scholarly journals The Effect of Chemotherapy on Estradiol Levels in Patients with HER 2-Overexpression Breast Cancer in Dr Moewardi General Hospital, Surakarta, Indonesia

2021 ◽  
Vol 9 (B) ◽  
pp. 1570-1574
Author(s):  
Imam Hafidh Zaini ◽  
Widyanti Soewoto ◽  
Ida Bagus Budhi
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Estradiol Level ◽  
Rank Test ◽  
Her2 Overexpression ◽  
Significant Difference ◽  
Before And After ◽  
Her 2 ◽  
The Mean ◽  
Estradiol Levels

AIM: This study aims to evaluate the effect of adjuvant chemotherapy on estradiol levels in patients with HER 2-overexpression breast cancer in a developing country. METHODS: This comparative study with pre- and post-design model observation approach, involving patients with HER 2-overexpression breast cancer who had undergone surgery and had never received chemotherapy or hormonal therapy before, who were then given adjuvant chemotherapy. Estradiol levels were measured before and after chemotherapy. The study was carried out in the surgical oncology division of RSUD Dr. Moewardi (RSDM) Surakarta from January 2020-December 2020. Descriptive data are presented in a frequency table based on age, menstrual status, parity status, breastfeeding status, contraception, contraception duration, family history, stage, and histological grade. Before and after chemotherapy in patients with breast cancer, the estradiol levels employed the paired sample t-test of the Wilcoxon rank test because the data did not meet the normality assumption. RESULTS: From the total data of 21 patients, 15 patients experienced a decrease in estradiol levels after chemotherapy, while six patients underwent an increase. The mean estradiol level before chemotherapy was 89.41 pg/ml, whereas the mean estradiol level after chemotherapy was 55.90 pg/ml. It indicates a difference in the decrease in estradiol levels of 33.51 pg/ml. The statistical test results also obtained a p-value of = 0.033 (p < 0.05), which signifies a significant difference between estradiol levels before and after chemotherapy. Thus, chemotherapy is effective in lowering estradiol levels in patients with breast cancer. CONCLUSION: Chemotherapy affects decreasing estradiol levels in patients with HER2 overexpression breast cancer.

scholarly journals Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer

2020 ◽  
Author(s):  
Takaaki Oba ◽  
Kazuma Maeno ◽  
Daiya Takekoshi ◽  
Mayu Ono ◽  
Tokiko Ito ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Poor Prognosis ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Prognostic Impact ◽  
Nutritional Index ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background: The prognostic nutritional index (PNI), which is an easily calculated nutritional index, is significantly associated with patient outcomes in various solid malignancies. This study aimed to evaluate the prognostic impact of PNI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC).Methods: We reviewed patients with breast cancer who underwent NAC and a subsequent surgery for breast cancer between 2005 and 2016. PNI before and after NAC were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count/mm3. The relationship between PNI and prognosis was retrospectively analyzed. Results: In total, 191 patients were evaluated. There was no significant difference in disease-free survival (DFS) between the pre-NAC PNI high group and the pre-NAC PNI low group (cutoff: 53.1). However, PNI decreased in 181 patients (94.7%) after NAC and the mean PNI also significantly decreased after NAC from 52.6 ± 3.8 pre-NAC to 46.5 ± 4.4 post-NAC (p < 0.01). The mean ΔPNI, which was calculated as pre-NAC PNI minus post-NAC PNI, was 5.4. The high ΔPNI group showed significantly poorer DFS than the low ΔPNI group (cut off: 5.26) (p = 0.015). Moreover, high ΔPNI was an independent risk factor of DFS on multivariate analysis (p = 0.042). Conclusions: High decrease of PNI during NAC predicts poor prognosis. Thus, maintaining the nutritional status during NAC may result in better treatment outcomes in patients with breast cancer.

scholarly journals Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer

2020 ◽  
Author(s):  
Takaaki Oba ◽  
Kazuma Maeno ◽  
Daiya Takekoshi ◽  
Mayu Ono ◽  
Tokiko Ito ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Poor Prognosis ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Prognostic Impact ◽  
Nutritional Index ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background: The prognostic nutritional index (PNI), which is an easily calculated nutritional index, is significantly associated with patient outcomes in various solid malignancies. This study aimed to evaluate the prognostic impact of PNI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Methods: We reviewed patients with breast cancer who underwent NAC and a subsequent surgery for breast cancer between 2005 and 2016. PNI before and after NAC were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count/mm3. The relationship between PNI and prognosis was retrospectively analyzed. Results: In total, 191 patients were evaluated. There was no significant difference in disease-free survival (DFS) between the pre-NAC PNI high group and the pre-NAC PNI low group (cutoff: 53.1). However, PNI decreased in 181 patients (94.7%) after NAC and the mean PNI also significantly decreased after NAC from 52.6 ± 3.8 pre-NAC to 46.5 ± 4.4 post-NAC (p < 0.01) . The mean ΔPNI, which was calculated as pre-NAC PNI minus post-NAC PNI, was 5.4. The high ΔPNI group showed significantly poorer DFS than the low ΔPNI group (cut off: 5.26) (p = 0.015). Moreover, high ΔPNI was an independent risk factor of DFS on multivariate analysis (p = 0.042). Conclusions: High decrease of PNI during NAC predicts poor prognosis. Thus, maintaining the nutritional status during NAC may result in better treatment outcomes in patients with breast cancer.

scholarly journals Improved urinary melatonin level as the perspective indicator that leads to better sleeping quality in bladder cancer patients

2020 ◽  
Vol 12 ◽  
pp. 175628722094087
Author(s):  
Tse-Chou Cheng ◽  
Yi-Hua Lee ◽  
Yuan-Ping Chang ◽  
De-Chih Lee
Keyword(s):  
Bladder Cancer ◽  
Sleep Quality ◽  
Cancer Patients ◽  
Rank Test ◽  
Melatonin Level ◽  
Poor Sleep ◽  
Melatonin Concentration ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Background: Individuals with higher-than-average melatonin concentrations are less likely to develop cancer. In cancer patients, psychosomatic coping patterns and treatment side effects are important indicators of cancer prevention and immune system deterioration. This study focused on changes in the urinary melatonin concentration, life resilience, and sleep quality in bladder cancer patients before, and 3 months after, treatment. Methods: A controlled before-and-after study was performed. The subjects were patients who were previously diagnosed with bladder cancer and had received treatment (transurethral resection of bladder tumor + intravesical chemotherapy). Data from 23 subjects were analyzed. Results: The results showed a significant difference in the melatonin concentration before and after treatment (Wilcoxon signed-rank test, Z = −2.220, p = 0.026). The melatonin concentration in 16 patients (70%) increased after treatment. The mean Pittsburgh Sleep Quality Index (PSQI) score before treatment was 7.348 (SD = 4.030), which was associated with poor sleep quality. The mean PSQI score after treatment was 6.435 (SD = 3.300; Z = −2.071; p = 0.038). These results represent the improved sleep quality in patients post-treatment. Conclusions: After treatment, the urinary melatonin concentration and sleep quality (PSQI) improved, both of which were statistically significant in bladder cancer patients. Consequently, bladder cancer treatment should be initiated as soon as possible. There was no significant difference in overall life resilience before and after treatment, possibly because elderly individuals have strong personality traits and emotional stability and are not easily affected by life events or stress.

scholarly journals Implementation of Surgeon-Initiated Gene Expression Profile Testing (Oncotype DX) Among Patients With Early-Stage Breast Cancer to Reduce Delays in Chemotherapy Initiation

2017 ◽  
Vol 13 (9) ◽  
pp. e815-e820 ◽  
Author(s):  
Katya Losk ◽  
Rachel A. Freedman ◽  
Nancy U. Lin ◽  
Mehra Golshan ◽  
Stephen M. Pochebit ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Intervention Implementation ◽  
Medical Oncologists ◽  
Before And After ◽  
The Mean ◽  
Clinically Significant ◽  
Chemotherapy Initiation ◽  
Reduced Time

Purpose: Delays to adjuvant chemotherapy initiation in breast cancer may adversely affect clinical outcomes and patient satisfaction. We previously identified an association between genomic testing (Onco type DX) and delayed chemotherapy initiation. We sought to reduce the interval between surgery and adjuvant chemotherapy initiation by developing standardized criteria and workflows for Onco type DX testing. Methods: Criteria for surgeon-initiated reflex Onco type DX testing, workflows for communication between surgeons and medical oncologists, and a streamlined process for receiving and processing Onco type DX requests in pathology were established by multidisciplinary consensus. Criteria for surgeon-initiated testing included patients ≤ 65 years old with T1cN0 (grade 2 or 3), T2N0 (grade 1 or 2), or T1/T2N1 (grade 1 or 2) breast cancer on final surgical pathology. Medical oncologists could elect to initiate Onco type testing for cases falling outside the criteria. We then examined 720 consecutive patients with breast cancer who underwent Onco type DX testing postoperatively between January 1, 2014 and November 28, 2016 and measured intervals between date of surgery, Onco type DX order date, result received date, and chemotherapy initiation date (if applicable) before and after intervention implementation. Results: The introduction of standardized criteria and workflows reduced time between surgery and Onco type DX ordering, and time from surgery to receipt of result, by 7.3 days ( P < .001) and 6.3 days ( P < .001), respectively. The mean number of days between surgery and initiation of chemotherapy was also reduced by 6.4 days ( P = .004). Conclusion: Developing consensus on Onco type DX testing criteria and implementing streamlined workflows has led to clinically significant reductions in wait times to chemotherapy decision making and initiation.

scholarly journals Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer

2020 ◽  
Author(s):  
Takaaki Oba ◽  
Kazuma Maeno ◽  
Daiya Takekoshi ◽  
Mayu Ono ◽  
Tokiko Ito ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Poor Prognosis ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Prognostic Impact ◽  
Nutritional Index ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background: The prognostic nutritional index (PNI), which is an easily calculated nutritional index, is significantly associated with patient outcomes in various solid malignancies. This study aimed to evaluate the prognostic impact of PNI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Methods: We reviewed patients with breast cancer who underwent NAC and a subsequent surgery for breast cancer between 2005 and 2016. PNI before and after NAC were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count/mm 3 . The relationship between PNI and prognosis was retrospectively analyzed. Results: In total, 191 patients were evaluated. There was no significant difference in disease-free survival (DFS) between the pre-NAC PNI high group and the pre-NAC PNI low group (cutoff: 53.1). However, PNI decreased in 181 patients (94.7%) after NAC and the mean PNI also significantly decreased after NAC from 52.6 ± 3.8 pre-NAC to 46.5 ± 4.4 post-NAC ( p < 0.01). The mean ΔPNI, which was calculated as pre-NAC PNI minus post-NAC PNI, was 5.4. The high ΔPNI group showed significantly poorer DFS than the low ΔPNI group (cut off: 5.26) ( p = 0.015). Moreover, high ΔPNI was an independent risk factor of DFS on multivariate analysis ( p = 0.042). Conclusions: High decrease of PNI during NAC predicts poor prognosis. Thus, maintaining the nutritional status during NAC may result in better treatment outcomes in patients with breast cancer.

Neoadjuvant therapy (NAT) for breast cancer at the Odette Cancer Centre: What have we been doing and how do we compare?

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 131-131
Author(s):  
Claudia Arce ◽  
Sonal Gandhi
Keyword(s):  
Breast Cancer ◽  
Care Pathway ◽  
Clinical Care ◽  
Locally Advanced ◽  
Cancer Centre ◽  
Significant Difference ◽  
Before And After ◽  
Her 2 ◽  
Cancer Phenotype ◽  
Clinical Care Pathway

131 Background: NAT is standard of care for locally advanced breast cancer (LABC). Early breast cancer (EBC) may also benefit, particularly certain subtypes, such as HER2-enriched or basal- like. We developed a clinical care pathway to standardize the assessment and treatment of LABC and higher-risk EBC at the Odette Cancer Centre (OCC). Purpose: Evaluate treatment patterns within the LABC/NAT program at the OCC, and to determine if these patterns changed after the introduction of a clinical care pathway. This study also aimed to evaluate treatment efficacy (pCR rates) by NAT regimen and breast cancer phenotype, as compared to the literature. Methods: Retrospective chart review of patients treated with NAT at the OCC from January 2008 to March 2012. Results: 158 patients were reviewed. Median age at diagnosis was 50 years (28-85), and median tumor size was 7 cm (0-21). 74% were stage IIB-IIIB, and 11.2% were considered non-LABC (or EBC). 65.8% of breast cancers were estrogen receptor positive (ER+), and 29.7% were HER-2 positive (HER2+). 96% of NAT chemotherapy regimens were anthracycline and taxane-based, and trastuzumab was given to 29.7% of HER-2 positive cases. pCR was achieved in 20.9% of all cases and this did not vary by type of chemotherapy regimen; pCR rates did vary by breast cancer phenotype, with 6.25%, 57.5% and 25% pCR achieved for ER+, HER2+ and triple negative (TN) cancers, respectively. Median follow-up was 13 months (0-46), and overall DFS was 90%; survival did not vary by NAT regimen or pCR, but did vary by phenotype, whereby DFS was 100% for HER-2 positive, 90% for ER+, and 78% for TN cancers. There was no significant difference found in types of patients, NAT regimen, or pCR rates before and after the pathway was introduced. Conclusions: Practice patterns at the OCC in NAT for breast cancer remained unchanged before and after development of a clinical care pathway, which was meant to standardize the approach to and to possibly increase the use of NAT from beyond LABC to higher-risk EBC. This is likely due to limited pathway dissemination, but other factors contributing to this should be evaluated. pCR rates by cancer phenotype were similar to those found in the literature.

scholarly journals Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer

2019 ◽  
Author(s):  
Takaaki Oba ◽  
Kazuma Maeno ◽  
Daiya Takekoshi ◽  
Mayu Ono ◽  
Tokiko Ito ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Poor Prognosis ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Prognostic Impact ◽  
Nutritional Index ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background The prognostic nutritional index (PNI), which is an easily calculated nutritional index, is significantly associated with patient outcomes in various solid malignancies. This study aimed to evaluate the prognostic impact of PNI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Methods We reviewed patients with breast cancer who underwent NAC and a subsequent surgery for breast cancer between 2005 and 2016. PNI before and after NAC were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count/mm3. The relationship between PNI and prognosis was retrospectively analyzed. Results In total, 191 patients were evaluated. There was no significant difference in disease-free survival (DFS) between the pre-NAC PNI high group and the pre-NAC PNI low group (cutoff: 53.1). However, PNI decreased in 181 patients (94.7%) after NAC and the mean PNI also significantly decreased after NAC from 52.6 ± 3.8 pre-NAC to 46.5 ± 4.4 post-NAC (p < 0.01) . The mean ΔPNI, which was calculated as pre-NAC PNI minus post-NAC PNI, was 5.4. The high ΔPNI group showed significantly poorer DFS than the low ΔPNI group (cut off: 5.26) (p = 0.015). Moreover, high ΔPNI was an independent risk factor of DFS on multivariate analysis (p = 0.025). Conclusions High decrease of PNI during NAC predicts poor prognosis. Thus, maintaining the nutritional status during NAC may result in better treatment outcomes in patients with breast cancer.

PERBEDAAN FINANCIAL PERFORMANCE PASCA SECONDARY OFFERINGS

Wahana ◽  
2019 ◽  
Vol 22 (1) ◽  
pp. 41-49
Author(s):  
Djaja Perdana ◽  
Herbowo Herbowo
Keyword(s):  
Financial Performance ◽  
Stock Exchange ◽  
Hypothesis Test ◽  
Poor Performance ◽  
Rank Test ◽  
Growth Ratio ◽  
Significant Difference ◽  
Before And After ◽  
Signed Rank Test ◽  
Asset Turnover

This study aims to examine the differences in corporate financial performance before and after secondary offerings. The financial performance is proxied by WCR, DER, Solvency, ROA, ROE, Asset Turnover (ATO) and Growth ratio which representing the value of liquidity, financing, activity, performance and growth of the firm. The study involved 67 samples of the companies listed on the Indonesia Stock Exchange conducting secondary offerings during 2008-2013 period and selected through purposive random sampling method and using Financial Statement data from 2005-2016 period. Hypothesis test is performed using Wilcoxon Signed Rank test. The results of this study indicate that there is no significant difference in the ratio of Solvency, ROA and ROE between before and after secondary offerings, but there are significant differences in the ratio of WCR, DER, Asset Turnover and Growth. WCR ratio after secondary offerings increased, while DER ratio after secondary offerings decreased, the condition of both ratios showed better performance. While the indication of poor performance seen in decreasing asset turnover ratio and growth ratio.Keywords : agency theory, financial performance, secondary offerings

Correlation of AGR2 expression with the incidence of metastasis in luminal breast cancer

2021 ◽  
pp. 1-5
Author(s):  
David Samuel Kereh ◽  
John Pieter ◽  
William Hamdani ◽  
Haryasena Haryasena ◽  
Daniel Sampepajung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Mean Value ◽  
Rank Test ◽  
Luminal Breast Cancer ◽  
P Value ◽  
Strong Positive Correlation ◽  
Breast Cancer Patients ◽  
The Mean ◽  
Spearman Test

BACKGROUND: AGR2 expression is associated with luminal breast cancer. Overexpression of AGR2 is a predictor of poor prognosis. Several studies have found correlations between AGR2 in disseminated tumor cells (DTCs) in breast cancer patients. OBJECTIVE: This study aims to determine the correlation between anterior Gradient2 (AGR2) expression with the incidence of distant metastases in luminal breast cancer. METHODS: This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and the network. ELISA methods examine AGR2 expression from blood serum of breast cancer patients. To compare the AGR2 expression in metastatic patients and the non-metastatic patient was tested with Mann Whitney test. The correlation of AGR2 expression and metastasis was tested with the Rank Spearman test. RESULTS: The mean value of AGR2 antibody expression on ELISA in this study was 2.90 ± 1.82 ng/dl, and its cut-off point was 2.1 ng/dl. Based on this cut-off point value, 14 subjects (66.7%) had overexpression of AGR2 serum ELISA, and 7 subjects (33.3%) had not. The mean value AGR2 was significantly higher in metastatic than not metastatic, 3.77 versus 1.76 (p < 0.01). The Spearman rank test obtained a p-value for the 2 tail test of 0.003 (p < 0.05), which showed a significant correlation of both, while the correlation coefficient of 0.612 showed a strong positive correlation of AGR2 overexpression and metastasis. CONCLUSIONS: AGR2 expression is correlated with metastasis in Luminal breast cancer.

scholarly journals A Randomized, Controlled, Parallel-Group, Trial on the Effects of Melatonin on Fatigue Associated with Breast Cancer and Its Adjuvant Treatments

2021 ◽  
Vol 20 ◽  
pp. 153473542098834
Author(s):  
Abdolazim Sedighi Pashaki ◽  
Kamal Mohammadian ◽  
Saeid Afshar ◽  
Mohammad Hadi Gholami ◽  
Abbas Moradi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Intervention Group ◽  
Chi Square ◽  
Significance Level ◽  
Severe Fatigue ◽  
Before And After ◽  
Brief Fatigue Inventory ◽  
Chi Square Test ◽  
Student’S T

Objective: Fatigue associated with malignant conditions and their treatments is a disabling condition. This trial assessed the anti-fatigue effects of melatonin coadministration during adjuvant treatment of patients with the breast cancer. Material and Methods: Patients with breast cancer were randomly assigned to receive melatonin or placebo during adjuvant chemotherapy and radiotherapy. Thirty-seven patients were randomly enrolled in each group. The mean ages of patients in the intervention and control groups were 50.47 ± 10.79 and 46.05 ± 10.55 years, respectively ( P = .223). The intervention group received oral melatonin (18 mg/day) from 1 week before until 1 month after the adjuvant radiotherapy. The level of fatigue was assessed before and after intervention using Brief Fatigue Inventory (BFI) in both groups. To analyze data, the Student’s t-test and the Chi-square test were used at a significance level of P ≤ .05. Results: The BFI score was similar before the intervention in both groups, however, after the intervention, it was significantly lower in the melatonin group ( P < .001). Moreover, the frequency of severe fatigue in the melatonin group was significantly lower than in the placebo group after intervention (42.1% vs 83.3%, P < .001). Conclusion: Coadministration of melatonin during adjuvant chemotherapy and radiotherapy of women with breast cancer decreased the levels of fatigue associated with the malignant condition and its treatments.

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