biomechanical and regenerating ability, can play an important role. We aimed to investigate the relationship between the genetic variants of LGALS3, one of these modulators, with Laryngeal Squamous Cell Carcinoma (LSCC). Methods LGALS3 gene variations were genotyped by PCR-RFLP method using genomic DNA samples obtained from peripheral blood samples of 74 patients diagnosed with LSCC and 94 healthy controls. Results The C allele carriage for the Rs4652 genetic variant was found to be higher (p=0.017) in patients with LSCC. Statistical relationships were found between homozygous genotypes of this variant (CC/AA) with advanced tumor stage (p=0.017) and presence of reflux (p=0.036). CC genotype for rs4644 was found to be higher in cases with positive family history (p=0.036). Conclusions Our findings of LGALS3 gene variants, which are also found to be associated with other solid cancers, suggest that they may play a role in LSCC pathophysiology similarly.

scholarly journals Is There a Place for Immune Checkpoint Inhibitors in Vulvar Neoplasms? A State of the Art Review

2020 ◽  
Vol 22 (1) ◽  
pp. 190
Author(s):  
Fulvio Borella ◽  
Mario Preti ◽  
Luca Bertero ◽  
Giammarco Collemi ◽  
Isabella Castellano ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
State Of The Art ◽  
Checkpoint Inhibitors ◽  
Early Stage ◽  
Survival Rates ◽  
Younger Women ◽  
Multiple Tumor ◽  
Tumor Types

Vulvar cancer (VC) is a rare neoplasm, usually arising in postmenopausal women, although human papilloma virus (HPV)-associated VC usually develop in younger women. Incidences of VCs are rising in many countries. Surgery is the cornerstone of early-stage VC management, whereas therapies for advanced VC are multimodal and not standardized, combining chemotherapy and radiotherapy to avoid exenterative surgery. Randomized controlled trials (RCTs) are scarce due to the rarity of the disease and prognosis has not improved. Hence, new therapies are needed to improve the outcomes of these patients. In recent years, improved knowledge regarding the crosstalk between neoplastic and tumor cells has allowed researchers to develop a novel therapeutic approach exploiting these molecular interactions. Both the innate and adaptive immune systems play a key role in anti-tumor immunesurveillance. Immune checkpoint inhibitors (ICIs) have demonstrated efficacy in multiple tumor types, improving survival rates and disease outcomes. In some gynecologic cancers (e.g., cervical cancer), many studies are showing promising results and a growing interest is emerging about the potential use of ICIs in VC. The aim of this manuscript is to summarize the latest developments in the field of VC immunoncology, to present the role of state-of-the-art ICIs in VC management and to discuss new potential immunotherapeutic approaches.

INNV-05. MULTIDISCIPLINARY SPINE ONCOLOGY CARE ACROSS THE DISEASE CONTINUUM - UPDATES FOR THE BEDSIDE AND THE BOARDS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi106-vi106
Author(s):  
Erin Dunbar
Keyword(s):  
Initial Symptom ◽  
Multidisciplinary Program ◽  
Current State ◽  
Future State ◽  
Concise Review ◽  
Initial Tumor ◽  
Oncology Care ◽  
Resultant Increase ◽  
Tumor Types ◽  
Primary Spine

Abstract In response to the increased prevalence and complexity of metastatic and primary spine oncology, there has been a resultant increase in stakeholders, treatments and outcomes. A subset of the global multidisciplinary authors will present a timely and concise review of the contents of NOP’s Volume-7, supplement-1, “Multidisciplinary Spine Oncology Care Across the Disease Continuum”. The first portion will review: Epidemiology, Tumor Types, Presentation, Initial Tumor-directed Management, Initial Symptom-directed Management, Subsequent Tumor-directed Management, Subsequent Symptom-directed Management, and Multidisciplinary Program Development and Resources for Stakeholders. The second portion will challenge the current state of care and engage the attendees toward developing initiatives needed for a future state of care. Attendees will receive an update for both the bedside and the boards.

Radioembolization for Rare Metastatic Disease

2021 ◽  
Author(s):  
Andrew S. Niekamp ◽  
Govindarajan Narayanan ◽  
Brian J. Schiro ◽  
Constantino Pena ◽  
Alex Powell ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Hepatocellular Carcinoma ◽  
Metastatic Colorectal Cancer ◽  
Treatment Modality ◽  
Treatment Options ◽  
Efficacy And Safety ◽  
Multiple Tumor ◽  
Tumor Types ◽  
Hepatic Malignancies ◽  
Yttrium 90

AbstractRadioembolization has become a widespread treatment modality for both primary and metastatic hepatic malignancies. Although the majority of data and indication for yttrium-90 radioembolization have been for hepatocellular carcinoma and metastatic colorectal cancer, radioembolization with yttrium-90 has rapidly expanded into the treatment options for multiple tumor types with metastases to the liver. This article reviews the clinical data and expanding utilization of radioembolization for rare metastatic diseases with an emphasis on efficacy and safety.

scholarly journals Graphene oxide selectively targets cancer stem cells, across multiple tumor types: Implications for non-toxic cancer treatment, via “differentiation-based nano-therapy”

Oncotarget ◽  
2015 ◽  
Vol 6 (6) ◽  
pp. 3553-3562 ◽  
Author(s):  
Marco Fiorillo ◽  
Andrea F. Verre ◽  
Maria Iliut ◽  
Maria Peiris-Pagés ◽  
Bela Ozsvari ◽  
...  
Keyword(s):  
Stem Cells ◽  
Graphene Oxide ◽  
Cancer Stem Cells ◽  
Cancer Treatment ◽  
Multiple Tumor ◽  
Tumor Types
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