Preoperative Metastatic Brain Tumor-Associated Intracerebral Hemorrhage Is Associated With Dismal Prognosis

ObjectIntra-tumoral hemorrhage is considered an imaging characteristic of advanced cancer disease. However, data on the influence of intra-tumoral hemorrhage in patients with brain metastases (BM) remains scarce. We aimed at investigating patients with BM who underwent neurosurgical resection of the metastatic lesion for a potential impact of preoperative hemorrhagic transformation on overall survival (OS).MethodsBetween 2013 and 2018, 357 patients with BM were surgically treated at the authors’ neuro-oncological center. Preoperative magnetic resonance imaging (MRI) examinations were assessed for the occurrence of malignant hemorrhagic transformation.Results122 of 375 patients (34%) with BM revealed preoperative intra-tumoral hemorrhage. Patients with hemorrhagic transformed BM exhibited a median OS of 5 months compared to 12 months for patients without intra-tumoral hemorrhage. Multivariate analysis revealed preoperative hemorrhagic transformation as an independent and significant predictor for worsened OS.ConclusionsThe present study identifies preoperative intra-tumoral hemorrhage as an indicator variable for poor prognosis in patients with BM undergoing neurosurgical treatment.

Changes in gynecologic and breast cancer diagnoses during the first wave of the COVID-19 pandemic: analysis from a tertiary academic gyneco-oncological center in Germany

Purpose With the beginning of 2021, the world has been suffering from the COVID-19 pandemic for more than 1 year. More and more, we are able to evaluate side effects of the pandemic in the healthcare sector. A negative impact on cancer diagnoses is one of them. Careful observation of trends in an academic gyneco-oncological context appears important to identify potential negative developments. Methods We analyzed the case number of gynecologic and breast cancer diagnoses in the period from January to June 2020 compared to 2019 and during the period of the first general German lockdown (March 22nd until May 5th 2020). Patients were characterized by age, tumor type, FIGO or TNM stage and presence of symptoms at initial hospital presentation. Results The frequency of newly diagnosed gynecologic and breast cancer cases from beginning of January until end of June changed by − 10% and by − 12% during the lockdown in 2020 compared to 2019. In both periods, reduction of breast cancer cases was relatively larger than decrease of gynecologic cancers. Moreover, median patient age decreased. For the first half of 2020, we found a shift towards higher tumor stages (N+/M1 or FIGO III–IV). During the lockdown period, the appearance of tumor-associated symptoms at diagnosis increased by about 12%. Conclusion This analysis illustrates the anticipated general decrease in diagnoses of primary cancers during the lockdown periods in 2020 due to COVID-19 pandemic for gynecologic and breast cancer cases.

Extravasation of antineoplastic agents in an Oncological Center

Introduction/Objective: This retrospective cross-sectional cohort study analyzed the extravasation index of antineoplastic therapy agents, demographic and clinical data. Methods: Seventy-six patients were evaluated in the period between 2017-2019. The project was approved by the Research Ethics Committee of a Brazilian Foundation. Results: In 72 months, 105,890 applications were administered, of which the incidence rate of extravasation of antineoplastic agents was 0.071%. Patients (N=311) selected for this study had a mean age of 55.42 years and a median age of 57. The most frequent diagnoses were breast cancer (11.66%), ovarian cancer (10%), colon cancer (8.33), rectal cancer (8.33) and uterine cancer (8.33%). The main variables that presented a significant impact with p <0.05 were ECOG Scale of Performance Status, ethnicity, age (risk ratio of 3% plus for each year of life), cancer staging, lymphadenectomy, use of venous catheter, forearm puncture, use of alkylating and alkaloids agents in peripheral venous access, and patients with tumor located in the pelvis using alkylating agents. Conclusion: The findings reinforce the need for further studies, since it was not possible to compare results with some variables that demonstrated a significant increase in the risk for the event.

Analysis of the assortment of narcotic drugs used for the treatment of pain in cancer patients in the palliative care unit

A study of the assortment of narcotic drugs for the relief of acute and chronic pain syndrome in cancer patients in the palliative care unit of the Oncological Center was carried out. It has been shown that practically all registered dosage forms of opioid analgesics are used

Pediatric Lymphoma Complicated by Intussusception

Intestinal intussusception is rare in children over the age of 6 years and, in most cases, is due to the presence of anatomical reasons. Tumors of the gastrointestinal tract are one of the etiological factors in the development of ileus in older children. The paper presents the case of a 7-year-old child who was admitted to the clinic with the abdominal pain syndrome that resolved on its own. With a repeated pain attack, intestinal intussusception was diagnosed, the patient was urgently operated. Laparoscopic complete reduction of intussusception failed, which required conversion of the access. After straightening the intussusception of the small intestine, there was detected a tumor of the ileum, which practically blocked the intestinal lumen. The segment of the intestine with the tumor was resected with an end-to-end anastomosis. In the postoperative period, the patient was diagnosed with intestinal lymphoma based on the test studies of the operating material. After stabilizing the condition, the child was transferred to an oncological center.