Application of Western patients-based Adjuvant! Online (AOL) model on Korean colon cancer patients.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 599-599
Author(s):  
M. Jung ◽  
G. Kim ◽  
J. Ahn ◽  
N. Kim ◽  
H. Chang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Internal Model ◽  
Assessment Model ◽  
Cancer Center ◽  
Risk Assessment Model ◽  
Cancer Specific Survival ◽  
Tumor Registry ◽  
Study Population

599 Background: Adjuvant! Online (AOL) is a web-accessible risk-assessment model that predicts the mortality and the benefits of adjuvant therapy ( www.adjuvantonline.org ). AOL has never been validated for Asian colon cancer patients. Methods: Using the Yonsei Tumor Registry (YTR) database, we calculated the survival for the patients with T1-4, N0-2, M0 colon cancer who were treated at the Yonsei Cancer Center between 1990 and 2005. Observed and predicted 5-year survival was compared for each patient. Results: The median age of the study population was 60 years (range, 15-87 years) and the median follow-up duration was 7.9 years (range, 0.06-19.8 years) for all 1,431 patients. While AOL underestimate overall survival (OS) (predicted-observed=-1.02%, P=0.008), it overestimate colon cancer-specific survival (CCSS) (predicted-observed=3.8%, P<0.001) in Korean patients. Especially, AOL underestimated OS and CCSS in younger patients than age 50 years (predicted-observed=-4.3%, P<0.001 and predicted-observed=-3.5%, P<0.001, respectively). We conducted an internal model validation by using a Korean version of AOL (KAOL), which was a new model for prognosis based on AOL's parameters. 5-year OS and CCSS between the observed and the KAOL predicted survival were not different (77.25 vs. 77.15, P=0.873 and 77.4% vs. 77.6%, P=0.78, respectively). The concordance indexes about OS and CCSS were 0.75 and 0.74, respectively. Conclusions: KAOL model for Korean colon cancer patients is more suitable to predict 5-year outcomes compared to ALO model for Western patients. No significant financial relationships to disclose.

scholarly journals A Thrombotic Biomarker-Based Risk Assessment Scoring Model for Disease Recurrence in Breast Cancer Patient Candidate to Systemic Chemotherapy

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2426-2426
Author(s):  
Anna Falanga ◽  
Cinzia Giaccherini ◽  
Marina Marchetti ◽  
Giovanna Masci ◽  
Cristina Verzeroli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Cancer Patients ◽  
Disease Recurrence ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Breast Cancer Patients ◽  
Scoring Model ◽  
D Dimer

Background. Hypercoagulability, a common finding in cancer patients, is associated with an increased risk of both thrombosis and tumor development. The HYPERCAN study (ClinicalTrials.gov, ID# NCT02622815) is an ongoing Italian prospective, multicenter, observational study, evaluating the predictive value of thrombotic markers for early cancer diagnosis in healthy subjects and for cancer prognosis and venous thromboembolism in patients with newly diagnosed malignant disease. In this analysis of a large cohort of patients with breast cancer, we evaluated whether pre-chemotherapy thrombotic biomarker levels: 1. are associated with breast cancer-specific clinicopathological features; and 2. may predict for disease recurrence (DR). Patients and Methods. D-dimer, fibrinogen, prothrombin fragment 1+2 (F1+2), and FVIIa/antithrombin complex (FVIIa/AT) levels were measured in 701 early-stage resected breast cancer patients, candidate to adjuvant chemotherapy and prospectively enrolled in the HYPERCAN study. Significant prognostic parameters for DR were identified by Cox-regression multivariate analysis and used for generating a risk assessment model. The study protocol is approved by the local Ethics Committee. Informed written consent is obtained from all study subjects. Results. Increased pre-chemotherapy D-dimer, fibrinogen, and F1+2 levels were significantly associated with a large tumor size (≥ 5 cm) and lymph node positivity. After 3.4 years follow-up, 71 patients experienced a DR. Comparison of the levels of the hypercoagulation variables of patients who experienced relapse versus patients who remained disease-free during follow-up showed that there were no statistical differences for all, but F1+2 biomarker levels, which were significantly higher in the group patients who relapsed [223 (115-618) vs 197 (115-385) pmol/l; p=0.024]. In addition, correlation analyses showed that pre-chemotherapy levels of fibrinogen were significantly and inversely associated with time to relapse (β = -0.317; p=0.012). Cox-multivariate analysis identified F1+2 (HR 2; 95% CI, 1.1-3.6; p=0.019), tumor size ≥ 5cm (HR 2.6; 95% CI, 1.4-4.6; p=0.001), and Luminal B HER2-neg or TN molecular subtypes (HR 3.9; 95% CI, 2.1-7.5; p<0.001) as independent risk factors for DR. Based on these variables, we generated a risk assessment model that significantly identified patients at low- versus high-risk of DR (cumulative incidence: 6.2 vs 20.7%; HR=3.5; p<0.001). Conclusion. Our prospective laboratory data from the HYPERCAN breast cancer subjects were essential for generating a scoring model for DR risk assessment. Future investigations addressing the role of plasma thrombotic biomarkers in breast cancer patients' management are warranted and may provide the rationale for development of new therapeutic strategies. Project funded by AIRC "5xMILLE Multiunit extension program" n. 12237 grant from the "Italian Association for Cancer Research (AIRC)". Disclosures Santoro: Bayer: Consultancy, Speakers Bureau; Amgen: Speakers Bureau; BMS: Consultancy; Sandoz: Speakers Bureau; Eisai: Consultancy, Speakers Bureau; Novartis: Speakers Bureau; Lilly: Speakers Bureau; Celgene: Speakers Bureau; Servier: Consultancy, Speakers Bureau; Gilead: Consultancy, Speakers Bureau; AstraZeneca: Speakers Bureau; Roche: Speakers Bureau; Abb-Vie: Speakers Bureau; Pfizer: Consultancy, Speakers Bureau; Arqule: Consultancy, Speakers Bureau; MSD: Speakers Bureau; Takeda: Speakers Bureau; BMS: Speakers Bureau.

scholarly journals Data Driven Mathematical Model of FOLFIRI Treatment for Colon Cancer

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2632
Author(s):  
Aparajita Budithi ◽  
Sumeyye Su ◽  
Arkadz Kirshtein ◽  
Leili Shahriyari
Keyword(s):  
Mathematical Model ◽  
Colon Cancer ◽  
Cancer Patients ◽  
Immune Cell ◽  
Treatment Options ◽  
Data Driven ◽  
T Helper ◽  
Primary Tumors ◽  
Cell Fractions

Many colon cancer patients show resistance to their treatments. Therefore, it is important to consider unique characteristic of each tumor to find the best treatment options for each patient. In this study, we develop a data driven mathematical model for interaction between the tumor microenvironment and FOLFIRI drug agents in colon cancer. Patients are divided into five distinct clusters based on their estimated immune cell fractions obtained from their primary tumors’ gene expression data. We then analyze the effects of drugs on cancer cells and immune cells in each group, and we observe different responses to the FOLFIRI drugs between patients in different immune groups. For instance, patients in cluster 3 with the highest T-reg/T-helper ratio respond better to the FOLFIRI treatment, while patients in cluster 2 with the lowest T-reg/T-helper ratio resist the treatment. Moreover, we use ROC curve to validate the model using the tumor status of the patients at their follow up, and the model predicts well for the earlier follow up days.

scholarly journals Changes in fatigue, barriers, and predictors towards physical activity in advanced cancer patients over a period of 12 months—a comparative study

2021 ◽  
Author(s):  
J. Frikkel ◽  
M. Beckmann ◽  
N. De Lazzari ◽  
M. Götte ◽  
S. Kasper ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Physical Functioning ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Advanced Cancer Patients ◽  
Psychological Conditions ◽  
Patient Reported

Abstract Purpose Physical activity (PA) is recommended to improve advanced cancer patients’ (ACP) physical functioning, fatigue, and quality of life. Yet, little is known about ACPs’ attitude towards PA and its influence on fatigue and depressiveness over a longer period. This prospective, non-interventional cohort study examined ACPs’ fatigue, depression, motivation, and barriers towards PA before and after 12 months of treatment among ACP Methods Outpatients with incurable cancer receiving treatment at a German Comprehensive Cancer Center reporting moderate/severe weakness/tiredness during self-assessment via MIDOS II were enrolled. Fatigue (FACT-F), depression (PHQ-8), cancer-related parameters, self-assessed PA behavior, motivation for and barriers against PA were evaluated (T0). Follow-up data was acquired after 12 months (T1) using the same questionnaire. Results At follow-up, fatigue (p=0.017) and depressiveness (p=0.015) had increased in clinical relevant extent. Physically active ACP did not show significant progress of FACT-F (p=0.836) or PHQ-8 (p=0.799). Patient-reported barriers towards PA remained stable. Logistic regression analyses identified motivation as a positive predictor for PA at both time points (T0, β=2.152, p=0.017; T1, β =2.264, p=0.009). Clinically relevant depression was a negative predictor for PA at T0 and T1 (T0, β=−3.187, p=0.044; T1, β=−3.521, p=0.041). Conclusion Our findings emphasize the importance of psychological conditions in physical activity behavior of ACP. Since psychological conditions seem to worsen over time, early integration of treatment is necessary. By combining therapy approaches of cognitive behavioral therapy and exercise in interdisciplinary care programs, the two treatment options might reinforce each other and sustainably improve ACPs’ fatigue, physical functioning, and QoL. Trial registration German Register of Clinical Trials, DRKS00012514, registration date: 30.05.2017

scholarly journals Utility of telemedicine in COVID-19 pandemic: our experience at a tertiary cancer center in North East India

2020 ◽  
Vol 8 (11) ◽  
pp. 4027
Author(s):  
Ashok Kumar Das ◽  
Sumanjit S. Boro ◽  
Anupam Das ◽  
Partha Pratim Medhi ◽  
Kaberi Kakati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Task Force ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Cross Sectional ◽  
Ongoing Treatment ◽  
North East ◽  
Phone Calls

Background: Telemedicine is a very useful tool of communication between the doctor and the patient. The aim of this study was to find out the utility of telemedicine during the lockdown period of COVID-19 pandemic in North East India.Methods: It is a cross sectional study among the cancer patients at our center on follow up or ongoing treatment and analysis of all the data acquired from telephonic conversation with our patients from 30th March, 2020 to 3rd May, 2020. Have contacted 4181 patients during this period over phone. All phone calls were done by respective department doctors.Results: From the demographic data, we get that 35.4% of patients were at good physical condition, 3.5% with poor general condition, 11.6% patients having ongoing treatment in our institute, 21.1% patients expired, 0.9% patients have nonmalignant diagnosis, 1.4% patients left the institute due to various reasons. Analyzed this data with brain storming sessions amongst the COVID-19 task force doctors and tried to find out solutions of each problem.Conclusions: Telemedicine cannot replace conventional method of in person treatment, but it proved to be a useful tool during the COVID-19 pandemic for patient follow up and treatment of cancer patients.

Patterns of failure after definitive treatment for T4a larynx cancer in the Veterans Affairs Health System.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18006-e18006
Author(s):  
Rohith S. Voora ◽  
Bharat Panuganti ◽  
Mitchell Flagg ◽  
Abhishek Kumar ◽  
Nikhil V. Kotha ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Disease Recurrence ◽  
Distant Recurrence ◽  
Larynx Cancer ◽  
Definitive Treatment ◽  
Lower Probability ◽  
Cancer Specific Survival ◽  
Curative Intent

e18006 Background: Both chemoradiotherapy (CRT) and total laryngectomy (TL) with adjuvant therapy are curative-intent treatment options for patients with T4a larynx cancer. Disease recurrence is a known negative prognosicator, but differences in recurrence patterns and the subsequent survival associations are not well characterized. To address this knowledge gap, we present long-term recurrence and survival outcomes from a novel longitudinal data source. Methods: Retrospective study of non-metastatic T4a larynx cancer patients diagnosed between 2000-2017 who underwent curative-intent treatment (TL with adjuvant therapy or primary CRT) from the VA Informatics and Computing Infrastructure database. Adjuvant therapy consisted of either postoperative radiotherapy (RT) or CRT. Fine-Gray and Cox models were used to evaluate primary outcomes – time to locoregional recurrence and distant recurrence. Secondary outcomes included overall survival (OS), cancer-specific survival (CSS), non-cancer specific survival (NCSS), and disease-free survival (DFS). These multivariable models accounted for age, race, alcohol history, smoking status, education and income, Charlson-Deyo score, N-classification, and tumor subsite. Results: The study included 1,114 patients with a median follow-up time of 63.3 months among those alive at last follow up. In the TL group, adjuvant RT was used in 69% and adjuvant CRT was used in 31%. Median time to first recurrence was 24.4 months with overall incidence of 28.5% locoregional and 9.5% distant recurrence. Primary CRT patients had higher rates of locoregional (37.2 vs. 22.9%) and distant recurrence (13.3 vs. 7.0%) (p < 0.0001). Median OS was 27.3 months for CRT (95% CI: 23.6-32.4 months) and 47.5 months (95% CI: 39.6-52.1 months) for TL. Median DFS was 14.1 months for CRT (95% CI:12.5-17.2 months) and 37.9 months (95% CI 31.2-47.5 months) for TL. On multivariable analysis compared to CRT, TL was associated with longer time to locoregional (HR 0.50, 95% CI:0.40-0.61) and distant recurrence (HR 0.50, 95% CI:0.34-0.73). Having N+ disease increased risk of distant recurrence (HR 2.20, 95% CI:1.42-3.41). TL was associated with improved OS (HR 0.78, 95% CI:0.67 – 0.91), CSS (HR 0.73, 95% CI:0.59 – 0.89), and DFS (HR 0.58, 95% CI 0.49-0.69) compared to CRT; NCSS was equivalent between groups (HR 1.09, 95% CI:0.88-1.35). Of the CRT patients with locoregional failures, 67/163 (41.1%) were salvaged with surgery. Conclusions: In this cohort of T4a larynx cancer patients, surgical management demonstrated favorable recurrence and survival results. TL with adjuvant therapy was associated with significantly lower incidence of both locoregional and distant recurrence and increased OS, CSS and DFS compared to CRT. Lower probability of disease recurrence, in addition to a survival advantage, should be considered as an important advantage to up-front surgery.

Determinants of health-related quality of life in colon cancer patients include stoma and smoking habits, but not type of surgery

2019 ◽  
Author(s):  
Catarina Tiselius ◽  
Andreas Rosenblad ◽  
Eva Strand ◽  
Kennet Smedh
Keyword(s):  
Quality Of Life ◽  
Colon Cancer ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Linear Regression Analysis ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background: Health-related quality of life (HRQoL) has gained increased attention in cancer care. Studies have shown that poor QoL might worsen the cancer related prognosis. The aim of this study was to investigate HRQoL in patients with colon cancer and to compare data with reference values from the general population in Sweden at diagnosis (baseline) and at six months of follow-up. Methods : This was a prospective population-based study of colon cancer patients from Västmanland County, Sweden, included between March 2012 and September 2016. HRQoL was measured using the cancer-specific EORTC QLQ-C30 questionnaire. Data on HRQoL was compared with Swedish population reference values. Multiple linear regression analysis adjusted for age, sex, body mass index (BMI), American Society of Anaesthesiology (ASA) physical status classification, emergency/elective surgery, and resection with/without a stoma and tumour stage (TNM), was used. Results : A total of 67% (376/561) of all incident colon cancer patients (196 [52.1%] females) were included. Mean (range) age was 73 (30-96) years. The univariate analysis showed that patients with colon cancer had worse QoL (8/15 parameters) compared with a Swedish reference population both at baseline and at 6 months follow-up. Furthermore, linear regression analysis showed that patients with more comorbidity (ASA 3 and 4), smokers and patients planned to be operated on with a stoma, were at higher risks for poor QoL than the other included patients. Conclusions : The reported determinants of HRQoL may be used to identify risk groups and enable individualized care for patients that need more support from health care.

scholarly journals Application of a domicile-based exercise program for shoulder rehabilitation after breast cancer surgery

2012 ◽  
Vol 20 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Eliana Louzada Petito ◽  
Afonso Celso Pinto Nazário ◽  
Simone Elias Martinelli ◽  
Gil Facina ◽  
Maria Gaby Rivero De Gutiérrez
Keyword(s):  
Breast Cancer ◽  
Experimental Study ◽  
Cancer Patients ◽  
Preoperative Evaluation ◽  
Exercise Program ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Quasi Experimental ◽  
Study Population

The aim of this study was to evaluate the effectiveness of an exercise program for the recuperation of the range of motion (ROM) of the shoulder. This is a quasi-experimental study developed at the Mastology Outpatient Clinic of the Federal University of São Paulo - Brazil, from August 2006 to June 2008, with 64 breast cancer patients undergoing surgery. The intervention consisted of: preoperative evaluation of the ROM, verbal and written guidance, demonstration and implementation of the exercises and revaluation at the outpatient follow-up appointments until the 105th postoperative day (PO). From the 7th PO a significant increase was observed in the ROM, which continued until the 105th PO. The minimum time for recovery was 105 days for the women undergoing mastectomy, and 75 days for those undergoing quadrantectomy. There was satisfactory adherence of 78.6% of the women. The domicile program was effective for the recovery of ROM in the study population, benefiting women who can not attend a presential program.

Initiation and Discontinuation of Complementary Therapy Among Cancer Patients

2007 ◽  
Vol 25 (33) ◽  
pp. 5267-5274 ◽  
Author(s):  
Sung-Gyeong Kim ◽  
Eun-Cheol Park ◽  
Jae-Hyun Park ◽  
Myung-Il Hahm ◽  
Jin-Hwa Lim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Initial Treatment ◽  
Stage Iv ◽  
Complementary Therapy ◽  
Cancer Center ◽  
Cumulative Probability ◽  
Colorectal Cancer Patients ◽  
The Impact

PurposeTo identify the initiation or discontinuation of complementary therapy (CT) and determine the impact of sociodemographic and clinical factors on CT use among cancer patients.Patients and MethodsEligible patients were age 20 or older; newly diagnosed with stomach, liver, or colorectal cancer; and started their initial treatment at the National Cancer Center, Korea, between April 1, 2001, and April 30, 2003. In total, 541 cancer patients were surveyed in face-to-face interviews at baseline, and telephone follow-up interviews were performed every 3 months for 3 years.ResultsA total of 281 patients commenced CT after diagnosis; 164 patients stopped using CT during the follow-up period. The overall cumulative probability of starting CT at 1, 2, and 3 years was 50%, 54%, and 55%, respectively. In a Cox multivariate analysis, stomach and liver cancer were associated with an increased probability of initiating CT compared with colorectal cancer. Patients who were classified as stage I, II, or III at diagnosis were associated with a decreased probability of discontinuing CT compared with stage IV.ConclusionMost cancer patients started to use CT during the initial treatment period. Thus, physicians should communicate with cancer patients about CT at this phase. In particular, more attention should be paid to women and individuals with higher household incomes because these groups are more likely to start CT.

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