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Rajiv V. Dave Baek Kim Alona Courtney Rachel OConnell Tim Rattay Vicky P. Taxiarchi Jamie J. Kirkham Elizabeth M. Camacho Patricia Fairbrother Nisha Sharma Christopher W. J. Cartlidge Kieran Horgan Stuart A. McIntosh Daniel R. Leff Raghavan Vidya Shelley Potter Chris Holcombe Ellen Copson Charlotte E. Coles Ramsey I. Cutress Ashu Gandhi Cliona C. Kirwan 《British journal of cancer》2021,124(11):1785
Background The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions.Methods This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting.Findings Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey.Conclusions The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown.Subject terms: Breast cancer, Surgical oncology, Health care economics, Quality of life, Health policy 相似文献
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O.R. Mitchell R. Dave J. Bekker P.A. Brennan 《The British journal of oral & maxillofacial surgery》2021,59(3):384-385
The first COVID-19 vaccination was given in December 2020 and there is an effort to vaccinate the international population on a massive scale. Common side effects from the vaccine include headache and tiredness. Regional lymphadenopathy has been described in relation to other vaccines. We describe two cases of supraclavicular reactive lymphadenopathy presenting in patients who had the COVID vaccination in the ipsilateral arm. Awareness of this diagnosis is important for patients presenting to the neck lump clinic. 相似文献
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Dave E. W. van der Kruijssen Auke J. S. van der Kuil Geraldine R. Vink Cornelis J. A. Punt Johannes H. W. de Wilt Sjoerd G. Elias Miriam Koopman 《International journal of cancer. Journal international du cancer》2023,152(7):1360-1369
We studied the prognostic value of primary tumor sidedness in metastatic colorectal cancer over time and across treatment lines. Population data on synchronous metastatic colorectal cancer patients were extracted from the Netherlands Cancer Registry and SEER database. Pubmed, EMBASE and Cochrane library were searched for prospective studies on metastatic colorectal cancer to conduct a meta-analysis. Inclusion criteria consisted of metastatic disease, systemic treatment with palliative intent and specification of primary tumor location. Data were pooled using a random-effects model. For the population-based data, multivariable Cox models were constructed. The Grambsch-Therneau test was conducted to evaluate the potential time-varying nature of sidedness. Meta-regression incorporating treatment-line as variable was conducted to test the pre-specified hypothesis that the prognostic value of sidedness varies over time. Analysis of 12 885 and 16 160 synchronous metastatic colorectal cancer patients registered in the Netherlands Cancer Registry and SEER database, respectively, indicated a time-varying prognostic value of sidedness (P < .01). Thirty-one studies were selected for the meta-analysis (9558 patients for overall survival analysis). Pooled univariable hazard ratioleft-sided/right-sided for overall survival was 0.71 (95% CI: 0.65-0.76) in 1st-line, 0.76 (0.54-1.06) in 2nd-line and 1.01 (0.86-1.19) in 3rd-line studies. Hazard ratios were significantly influenced by treatment line (P = .035). The prognostic value of sidedness of the primary tumor in metastatic colorectal cancer patients treated with palliative systemic therapy decreases over time since diagnosis, suggesting that sidedness may not be a useful stratification factor in late-line trials. This decrease in prognostic value should be taken into account when providing prognostic information to patients. 相似文献
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Robert Baird Dave R. Lal Robert L. Ricca Karen A. Diefenbach Cynthia D. Downard Julia Shelton Stig Sømme Julia Grabowski Tolulope A Oyetunji Regan F. Williams Tim Jancelewicz Roshni Dasgupta L. Grier Arthur Akemi L. Kawaguchi Yigit S. Guner Ankush Gosain Robert L. Gates Juan E. Sola Adam Goldin 《Journal of pediatric surgery》2019,54(4):675-687
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