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2021 ◽  
Vol 10 (21) ◽  
pp. 4829
Author(s):  
Leonor Drouin ◽  
Benedetta Guani ◽  
Vincent Balaya ◽  
Henri Azaïs ◽  
Sarah Betrian ◽  
...  

Background: The aim of this study was to assess current French practices in the management of patients with advanced epithelial ovarian cancer. Method: a 58-question electronic survey was distributed anonymously to the members of the SFOG (French Society of Gynaecological Oncology), GINECO-ARCAGY (National Investigators Group for Ovarian and Breast Cancer Studies in France) and FRANCOGYN (French research group in oncological and gynaecological surgery). Initial diagnostic workup and staging, pathological data, surgical data, treatments and follow-up strategies were assessed. Results: a total of 107 participants responded to emailed surveys. Most of the respondents were obstetrician-gynaecologists (37.4%), surgical oncologists (34.6%) and medical oncologists (17.8%). According to most (76.8%) participants, less than 50% of patients were eligible for primary debulking surgery (PDS). The LION study criteria were applied in 69.5% of cases during PDS and 39% after chemotherapy. The timing of BRCA testing was very heterogeneous and ranged from 1 to 6 months. The use of bevacizumab as an adjuvant schedule was lower in cases of no residual disease (for 54.5% of respondents) compared to cases of residual disease (for 63.6% of respondents). In cases of BRCA1-2 mutations, olaparib was given by 75.8–84.8% of respondents, whereas niraparib was given in cases of BRCA wild-type diseases. Conclusion: this survey provides an extensive and a unique review of current French practices in the management of patients with advanced epithelial ovarian cancer in 2021.


Endoscopy ◽  
2021 ◽  
Author(s):  
Wladyslaw Januszewicz ◽  
Klaudiusz Witczak ◽  
Paulina Wieszczy ◽  
Magda Socha ◽  
Maryla Helena Turkot ◽  
...  

Background and aims A significant proportion of upper gastrointestinal cancers (UGICs) remain undetected during esophagogastroduodenoscopy (EGD). We investigated the characteristics and risk factors of UGICs missed during endoscopy. Methods In this nationwide registry-based study, we analyzed two large Polish datasets: the National Health Fund and the National Cancer Registry, to identify individuals who underwent EGD and were subsequently diagnosed with UGICs. Cancers diagnosed <6 months after EGD were defined as “prevalent” and those within ≥6 and <36 months as “missed.” We compared the characteristics of missed and prevalent cancers and analyzed the risk factors for missed UGICs in a multivariable regression model. Results We included 4,105,399 patients (mean age 56.0 [±17.4] years; 57.5% female) who underwent 5,877,674 EGDs between 2012-2018. Within this cohort, 33,241 UGICs were diagnosed, of which 1,993 (6.0%) were missed. Within esophageal neoplasms, adenocarcinomas were more commonly missed than squamous-cell cancers (6.1% vs. 4.2%) with a relative risk of 1.4 (95% confidence interval [CI]:1.2–1.5, P=0.011). In the stomach, missed adenocarcinomas constituted 5.7%. Overall, missed UGICs presented more often at an advanced stage than prevalent cancers (42.2% vs. 36.2%, P<.001). Risk factors for missed UGICs included: initial EGD performed within primary (vs. secondary) care (odds ratio[OR] 1.3, 95%CI:1.2–1.5), female gender (OR 1.3; 95%CI:1.2–1.4), and higher comorbidity (Charlson comorbidity index ≥5 vs. 0; OR 6.0; 95%CI:4.7–7.5). Conclusions Esophageal adenocarcinomas are most commonly missed among UGICs. Overlooked cancers occur more frequently within the primary care sector and are found more often in women and individuals with multiple comorbidities.


Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5234
Author(s):  
Chika Shichijo ◽  
Keita Kai ◽  
Kazuki Jinnouchi ◽  
Masashi Nishihara ◽  
Hideo Hara ◽  
...  

Cerebral infarction (CI) severely affects the prognosis of patients with malignancy. The aim of the study was to compare the pathology of CI between cases with and without malignancy focusing on intracranial Mönckeberg’s atherosclerosis. Among 778 autopsy cases of craniotomy, 53 cases of “cerebral infarction without malignancy group” (CI group), 50 cases of “malignant tumor without CI group” (MT group), and 39 cases of “cerebral infarction with malignancy group” (CM group) were identified. Mönckeberg’s atherosclerosis was mainly found in the basal ganglia and its prevalence in the CM group (38.5%) was significantly higher than in the MT group (12.0%, p = 0.005), and apparently higher than in the CI group (18.9%, p = 0.057). The CI group was significantly older, had higher BMIs, and a greater prevalence of hypertension and atrial fibrillation compared to the CM group. In addition, the prevalence of chronic renal disease was significantly lower in the CM group (2.6%, p = 0.012) than in the CI group (20.8%). Our results indicated that Mönckeberg’s atherosclerosis was often found in the basal ganglia of CM cases and that intracranial Mönckeberg’s atherosclerosis is a potential risk factor for CI in patients with advanced stage malignancy.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mustafa Şentürk ◽  
Murat Çakır ◽  
Mehmet Aykut Yıldırım ◽  
Ömer Kişi

Background and Aim. Endoscopic stenting is a generally safe and effective palliative treatment for esophageal malignancies. In this study, we aimed to present endoscopic stent applications, adverse events, and relative advantages of covered versus uncovered stents in our center. Methods. We examined cases of endoscopic stenting for palliative treatment of advanced stage esophageal cancers between January 2014 and July 2019. Age, gender, location of mass, adverse events, survival time, and stent type were evaluated. Outcomes of fully covered and uncovered self-expanding stents were compared with regard to adverse events, including stent migration and occlusion. Results. The mean age of the patients was 66.4 ± 1 , 52 were male, and 8 were female. Patients were followed up for a mean of 133 days. The most common complication due to stenting was migration. 13 patients developed adverse events. Migration was the most common adverse event, occurring in 8 (13%) patients. Although the migration rate of fully covered stents was higher than uncovered stents, there was no statistically significant difference ( p = 0.47 ). Stent occlusion was observed in 4 patients. In three cases, it was due to the tumor; an uncovered stent was placed again in these cases. Food-related occlusion developed in one patient. There was no statistical difference in terms of overall adverse event rate when comparing fully covered stents to uncovered stents ( p = 0.68 ). Conclusion. Endoscopic stenting is a viable palliative method with low morbidity and mortality in experienced centers. Though there are relative advantages with covered versus uncovered stents in individual cases, the overall adverse event rate is low and relatively similar.


2021 ◽  
Vol 10 (4) ◽  
pp. 888
Author(s):  
Timothy Samec ◽  
Raed Seetan

Cancer ranks as a leading cause of death worldwide; an estimated 1.7 million new diagnoses were reported in 2021. Ovarian cancer, the most lethal of gynecological malignancies, has no effective screening with over 70% of patients being diagnosed in an advanced stage. The aim of this study was to determine the most statistically significant contributing factors through a multivariate regression into the severity of female gynecological cancers. Data from the surveillance, epidemiology, and end results program (SEER) cancer database were utilized in this study. Several attempted multivariate linear regressions were implemented with further reduced models; however, a linear model could not be properly fit to the data. Because of unmet assumptions, a nonparametric moving, local regression, locally estimated scatterplot smoothing (LOESS), was performed. After smoothing factors were included to reduced-models, residual information was minimized although few conclusions can be drawn from the resulting statistics. These issues were prevalent mainly because of the massive variability in the data and inherent lack of linearity. This can be a significant issue with clinical data that does not dive deeper into cancer-dependent factors including genetic expression and cell surface receptor overexpression. General patient demographic data and diagnostic information alone does not provide enough detail to make a definite conclusion or prediction on patient survivability. Increased attention to the acquisition of tumor tissue for genomic and proteomic analysis in addition to next-generation sequencing methods can lead to significant improvements in prognostic predictions.


Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5180
Author(s):  
Shivani Krishnamurthy ◽  
David Gilot ◽  
Seong Beom Ahn ◽  
Vincent Lam ◽  
Joo-Shik Shin ◽  
...  

As the second and third leading cancer-related death in men and the world, respectively, primary liver cancer remains a major concern to human health. Despite advances in diagnostic technology, patients with primary liver cancer are often diagnosed at an advanced stage. Treatment options for patients with advanced hepatocarcinoma (HCC) are limited to systemic treatment with multikinase inhibitors and immunotherapy. Furthermore, the 5-year survival rate for these late-stage HCC patients is approximately 12% worldwide. There is an unmet need to identify novel treatment options and/or sensitive blood-based biomarker(s) to detect this cancer at an early stage. Given that the liver harbours the largest proportion of immune cells in the human body, understanding the tumour–immune microenvironment has gained increasing attention as a potential target to treat cancer. The kynurenine pathway (KP) has been proposed to be one of the key mechanisms used by the tumour cells to escape immune surveillance for proliferation and metastasis. In an inflammatory environment such as cancer, the KP is elevated, suppressing local immune cell populations and enhancing tumour growth. In this review, we collectively describe the roles of the KP in cancer and provide information on the latest research into the KP in primary liver cancer.


Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5186
Author(s):  
Elżbieta Pawluczuk ◽  
Marta Łukaszewicz-Zając ◽  
Mariusz Gryko ◽  
Agnieszka Kulczyńska-Przybik ◽  
Barbara Mroczko

Gastric cancer (GC) is the second leading cause of cancer-related deaths worldwide. This malignancy is usually diagnosed at an advanced stage. Therefore, novel biomarkers useful in the early detection of GC are sorely needed. Some authors suggest the role of chemokines and their specific receptors in GC pathogenesis. The aim of the study was to investigate whether serum CXCL8 and its receptor (CXCR2) might be considered as potential candidates for biomarkers in the diagnosis and prognosis of GC. The study included 98 subjects: 64 GC patients and 34 healthy volunteers. CXCL8 and CXCR2 concentrations were assessed by the enzyme-linked immunosorbent assay (ELISA) method. Serum CXCL8 and CXCR2 concentrations were significantly higher in GC patients than in healthy controls, similar to the well-established tumor marker (CA19-9) and marker of inflammation (CRP). Diagnostic sensitivity of CXCL8 was the highest among all proteins tested and increased for the combined assessment with CA19-9. The area under the ROC curve for CXCL8 was higher than those for CXCR2 and classical tumor markers. Serum CXCL8 levels were indicated as a significant risk factor of GC occurrence. Our findings suggest that serum CXCL8 is a promising candidate for a biomarker in GC diagnosis and might be used as a significant predictor of GC risk.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Saleheh Salehi far ◽  
Maryam Soltani ◽  
Mahmoud Zardast ◽  
Mohammad Reza Ghasemian Moghaddam

Background. The present study was performed to investigate the factors related to the expression level of estrogen and progesterone receptor in patients with colorectal cancer. Material and Methods. This crosssectional study was performed on 54 patients suffering from colorectal cancer referring to Imam Reza Hospital in Birjand during 2018-2019. After the biopsy performed during surgery, the specimen was sent for immunohistochemistry, and the status of receptors was determined. Eventually, the data were analyzed by SPSS 22. Results. Out of the 54 patients studied, 64.8% were male. The mean age of the patients was 62.28 ± 14.03 years. The level of expression of beta-estrogen receptors and progesterone receptors had a significant relationship with age, consuming drugs of abuse, and familial history ( P = 0.001 ). Also, the level of expression of estrogen and progesterone receptors of patients with a more advanced stage of cancer was significantly lower ( P = 0.001 ). Conclusion. The extent of expression of estrogen and progesterone receptors affects the progression and prognosis of disease. Thus, through hormone therapy, a step can be taken to reduce the progression and even to treat colorectal cancer.


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