Opportunity costs of undergoing surgical resection and perioperative chemotherapy for pancreatic adenocarcinoma.

398 Background: Treatment of early stage pancreatic ductal adenocarcinoma (PDAC) includes surgical resection and either neoadjuvant or adjuvant chemotherapy. Due to the intensity of treatment and perioperative morbidity rates of pancreatic resection, patients may spend a significant portion of their survival time in receipt of clinical care. However, time spent in receipt of care has not been previously described in patients with early stage PDAC. The primary aim of this study was to determine the total time spent in receipt of surgical and perioperative chemotherapy in patients with resectable PDAC. Methods: A retrospective cohort study was performed of patients diagnosed with PDAC who underwent curative-intent resection at a single institution tertiary care center between January 2015 and October 2019. Patients who died within 30 days of surgery were excluded. Total care time, including all relevant clinician visits, laboratory, radiologic and procedural studies, and treatment visits, was abstracted from the primary medical record. Care time included estimated travel time based on patient address. Care time was divided into preoperative, surgical, and systemic therapy phases of care. Time spent in surgical care included the hospital length of stay, postoperative follow-up visits, and admissions for postoperative complications. Results: A total of 86 patients were identified. Median total preoperative care time was 29 hours (IQR 11-135; 0.4% of survival time, range 0% - 72.7%). Median total time spent in surgical care was 216 hours (IQR 164-371; 2% of survival time, range 0.3% - 68.4%). Among the patients who received systemic chemotherapy care within the same institutional health system (N = 41), median total time spent in receipt of systemic therapy was 447 hours (IQR 194-647; 3% of survival time, range 0.1% - 55.4%). 10.5% of patients (N = 9) spent more than 10% of total survival time in surgical care and 5.8% (N = 5) patients spent more than 10% of survival time in receipt of systemic care. Median cumulative travel time for patients was 19 hours (IQR 10.2-37.6). Conclusions: For the majority of patients undergoing resection for PDAC, time spent in receipt of surgical care does not appear to represent a substantial time burden relative to survival time. However, for a subset of patients, the time burden is considerable. Further research to determine predictors of increased time spent in receipt of multimodality cancer care is warranted to better inform patient and surgeon communication and decision-making.

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Metabolic Changes in Early-Stage Non–Small Cell Lung Cancer Patients after Surgical Resection

Cancers ◽

10.3390/cancers13123012 ◽

2021 ◽

Vol 13 (12) ◽

pp. 3012

Author(s):

Naseer Ahmed ◽

Biniam Kidane ◽

Le Wang ◽

Zoann Nugent ◽

Nataliya Moldovan ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Surgical Resection ◽

Cell Lung Cancer ◽

Early Stage ◽

Small Cell ◽

Resonance Spectroscopy ◽

Small Cell Lung ◽

Serum Samples ◽

Post Surgery

Metabolic alterations in malignant cells play a vital role in tumor initiation, proliferation, and metastasis. Biofluids from patients with non–small cell lung cancer (NSCLC) harbor metabolic biomarkers with potential clinical applications. In this study, we assessed the changes in the metabolic profile of patients with early-stage NSCLC using mass spectrometry and nuclear magnetic resonance spectroscopy before and after surgical resection. A single cohort of 35 patients provided a total of 29 and 32 pairs of urine and serum samples, respectively, pre-and post-surgery. We identified a profile of 48 metabolites that were significantly different pre- and post-surgery: 17 in urine and 31 in serum. A higher proportion of metabolites were upregulated than downregulated post-surgery (p < 0.01); however, the median fold change (FC) was higher for downregulated than upregulated metabolites (p < 0.05). Purines/pyrimidines and proteins had a larger dysregulation than other classes of metabolites (p < 0.05 for each class). Several of the dysregulated metabolites have been previously associated with cancer, including leucyl proline, asymmetric dimethylarginine, isopentenyladenine, fumaric acid (all downregulated post-surgery), as well as N6-methyladenosine and several deoxycholic acid moieties, which were upregulated post-surgery. This study establishes metabolomic analysis of biofluids as a path to non-invasive diagnostics, screening, and monitoring in NSCLC.

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ON THE SURVIVAL AND METABOLISM OF NORMAL AND HYPOTHERMIC PRE-VIABLE HUMAN FOETUSES

Journal of Endocrinology ◽

10.1677/joe.0.0230069 ◽

1961 ◽

Vol 23 (1) ◽

pp. 69-77 ◽

Cited By ~ 2

Author(s):

S. KULLANDER ◽

B. SUNDÉN

Keyword(s):

Body Temperature ◽

Survival Time ◽

Glycogen Content ◽

Adrenal Glands ◽

Early Stage ◽

The Body ◽

Protein Nitrogen ◽

Different Temperatures ◽

Human Foetuses ◽

General Reduction

SUMMARY A total of twenty-three human pre-viable foetuses (7–400 g.) were removed by abdominal hysterotomy (legal abortions) and studied during survival in an anoxic state at different temperatures. The duration of survival, as judged by ECG waves, at 37° c was about 3 hr.; it was longer for female foetuses than for males, and longer for large foetuses than for small ones. General reduction of the body-temperature to 4° c during periods varying between 30 min. and 6 hr. with subsequent rewarming to and maintenance at 37° c increased the survival time by a further 1–2 hr. The blood sugar did not decrease either during the period of survival or during hypothermia, but the non-protein nitrogen increased, while acidosis and hyperkalaemia developed. The glycogen content of the liver decreased during the anoxic period of survival and diminished further during hypothermia. The adrenal glands produced adrenaline in addition to noradrenaline during the anoxic phase, and this may occur in a very early stage of intrauterine life.

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Another Way of Early Pottery Distribution in Eastern Europe? Case Study of the Pezmog 4 Site, European Far Northeast

Radiocarbon ◽

10.2458/56.16952 ◽

2014 ◽

Vol 56 (2) ◽

pp. 733-741 ◽

Cited By ~ 2

Author(s):

Victor N Karmanov ◽

Natalia E Zaretskaya ◽

Alexander V Volokitin

Keyword(s):

Eastern Europe ◽

River Basin ◽

Radiocarbon Dating ◽

Early Stage ◽

River Basins ◽

Ural Region ◽

Time Range ◽

Forest Zone ◽

Early Pottery

A case study of the Neolithic comb ceramic site Pezmog 4 of the Kama culture presents a situation when results of radiocarbon dating change long-existing concepts concerning the development of archaeological events. Until the early 2000s, the chronology of the Kama culture, distributed mainly in the Kama and Vychegda River basins, has been based on comparative-typological analysis. Estimates of the age of this culture changed from the 3rd millennium BC in the 1950s to the 1st half of the 4th millennium BC by the 1990s. Research concerning the Pezmog 4 site in the central Vychegda River basin in 1999–2002 has abruptly changed this chronological understanding. The data obtained put the age of the early stage of Kama culture within the time range 5750–5620 cal BC and allowed us to propose the existence of another way of early pottery distribution in the forest zone of eastern Europe at the beginning of the 6th millennium BC. This innovation probably penetrated from the trans-Ural region.

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Osimertinib as neoadjuvant treatment for resectable stage II-IIIB EGFR mutant lung adenocarcinoma (NEOS).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.8524 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 8524-8524

Author(s):

Chao Lyu ◽

Wentao Fang ◽

Haitao Ma ◽

Jia Wang ◽

Wenjie Jiao ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Surgical Resection ◽

Interim Analysis ◽

Kinase Inhibitors ◽

Response Rate ◽

Early Stage ◽

Neoadjuvant Treatment ◽

Complete Response ◽

Stage Ii ◽

Meaningful Improvement

8524 Background: Neoadjuvant treatment has demonstrated efficacy in several types of cancer and is increasingly used for the treatment of early-stage cancers with the potential of cancer downstaging to enhance complete surgical resection and to improve clinical outcomes. Recent evidences have demonstrated that the neoadjuvant use of first/second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) may provide clinically meaningful improvement in EGFRm non-small cell lung cancer (NSCLC) patients, however, limited data were reported on osimertinib, the third-generation EGFR-TKI, in the neoadjuvant setting. Here we present an interim analysis of osimertinib as neoadjuvant treatment for resectable EGFRm NSCLC. Methods: NEOS is a prospective, multi-center, single-arm study to evaluate the efficacy and safety of osimertinib as neoadjuvant treatment in resectable EGFRm (19del/L858R) lung adenocarcinoma. Eligible patients were treated with osimertinib 80 mg orally per day for six weeks followed by surgery. Assessment of response to neoadjuvant therapy was performed according to RECIST 1.1. The primary endpoint was response rate. Secondary endpoints included safety, R0 surgical resection rate, quality of life, major pathologic response (MPR) rate, pathological complete response (pCR) rate, and N2 downstaging rate. Results: As of Dec. 17, 2020, 18 eligible patients (median age 61 [range 46-73], 27.8% male, 22.2% ECOG PS 1) have been enrolled. Patients with clinical stages IIa, IIb, and IIIa (8th AJCC) accounted for 16.7%, 22.2% and 61.1%, respectively. Half (9/18) of the patients had EGFR exon 21 L858R mutations and the other half (9/18) had EGFR exon 19del mutations. Amongst all 15 patients who completed efficacy assessment after neoadjuvant osimertinib, the response rate (RR) was 73.3% (11/15) and the disease control rate (DCR) was 100% (15/15). R0 surgical resection was performed in 93.3% (14/15) patients. Pathological downstaging occurred in 53.3% (8/15) patients. 42.9% (3/7) of the patients with confirmed N2 lymph nodes experienced downstaging to N0 disease after receiving neoadjuvant osimertinib. One patient was identified with a pCR. Adverse events (AEs) were reported in 66.7% (12/18) of patients, with the most common AE being rash (8/18, 44.4%), oral ulceration (8/18, 44.4%), and diarrhea (5/18, 27.8%). No grade 3-5 AEs or serious AEs were reported. Conclusions: Interim analysis from this study indicated neoadjuvant osimertinib as an effective and feasible treatment in patients with resectable stage II-IIIB EGFRm NSCLC. The trial is ongoing and the final results will be provided in the future. Clinical trial information: ChiCTR1800016948.

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Percutaneous ablation therapy versus surgical resection in the treatment for early-stage hepatocellular carcinoma: a meta-analysis of 21,494 patients

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-013-1530-1 ◽

2013 ◽

Vol 139 (12) ◽

pp. 2021-2033 ◽

Cited By ~ 25

Author(s):

Jia-yan Ni ◽

Lin-feng Xu ◽

Hong-liang Sun ◽

Jing-xing Zhou ◽

Yao-ting Chen ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Surgical Resection ◽

Early Stage ◽

Meta Analysis ◽

Percutaneous Ablation ◽

Ablation Therapy

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Age, tumor size, type of surgery, and gender predict survival in early stage (stage I and II) non-small cell lung cancer after surgical resection

Lung Cancer ◽

10.1016/j.lungcan.2009.08.008 ◽

2010 ◽

Vol 68 (3) ◽

pp. 398-402 ◽

Cited By ~ 32

Author(s):

Mohit Agarwal ◽

Govinda Brahmanday ◽

Gary W. Chmielewski ◽

Robert J. Welsh ◽

K.P. Ravikrishnan

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Surgical Resection ◽

Tumor Size ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Size Type ◽

And Gender ◽

Type Of Surgery

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Case Report: Carcinoma of Colon

Journal of Gastrointestinal Disorders and Liver Functions ◽

10.15436/2471-0601.18.1837 ◽

2018 ◽

Vol 4 (1) ◽

pp. 1-3

Author(s):

sushila ladumor ◽

Adham Darweesh

Keyword(s):

Colorectal Cancer ◽

Case Report ◽

Survival Rate ◽

Gastrointestinal Tract ◽

Colorectal Carcinoma ◽

Surgical Resection ◽

Early Stage ◽

Occult Lesion ◽

Carcinoma Of Colon ◽

Ct And Mri

Colorectal cancer is a disease that is curable if diagnosed at early stage and also it is preventable if predisposing adenomas are detected and removed. Colorectal Carcinoma (CRC) is commonest malignancy of the gastrointestinal tract and is the second most usually diagnosed cancer in adults, mainly at 6th to 7th decades of life[2]. CT and MRI are the modalities of choice used for staging. Colonoscopy for better evaluation and tissue diagnosis as well as to see other occult lesion. Surgical resection may be curative although five-year survival rate is 40 - 50 %.

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A randomised trial comparing preoperative to perioperative chemotherapy in early-stage non-small-cell lung cancer (IFCT 0002 trial)

European Journal of Cancer ◽

10.1016/j.ejca.2013.04.013 ◽

2013 ◽

Vol 49 (12) ◽

pp. 2654-2664 ◽

Cited By ~ 22

Author(s):

Virginie Westeel ◽

Elisabeth Quoix ◽

Marc Puyraveau ◽

A. Lavolé ◽

Denis Braun ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Randomised Trial ◽

Small Cell ◽

Perioperative Chemotherapy ◽

Small Cell Lung

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Clinical study of mucosa-associated lymphoid tissue lymphomas of the head and neck

The Journal of Laryngology & Otology ◽

10.1017/s0022215111002192 ◽

2011 ◽

Vol 126 (3) ◽

pp. 271-275

Author(s):

S Hosokawa ◽

J Okamura ◽

Y Takizawa ◽

G Takahashi ◽

K Hosokawa ◽

...

Keyword(s):

Head And Neck ◽

Surgical Resection ◽

Lymphoid Tissue ◽

Early Stage ◽

Local Treatment ◽

Response To Treatment ◽

Limited Information ◽

Early Stage Disease ◽

First Choice

AbstractBackground:Limited information is available on mucosa-associated lymphoid tissue lymphomas arising in the head and neck.Method:A retrospective analysis was conducted of 20 patients who were histologically diagnosed with mucosa-associated lymphoid tissue lymphoma and treated at our institution between January 1990 and December 2009.Results:Treatment consisted of surgical resection alone in two patients (10 per cent), surgical resection with consecutive radiotherapy in one (5 per cent), and radiotherapy alone in eight (40 per cent). Three patients (15 per cent) were treated with systemic chemotherapy, and three (15 per cent) received chemoradiotherapy. Three patients (15 per cent) were informed of the diagnosis but not treated for their condition.Conclusion:All of the 20 patients were still alive after a mean follow-up period of 50.8 months. Local treatment for mucosa-associated lymphoid tissue lymphoma of the head and neck should be the first choice in early-stage disease. However, prolonged follow up is important to determine these patients' long-term response to treatment.

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