Chemotherapy Extravasation: Incidence of and Factors Associated With Events in a Community Cancer Center

2021 ◽  
Vol 25 (6) ◽  
pp. 680-686
Author(s):  
Nancy Ehmke
Keyword(s):  
Cancer Center ◽  
Factors Associated

scholarly journals Nephrectomy Delay of More than 10 Weeks from Diagnosis Is Associated with Decreased Overall Survival in pT3 RCC

2021 ◽  
Vol 8 (2) ◽  
pp. 27-33
Author(s):  
Jiping Zeng ◽  
Ken Batai ◽  
Benjamin Lee
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Logistic Regression ◽  
Proportional Hazards ◽  
Surgical Margin ◽  
Cox Proportional Hazards ◽  
Cancer Center ◽  
Integrated Network ◽  
Factors Associated ◽  
The Impact

In this study, we aimed to evaluate the impact of surgical wait time (SWT) on outcomes of patients with renal cell carcinoma (RCC), and to investigate risk factors associated with prolonged SWT. Using the National Cancer Database, we retrospectively reviewed the records of patients with pT3 RCC treated with radical or partial nephrectomy between 2004 and 2014. The cohort was divided based on SWT. The primary out-come was 5-year overall survival (OS). Logistic regression analysis was used to investigate the risk factors associated with delayed surgery. Cox proportional hazards models were fitted to assess relations between SWT and 5-year OS after adjusting for confounding factors. A total of 22,653 patients were included in the analysis. Patients with SWT > 10 weeks had higher occurrence of upstaging. Using logistic regression, we found that female patients, African-American or Spanish origin patients, treatment in academic or integrated network cancer center, lack of insurance, median household income of <$38,000, and the Charlson–Deyo score of ≥1 were more likely to have prolonged SWT. SWT > 10 weeks was associated with decreased 5-year OS (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.15–1.33). This risk was not markedly attenuated after adjusting for confounding variables, including age, gender, race, insurance status, Charlson–Deyo score, tumor size, and surgical margin status (adjusted HR, 1.13; 95% CI, 1.04–1.24). In conclusion, the vast majority of patients underwent surgery within 10 weeks. There is a statistically significant trend of increasing SWT over the study period. SWT > 10 weeks is associated with decreased 5-year OS.

Patient factors associated with time to medication receipt of oral anti-cancer drugs.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1519-1519
Author(s):  
Morgan RL Lichtenstein ◽  
Melissa Beauchemin ◽  
Sahil Doshi ◽  
Rohit Raghunathan ◽  
Cynthia Law ◽  
...  
Keyword(s):  
Financial Assistance ◽  
Cancer Center ◽  
Prior Authorization ◽  
Cancer Drugs ◽  
Free Standing ◽  
Oncology Patients ◽  
Related Factors ◽  
Factors Associated ◽  
Anti Cancer ◽  
Race Ethnicity

1519 Background: The past decade has seen a dramatic increase in the number of Food and Drug Administration approvals of oral anti-cancer drugs (OACDs). Most OACD prescriptions require coordination between providers, payers, specialty pharmacists, and financial assistance organizations, which can delay drug receipt. We evaluated median time to OACD receipt (TTR) from initial OACD prescription submission and assessed clinical and process-related factors associated with TTR. Methods: We prospectively collected data on all new OACD prescriptions for adult oncology patients at a large, urban outpatient cancer center from 1/1/2018 to 12/31/2019. We collected patient demographic, medical, and insurance data; prescription submission and delivery dates; and interactions with payers and financial assistance groups. TTR was defined as the number of days from OACD initial prescription to patient receipt of the drug. We estimated the median TTR across all patients and used multivariable logistic regression to identify factors associated with TTR above the median. Results: The cohort included 1080 patients who were prescribed 1269 new OACDs. Of these prescriptions, 84% (N=1069) were received, and 71% (N=896) required prior authorization. The median patient age was 66, 44% identified as Non-Hispanic White (White), 25% of patients had commercial insurance, 16% had Medicaid alone, and 58% had Medicare alone or in combination with another plan. The median TTR per patient was 7 days (IQR 0 – 142; 25% ≥ 14 days and 5% ≥ 30 days). In unadjusted analyses, insurance and race/ethnicity were associated with TTR. Compared with patients covered by Medicaid, those with Medicare and supplemental insurance (a partial, not free-standing plan) had nearly 2.5 times the odds of TTR >7 days controlling for other factors. Race/ethnicity showed a trend toward longer TTR with Non-Hispanic Black (Black) patients having a longer TTR compared to White patients, controlling for other factors. We did not observe statistically significant effects of either comorbidity or prior authorization requirement on TTR. Conclusions: Though the majority of oncology patients prescribed OACDs receive the drug, 71% of prescriptions required prior authorization and a quarter of patients waited at least two weeks. Disparities in TTR are primarily driven by financial factors, specifically insurance type.[Table: see text]

Factors Affecting the Use of Palliative Radiotherapy in Ontario

2001 ◽  
Vol 19 (1) ◽  
pp. 137-144 ◽  
Author(s):  
J. Huang ◽  
S. Zhou ◽  
P. Groome ◽  
S. Tyldesley ◽  
J. Zhang-Solomans ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Palliative Radiotherapy ◽  
Cancer Center ◽  
Factors Affecting ◽  
Cancer Centers ◽  
Factors Associated ◽  
Cancer Registry Data ◽  
Barriers To Access ◽  
Ontario Cancer Registry ◽  
Primary Measure

PURPOSE: To describe the use of palliative radiotherapy (PRT) and to identify factors associated with the use of PRT. MATERIALS AND METHODS: The Ontario Cancer Registry was used to identify 193,253 adult patients who died of cancer between 1986 and 1995. Radiotherapy records from all Ontario cancer centers and the data on socioeconomic status (SES) from the Canadian Census were linked to the Ontario Cancer Registry data. The proportion of cases who received at least one course of PRT at any time within 2 years of death (PRT2Y) was used as a primary measure of the use rate of PRT. RESULTS: Overall, 26.4% of cases underwent at least one course of PRT. PRT2Y remained relatively constant over the study period. PRT2Y was disease-specific and ranged from 4% for pancreatic cancer to 41% for prostate cancer. Age was negatively associated with PRT2Y (adjusted odds ratio [OR], 4.5 for the youngest group), and SES was positively associated with PRT2Y (adjusted OR, 1.2 for patients from wealthy communities). Patients who were initially diagnosed in a hospital affiliated with a cancer center (adjusted OR, 1.4) or who lived in a county in which a cancer center is located (adjusted OR, 1.2), or who resided in certain regions (adjusted OR, 1.20 for Hamilton and 1.17 for Kingston), were more likely to be treated with PRT. CONCLUSION: The use of PRT varied across the dispersed population in Ontario and was influenced by factors unrelated to the patient’s needs. An effort should be made to reduce barriers to access for disadvantaged groups.

Factors associated with the desire to undergo post-mastectomy breast reconstruction in a Mexican breast cancer center

2020 ◽  
Author(s):  
Paulina Bajonero-Canonico ◽  
Ana S. Ferrigno ◽  
Jorge A. Saldaña-Rodriguez ◽  
David E. Hinojosa-Gonzalez ◽  
Cristel G. de la O-Maldonado ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Center ◽  
Factors Associated

Association of baseline health and gender with small renal mass pathology.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 515-515
Author(s):  
Wassim Bazzi ◽  
Sheila Dejbakhsh ◽  
Melanie Bernstein ◽  
Jonathan A. Coleman ◽  
Paul Russo
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Tumor Size ◽  
Cancer Center ◽  
Cell Renal Cell Carcinoma ◽  
Factors Associated ◽  
Preoperative Serum ◽  
And Gender ◽  
Baseline Health

515 Background: Previous reports describe that 20% of small renal masses (SRM) are benign and women are twice as likely to have benign pathology. In this study we further explore the association of baseline health and gender with SRM pathology. Methods: After IRB approval, retrospective chart review of patients who have undergone nephrectomy at Memorial Sloan-Kettering Cancer Center from 05/1998 to 10/2012 with final path ≤ 4cm and staged as pT1a if malignant. Tumor size ≤ 4cm was chosen to limit the tumor mass effect on renal function. Patients with solitary kidney, multiple and bilateral tumors, and history of prior renal surgeries were excluded. Collected data included age, gender, race, ASA class for medical co−morbidities which were divided into low (I−II) and high (III−IV), procedure, preoperative serum creatinine, eGFR, and final pathology. eGFR was calculated using the CKD−Epi formula. Preoperative Chronic kidney disease (pCKD) was defined as eGFR < 60 mL/min per 1.73 m2. Malignant pathologies were clear cell renal cell carcinoma (RCC), papillary RCC and chromophobe RCC whereas benign were oncocytoma, angiomyolipoma and other. Logistic regression analysis was performed to determine clinical factors associated with malignant SRM. Results: Our cohort consisted of 1726 patients with mean age 59.7 yrs. 61% (n=1045) were men, 90% (n=1,553) were white, 43% (n=736) had high ASA, 89% (1,540) underwent partial nephrectomy, 30% (n=525) had pCKD, 83% (n=1426) with malignant pathology and mean tumor size 2.5cm. On bivariable analysis patients with malignant SRM had a higher proportion of men (64.3 vs. 42.7%, p<0.001), high ASA class (43.8 vs. 37.3%, p=0.041) and larger tumors (2.6 vs. 2.3, p<0.001). There were no differences in age, race, mean eGFR or proportion with pCKD. On logistic regression analysis by gender factors associated with malignant pathology in women were high ASA class (OR 1.57, 95% CI 1.07−2.32) and tumor size (OR 1.48, 95% CI 1.20−1.81), and in men tumor size only (OR 1.33, 95% CI 1.06−1.67). Conclusions: Our results are in line with previous reports on the association of male gender and larger tumor size with malignant SRM. In addition we do show that among women those with poor health have a higher likelihood for having a malignant SRM.

Sociodemographic factors associated with cancer treatment completion among women with breast cancer at Butaro Cancer Center of Excellence (BCCOE) in Rwanda.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19220-e19220
Author(s):  
Abirami Natarajan ◽  
Niclas Rudolfson ◽  
Daniel O'Neil ◽  
Lauren Schleimer ◽  
Jean Marie Vianney Dusengimana ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Hormonal Therapy ◽  
Advanced Disease ◽  
Locally Advanced ◽  
Treatment Completion ◽  
Sociodemographic Factors ◽  
Cancer Center ◽  
Factors Associated ◽  
Complete Treatment

e19220 Background: Many barriers exist to delivering comprehensive breast cancer care in low-income countries. We examined sociodemographic factors associated with treatment completion among women receiving care for breast cancer at Butaro Cancer Center of Excellence (BCCOE), Rwanda’s first public cancer facility. Methods: We retrospectively measured treatment completion rates in women with early and locally advanced breast cancer diagnosed at BCCOE between July 1, 2012 and December 31, 2016. We defined treatment completion as receipt of surgery, 4 cycles of chemotherapy, and initiation of hormonal therapy for estrogen receptor positive (ER+) breast cancer. We used logistic regression to examine associations between socio-demographic and clinical factors and treatment completion. Travel time was estimated using a geographic information systems model using the WHO tool AccessMod 5.0. Results: Of 212 eligible women, 138 (65%) had surgery and 141 (66%) received 4 cycles of chemotherapy. Among 139 women with ER+ cancer, 59% initiated hormonal therapy. Overall 56% received all indicated treatment including surgery, chemotherapy, and hormonal therapy (if ER positive); 44% did not complete indicated treatment. Women who lived closer to the hospital ( <50 minutes travel time) were more likely than other women to complete treatment (OR 4.2; 95% CI 1.1-15.1). Women with early-stage disease were also more likely than women with locally advanced disease to complete treatment (OR 2.2, 95% CI 1.1-4.4). Among 100 women with available information about ubudehe (Rwandan social categorization used as a proxy for socioeconomic status), rates of treatment completion were higher for women who were eligible for social support (ie: transportation support or insurance subsidy) than women who were not (74% v. 63%), although this difference was not statistically significant (p= 0.51). Conclusions: Significant barriers exist for breast cancer patients receiving treatment in this low resource setting; nevertheless, over half of the patients completed therapy. Interventions are needed to facilitate care for women with long travel times and locally advanced disease to reduce disparities in outcomes for this population of patients. Further research is needed to determine the role of social support in treatment completion.

scholarly journals Incidence and risk factors for hypoglycemia in patients with hepatocellular carcinoma

2021 ◽  
Author(s):  
XiaoJing Zheng ◽  
Hong-Hong Yan ◽  
Bin Gan ◽  
Xiao-Ting Qiu ◽  
Jie Qiu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Logistic Regression ◽  
Hba1c Level ◽  
Glycated Hemoglobin ◽  
Multivariate Logistic Regression Analysis ◽  
Cancer Center ◽  
Regression Analyses ◽  
Multivariate Logistic Regression ◽  
Factors Associated

Abstract AimTo evaluate the incidence and risk factors for hypoglycemia in patients with hepatocellular carcinoma (HCC).MethodsWe collected and analyzed the clinical data of patients with HCC in our cancer center between April 2020 and June 2021. Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with hypoglycemia.ResultsThe incidence rate of hypoglycemia in patients with HCC was 28.9% (67/232). Multivariate logistic regression analysis showed a significant association between hypoglycemia and Child-Pugh grade C (odds ratio [OR]=7.3, 95% confidence interval [CI] 2.28–23.31, p=0.001), alpha-fetoprotein (AFP) level (OR=1.000035, 95% CI 1.000007–1.000063, p=0.015), and glycated hemoglobin (HbA1c) level (OR=0.46, 95% CI 0.29–0.73, p=0.001).ConclusionChild-Pugh stage and HbA1c and AFP levels were associated with hypoglycemia in patients with HCC. Our study suggests that these three factors should be comprehensively considered when estimating the risk of hypoglycemia in these patients, and the diagnosis, treatment, and nursing plan should be adjusted in time to reduce the incidence of hypoglycemia.

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