Liver metastases in mCRPC patients post-therapy with abiraterone (Abi) and/or abiraterone/enzalutamide (Enza).

250 Background: Liver metastases (mets) are a particularly poor prognostic group among mCRPC patients. The objective of this study is to characterize mCRPC patients who have had treatment with Abi or Enza to identify risk factors that may be associated with subsequent development of liver mets. Methods: A sample of 67 patients (n = 17 liver mets and 50 non-liver met patients matched by treatment history) seen at Tulane Cancer Center were selected for analysis. All patients had prior Abi and or Abi/Enza. Race, age at PCa diagnosis and Gleason Score at PCa diagnosis were assessed. For patients with liver mets, total liver metastatic volume was measured using CT scans and correlated against PSA, LDH and AST values at the time of the scan. Wilcoxon rank sum tests were run analyzing PSA, LDH and AST at the start of Abi treatment, end of Abi treatment as well the duration of Abi treatment, and the nadir PSA for these patients. Results: Patients were predominantly Caucasian, had a median Gleason Score of 8 at diagnosis and were at a median age of 57 for those with liver mets and 62 for non-liver met at PCa diagnosis. Pearson correlation analysis of the total liver lesion volume and lab values revealed a significant correlation for LDH (R = 0.491, < 0.01) and AST (R = 0.368, p < 0.05), but not for PSA. Further evaluation of PSA and AST values at the start and end of Abi treatment as well as at nadir PSA revealed no statistically significant differences between liver met patients and non-liver met patients. However, there was a significant difference (p = 0.015) between LDH levels at the end of Abi treatment with a median of 347 U/L for liver met and 238 U/L for non-liver met patients. Conclusions: LDH and AST levels correlate with extent of liver metastases. Additionally, elevated LDH at the end of Abi treatment is indicative of an increased risk for developing liver metastases. Larger sample sizes and molecular characterization of these tumors are required to gain more insights into this important patient population.

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PATH-19. MOLECULAR, HISTOLOGIC AND CLINICAL CHARACTERISTICS OF OLIGODENDROGLIOMAS: A MULTI-INSTITUTIONAL RETROSPECTIVE STUDY

Neuro-Oncology ◽

10.1093/neuonc/noaa215.701 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii168-ii168

Author(s):

Antonio Dono ◽

Kristin Alfaro-Munoz ◽

Yuanqing Yan ◽

Carlos Lopez-Garcia ◽

Zaid Soomro ◽

...

Keyword(s):

Health Science ◽

Cancer Center ◽

Subtotal Resection ◽

Adjuvant Radiation ◽

Science Center ◽

Who Grade ◽

Pik3ca Mutations ◽

Increased Risk ◽

Significant Difference ◽

Grade 3

Abstract In the 2016 WHO classification of CNS tumors, oligodendrogliomas are molecularly defined by IDH1 or IDH2 mutations and 1p/19q co-deletion. Some reports suggest that PI3K pathway alterations may confer increased risk of progression and poor prognosis in oligodendroglioma. However, factors that influence prognosis in molecularly defined oligodendroglioma (mOGD) have not been thoroughly studied. Also, the benefits of adjuvant radiation and temozolomide in mOGDs remain to be determined. 107 mOGDs diagnosed between 2008-2018 at the University of Texas Health Science Center at Houston (n= 39) and MD Anderson Cancer Center (n= 68) were included. A retrospective review of the demographic, clinical, histologic, molecular, and outcomes were performed. Median age at diagnosis was 37 years and 61 (57%) patients were male. There were 64 (60%) WHO Grade 2 and 43 (40%) WHO Grade 3 tumors. Ninety-five (88.8%) tumors were IDH1-mutant and 12 (11.2%) were IDH2-mutant. Eighty-two (77%) patients were stratified as high-risk: older than 40-years and/or subtotal resection (RTOG 9802). Gross-total resection was achieved in 47 (45%) patients. Treatment strategies included observation (n= 15), temozolomide (n= 11), radiation (n= 13), radiation with temozolomide (n= 62) and other (n= 6). Our results show a benefit of temozolomide vs. observation in progression-free survival (PFS). However, no benefit in PFS or overall survival (OS) was observed when comparing radiation vs. radiation with temozolomide. PIK3CA mutations were detected in 15 (14%) cases, and patients with PIK3CA-mutant mOGDs showed worse OS (10.7-years vs 15.1-years, p= 0.009). Patients with WHO Grade 3 tumors had shorter PFS but no significant difference in OS was observed compared to grade 2. Our findings suggest that mOGDs harboring PIK3CA mutations have worse OS. Except for an advantage in PFS in temozolomide treated patients, adjuvant treatment with radiation or the combination of both, showed no significant advantage in terms of OS.

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Racial variations in upgraded gleason scores of active surveillance candidates.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.e548 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. e548-e548

Author(s):

Krishna Pandya ◽

Allison H. Feibus ◽

Andrew B. Sholl ◽

Jonathan L. Silberstein

Keyword(s):

African American ◽

Active Surveillance ◽

Gleason Score ◽

Low Risk ◽

High Grade ◽

Total Cohort ◽

Median Serum ◽

Increased Risk ◽

Significant Difference ◽

Racial Variations

e548 Background: Currently, active surveillance is an appropriate option for patients who have low risk PCa as determined by the NCCN as Gleason Score (GS) ≤ 6 and a PSA <10. Methods: Following IRB approval, we determined that 141 men from our database had low risk PCa and were eligible for AS, but underwent radical prostatectomy (RP). We performed a retrospective review of these patients examining GS upon RP. Disease upgrading on RP was considered Gleason score ≥ 7. A two-tailed t-test was performed to examine whether African American (AA) patients had greater incidence of upgrading on RP than non-African American patients. Results: Of the 141 patients identified (36 AA, 105 non-AA) there were no significant differences in age at RP (59 AA, 59 non-AA), median PSA (5.5 ng/dL AA, 5.4 ng/dL non-AA), and number of positive cores (3 AA, 3 non-AA) at biopsy when stratified by race. A total of 85 patients (19 AA, 66 non-AA) were found to have an upgraded GS at the time of RP; again without significant difference with respect to age (60 AA, 61 non-AA), serum PSA (5.3 AA, 5.35 non-AA), total cores taken at biopsy (12 AA, 12 non-AA) and median positive cores (3.5 AA, 3 non-AA). Of the 85 patients upgraded, 66 (12 AA, 54 non-AA) were 3+4 and the remainder were ≥ 4+3. There was no significant racial variation for patients upgraded to Gleason 3+4 (p>0.05). Next we reviewed the presence of tertiary pattern 5 within these 3+4 patients and found it present in 1 patient who was AA. For the 19 patients with ≥ 4+3 upgrading, with respect to race (7 AA, 12 non-AA, p = .08) there were no significant differences in age, serum PSA, median positive and total cores taken at biopsy. However, when comparing these 19 upgraded ≥ 4+3 patients to the total cohort, they had a higher median serum PSA (6.16 ng/dLvs 5.4 ng/dL) and higher positive cores (4 vs 3) on biopsy. For these 19 patients, upgrading resulted in reclassification from low to high-grade (GS ≥ 8) PCa in 7 patients. Conclusions: African American patients with low risk PCa have do not have an increased risk of significant upgrading at RP when compared with other races, and further investigation is needed to identify factors that contribute to upgrading.

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Familial multiple sclerosis: volumetric assessment in clinically symptomatic and asymptomatic individuals

Multiple Sclerosis Journal ◽

10.1177/135245859900500202 ◽

1999 ◽

Vol 5 (2) ◽

pp. 74-77 ◽

Cited By ~ 7

Author(s):

Jennifer C Fulton ◽

Robert I Grossman ◽

Lois J Mannon ◽

Jayaram Udupa ◽

Dennis L Kolson

Keyword(s):

Multiple Sclerosis ◽

Monozygotic Twins ◽

Subsequent Development ◽

Monozygotic Twin ◽

Lesion Volume ◽

Sibling Pairs ◽

Clinically Normal ◽

Volumetric Assessment ◽

Significant Difference ◽

Normal Offspring

A genetic basis for clustering of multiple sclerosis (MS) cases, based on studies of MS families, has been proposed for decades. Few reports provide detailed neurological as well as neuroradiological findings on these patients. We report total T2-weighted intracranial lesion volumes on members of three familial MS cohorts: a mother and father with conjugal MS with one affected son and a neurologically normal son and daughter, one pair of monozygotic twin sisters with MS, and a female sibling pair with MS. We hypothesized that asymptomatic siblings in a family with two affected parents and another affected child might demonstrate clinically silent T2-weighted lesions; and that monozygotic twins with MS are more likely to express similar T2-weighted lesion volumes than non-twin sibling pairs. We found clinically silent lesions in unaffected children of the symptomatic parent couple, with a significant difference in total T2 lesion volume between these unaffected siblings and their parents, as well as their affected brother. In our other sibling pairs, T2 lesion volumes were similar between the twins and significantly different in the non-twin pair, despite similar levels of clinical functioning as determined by EDSS scoring. These results suggest that foci of demyelination might be expected in clinically normal offspring of parents with MS, possibly reflecting a genetic predisposition to subsequent development of MS.

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Perbedaan arus puncak ekspirasi antara anak asma dengan obesitas dan anak asma tanpa obesitas

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.18839 ◽

2013 ◽

Vol 10 (1) ◽

pp. 19

Author(s):

Nurul Hadi ◽

Madarina Julia ◽

Roni Naning

Keyword(s):

Peak Flow ◽

Pearson Correlation ◽

Cross Sectional Study ◽

Growth Chart ◽

Z Score ◽

Flow Meter ◽

Cross Sectional ◽

Asthmatic Children ◽

Increased Risk ◽

Significant Difference

Background: Obesity in children is associated with impairment of pulmonary function and increased risk of asthma. Obesity in asthmatic children may reduce lung function, that can be assessed by peak flow meter, a practical and an inexpensive tool.Objectives: To compare the peak expiratory flow (PEF) between obese and non-obese asthmatic children.Method: We conducted a cross sectional study in Yogyakarta during March 2010-September 2012. Fifty obese asthmatic patients and 50 non obese asthmatic control subjects participated in this study. Inclusion criteria were asthmatic patient, according to Pedoman Nasional Asma Anak (PNAA), and 6-18 years of age. Exclusion criteria were asthmatic attack, respiratory disease, heart disease and congenital chest malformation. Obesity is defined as body mass index (BMI) for age more than +3 SD WHO growth chart standards BMI for age 2007 z-score. Z-score is calculated with WHO AnthroPlus for Personal Computers. Data PEF is taken with electrical peak flow meter when the patient was not suffering from asthma attack. Normal PEF was defined as PEF ≥80% average (predicted) value for height.Results: The mean of age of asthmatic children in this study was 9.38 years and 9.50 years for non obese and obese respectively. The PFR was not different between obese asthmatic children and non obese asthmatic children (p=0,83). Pearson correlation of PFR and z-score BMI for age was positive weak correlation (r=0.12). There was significant difference of PFR between z-score BMI for age <3,20 and z-score BMI for age ≥3.20 (p=0.03). Significant difference of PFR also appears in duration of illness (p<0.001).Conclusion: There is no PFR difference between obese asthmatic children and non-obese asthmatic children. The difference of PFR emerges when statistic analysis performed using z-score BMI ≥3.20.

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Clinicopathologic and outcome characteristics of breast cancer with liver metastases (BCLM): a population study of the SEER database and a registry analysis of 1728 women

10.21203/rs.3.rs-17121/v1 ◽

2020 ◽

Author(s):

zhonghua wang ◽

Lei ji ◽

Lei Cheng ◽

Xiuzhi Zhu ◽

Yu Gao ◽

...

Keyword(s):

Breast Cancer ◽

Targeted Therapy ◽

Liver Metastases ◽

Cancer Patients ◽

Triple Negative ◽

Cancer Center ◽

Seer Database ◽

Breast Cancer Patients ◽

Death Risk ◽

Increased Risk

Abstract Background Breast cancer patients generally have a worse prognosis in presence of liver metastasis. The purpose of this study was to evaluate the risk factors and prognosis of breast cancer patients with liver metastases (BCLM). Methods Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed 2010 to 2016 and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were analyzed for further exploration. We extracted the clinicopathological characteristics for analysis by two independent authors. Logistic regression was used to identify factors associated with the risk of liver metastases. Survival analysis was completed using Cox proportional hazards regression model and Kaplan-Meier analysis. Results Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+), were associated with increased risk of the liver metastases. The median overall survival (OS) after BCLM diagnosis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS 38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the poorest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with subtype of HR+/HER2-, if the patients did not receive HER2-targeted therapy. For BCLM patients who had received HER2-targeted therapy, however, HR+/HER2+ was an indicator for decreased death risk in comparison of the subtype of HR+/HER2- (HR=0.74; 95% CI=0.58-0.95; P<0.001). Conclusions BCLM is associated with poor survival, depending on HR/HER2-defined subtypes. Patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative BCLM patients. HER2-targeted therapy should be recommended for HER2+ BCLM patients.

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Impact of bilateral mastectomy with or without immediate reconstruction on time to subsequent therapy in breast cancer in a community oncology clinic.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e18154 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e18154-e18154

Author(s):

Rajshekhar Chakraborty ◽

Ronald Regal ◽

Brian Johnson ◽

Jennifer Benedict ◽

Bret Edward Buckley Friday

Keyword(s):

Breast Cancer ◽

Prophylactic Mastectomy ◽

Contralateral Prophylactic Mastectomy ◽

Bilateral Mastectomy ◽

Cancer Center ◽

Immediate Reconstruction ◽

Community Oncology ◽

Increased Risk ◽

Significant Difference ◽

Definitive Surgery

e18154 Background: Due to an increase in the elective decision to pursue contralateral prophylactic mastectomy (CPM), the incidence of bilateral mastectomy (BM) with/without postmastectomy reconstruction (R) [BM+/-R] has increased in the last decade. While prior studies at academic centers have investigated concerns regarding its impact on subsequent cancer therapy, we hypothesized that BM+/-R is associated with a delay in initiation of adjuvant therapy (AT) in a community oncology clinic. Methods: This study involved chart review of all patients who underwent mastectomy as definitive surgery for stage I-III breast cancer between 2007 and 2012 and were subsequently followed at Essentia Health Cancer Center. The primary endpoint of the study was the proportion of patients receiving subsequent AT within 6 weeks of surgery (TST6) when compared between different surgical groups. Results: A total of 478 patients were included in the study, with a median age of 63 years. Patients were divided into 4 groups, BM-R (n = 133), BM+R (n = 73), unilateral mastectomy (UM) –R (n = 244) and UM+R (n = 28). Significant demographic differences were identified between the groups including age ( p< 0.001), medical comorbidities ( p< 0.001), and BMI ( p< 0.001). The incidence of any major post-operative complication (including flap/implant failure, infection and wound necrosis/dehiscence) or additional surgeries within 6 weeks of surgery was higher in patients undergoing reconstruction, [BM+R (19%) and UM+R (18%)] compared to those who did not [BM-R (6%) and UM-R (4%)] ( p< 0.001). Patients having major complications or needing additional surgeries within 6 weeks had a lower adjusted likelihood of achieving TST6 compared to those who did not (OR = 0.35; p= 0.009). However, there was no significant difference in TST6 between the surgical groups ( p= 0.31). Conclusions: Immediate post-mastectomy reconstruction is associated with a significantly increased risk of postoperative complications or need for additional surgeries within 6 weeks. In an appropriately selected patient population, CPM and reconstruction do not significantly delay subsequent AT in a community oncology clinic.

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Differential risk factors between uterine sarcomas and malignant mixed Müllerian tumors.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e23551 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e23551-e23551

Author(s):

Caroline Hana ◽

Philippos Apolinario Costa ◽

Gina Z. D'Amato ◽

Jonathan C. Trent

Keyword(s):

Risk Factors ◽

Malignant Tumors ◽

Pearson Correlation ◽

Positive Family History ◽

Uterine Sarcoma ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Uterine Sarcomas ◽

Age At Menopause ◽

Significant Difference

e23551 Background: Uterine sarcomas are malignant tumors of the smooth muscle or connective tissue of the uterus. Its main histological types are leiomyosarcomas and endometrial stromal sarcomas, with recent classifications considering malignant mixed müllerian tumors (MMMT) as a dedifferentiated endometrial carcinoma rather than a primary uterine sarcoma. We hypothesize there are different risk factors which predispose to MMMT as compared to uterine sarcomas. This study investigates these risk factors to determine if they contribute to the development of either disease. Methods: Under an IRB-approved protocol, we identified patients with uterine sarcomas and MMMT treated at Sylvester Comprehensive Cancer Center and University of Miami Hospital between 2010 and 2020 by Patient Atlas (clinical database tool; Miami, FL). We compared the risk factors known to be associated with endometrial carcinomas between uterine sarcomas and MMMT using independent sample t-test, Chi Square, Spearman Rho and Pearson correlation. Results: A total of 59 patients with MMMT and 115 cases of uterine sarcoma were identified in our database. In the sarcoma group, the most common histology was leiomyosarcoma (n = 76, 66%). Upon analysis of the characteristics of the sarcoma and MMMT cohorts respectively, 38 (33%) vs 16 (27%) were Hispanics, 18 (15%) vs 13 (22%) had diabetes, 26 (22%) vs 20 (34%) used contraception or hormonal replacement therapy (HRT), 35 (30%) vs 17 (28%) were alcohol users, 26 (22%) vs 15 (25%) were smokers, and 54 (47%) vs 31 (52%) had a positive family history of cancer, with no statistically significant differences found (p > 0.05). The sarcoma group had a significantly lower age at diagnosis (AAD) (53 vs. 65, P < 0.001) and a larger tumor size (11.3 vs. 7.3 cm, p < 0.0005). Use of contraception or HRT was not significantly different among the 2 groups (χ(1) = 0.699, p = 0.4). Similarly, no significant difference was found in the mean age of menarche/menopause, patient’s weight, median gravidity and parity (p > 0.05). The patient’s weight and BMI negatively correlated with the AAD in the MMMT group (ρ = - 0.279, p = 0.043 and r = -0.274, p = 0.041 respectively). Older age at menopause was associated with older AAD in the sarcoma group (ρ = 0.571, p = 0.0001). Patients with higher gravidity and parity had an older AAD among the 2 groups (p ≤ 0.05). Conclusions: The uterine sarcoma patients had significantly younger AAD than the MMMT group, with the age at menopause being positively correlated with the AAD. The use of contraception or HRT were not significantly different among the 2 cohorts, suggesting that there could be an overlap of the risk factors of MMMT and uterine sarcomas. Interestingly, higher gravidity and parity were associated with an older AAD. In the MMMT group, patient’s weight and BMI were inversely associated with the AAD. Larger studies are needed to investigate whether similarities or discrepancies in the studied risk factors truly exist.

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Risk of death from prostate cancer after radical prostatectomy or brachytherapy in men with low- or intermediate-risk disease.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.198 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 198-198

Author(s):

N. D. Arvold ◽

M. Chen ◽

J. W. Moul ◽

B. J. Moran ◽

D. E. Dosoretz ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Gleason Score ◽

Specific Antigen ◽

Low Risk ◽

Study Cohort ◽

Intermediate Risk ◽

Risk Of Death ◽

Increased Risk ◽

Significant Difference

198 Background: Radical prostatectomy (RP) and brachytherapy (BT) are widely utilized treatments for favorable-risk prostate cancer (PC). We estimated the risk of PC-specific mortality (PCSM) following RP or BT in men with low- or intermediate-risk PC using prospectively collected data. Methods: The study cohort comprised 5,760 men with low-risk PC (prostate-specific antigen [PSA] level ≤ 10 ng/mL, clinical category T1c or 2a, and Gleason score ≤ 6), and 3,079 men with intermediate-risk PC (PSA level 10-20 ng/mL, clinical T2b or T2c, or Gleason score 7). Competing risks multivariable regression was performed to assess risk of PCSM after RP or BT, adjusting for age, treatment year, cardiovascular comorbidity, and known PC prognostic factors. Results: There was no significant difference in the risk of PCSM among men with low-risk PC (11 vs. 6 deaths: adjusted hazard ratio [AHR], 1.62; 95% CI, 0.59–4.45; P = 0.35) who received BT compared to RP. However among men with intermediate-risk PC, despite significantly shorter median follow-up for men undergoing BT as compared to RP (4.1 vs. 7.2 years, P < 0.001), there was a trend toward an increased risk of PCSM (18 vs. 9 deaths: AHR, 2.30; 95% CI, 0.95–5.58; P = 0.07) for men treated with BT. Conclusions: The risk of PCSM among men with low-risk PC was not significantly different following RP or BT, however there may be a reduced risk of PCSM after RP as compared to BT in men with intermediate-risk PC. [Table: see text] No significant financial relationships to disclose.

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The outcome of preoperative chemotherapy followed by surgery and upfront surgery for liver metastases from colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.4_suppl.516 ◽

2013 ◽

Vol 31 (4_suppl) ◽

pp. 516-516

Author(s):

Jung Sun Kim ◽

Sunyoung Kim ◽

Hye Jeong Cho ◽

Eun Kyung Shim ◽

Jae Hwan Oh ◽

...

Keyword(s):

Liver Metastases ◽

Preoperative Chemotherapy ◽

Disease Free Survival ◽

Cancer Center ◽

R0 Resection ◽

Optimal Sequence ◽

Surgery Group ◽

Increased Risk ◽

Comorbidity Index ◽

Extrahepatic Metastases

516 Background: Hepatic metastasectomy is the only curative option for patients (pts) with colorectal liver metastases (CRLM) but the optimal sequence of surgery and chemotherapy has not been established. We evaluated disease-free survival (DFS) in pts who were treated with difference sequences for resectable CRLM. Methods: Pts who had radiologically diagnosed with CRLM and underwent preoperative chemotherapy (preopCT) followed by surgery or upfront hepatic resection from Jan 2008 to Dec 2010, in National Cancer Center, Korea, were identified and their medical records were reviewed. Pts with number of metastatic nodules (mets) less than 6, and who were untreated for metastastic setting were analyzed. Those with tumor invasion of major intrahepatic vessels, extrahepatic metastases, or combined other advanced cancer were excluded. Results: Of 208 pts who underwent hepatic metastasectomy for suspicious CRLM, 123 pts who fulfilled the above criteria were analyzed. 34 (28%) pts received preopCT followed by surgery and 89 (72%) pts underwent upfront surgery. Postoperative chemotherapy was administered for 34 (100%) of preopCT group and 73 (82%) of upfront surgery group. Number of mets, baseline tumor marker levels, and R0 resection rate were similar between the two groups. But, early relapse was more in upfront surgery group. DFS at 3 year was 14% (95% CI 29%-34%) in preopCT group and 48% (95% CI 36%-59%) in upfront surgery group. In multivariate analysis, age > 65, Charlson comorbidity index > 0, mets≥3, and R1/R2 resection were significantly associated with increased risk for DFS events, while PreopCT was marginally associated with adverse outcome (Table). Conclusions: Upfront surgery, rather than preoperative chemotherapy followed by surgery, might be a favorable treatment option for resectable CRLM in terms of DFS. [Table: see text]

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Assessing the demographics of fertility preservation discussions in cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.135 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 135-135

Author(s):

Michael E Auster ◽

Michelle Janania Martinez ◽

Jean-Pierre Blaize ◽

Lakene Raissa Djoufack Djoumessi ◽

Brian Warnecke ◽

...

Keyword(s):

Young Adults ◽

Fertility Preservation ◽

Early Stage ◽

Demographic Data ◽

Retrospective Chart Review ◽

Fertility Treatment ◽

Cancer Center ◽

P Value ◽

Increased Risk ◽

Significant Difference

135 Background: Young adults undergoing cancer treatment often face increased risk of infertility. Despite current ASCO guidelines recommending prompt fertility preservation education, knowledge about prevalence and barriers to oncofertility care is lacking. This is particularly true for patients in medically underserved and minority communities. This study sought to characterize the utilization of oncofertility counseling in a major Hispanic serving institution. Methods: Retrospective chart review was performed at the University of Texas Mays Cancer Center San Antonio and included patients diagnosed with testicular, early stage breast cancer or leukemia/lymphoma between age 18-40 from 2015-2019. Demographic data including ethnicity, race, funding, zip code were collected. Chart reviewed determined if fertility counseling was provided and which patients elected for oncofertility treatments. Results: Of 304 evaluable patients, only 120 had documented fertility discussions. There was no significant difference in the odds of counseling between gender, funding, or race. However, the odds of receiving fertility discussions was higher in non-Hispanic whites compared to Hispanic whites with an odds ratio of 1.94 (P value of 0.032). For those who opted for fertility treatment there was no statistically significant difference between diagnosis, race, ethnicity, or payment status. Conclusions: Our study demonstrates oncofertility discussions occur in a relatively small proportion of eligible patients. Additionally, patients who self -identify as Hispanic were less likely to receive fertility discussions. This study demonstrates that more research is necessary to evaluate the barriers to fertility discussion and treatment, and how these barriers result in decreased oncofertility education in Hispanic young adults with curable malignancies. [Table: see text]

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