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Kerri M. Winters-Stone Karen S. Lyons Jessica Dobek Nathan F. Dieckmann Jill A. Bennett Lillian Nail Tomasz M. Beer 《Journal of cancer survivorship》2016,10(4):633-644
Background
Prostate cancer can negatively impact quality of life of the patient and his spouse caregiver, but interventions rarely target the health of both partners simultaneously. We tested the feasibility and preliminary efficacy of a partnered strength training program on the physical and mental health of prostate cancer survivors (PCS) and spouse caregivers.Methods
Sixty-four couples were randomly assigned to 6 months of partnered strength training (Exercising Together, N = 32) or usual care (UC, N = 32). Objective measures included body composition (lean, fat and trunk fat mass (kg), and % body fat) by DXA, upper and lower body muscle strength by 1-repetition maximum, and physical function by the physical performance battery (PPB). Self-reported measures included the physical and mental health summary scales and physical function and fatigue subscales of the SF-36 and physical activity with the CHAMPS questionnaire.Results
Couple retention rates were 100 % for Exercising Together and 84 % for UC. Median attendance of couples to Exercising Together sessions was 75 %. Men in Exercising Together became stronger in the upper body (p < 0.01) and more physically active (p < 0.01) than UC. Women in Exercising Together increased muscle mass (p = 0.05) and improved upper (p < 0.01) and lower body (p < 0.01) strength and PPB scores (p = 0.01) more than UC.Conclusions
Exercising Together is a novel couples-based approach to exercise that was feasible and improved several health outcomes for both PCS and their spouses.Implications for cancer survivors
A couples-based approach should be considered in cancer survivorship programs so that outcomes can mutually benefit both partners.Trial registration
ClinicalTrials.gov NCT009540443.
Purpose
Short stature has been reported in pediatric cancer survivors. Data on retinoblastoma survivors are limited. We conducted a cross-sectional study to assess the height in retinoblastoma survivors.Method
The recorded height was compared with median height for age and sex as per the Indian Academy of Pediatrics. Z-score less than ?2 was considered short statured.Result
Thirty percent of the survivors were short statured. The mean height was shorter than the mean 50th percentile height (119.7 ± 14.8 vs 128.7 ± 15 cm, p < 0.001). Previous chemotherapy showed a trend toward association (p = 0.09).Conclusion
Short stature affects a significant number of retinoblastoma survivors.4.
Ryo Tanaka Sang-Woong Lee Masaru Kawai Keitaro Tashiro Satoshi Kawashima Syuji Kagota Kotaro Honda Kazuhisa Uchiyama 《Gastric cancer》2017,20(5):861-871
Background
The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear.Methods
This study was a single-center, prospective randomized trial involving patients with gastric cancer undergoing curative gastrectomy. The primary end point was the length of postoperative hospital stay. Secondary end points were the postoperative complication rate, admission costs, weight loss, and amount of physical activity.Results
From July 2013 to June 2015, we randomized 148 patients into an ERAS protocol group (n = 73) and a conventional protocol group (n = 69); six patients withdrew from the study. The hospital stay was significantly shorter in the ERAS protocol group than in the conventional protocol group (9 days vs 10 days; P = 0.037). The ERAS protocol group had a significantly lower rate of postoperative complications of grade III or higher (4.1% vs 15.4%; P = 0.042) and reduced costs of hospitalization (JPY 1,462,766 vs JPY 1,493,930; P = 0.045). The ratio of body weight to preoperative weight at 1 week and 1 month after the operation was higher in the ERAS protocol group (0.962 vs 0.957, P = 0.020, and 0.951 vs 0.937, P = 0.021, respectively). The ERAS protocol group recorded more physical activity in the first week after surgery.Conclusions
The ERAS protocol is safe and efficient, and seems to improve the postoperative course of patients with gastric cancer.5.
Giovanna Mariscotti Manuela Durando Nehmat Houssami Mirella Fasciano Alberto Tagliafico Davide Bosco Cristina Casella Camilla Bogetti Laura Bergamasco Paolo Fonio Giovanni Gandini 《Breast cancer research and treatment》2017,166(3):765-773
Purpose
To compare the interpretive performance of synthetic mammography (SM), reconstructed from digital breast tomosynthesis (DBT), and full-field digital mammography (FFDM) in a diagnostic setting, covering different conditions of breast density and mammographic signs.Methods
A retrospective analysis was conducted on 231 patients, who underwent FFDM and DBT (from which SM images were reconstructed) between September 2014–September 2015. The study included 250 suspicious breast lesions, all biopsy proven: 148 (59.2%) malignant and 13 (5.2%) high-risk lesions were confirmed by surgery, 89 (35.6%) benign lesions had radiological follow-up. Two breast radiologists, blinded to histology, independently reviewed all cases. Readings were performed with SM alone, then with FFDM, collecting data on: probability of malignancy for each finding, lesion conspicuity, mammographic features and dimensions of detected lesions.Results
Agreement between readers was good for BI-RADS classification (Cohen’s k-coefficient = 0.93 ± 0.02) and for lesion dimension (Wilcoxon’s p = 0.76). Visibility scores assigned to SM and FFDM for each lesion were similar for non-dense and dense breasts, however, there were significant differences (p = 0.0009) in distribution of mammographic features subgroups. SM and FFDM had similar sensitivities in non-dense (respectively 94 vs. 91%) and dense breasts (88 vs. 80%) and for all mammographic signs (93 vs. 87% for asymmetric densities, 96 vs. 75% for distortion, 92 vs. 85% for microcalcifications, and both 94% for masses). Based on all data, there was a significant difference in sensitivity for SM (92%) vs. FFDM (87%), p = 0.02, whereas the two modalities yielded similar results for specificity (SM: 60%, FFDM: 62%, p = 0.21).Conclusions
SM alone showed similar interpretive performance to FFDM, confirming its potential role as an alternative to FFDM in women having tomosynthesis, with the added advantage of halving the patient’s dose exposure.6.
Mette Linnet Olesen Anne-Katrine Duun-Henriksen Helena Hansson Bent Ottesen Klaus Kaae Andersen Vibeke Zoffmann 《Journal of cancer survivorship》2016,10(5):832-841
Purpose
We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors’ quality of life (QOL), impact of cancer, distress, anxiety, depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence.Methods
We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical, psychological, social, and spiritual well-being were assessed before randomization and at 3 and 9 months after randomization using t tests. Bonferroni and Pipper corrections were applied for multiple testing adjustments.Results
At 9 months, the GSD-GYN-C plus UC group scored significantly higher on the QOL-CS total scale (P?=?0.02) and on the QOL-CS physical well-being subscale (P?=?0.01), compared to women receiving UC alone. After adjusting for baseline scores, only the difference in the physical well-being subscale was statistically significant. No other measured outcomes differed between the intervention and control groups after baseline adjustment.Conclusion
We observed higher physical well-being 9 months after randomization in the GSD-GYN-C group, as compared to women receiving usual care.Implications for Cancer Survivors
The results suggest that the person-centered intervention GSD-GYN-C may improve physical well-being in gynecological cancer survivors. However, further testing is needed.7.
Zuoliang Liu Tong Zhou Guodong Yang Guangjun Zhang 《Journal of gastrointestinal cancer》2018,49(2):158-166
Background/Aims
The minilaparotomy approach is feasible for the resection of colon cancer. This study aimed to compare the clinical and oncological outcomes of minilaparotomy and laparoscopic approaches in patients with colon cancer.Methods
We performed a retrospective analysis of consecutive patients undergoing minilaparotomy or laparoscopic resection for colon cancer from January 2009 to December 2014.Results
There were 376 patients with colon cancer. Seventy-one patients were excluded. The remaining 305 patients were allocated to the minilaparotomy (n = 146) group or laparoscopic group (n = 159). The demographic data of the two groups was similar except for body mass index. The time to first bowel movement (P = 0.000) and the hospital stay (P = 0.005) were less in the laparoscopic group. Compared with the minilaparotomy group, the mean operation time was longer and the costs higher for laparoscopic group (P = 0.000). The morbidity, mortality, and local recurrence were comparable between the two groups. The 5-year overall and disease-free survival rates were also similar (overall survival is 75.3 vs. 72.9%, P = 0.648; disease-free survival is 66.2 vs. 70.2%, P = 0.914).Conclusion
The minilaparotomy approach was safe and equivalent to laparoscopic approach for patients with colon cancer. It is an alternative to the laparoscopic approach in selected patients.8.
Ji Hyeon Joo Su Ssan Kim Seung-Do Ahn Eun Kyung Choi Jin Hong Jung Yuri Jeong Sei Hyun Ahn Byung Ho Son Jong Won Lee Hee Jung Kim Beom Seok Go Hak Hee Kim Joo Hee Cha Hee Jung Shin Eun Young Chae 《Breast cancer research and treatment》2017,166(2):511-518
Purpose
To analyze the prognostic role of pathologic confirmation of internal mammary lymph nodes (IMNs) for breast cancer patients who received neoadjuvant chemotherapy.Methods
Of the patients who were treated with neoadjuvant chemotherapy, surgery, and radiation therapy between 2009 and 2013, 114 women had suspicious IMNs and FNAB was attempted. Clinical IMN metastasis was diagnosed by 18F-FDG PET/CT positivity or pathologic confirmation (N = 70). Patients were divided into the FNAB(+) or FNAB(?) IMN group.Results
The pathologic confirmation rate was 57% (40 of 70 patients). Rates were 74% in US-positive, 70% in MRI-positive, and 55% in PET-positive patients. Nodal stage was cN2b (6%) or cN3b (94%). Five-year progression-free survival (PFS) was significantly worse in patients with FNAB(+) IMN metastasis than FNAB(?) IMN metastasis (61% vs. 87%, P = 0.03). FNAB(+) IMN patients showed worse distant metastasis and regional recurrence-free survival without statistical significance (69% vs. 86%, P = 0.06, and 81% vs. 96%, P = 0.06). With median follow-up of 50.5 months (13.0–97.0 months), overall survival at 5 years was 77%, and PFS was 72%.Conclusions
Patients with FNAB-proven IMN metastasis had worse treatment outcomes compared to patients with clinically diagnosed IMN metastasis in cN2b/N3b breast cancer.9.
Anne Blaes Heather Beckwith Natalia Florea Robert Hebbel Anna Solovey David Potter Douglas Yee Rachel Vogel Russell Luepker Daniel Duprez 《Breast cancer research and treatment》2017,166(2):541-547
Purpose
Aromatase inhibitors (AI) have been shown to reduce breast cancer-related mortality in women with estrogen positive (ER+) breast cancer. The use of AIs, however, has been associated with higher rates of hypertension, hyperlipidemia, and cardiovascular (CV) events.Methods
A cross-sectional study of 25 healthy postmenopausal women and 36 women with curative intent breast cancer on an AI was performed to assess endothelial dysfunction, an indicator of risk for CV events. Consented subjects underwent vascular testing using the HDI/Pulse Wave CR-2000 Cardiovascular Profiling System and the EndoPAT2000 system.Results
Mean age was 61.7 and 59.6 years (cases, controls). Most subjects were Caucasian and overweight. Controls had a lower mean systolic blood pressure (128.6 mmHg vs. 116.2 mmHg, p = 0.004). Median estradiol levels were reduced in cases (2 vs. 15 pg/ml, p < 0.0001). EndoPAT ratio (0.8 vs. 2.7, p < 0.0001) was significantly reduced in cases as compared to controls. Median large artery elasticity (12.9 vs. 14.6 ml/mmHg × 10, p = 0.12) and small artery elasticity (5.2 vs. 7.0 ml/mmHg × 100, p = 0.07) were also reduced though not statistically significant. There was no correlation between use of chemotherapy, radiation therapy, type of AI, or duration of AI use and endothelial function. When adjusting for differences in blood pressure, results remained significant.Conclusion
Breast cancer cases on AIs have reductions in endothelial function, a predictor of adverse CV disease. Impact: Vascular function changes in breast cancer cases on AIs compared to postmenopausal women. Further work is needed to evaluate vascular changes over time.10.
Purpose
This study evaluated the feasibility and preliminary efficacy of two 6-month, self-regulation interventions that focused on daily self-weighing (DSW) and used objective monitoring and tailored feedback about weight (±activity), to prevent weight gain among African American breast cancer survivors.Methods
Participants (n = 35) were randomized to an intervention + activity monitoring (INT+), intervention (INT), or control (CON) group. Interventions included a wireless scale (±activity tracker) that transmitted objective data to a mobile app/website, emailed lessons, and tailored feedback based on objective weight (±activity data). Participants completed in-person and online assessments at baseline, 3 months, and 6 months.Results
Ninety-four percent of participants completed assessments at 3 months, and 97 % at 6 months. Median (IQR) weight change after 6 months was ?0.9 % (?4.4–0.1) in the INT+ (p = 0.075; p = 0.067 vs. CON) and ?0.2 % (?4.2–1.3) in the INT groups (p = 0.463; p = 0.357 vs. CON), versus a 0.2 % (?0.7–1.7) gain in the CON group. The proportion of INT+, INT, and CON participants that were at or below baseline weight was 72.7, 53.8, and 45.5 %, respectively (effect sizes d = 0.64, d = 0.18). Most INT+ participants weighed and wore trackers ≥5 days/week (INT+, 81.9 % vs. INT, 38.5 % vs. CON, 0 %; p < 0.0005; INT+, 72.7 %). Both intervention groups perceived DSW as positive, and 100 % would recommend the program to other breast cancer survivors.Conclusion
An intervention focused on DSW as a self-monitoring strategy shows promise for preventing weight gain in breast cancer survivors.Implications for cancer survivors
Daily self-monitoring of weight and activity may be a feasible and accessible approach to promote weight gain prevention in breast cancer survivors.Clinical trial registration
ClinicalTrials.gov, NCT0203035311.
J. S. Thomas A. M. Hanby N. Russell G. van Tienhoven K. Riddle N. Anderson D. A. Cameron J. M. S. Bartlett T. Piper C. Cunningham P. Canney I. H. Kunkler On behalf of the SUPREMO Trial Management Group 《Breast cancer research and treatment》2017,161(1):63-72
Purpose
The PELICAN trial evaluates for the first time efficacy and safety of pegylated liposomal doxorubicin (PLD) versus capecitabine as first-line treatment of metastatic breast cancer (MBC).Methods
This randomized, phase III, open-label, multicenter trial enrolled first-line MBC patients who were ineligible for endocrine or trastuzumab therapy. Cumulative adjuvant anthracyclines of 360 mg/m2 doxorubicin or equivalent were allowed. Left ventricular ejection fraction of >50 % was required. Patients received PLD 50 mg/m2 every 28 days or capecitabine 1250 mg/m2 twice daily for 14 days every 21 days. The primary endpoint was time-to-disease progression (TTP).Results
210 patients were randomized (n = 105, PLD and n = 105, capecitabine). Adjuvant anthracyclines were given to 37 % (PLD) and 36 % (capecitabine) of patients. No significant difference was observed in TTP [HR = 1.21 (95 % confidence interval, 0.838–1.750)]. Median TTP was 6.0 months for both PLD and capecitabine. Comparing patients with or without prior anthracyclines, no significant difference in TTP was observed in the PLD arm (log-rank P = 0.64). For PLD versus capecitabine, respectively, overall survival (median, 23.3 months vs. 26.8 months) and time-to-treatment failure (median, 4.6 months vs. 3.7 months) were not statistically significantly different. Compared to PLD, patients on capecitabine experienced more serious adverse events (P = 0.015) and more cardiac events among patients who had prior anthracycline exposure (18 vs. 8 %; P = 0.31).Conclusion
Both PLD and capecitabine are effective first-line agents for MBC.12.
Hiroko Kunitake Marcia M. Russell Ping Zheng Greg Yothers Stephanie R. Land Laura Petersen Louis Fehrenbacher Jeffery K. Giguere D. Lawrence Wickerham Clifford Y. Ko Patricia A. Ganz 《Journal of cancer survivorship》2017,11(1):111-118
Purpose
Little is known about health-related quality of life (HRQL) in long-term survivors (LTS) of colorectal cancer (CRC).Methods
Long-term CRC survivors (≥5 years) treated in previous National Surgical Adjuvant Breast and Bowel Project trials were recruited from 60 sites. After obtaining consent, a telephone survey was administered, which included HRQL instruments to measure physical health (Instrumental Activities of Daily Living [IADL], SF-12 Physical Component Scale [PCS], SF-36 Vitality Scale), mental health (SF-12 Mental Component Scale [MCS], Life Orientation Test, and Impact of Cancer), and clinical symptoms (Fatigue Symptom Inventory [FSI], European Organization for Research and Treatment of Cancer Colorectal Module [EORTC-CR38], and Brief Pain Inventory). A multivariable model identified predictors of overall quality of life (global health rating).Results
Participants (N = 708) had significantly higher HRQL compared with age group-matched non-cancer controls with higher mean scores on SF-12 PCS (49.5 vs. 43.7, p = <0.05), MCS (55.6 vs. 52.1, p = <0.05), and SF-36 Vitality Scale (67.1 vs. 59.9, p = <0.05). Multivariable modeling has demonstrated that better overall physical and mental health (PCS and MCS), positive body image (EORTC-CR38 scale), and less fatigue (FSI), were strongly associated with overall quality of life as measured by the global health rating. Interestingly, ability to perform IADLs, experience of cancer, gastrointestinal complaints, and pain, were not important predictors.Conclusions
In long-term CRC survivors, overall physical and mental health was excellent compared with general population. Other disease-related symptoms did not detract from good overall health.Implications for cancer survivors
LTS of CRC within the setting of a clinical trial have higher HRQL than the general population, and treatment regimens do not appear to be associated with any significant late effects on quality of life.Trial Registration: NSABP LTS-01: NCT00410579.13.
Y. Wang Y. Li L. Xia K. Niu X. Chen D. Lu R. Kong Z. Chen J. Sun 《Clinical & translational oncology》2018,20(3):366-373
Background
Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is the optimal treatment for EGFR-mutant advanced non-small cell lung cancer (NSCLC). However, most patients developed systemic or local progression due to acquired EGFR-TKI resistance. This retrospective study aimed to evaluate the feasibility of continued EGFR-TKI with concurrent radiotherapy (CTCRT) in patients with local progression after front-line EGFR-TKI treatment.Methods
Advanced NSCLC patients with active EGFR mutation who received EGFR-TKI were treated with CTCRT after local progression. Medical data were analyzed for time to progression (TTP), progression-free survival (PFS), tumor response rate, overall survival (OS) and adverse events.Results
A total of 50 irradiated lesions from 44 patients were included. Median TTP and PFS of measurable lesions (n = 31) were both significantly prolonged after local radiotherapy (TTP1 + TTP2 vs. TTP1: 21.7 vs. 16.0 months, P = 0.010; PFS1 + PFS2 vs. PFS1: 21.3 vs. 16.0 months, P = 0.027). For all lesions (n = 50), objective response rate (ORR) and local tumor control rate (LCR) were 54.0 and 84.0%, respectively. Median OS was 26.6 months. There were no serious adverse events before or after radiotherapy.Conclusions
The treatment modality of CTCRT is considerable and effective for EGFR-mutant NSCLC patients even with local failure from front-line EGFR-TKI treatment.14.
Yiran Wang Junnan Wang Fei Long Ning Wang Bingbing Zhang Huan Han Yajie Wang 《Breast cancer (Tokyo, Japan)》2018,25(4):431-437
Background
The genotype of Fanconi Anemia complementation group M (FANCM) was previously found to be associated with breast cancer risk in several populations. Here, we studied the expression of FANCM and its correlation with clinical characteristics in Chinese patients with breast cancer.Methods
We performed an immunohistochemical study of FANCM protein in clinical breast cancer tissues from 310 patients along with 44 adjacent tissues.Results
FANCM protein level is lower in triple-negative breast cancer tissues than in other subtypes (P = 0.008). In addition, high FANCM expression correlated with pathology type IDC (P = 0.040), estrogen receptor positive (P < 0.001), progesterone receptor positive (P = 0.001), and low Ki-67 status (P = 0.003). Multivariate analysis revealed that FANCM status was an independent prognostic factor for overall survival (P = 0.017) in luminal B breast cancer.Conclusions
FANCM levels are significantly associated with different subtypes of human breast cancer. Specifically, FANCM could play a role in the progression of luminal B breast cancer.15.
Meng Yang Azalea Ayuningtyas Stacey A. Kenfield Howard D. Sesso Hannia Campos Jing Ma Meir J. Stampfer Jorge E. Chavarro 《Cancer causes & control : CCC》2016,27(9):1153-1161
Background
Circulating fatty acids are highly correlated with each other, and analyzing fatty acid patterns could better capture their interactions and their relation to prostate cancer. We aimed to assess the associations between data-derived blood fatty acid patterns and prostate cancer risk.Methods
We conducted a nested case–control study in the Physicians’ Health Study. Fatty acids levels were measured in whole blood samples of 476 cases and their matched controls by age and smoking status. Fatty acid patterns were identified using principal component analysis. Conditional logistic regression was used to estimate odds ratio (OR) and 95 % confidence interval (CI).Results
Two patterns explaining 40.9 % of total variation in blood fatty acid levels were identified. Pattern 1, which mainly reflects polyunsaturated fatty acid metabolism, was suggestively positively related to prostate cancer risk (ORquintile 5 vs. quintile 1 = 1.37, 95 % CI = 0.91–2.05, P trend = 0.07). Pattern 2, which largely reflects de novo lipogenesis, was significantly associated with higher prostate cancer risk (ORquintile5 vs. quintile1 = 1.63, 95 % CI = 1.04–2.55, P trend = 0.02). This association was similar across tumor stage, grade, clinical aggressiveness categories and follow-up time.Conclusion
The two patterns of fatty acids we identified were consistent with known interactions between fatty acid intake and metabolism. A pattern suggestive of higher activity in the de novo lipogenesis pathway was related to higher risk of prostate cancer.16.
R. Diaz-Beveridge G. Bruixola D. Lorente J. Caballero E. Rodrigo Á. Segura D. Akhoundova A. Giménez J. Aparicio 《Clinical & translational oncology》2018,20(3):322-329
Background
Sorafenib is a standard treatment for patients (pts) with advanced hepatocellular carcinoma (aHCC), although the clinical benefit is heterogeneous between different pts groups. Among novel prognostic factors, a low baseline neutrophil-to-lymphocyte ratio (bNLR) and early-onset diarrhoea have been linked with a better prognosis.Purpose
To identify prognostic factors in pts with aHCC treated with 1st-line sorafenib and to develop a new prognostic score to guide management.Materials and methods
Retrospective review of 145 pts bNLR, overall toxicity, early toxicity rates and overall survival (OS) were assessed. Univariate and multivariate analysis of prognostic factors for OS was performed. The prognostic score was calculated from the coefficients found in the Cox analysis. ROC curves and pseudoR2 index were used for internal validation. Discrimination ability and calibration were tested by Harrel’s c-index (HCI) and Akaike criteria (AIC).Results
The optimal bNLR cut-off for the prediction of OS was 4 (AUC 0.62). Independent prognostic factors in multivariate analysis for OS were performance status (PS) (p < .0001), Child–Pugh (C–P) score (p = 0.005), early-onset diarrhoea (p = 0.006) and BNLR (0.011). The prognostic score based on these four variables was found efficient (HCI = 0.659; AIC = 1.180). Four risk groups for OS could be identified: a very low-risk (median OS = 48.6 months), a low-risk (median OS = 11.6 months), an intermediate-risk (median OS = 8.3 months) and a high-risk group (median OS = 4.4 months).Conclusions
PS and C–P score were the main prognostic factors for OS, followed by early-onset diarrhoea and bNLR. We identified four risk groups for OS depending on these parameters. This prognostic model could be useful for patient stratification, but an external validation is needed.17.
Wanjing Chen Xiaoai Lv Xiaohong Xu Xiufei Gao Bei Wang 《Breast cancer (Tokyo, Japan)》2018,25(4):464-469
Aims
This meta-analysis aimed to evaluate the impact of breast reconstruction on the psychological aspects in patients with breast cancer.Methods
A literature search on PubMed, Embase, ScienceDirect and Google scholar databases was conducted up to September 2017. The pooled risk radio (RR) or standard mean difference (SMD) and the corresponding 95% confidence intervals (CIs) were calculated using the RevMan 5.3 software.Results
A total of 5 studies were included in this meta-analysis. There were 551 breast cancer patients receiving mastectomy plus breast reconstruction and 574 breast cancer patients receiving mastectomy alone. The results showed that breast reconstruction can significantly decrease the incidence of anxiety (RR = 0.62, 95% CI 0.47–0.82, P = 0.0006)/depression (RR = 0.54, 95% CI 0.32–0.93, P = 0.02) and scale score for evaluating anxiety (SMD = ? 0.20, 95% CI ? 0.37 to ? 0.03, P = 0.02)/depression (SMD = ? 0.22, 95% CI ? 0.39 to ? 0.66, P = 0.007) compared with mastectomy alone.Conclusions
Breast reconstruction after mastectomy was benefit for improving the psychological damages in patients with breast cancer.18.
Breast cancer in elderly women and altered clinico-pathological characteristics: a systematic review
M. Lodi L. Scheer N. Reix D. Heitz A.-J. Carin N. Thiébaut K. Neuberger C. Tomasetto C. Mathelin 《Breast cancer research and treatment》2017,166(3):657-668
Purpose
Breast cancer is the most common malignancy in women in terms of incidence and mortality. Age is undoubtedly the biggest breast cancer risk factor. In this study we examined clinical, histological, and biological characteristics and mortality of breast cancer in elderly women along with their changes with advancing age.Methods
We reviewed 63 original articles published between 2006 and 2016 concerning women over 70 years with breast cancer.Results
Compared to patients 70–79 years, patients aged 80 and over had larger tumor size with fewer T1 (42.9% vs 57.7%, p < 0.01) and more T2 lesions (43.5% vs 33.0%, p < 0.01). Lymph nodes and distant metastases were more frequent, with more N + (49.5% vs 44.0%, p < 0.01) and more M1 (8.0% vs 5.9%, p < 0.01). Infiltrating mucinous carcinomas were more frequent (4.3% vs 3.7%, p < 0.01). Tumors had lower grades, with more grade 1 (23.2% vs 19.8%, p = 0.01) and fewer grade 3 (21.5% vs 25.5%, p < 0.01), and were more hormone-sensitive: PR was more often expressed (72.6% vs 67.3%, p < 0.01). Lympho-vascular invasion was less frequent in the 80 years and over (22.9% vs 29.7%, p = 0.01). Breast cancer-specific mortality was higher both at 5 years (25.8% vs 17.2%, p < 0.01) and 10 years (32.7% vs 26.6%, p < 0.01).Conclusion
Clinico-pathological characteristics, increased incidence, and mortality associated with aging can be explained on one hand by biological changes of the breast such as increased estrogen sensitivity, epithelial cell alterations, immune senescence, and tumor microenvironment modifications. However, sociologic factors such as increased life expectancy, under-treatment, late diagnosis, and insufficient individual screening, are also involved.19.
J. Garde-Noguera M. Gil-Raga E. Evgenyeva J. A. García A. Llombart-Cussac C. Camps-Herrero 《Clinical & translational oncology》2016,18(4):405-412
Purpose
To analyse the prognostic role of the immunohistochemical expression of pKDR in patients with advanced colorectal cancer treated with oxaliplatin and fluoropyrimidines combination chemotherapy with or without bevacizumab.Methods
Retrospective multicentre study, carried out at four hospitals in the Valencian Community (Spain). Patients evolution was compared based on the immunohistochemical expression of pKDR, classified using 4 categories: 0 (undetectable), 1 (mild), 2 (moderate) and 3 (high intensity). Patients were divided into two groups for the analysis: group 1 with low expression (0–1) vs. group 2 with high expression (2–3).Results
Histological samples for the pKDR analysis were available for 84 of the 112 patients selected. Seven (8.3 %) had undetectable or mild expression of pKDR (Group 1) and 77 (91.7 %) showed moderate or high expression of pKDR (Group 2). Response rate in Group 1 was 100 % compared to 54.2 % in Group 2 (p = 0.019). Progression-free survival (PFS) (15 vs. 12 months, p = 0.4) and overall survival (OS) (28 vs. 22 months, p = 0.09) were numerically but not significantly higher in patients from Group 1 vs. Group 2. Patients from Group 2 who received bevacizumab presented a significantly higher PFS (13 vs. 11, p = 0.015) and a numerically higher OS (23 vs. 17 months, p = 0.27) than those treated exclusively with chemotherapy.Conclusions
Our results suggest that the absence or low expression of pKDR is associated with a better prognostic profile in patients with advanced colorectal cancer treated with chemotherapy and bevacizumab. Patients with a high pKDR expression benefit from the combination of chemotherapy with bevacizumab.20.
Tokiko Endo Takako Morita Mikinao Oiwa Namiko Suda Yasuyuki Sato Shu Ichihara Misaki Shiraiwa Kazuaki Yoshikawa Takao Horiba Hirotoshi Ogawa Yukie Hayashi Tomonari Sendai Takahisa Arai 《Breast cancer (Tokyo, Japan)》2018,25(2):159-166