ecancermedicalscience最新文献

Introduction: Cervical cancer, mostly caused by human papilloma virus (HPV), has disproportionately high incidence in developing countries. HPV infection being essentially a sexually transmitted infection, high-risk behaviour women with multiple sexual contacts like female sex workers (FSWs) are at higher risk of co-infection with HPV and of developing cervical precancer and cancer.

Objective: This study aimed to determine the prevalence and determinants of HPV infection and cervical intraepithelial neoplasia (CIN) among FSWs in Mumbai, India.

Methods: A cross-sectional study was conducted among 448 FSWs, between the ages of 18-50 years, by collaborating with local non-government organizations working for the health and welfare of FSW communities at sexually transmitted diseases clinics. All FSWs were screened for HPV DNA by hybrid capture II followed by reference diagnosis of colposcopy and/or cervical biopsy.

Results: The prevalence of HPV DNA positivity was 35.5% and CIN was 2.2%. Factors significantly associated with HPV DNA positivity were age group younger than 30 years odds ratio (OR = 2.098, 95% confidence interval (CI) 1.408-3.127), Illiteracy (OR = 2.015, 95% CI 1.305-3.112), being single (OR = 2.409, 95% CI 1.558-3.724), less than 18 years of age at time of initiating work as FSW (OR = 3.718, 95% CI 3.718-2.392), having more than five clients per day (OR = 2.078, 95% CI 1.301-3.318), been working as a FSW for more than 5 years (OR = 2.321, 95% CI 1.455-3.701), not using barrier contraception methods (OR = 5.155, 95% CI 3.395-7.827) and having no exposure to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) education program (OR = 29.153, 95% CI 15.385-55.240). FSWs with a positive HPV DNA test are substantially more likely to have CIN compared to those with a negative test (OR = 7.6, 95% CI 1.59-36.25).

Conclusion: The prevalence of HPV infection and CIN was high among FSWs. FSWs with a positive HPV DNA test had a seven times higher risk of developing CIN. The persistence of HPV infection is expected to significantly raise the risk of cervical cancer in the future. It is suggested to have an integrated approach towards cervical cancer screening and HIV/AIDS control activities.

Background: While cancer stands as a prominent global contributor to mortality, the BRICS countries, which contribute a considerable proportion of the world's economy, also account for a substantial proportion of global cancer-related deaths. The study aims to compile data on the incidence, mortality and disability-adjusted life years (DALYs) of leading cancers in BRICS countries to assess any variations in these parameters.

Methods: Indicators such as the age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR) were abstracted from GLOBOCAN 2022. Global Burden of Disease 2019 provided an overview of DALYs. Additionally, 'Cancer Tomorrow' provided projections for future cancer rates up to 2050.

Results: The findings revealed that Russia had the highest ASIR for both sexes. Among males, leading cancer sites included prostate, lung and colorectum, while India stood out with lip and oral cavity cancer as the primary site. Breast cancer dominated among females in all BRICS countries, except China, where lung cancer took precedence. South Africa recorded the highest ASMR for both sexes, with Russia leading among males and South Africa among females. Lung cancer has been the leading cause of death in all countries except India, where breast cancer leads. Trachea, bronchus and lung cancers contributed the most to DALYs, except in India, where breast cancer prevailed. South Africa and India are anticipated to have the highest increase in new cancer cases and deaths in future.

Conclusion: Breast and lung cancers accounted for the highest incidence, mortality and DALYs in females and males, respectively. Although the BRICS countries anticipate sustained economic growth and have viable cancer control plans, it is essential to investigate cancer risk factors and health systems influencing cancer incidence and outcomes.

Background: Microsatellite stable (MSS) metastatic colorectal cancer (CRC) remains predominantly managed with chemotherapy. The use of immunotherapy, whether alone or in combination with other systemic or local treatments, displays limited success, especially in the context of active liver metastases (LM). The mechanisms responsible for this resistance are not fully understood.

Methods: We conducted a comprehensive search across electronic databases such as Medline, PubMed, Google Scholar and ScienceDirect. This search targeted translational studies evaluating the liver tumour immune microenvironment and immune tolerance mechanisms in CRC with LM and prospective studies that assessed immunotherapy either as a standalone treatment or in combination with other systemic or local therapies for patients diagnosed with MSS CRC. Our primary objectives included elucidating the mechanisms of resistance originating from LM in a non-systematic literature review and presenting a summary of the outcomes observed in prospective trials utilising immune checkpoint inhibitors (ICIs), with a focus on the presence of LM.

Findings: There were 16 prospective trials evaluating immunotherapy for metastatic CRC comprising 1,713 patients. Response rates to immunotherapy inpatients with colorectal liver metastases (CRLM) varied from 0% to 23%. Overall, reduced or null responses to immunotherapy in the presence of liver metastasis in comparison to patients without liver involvement were observed.

Conclusion: Studies consistently show the resistance derived from classical ICI, both alone and in combination with other systemic treatments in patients with CRLM. The design of upcoming trials using immunotherapy should consider LM as a stratification factor or contemplate excluding patients with liver involvement.

Background: Nasopharyngeal carcinoma (NPC) is a rare but significant public health concern, especially in Africa, with a rising global incidence. This study aimed to investigate the pattern of presentation, treatment outcomes and impact on health-related quality of life (HRQOL) of NPC patients at a tertiary institution in Lagos, Nigeria.

Methodology: A retrospective review of all nasopharyngeal cancer patients (n = 125) treated at a tertiary centre in Lagos, Nigeria, from May 2019 to 2022 was done. The European Organisation for Research and Treatment of Cancer (EORTC) H&N 35 questionnaire was used to assess HRQOL at 1-year post treatment and the data were analysed using a statistical package for the social sciences v26.0.

Results: Among 125 patients, the mean age was 46.21 ± 17.82 years with 76% male. Comorbidities were reported in 34 patients (27.2%), smoking history in 18 patients (14.4%) and 50 patients (40%) reported alcohol consumption. Environmental risk factors were identified in six patients (4.8%). The most prevalent histology was squamous cell carcinoma (92.8%), and stage IV was the most common stage (42.4%). Chemoradiation was the primary treatment (63.2%), with intensity-modulated radiotherapy being the most utilised approach (51.2%). Among 125 patients, 51 completed the EORTC questionnaire. Weight loss, sticky saliva, dry mouth, difficulties in swallowing and problems with the sense of taste and smell were the most severe symptoms reported by patients. In the follow-up, 79.2% of patients were reached (50.4% alive, 28.8% deceased). Mortality was significantly associated with age >65 years, weight loss at presentation and consumption of grilled/smoked food.

Conclusion: The study highlights key aspects of NPC in our region including the predominance in males, advanced disease stage at presentation and persistent symptoms post-treatment. Our findings point to the need for targeted initiatives to improve early detection and quality of life for nasopharyngeal patients in the country.

Objectives: To retrospectively describe the clinicopathological profile and treatment outcome of sex cord ovarian tumours (SCOTs), from a single institution.

Methods: Patients who operated for SCOT between January 2011 and December 2020 were identified from the institution's discharge summaries. Treatment details and oncologic outcomes were analyzed using descriptive statistics, SPSS statistics version 21. Progression-free survival and overall survival were plotted using the Kaplan-Meier method.

Results: Over 10 years, 120 patients underwent surgery with 73 (61%) malignant SCOTs. Eight (6.6%) were referred with recurrence. Granulosa cell histology (61/73, 83.5%) and federation of gynaecology and obstetrics (FIGO) stage I disease (57/65, 78.62%) were predominant. Three (3/26,11.53%) had lymph node involvement. Adjuvant chemotherapy was advised in 53.4% (39/73).Over a median period of 47 months (1-130 months), eleven (15.06%) patients recurred (5-year recurrence rate: 9.58%) and 6 died (5-year survival rate: 89.04%).Among 65 patients with upfront disease, 9 (13.8%) recurred over a median period of 46 months (1-65 months) with 4 disease-related deaths. On univariate analysis, incomplete cytoreduction hazard ratios (HR 58.391, 95% CI 5.042-674.854), advanced FIGO stage (HR 15.931, 3.74-67.89) and nongranulosa histology was associated with recurrence. On multivariate analysis, advanced FIGO stage (HR 20.099, 95% CI 3.75-107.711) and non granulosa histology (HR 31.35, 95% 2.801-350.897 ) remained significant. Lymphadenectomy and adjuvant chemotherapy did not prevent recurrence.

Introduction: The emotional impacts of oncological treatments can negatively affect sexual health and intimate relationships. Advances in cancer management have extended patient survival, underscoring the importance of addressing sexual health post-diagnosis.

Objectives: To explore physicians' practices regarding the approach to sexual health during oncological consultations; identifying barriers to addressing sexuality and assessing the need for sexual health training.

Methods: An observational, cross-sectional study that assessed the management of sexual health by physicians involved in oncological treatment, using an anonymous questionnaire distributed via SurveyMonkey.

Results: Of 133 physicians surveyed, 31.6% never or rarely address sexual health. Only 10.5% feel frequently prepared on this topic, while 24.8% almost never have the appropriate tools to address it. 97.7% of oncologists and 92.9% of otolaryngologists (ENTs) recognize the need for sexual health training. Sexual health was more frequently discussed among patients diagnosed with prostate, cervical and breast cancer, and less so among those with ENT, bladder and colorectal tumours. The approach was more frequent among patients treated with curative intent (77.4%) than those with palliative intent (5%). The main barriers identified were lack of training (46%), lack of time (39.8%) and patient discomfort (34.6%).

Conclusion: The majority of professionals dealing with oncological patients do not address their sexual health, with the lack of training, lack of time and patient discomfort being the main barriers identified. However, 92% indicate a need for sexual health training, which could contribute to early intervention, strategy establishment and timely referral to specialists in the field.

Introduction: The CYLD cutaneous syndrome is characterised by the appearance of multiple skin tumours, including cylindromas, spiradenomas, trichoepitheliomas and basal cell adenomas of the salivary gland and less frequently pulmonary cylindromas. The lesions appear in the second decade of life, typically present as single lesions, located mainly on the face and head and progressively increase in number, potentially affecting the torso, groin and axillae. Although lesions can affect both men and women, a higher frequency of affected women has been described.

Case presentation: CYLD cutaneous syndrome is caused by pathogenic variants in the CYLD gene, following an autosomal dominant inheritance pattern. We present the first Colombian case of a family affected by CYLD cutaneous syndrome, spanning three generations and characterised by early onset of skin lesions. This syndrome was molecularly confirmed by next-generation sequencing (NGS), reveling a heterozygous frameshift variant in the CYLD gene, specifically the type NM_015247.2 c.2291_2295delAACTA p.Lys764Ilefs*2, which was subsequently confirmed by Sanger sequencing.

Conclusion: Understanding the complex interplay of genetic, epigenetic and environmental factors in the malignant transformation of cylindroma to squamous eccrine ductal carcinoma is crucial for developing targeted therapies and improving patient outcomes.

Key messages: The CYLD cutaneous syndrome in a Colombian family.

Background: The purpose of this retrospective study was to determine the prognosis of altitude and pre-treatment hemoglobin (Hb) levels with progression-free survival (PFS) among women from the jungle and Andean regions of Peru with cervical cancer (CC) receiving weekly cisplatin and concurrent radiotherapy followed by brachytherapy or teletherapy boost.

Methods: Patients with advanced clinical stage II-IVA CC were grouped according to Hb level (≥ 12.0, 11.9-10.0, 9.9-9.0 and ≤ 8.9 g/dL). Outcome measures were PFS, overall survival and local PFS.

Findings: Between 1/2020 and 12/2022, 159 patients contributed demographic, clinical, pre-treatment Hb and outcome data with a median follow-up of 38 months. Kaplan-Meier estimates for survivals according to pre-treatment Hb level were significant when compared to a level of ≤8.9 g/dL, while estimates with altitude did not show statistical significance. Cox regression analysis of PFS demonstrated that pre-treatment Hb levels ≤8.9 g/dL (p = 0.000) were a significant factor. Age (p = 0.023), stage (p = 0.000), tumour size (p = 0.006) and treatment duration (p = 0.000) were also significant in the regression model.

Interpretation: There is no difference between altitude and survival, but the difference in pre-treatment Hb level was a prognostic indicator of survival, with a Hb level of ≤8.9 g/dL being the worst prognosis.

Introduction: Breast pathology is a very common reason for medical attention. Tissue diagnosis is usually obtained with core needle biopsy which could be performed by breast surgeons or interventional radiologists. Our aim was to assess the comparison of diagnostic performance between the two services.

Methods: A retrospective, descriptive and cross-sectional study was carried out on patients who had breast pathology at Instituto Nacional de Enfermedades Neoplasicas in 2019. Descriptive analyses, sensitivity and specificity were calculated using the R program version 4.2.3.

Results: From 1,082 patients with breast tumours who underwent core needle biopsy (CNB) during 2019, 782 cases were included. Breast surgeons performed 462 CNBs and radiologists performed 320 CNBs. The 87.5% were palpable tumours and 525 breast carcinomas were identified in the final pathology. The diagnostic performance showed that the sensitivity and specificity were greater than 95% and 98%, respectively. The waiting time in both showed that >95% underwent a CNB before 2 months. The breast surgery service performed the majority of the biopsies in less than 1 week since the indication of the execution of the CNB compared to the radiology service (90% versus 36%).

Conclusion: Both hospital services, breast surgery and radiology, are efficient in determining an accurate diagnosis using CNB. However, the breast surgery service performs CNB in a shorter time interval. Breast surgical oncologists are encouraged to perform CNB if there are understaffed radiology services to expedite the diagnosis and treatment of breast cancer patients.

Aims: To estimate the survival patterns of childhood leukaemias and lymphomas in Mato Grosso between 2001 and 2017.

Methods: Retrospective population-based cohort study, with case information extracted from the population-based cancer registries (PBCRs) of Mato Grosso for the period 2001-2017. Cases aged 0-19 years diagnosed with microscopically confirmed leukaemias or lymphomas were eligible. Five-year relative survival was calculated using the Eldererer II method, considering the interval between diagnosis and death, loss to follow-up or censoring, after passive follow-up in the mortality information system. Cases registered only by death certificate were excluded.

Results: 510 cases of leukaemia were analysed, with a predominance of males (56.1%) and an age range of 0-4 years (34.9%). The 5-year relative survival rate was 77.3% (95% CI: 73.6;80.9). As for lymphomas, there were 261 cases, predominantly in males and in the age group 5-9 years. The 5-year relative survival rate was 84.7% (95% CI: 78.3;88.9), with a better prognosis for females and 87.7% (95% CI: 80.8;95.1) in the 5-9 years age group.

Conclusion: The relative survival rates of childhood leukaemia and lymphoma in the state of Mato Grosso were lower than those of developed countries. The importance of early diagnosis and timely treatment for better outcomes is highlighted. The importance of using and continuously improving the quality of information from PBCRs in the state of Mato Grosso is highlighted.