cancer recurrence
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2022 ◽  
Vol 163 ◽  
pp. 66-76
Yuma Wada ◽  
Mitsuo Shimada ◽  
Yuji Morine ◽  
Tetsuya Ikemoto ◽  
Yu Saito ◽  

2022 ◽  
Vol 8 ◽  
Fang-Yu Yen ◽  
Wen-Kuei Chang ◽  
Shih-Pin Lin ◽  
Tzu-Ping Lin ◽  
Kuang-Yi Chang

Whether epidural anesthesia and analgesia (EA) is beneficial for postoperative cancer outcomes remains controversial and we conducted this historical cohort study to evaluate the association between EA and long-term outcomes following surgery for renal cell carcinoma (RCC). We collected patients receiving RCC surgery from 2011 to 2017 and followed up them until February 2020. Patient attributes, surgical factors and pathological features were gathered through electronic medical chart review. The association between EA and recurrence-free and overall survival after surgery was evaluated using Cox regression models with inverse probability of treatment weighting (IPTW) to balance the observed covariates. The median follow-up time for the 725 included patients was 50 months (interquartile range: 25.3–66.5) and 145 of them (20%) received perioperative EA. We demonstrated EA use was associated with better recurrence-free survival [IPTW adjusted hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.49–0.83, p < 0.001] and overall survival [IPTW adjusted HR: 0.66, 95% CI: 0.49–0.89, p = 0.006] in patients receiving surgical resection for RCC. More prospective studies are needed to verify this connection between EA and superior cancer outcomes after RCC surgery.

2022 ◽  
Vol 6 (1) ◽  
Kenta Takayasu ◽  
Koei Muguruma ◽  
Hidefumi Kinoshita

Immune checkpoint inhibitors, which promote or suppress the anti-tumor immune response, are becoming the mainstay of cancer treatment. In 2018, CheckMate 214 study showed a higher response rate with ipilimumab and nivolumab combination therapy compared to conventional therapy for advanced renal cell carcinoma. We report a case of complete response and durable response for two years to ipilimumab and nivolumab combination therapy in a patient with postoperative renal cancer recurrence that caused immune-related adverse events such as interstitial pneumonia and hepatotoxicity.

2022 ◽  
Zhensheng Li ◽  
Yue Li ◽  
Yunjiang Liu ◽  
Jun Zhang ◽  
Xiaohui Ji ◽  

Abstract Objective: To characterize the fear of cancer recurrence (FCR) and its relationship with anxiety and depression and quality of life (QoL) among Chinese breast cancer (BC) patients in China. Methods: Patients completed the questionnaires of QLQ-C30, QLQ-BR32 and HAD to assess FCR, QoL, anxiety and depression before radiotherapy. A cross-sectional analysis was performed. Chi-square and non-parametric tests and multivariate ordinal logistic regressions (mOLR) were utilized for reference analysis. Final covariates included age, BMI, TNM, surgery, chemotherapy, pain, and sleep disturbance. Results: From July 2015 to December 2016, 463 patients were prospectively enrolled. Their age mean (range) were 47 (19 - 89) years old. In total, 327 patients (70.6%) reported having FCR ‘a little bit’ (51.2%), ‘some’ (12.1%) and ‘very much’ (7.3%) in the past week. FCR severity ordered above (incl. ‘no’) was associated with anxiety score (median 1.5, 5.0, 7.0, 8.5 and level (‘abnormal’ rate 0%, 3.4%, 12.5%, 26.5%), depression score (median 2.0, 4.0, 6.0, 6.5) and level (‘abnormal’ rate 2.2%, 3.4%, 5.4%, 17.7%) (all p<0.001). mOLR showed that compared to ‘no’, three higher levels of FCR were associated with one level increase of anxiety with OR (p) as 1.983 (0.076), 4.291 (0.001), 8.282 (<0.001) and depression with OR (p) as 1.903 (0.062), 2.262 (0.065), 4.205 (0.004), respectively. FCR severity also was inversely associated with most QoL function scores (p<0.001). Conclusions: FCR was prevalent in Chinese BC patients and linearly associated with anxiety, depression and low QoL. It seems that a single-item question for FCR is a valid surrogate tool for distress screening in this population.

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Astrid Louise Bjørn Bennedsen ◽  
Luyi Cai ◽  
Rune Petring Hasselager ◽  
Aysun Avci Özcan ◽  
Khadra Bashir Mohamed ◽  

Abstract Background The immune system recognizes and destroys cancer cells. However, cancer cells develop mechanisms to avoid detection by expressing cell surface proteins. Specific tumour cell surface proteins (e.g. HLA-G, PD-L1, CDX2) either alone or in combination with the relative presence of immune cells (CD3 and CD8 positive T-cells) in the tumour tissue may describe the cancer cells’ ability to escape eradication by the immune system. The aim was to investigate the prognostic value of immunohistochemical markers in patients with colon cancer. Methods We conducted a retrospective study including patients diagnosed with pT3 and pT4 colon cancers. Immunohistochemical staining with HLA-G, PD-L1, CDX2, CD3, and CD8 was performed on tissue samples with representation of the invasive margin. PD-L1 expression in tumour cells and immune cells was reported conjointly. The expression of CD3 and CD8 was reported as a merged score based on the expression of both markers in the invasive margin and the tumour centre. Subsequently, a combined marker score was established based on all of the markers. Each marker added one point to the score when unfavourable immunohistochemical features was present, and the score was categorized as low, intermediate or high depending on the number of unfavourable stains. Hazard ratios for recurrence, disease-free survival and mortality were calculated. Results We included 188 patients undergoing colon cancer resections in 2011–2012. The median follow-up was 41.7 months, during which 41 (21.8%) patients had recurrence and 74 (39.4%) died. In multivariable regression analysis positive HLA-G expression (HR = 3.37, 95%CI [1.64–6.93]) was associated with higher recurrence rates, while a preserved CDX2 expression (HR = 0.23, 95%CI [0.06–0.85]) was associated with a lower risk of recurrence. An intermediate or high combined marker score was associated with increased recurrence rates (HR = 20.53, 95%CI [2.68–157.32] and HR = 7.56, 95%CI [1.06–54.16], respectively). Neither high expression of PD-L1 nor high CD3-CD8 score was significantly associated with recurrence rates. Patients with a high CD3-CD8 score had a significantly longer DFS and OS. Conclusions In tumour cells, expression of HLA-G and loss of CDX2 expression were associated with cancer recurrence. In addition, a combination of certain tumour tissue biomarkers was associated with colorectal cancer recurrence.

2022 ◽  
Vol 12 (1) ◽  
Ken Akashi ◽  
Toshihiko Sakai ◽  
Osamu Fukuoka ◽  
Yuki Saito ◽  
Masafumi Yoshida ◽  

AbstractIn head and neck cancer, early detection of recurrence after treatment is important. The contemporary development of therapeutic agents have improved the prognosis after recurrence; however, no biomarker has been established for evaluating therapeutic effects or detecting recurrence. Recently, circulating tumor DNA (ctDNA), which comprises DNA derived from tumor cells and exists in the form of cell-free DNA in the blood, has attracted attention as a minimally invasive and repeatable biomarker for detecting cancer. We validated the usefulness of ctDNA of human papilloma virus (HPV)-derived sequences as a biomarker in HPV-related p16-positive oropharyngeal cancer by assessing 25 patients with p16-positive oropharyngeal cancer. Blood samples were collected from each patient at multiple time points during the treatment, and the plasma was preserved. The ctDNA was extracted from the plasma and analyzed using digital polymerase chain reaction. HPV-derived ctDNA was detected in 14 (56%) of the 25 patients. In all the patients, the samples were found to be ctDNA-negative after initial treatment. Cancer recurrence was observed in 2 of the 14 patients; HPV-derived ctDNA was detected at the time of recurrence. Our results indicate that HPV-derived ctDNA can be a prospective biomarker for predicting the recurrence of p16-positive oropharyngeal cancer.

JMIR Cancer ◽  
10.2196/29745 ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. e29745
Clizia Cincidda ◽  
Silvia Francesca Maria Pizzoli ◽  
Gabriella Pravettoni

Background Patients with cancer and survivors may experience the fear of cancer recurrence (FCR), a preoccupation with the progression or recurrence of cancer. During the spread of COVID-19 in 2019, patients and survivors experienced increased levels of FCR. Hence, there is a greater need to identify effective evidence-based treatments to help people cope with FCR. Remotely delivered interventions might provide a valuable means to address FCR in patients with cancer. Objective The aim of this study is to first discuss the available psychological interventions for FCR based on traditional cognitive behavioral therapies (CBTs) or contemporary CBTs, in particular, mindfulness and acceptance and commitment therapy, and then propose a possible approach based on the retrieved literature. Methods We searched key electronic databases to identify studies that evaluated the effect of psychological interventions such as CBT on FCR among patients with cancer and survivors. Results Current evidence suggests that face-to-face psychological interventions for FCR are feasible, acceptable, and efficacious for managing FCR. However, there are no specific data on the interventions that are most effective when delivered remotely. Conclusions CBT interventions can be efficacious in managing FCR, especially at posttreatment, regardless of whether it is delivered face to face, on the web, or using a blended approach. To date, no study has simultaneously compared the effectiveness of face-to-face, web-based, and blended interventions. On the basis of the retrieved evidence, we propose the hypothetical program of an intervention for FCR based on both traditional CBT and contemporary CBT, named Change Of Recurrence, which aims to improve the management of FCR in patients with cancer and survivors.

2022 ◽  
Vol 12 (1) ◽  
Yanning Xu ◽  
Said M. Afify ◽  
Juan Du ◽  
Bingbing Liu ◽  
Ghmkin Hassan ◽  

AbstractCancer stem cells (CSCs) are capable of continuous proliferation, self-renewal and are proposed to play significant roles in oncogenesis, tumor growth, metastasis and cancer recurrence. We have established a model of CSCs that was originally developed from mouse induced pluripotent stem cells (miPSCs) by proposing miPSCs to the conditioned medium (CM) of cancer derived cells, which is a mimic of carcinoma microenvironment. Further research found that not only PI3K-Akt but also EGFR signaling pathway was activated during converting miPSCs into CSCs. In this study, we tried to observe both of PI3Kγ inhibitor Eganelisib and EGFR inhibitor Gefitinib antitumor effects on the models of CSCs derived from miPSCs (miPS-CSC) in vitro and in vivo. As the results, targeting these two pathways exhibited significant inhibition of cell proliferation, self-renewal, migration and invasion abilities in vitro. Both Eganelisib and Gefitinib showed antitumor effects in vivo while Eganelisib displayed more significant therapeutic efficacy and less side effects than Gefitinib on all miPS-CSC models. Thus, these data suggest that the inhibitiors of PI3K and EGFR, especially PI3Kγ, might be a promising therapeutic strategy against CSCs defeating cancer in the near future.

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