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RAGE and its ligands in breast cancer progression and metastasis. RAGE及其配体在乳腺癌进展和转移中的作用。
IF 3.1 Q2 ONCOLOGY Pub Date : 2025-01-03 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1507942
Madalina Coser, Bogdan Mihai Neamtu, Bogdan Pop, Calin Remus Cipaian, Maria Crisan

Introduction: Breast cancer is the most common form of cancer diagnosed worldwide and the leading cause of death in women globally, according to Globocan 2020. Hence, investigating novel pathways implicated in cancer progression and metastasis could lead to the development of targeted therapies and new treatment strategies in breast cancer. Recent studies reported an interplay between the receptor for advanced glycation end products (RAGE) and its ligands, S100 protein group, advanced glycation end products (AGEs) and high-mobility group box 1 protein (HMGB1) and breast cancer growth and metastasis.

Materials and methods: We used articles available in the NCBI website database PubMed to write this scoping review. The search words used were 'RAGE receptor' AND/OR 'breast cancer, RAGE ligands, glycation end products'. A total of 90 articles were included. We conducted a meta-analysis to assess the relationship between the RAGE rs1800624 polymorphism and breast cancer risk using fixed-effect or random-effect models to calculate odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs).

Results: RAGE upon activation by its ligands enhances downstream signaling pathways, contributing to breast cancer cells migration, growth, angiogenesis, metastasis, and drug resistance. In addition, studies have shown that RAGE and its ligands influence the way breast cancer cells interact with immune cells present in the tumor microenvironment (macrophages, fibroblasts), thus regulating it to promote tumor growth and metastasis.

Conclusion: Breast cancers with a high expression of RAGE are associated with poor prognosis. Targeting RAGE and its ligands impairs cell invasion and metastasis, showing promising potential for further research as potential prognostic biomarkers or targeted onco-therapeutics.

导读:根据Globocan 2020的数据,乳腺癌是全球诊断出的最常见的癌症形式,也是全球女性死亡的主要原因。因此,研究与癌症进展和转移有关的新途径可能会导致乳腺癌靶向治疗和新治疗策略的发展。最近的研究报道了晚期糖基化终产物受体(RAGE)及其配体、S100蛋白组、晚期糖基化终产物(AGEs)和高迁移率组1蛋白(HMGB1)与乳腺癌生长和转移之间的相互作用。材料和方法:我们使用NCBI网站数据库PubMed中的文章来撰写这篇范围综述。搜索词是“RAGE受体”和/或“乳腺癌,RAGE配体,糖基化终产物”。共纳入90篇文章。我们采用固定效应或随机效应模型计算优势比(ORs)及其相应的95%置信区间(95% ci),对RAGE rs1800624多态性与乳腺癌风险之间的关系进行了meta分析。结果:RAGE被其配体激活后,可增强下游信号通路,参与乳腺癌细胞的迁移、生长、血管生成、转移和耐药。此外,研究表明RAGE及其配体影响乳腺癌细胞与肿瘤微环境中存在的免疫细胞(巨噬细胞、成纤维细胞)相互作用的方式,从而调节其促进肿瘤生长和转移。结论:RAGE高表达的乳腺癌预后较差。靶向RAGE及其配体可损害细胞的侵袭和转移,显示出作为潜在预后生物标志物或靶向肿瘤联合治疗药物的进一步研究前景。
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引用次数: 0
A case of synovial sarcoma of the right mid-thigh and literature review. 右大腿中部滑膜肉瘤1例并文献复习。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1445143
Jing Zhang, Zhengyi Li, Guoqiang Guo, Chunchun Jin, Meifang Deng

Synovial sarcoma (SS) is a rare and malignant mesenchymal neoplasm. We report a case of a 16-year-old Chinese female diagnosed with biphasic synovial sarcoma. The imaging features, surgical procedures and pathological results of the lesion were described in detail. Additionally, we conducted a review of the literature on synovial sarcoma of the thigh over the past 2 decades, identifying a total of 25 relevant case reports and summarizing the characteristics of these cases. Synovial sarcoma has a high degree of malignancy, with a high recurrence and metastasis rate, and a 5-year survival rate of 36%-76% and a 10-year survival rate of 20%-63%, so early detection of the lesion and preoperative differential diagnosis are of paramount importance in the treatment of patients.

摘要滑膜肉瘤是一种罕见的恶性间充质肿瘤。我们报告一例16岁的中国女性被诊断为双相滑膜肉瘤。并对病变的影像学表现、手术方法及病理结果作了详细的描述。此外,我们对过去二十年来有关大腿滑膜肉瘤的文献进行了回顾,共确定了25例相关病例报告,并总结了这些病例的特征。滑膜肉瘤恶性程度高,复发转移率高,5年生存率为36%-76%,10年生存率为20%-63%,因此早期发现病变和术前鉴别诊断对患者的治疗至关重要。
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引用次数: 0
Lymphadenectomy in the treatment of sarcomas - indications and technique. 治疗肉瘤的淋巴腺切除术--适应症和技术。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-12-05 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1413734
Piotr Dunaj, Ewa Żukowska, Anna M Czarnecka, Maria Krotewicz, Aneta Borkowska, Paulina Chmiel, Tomasz Świtaj, Piotr Rutkowski

Sarcomas are a rare type of malignancy with limited treatment options so far. This analysis aimed to describe the impact of lymphadenectomy on treating sarcoma patients. Sarcomas characterized by lymphatic spread are rare. For this reason, lymphadenectomy is not a procedure that is performed frequently. However, there are histological subtypes that spread more frequently through lymphatic vessels, such as rhabdomyosarcoma (RMS), epithelioid sarcoma (ES), clear cell sarcoma (CCS), and angiosarcoma. On the other hand, synovial sarcoma (SS) is not characterized by an increased tendency to lymphogenous metastases. In our study, we focus on these subtypes of sarcomas. The relationship between lymphadenectomy results and the subsequent prognosis of the patients was investigated. Metastases in the lymph nodes are diagnosed synchronously with distant metastases or when the primary tumor is detected. At the same time, despite lymphadenectomy, sarcoma patients developed further distant metastases. Currently, lymphadenectomy is not a routinely recommended method of treatment for patients with sarcomas. Most often, its potential use is indicated in the case of epithelioid sarcoma, clear cell sarcoma, and rhabdomyosarcoma after a previous positive sentinel lymph node biopsy (SLNB) result. Multicenter randomized prospective clinical trials on the role of lymphadenectomy in the treatment of sarcomas are needed.

肉瘤是一种罕见的恶性肿瘤,迄今为止治疗方案有限。本分析旨在描述淋巴结切除术对治疗肉瘤患者的影响。以淋巴扩散为特征的肉瘤是罕见的。由于这个原因,淋巴结切除术并不是一个经常进行的手术。然而,有一些组织学亚型更频繁地通过淋巴管传播,如横纹肌肉瘤(RMS)、上皮样肉瘤(ES)、透明细胞肉瘤(CCS)和血管肉瘤。另一方面,滑膜肉瘤(SS)的特点是不增加淋巴转移的倾向。在我们的研究中,我们主要关注这些肉瘤亚型。探讨淋巴结切除术结果与患者预后的关系。淋巴结转移与远处转移或原发肿瘤同时诊断。同时,尽管进行了淋巴结切除术,肉瘤患者仍发生了进一步的远处转移。目前,淋巴结切除术并不是肉瘤患者的常规推荐治疗方法。大多数情况下,它的潜在用途是在前哨淋巴结活检(SLNB)结果阳性的上皮样肉瘤、透明细胞肉瘤和横纹肌肉瘤的病例中。需要多中心随机前瞻性临床试验来研究淋巴结切除术在肉瘤治疗中的作用。
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引用次数: 0
Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study. 癌症患者与非癌症患者的潜伏性肺结核患病率调查:一项病例对照研究。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-12-04 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1445678
Masoud Mortezazadeh, Mehdi Karimi, Mohsen Esfandbod, Abbas Mofidi, Nima Hemmati, Mehdi Kashani, Niyousha Shirsalimi, Seyyed Taher Seyyed Mahmoudi, Ehsan Kamali Yazdi

Background: Latent tuberculosis (TB) can reactivate in immunocompromised individuals, such as cancer patients undergoing chemotherapy, leading to severe complications. Understanding the prevalence of latent TB in this high-risk group is crucial, especially in regions with moderate to high TB burdens.

Aim: This study aims to determine the prevalence of latent tuberculosis in cancer patients before chemotherapy and immunotherapy to guide preventive interventions and reduce the risk of TB reactivation.

Methods: This case-control study was conducted at Sina Hospital in Tehran, Iran, from 2012 to 2022. A total of 392, including 107 newly diagnosed cancer (case) and 285 non-cancer (control) patients, were enrolled in this study. All patients had received the Bacillus Calmette-Guérin (BCG) vaccine at the age of one. They underwent a thorough clinical examination and were screened using the tuberculin skin test (TST) to detect latent TB. Any active TB cases were identified through acid-fast smear tests. The data collected from the study participants was then analyzed.

Results: The results showed no significant difference in the size of TST between cancer and non-cancer patients (cases: median = 2 mm, IQR: 1-12; controls: median = 2 mm, IQR: 1-5; p = 0.09). The prevalence of latent TB was 27.1% in cancer patients and 20.7% in non-cancer patients, with no significant association identified between latent TB and malignancies (P-value = 0.176). Over a median follow-up of 4 years, mortality was significantly higher in cancer patients compared to controls (42.1% vs 1.8%; P< 0.001, OR = 40.64). Additionally, deceased patients exhibited a greater prevalence of latent TB (44% vs 19.3% in survivors; P< 0.001, OR = 3.28), and increased size of TST was associated with higher mortality risk among cancer patients.

Conclusion: In conclusion, this study emphasizes the need for vigilant latent TB screening in cancer patients, given the association between larger TST sizes and increased mortality risk. While no direct link between cancer type and latent TB was found, proactive TB management remains crucial, particularly for those undergoing immunosuppressive therapy.

背景:潜伏性结核病(TB)可以在免疫功能低下的个体中重新激活,例如接受化疗的癌症患者,导致严重的并发症。了解潜伏性结核病在这一高危人群中的流行情况至关重要,特别是在结核病负担中至高的地区。目的:本研究旨在了解癌症患者化疗和免疫治疗前潜伏性结核的患病率,以指导预防干预,降低结核病再激活的风险。方法:本病例-对照研究于2012 - 2022年在伊朗德黑兰Sina医院进行。本研究共纳入392例患者,包括107例新诊断的癌症(病例)和285例非癌症(对照)患者。所有患者均在1岁时接种卡介苗。他们接受了彻底的临床检查,并使用结核菌素皮肤试验(TST)进行筛选,以检测潜伏性结核病。通过抗酸涂片试验确定任何活动性结核病例。然后对从研究参与者那里收集的数据进行分析。结果:肿瘤患者与非肿瘤患者的TST大小无显著差异(病例数:中位数= 2 mm, IQR: 1-12;对照组:中位数= 2mm, IQR: 1-5;P = 0.09)。潜伏性结核在癌症患者中患病率为27.1%,在非癌症患者中患病率为20.7%,潜伏性结核与恶性肿瘤之间无显著相关性(p值= 0.176)。在中位4年的随访中,癌症患者的死亡率明显高于对照组(42.1% vs 1.8%;P< 0.001,或= 40.64)。此外,死亡患者表现出更高的潜伏性结核病患病率(44%对19.3%的幸存者;P< 0.001, OR = 3.28), TST的增大与癌症患者较高的死亡风险相关。结论:综上所述,本研究强调,考虑到TST较大与死亡风险增加之间的关联,需要对癌症患者进行警惕的潜伏性结核病筛查。虽然没有发现癌症类型和潜伏性结核病之间的直接联系,但积极的结核病管理仍然至关重要,特别是对那些正在接受免疫抑制治疗的人。
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引用次数: 0
Prognostic and clinicopathological significance of survivin in gynecological cancer. 生存素在妇科肿瘤中的预后及临床病理意义。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-12-02 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1444008
Agapiti H Chuwa, David H Mvunta

Survivin belongs to the inhibitor of apoptosis protein (IAP) family and is encoded by the baculoviral inhibitor of apoptosis repeat-containing, or BIRC5, gene. It is preferentially expressed in cancers with functional complexity in cell signaling cascades such as extracellular signal-regulated kinases (ERK), mitogen-activated protein kinases (MAPK), heat shock protein-90 (HSP90), epidermal growth factor receptor (EGFR), phosphoinositide 3-kinase (PI3K), signal transducer and activator of transcription (STAT), hypoxia-inducible factor-1 alpha (HIF-1α), vascular endothelial growth factor (VEGF), and others. Survivin plays a role in cell division and cell death, properties that have attracted a large body of research to decipher its therapeutic and prognostic significance in cancer. Survivin has tumor-promoting effects in endometrial (EC) and ovarian (OC) cancers, and its upregulation in endometrial cancer has been associated with poor overall survival (OS). While survivin protein is abundantly expressed in OC, it is barely detectable in normal ovarian tissue or benign ovarian tumors. Survivin expression is also a marker for cervical intraepithelial neoplasia (CIN) and high-risk human papillomavirus, and a predictor of viral clearance and prognosis in uterine cervical cancer (UCC). Furthermore, nuclear survivin expression is very low in normal vulvar squamous epithelium and increases to become abundant in vulvar invasive squamous cell carcinoma (ISCC), conferring resistance to apoptosis in vulvar carcinogenesis. In this review, we discuss in detail the impact of survivin signaling on gynecological cancers and provide insight on its therapeutic and diagnostic potential, existing research gaps, and areas for future research.

Survivin属于凋亡抑制蛋白(IAP)家族,由杆状病毒凋亡重复序列抑制蛋白(BIRC5)基因编码。它优先在细胞信号级联功能复杂的癌症中表达,如细胞外信号调节激酶(ERK)、丝裂原活化蛋白激酶(MAPK)、热休克蛋白90 (HSP90)、表皮生长因子受体(EGFR)、磷酸肌肽3-激酶(PI3K)、信号转导和转录激活因子(STAT)、缺氧诱导因子-1α (HIF-1α)、血管内皮生长因子(VEGF)等。Survivin在细胞分裂和细胞死亡中发挥作用,这一特性吸引了大量研究来解读其在癌症治疗和预后方面的意义。Survivin在子宫内膜癌(EC)和卵巢癌(OC)中具有促瘤作用,其在子宫内膜癌中的上调与较差的总生存率(OS)相关。虽然survivin蛋白在卵巢癌中大量表达,但在正常卵巢组织或良性卵巢肿瘤中几乎检测不到。Survivin的表达也是宫颈上皮内瘤变(CIN)和高危人乳头瘤病毒的标志物,也是子宫癌(UCC)病毒清除和预后的预测因子。此外,核survivin在正常外阴鳞状上皮中的表达非常低,而在外阴浸润性鳞状细胞癌(ISCC)中表达丰富,从而在外阴癌变过程中抵抗细胞凋亡。在这篇综述中,我们详细讨论了survivin信号传导对妇科癌症的影响,并对其治疗和诊断潜力、现有研究空白和未来研究领域提出了见解。
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引用次数: 0
Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy applications in upper and lower gastrointestinal cancer, a review. 细胞减少手术后腹腔热化疗在上、下消化道肿瘤中的应用综述。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-11-26 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1496141
Denise Drittone, Francesca Matilde Schipilliti, Giulia Arrivi, Federica Mazzuca

Peritoneal metastases (PM) are the spread of tumor forms into the peritoneum as metastases from another organ. PM is a frequent condition in metastatic gastrointestinal cancer (colorectal, gastric, pancreatic, appendiceal, and cholangiocarcinoma); their presence confers a poor prognosis, reducing patient survival. The standard treatment consists of systemic chemotherapy according to current guidelines. In recent years, scientific evidence has shown how combined cytoreductive surgery (CRS) techniques followed by hyperthermic intraperitoneal chemotherapy (HIPEC) can improve survival in this patient population. Despite the results still obtained, using this combined technique is still under discussion. This review aims to highlight the benefits and limitations of this combined procedure, which is already widely used to treat peritoneal metastases in gynecological tumors.

腹膜转移(PM)是肿瘤形式从另一个器官转移到腹膜。PM是转移性胃肠道肿瘤(结直肠癌、胃癌、胰腺癌、阑尾癌和胆管癌)的常见病;它们的存在导致预后不良,降低患者存活率。根据目前的指导方针,标准治疗包括全身化疗。近年来,科学证据表明,联合细胞减少手术(CRS)技术和高温腹腔化疗(HIPEC)可以提高这类患者的生存率。尽管已经获得了结果,但使用这种联合技术仍在讨论中。这篇综述旨在强调这种联合手术的优点和局限性,这种联合手术已经广泛用于治疗妇科肿瘤的腹膜转移。
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引用次数: 0
Evaluation of outcomes of psychological interventions in terminally ill family caregivers: a brief overview. 对绝症家属照护者心理干预结果的评估:简要概述。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-11-26 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1482195
Masoud Rezaei, Sahar Keyvanloo Shahrestanaki, Arezoo Sheikh Milani, Masoumeh Neishabouri, Shiva Khaleghparast, Mohammad Reza Rajabi

Background: Family caregivers play a crucial role in supporting patients with incurable diseases, but often experience significant stress and anxiety. This study aimed to investigate the impact of psychological interventions on family caregivers, with a focus on reducing the burden of care, improving mental health and quality of life, and promoting family communication.

Method: This study conducted a brief overview of quantitative and qualitative research on assessing the impact of psychological interventions on family caregivers. A comprehensive literature search was conducted in PUBMED, SCOPUS, EMBASE, SCIENCE DIRECT and WEB OF SCIENCE to identify relevant papers, resulting in 20 articles being included. The included studies focused on evaluating the outcomes of psychological interventions on family caregivers.

Result: Ultimately, 20 relevant articles were retrieved from a pool of 500 articles, focusing on the evaluation of the primary outcomes of psychological interventions on family caregivers. The review of 20 articles revealed that interventions such as expressive writing and reminiscence therapy had a positive and significant impact on reducing the burden of care and fostering a positive care environment. Additionally, these interventions were found to be effective in improving self-esteem, family communication, and overall wellbeing.

Conclusion: The study emphasizes the need for further research to confirm the benefits of these interventions and their role in promoting family resilience. These findings highlight the potential of psychological interventions in alleviating the challenges faced by family caregivers of patients with incurable diseases.

背景:家庭照顾者在支持患有不治之症的患者方面发挥着至关重要的作用,但他们往往经历着巨大的压力和焦虑。本研究旨在探讨心理干预对家庭照顾者的影响,重点是减轻照顾负担,改善心理健康和生活质量,促进家庭沟通。方法:本研究对评估心理干预对家庭照顾者影响的定量和定性研究进行了简要概述。在PUBMED、SCOPUS、EMBASE、SCIENCE DIRECT和WEB OF SCIENCE中进行综合文献检索,确定相关论文,纳入20篇。纳入的研究侧重于评估心理干预对家庭照顾者的效果。结果:最终,从500篇文章中检索到20篇相关文章,重点评估了心理干预对家庭照顾者的主要结果。结果表明,表达性写作和回忆疗法等干预措施对减轻护理负担和营造积极的护理环境具有积极而显著的影响。此外,这些干预措施被发现在提高自尊、家庭沟通和整体幸福感方面是有效的。结论:本研究强调需要进一步的研究来证实这些干预措施的益处及其在促进家庭弹性方面的作用。这些发现强调了心理干预在缓解无法治愈的疾病患者的家庭照顾者所面临的挑战方面的潜力。
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引用次数: 0
Construction methods and latest applications of kidney cancer organoids. 肾癌器官组织的构建方法和最新应用。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-11-12 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1434981
Zhiqiang Li, Yanqiu You, Bingzheng Feng, Jibing Chen, Hongjun Gao, Fujun Li

Renal cell carcinoma (RCC) is one of the deadliest malignant tumors. Despite significant advances in RCC treatment over the past decade, complete remission is rarely achieved. Consequently, there is an urgent need to explore and develop new therapies to improve the survival rates and quality of life for patients. In recent years, the development of tumor organoid technology has attracted widespread attention as it can more accurately simulate the spatial structure and physiological characteristics of tumors within the human body. In this review, we summarize the main methods currently used to construct kidney cancer organoids, as well as their various biological and clinical applications. Furthermore, combining organoids with other technologies, such as co-culture techniques and microfluidic technologies, can further develop organoids and address their limitations, creating more practical models. This approach summarizes the interactions between different tissues or organs during tumor progression. Finally, we also provide an outlook on the construction and application of kidney cancer organoids. These rapidly evolving kidney cancer organoids may soon become a focal point in the development of in vitro clinical models and therapeutic research for kidney cancer.

肾细胞癌(RCC)是最致命的恶性肿瘤之一。尽管在过去十年中,RCC 的治疗取得了重大进展,但很少能实现完全缓解。因此,迫切需要探索和开发新的疗法,以提高患者的生存率和生活质量。近年来,肿瘤类器官技术的发展引起了广泛关注,因为它能更准确地模拟肿瘤在人体内的空间结构和生理特征。在这篇综述中,我们总结了目前用于构建肾癌类器官的主要方法及其各种生物学和临床应用。此外,将器官组织与其他技术(如共培养技术和微流控技术)相结合,可以进一步发展器官组织并解决其局限性,创建更实用的模型。这种方法总结了肿瘤进展过程中不同组织或器官之间的相互作用。最后,我们还对肾癌器官组织的构建和应用进行了展望。这些快速发展的肾癌器官组织可能很快就会成为体外临床模型开发和肾癌治疗研究的焦点。
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引用次数: 0
Interventions to improve access to cancer care in underserved populations in high income countries: a systematic review. 改善高收入国家服务不足人群获得癌症护理机会的干预措施:系统综述。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-11-05 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1427441
Anna Santos Salas, Nahyeni Bassah, Anna Pujadas Botey, Paula Robson, Julia Beranek, Iqmat Iyiola, Megan Kennedy

Background: Underserved populations both globally and in Canada face serious cancer inequities that result from systemic economic, environmental, and social conditions. These pose barriers in access to cancer care and lead to suboptimal cancer care experiences and outcomes. Knowledge of effective interventions to improve access to cancer care is needed to inform the design of tailored interventions for these populations.

Aim: To identify interventions and programs to improve access to cancer care for underserved populations in high income countries with universal health coverage (UHC) and the United States (US) throughout the cancer care continuum.

Methods: We conducted a systematic review following the PRISMA standards. We searched Medline, EMBASE, PsycINFO, CINAHL, Scopus, and the Cochrane Library. Inclusion criteria: quantitative and qualitative studies published in English in the last 10 years (2013-2023), describing interventions/programs to improve access to cancer care for underserved populations (18 years and over). We included studies in the US given the body of scholarship on equity in cancer care in that country. Screening, data extraction and analysis were undertaken by two independent reviewers.

Results: Our search yielded 7,549 articles, and 74 met the inclusion criteria. Of these, 56 were conducted in the US, 8 in Australia, 6 in Canada, and 4 in the United Kingdom. Most (90.5%) were quantitative studies and 47.3% were published between 2020-2023. Seven types of interventions were identified: patient navigation, education and counselling, virtual health, service redesign, financial support, improving geographical accessibility and multicomponent interventions. Interventions were mainly designed to mitigate language, distance, financial, lack of knowledge and cultural barriers. Most interventions focused on access to cancer screening, targeted rural populations, racialized groups and people with low socioeconomic status, and were conducted in community-based settings. The majority of interventions or programs significantly improved access to cancer care.

Conclusion: Our systematic review findings suggest that interventions designed to remove specific barriers faced by underserved populations can improve access to cancer care. Few studies came from countries with UHC. Research is required to understand tailored interventions for underserved populations in countries with UHC.

背景:无论是在全球还是在加拿大,未得到充分服务的人群都面临着严重的癌症不平等,这些不平等是由系统性的经济、环境和社会条件造成的。这些因素阻碍了癌症患者获得癌症治疗,并导致了不理想的癌症治疗体验和结果。我们需要了解改善癌症治疗机会的有效干预措施,以便为这些人群设计量身定制的干预措施提供信息。目的:在癌症治疗的整个过程中,确定在全民医保(UHC)的高收入国家和美国改善服务不足人群癌症治疗机会的干预措施和计划:我们按照 PRISMA 标准进行了系统性回顾。我们检索了 Medline、EMBASE、PsycINFO、CINAHL、Scopus 和 Cochrane 图书馆。纳入标准:过去 10 年(2013-2023 年)中用英语发表的定量和定性研究,这些研究描述了为改善服务不足人群(18 岁及以上)获得癌症护理的机会而采取的干预措施/计划。考虑到美国在癌症治疗公平性方面的学术成果,我们纳入了美国的研究。筛选、数据提取和分析工作由两名独立审稿人完成:结果:我们的搜索共获得 7549 篇文章,74 篇符合纳入标准。其中,美国 56 篇,澳大利亚 8 篇,加拿大 6 篇,英国 4 篇。大部分(90.5%)为定量研究,47.3%发表于 2020-2023 年间。研究确定了七类干预措施:患者导航、教育和咨询、虚拟医疗、服务重新设计、财政支持、改善地理可达性和多成分干预。干预措施主要是为了减少语言、距离、经济、知识和文化方面的障碍。大多数干预措施侧重于癌症筛查的可及性,针对农村人口、种族群体和社会经济地位较低的人群,并在社区环境中开展。大多数干预措施或计划都极大地改善了癌症治疗的可及性:我们的系统综述结果表明,旨在消除服务不足人群面临的特定障碍的干预措施可以改善癌症治疗的可及性。来自全民医保国家的研究很少。需要开展研究,以了解在实行全民医保的国家中为服务不足人群量身定制的干预措施。
{"title":"Interventions to improve access to cancer care in underserved populations in high income countries: a systematic review.","authors":"Anna Santos Salas, Nahyeni Bassah, Anna Pujadas Botey, Paula Robson, Julia Beranek, Iqmat Iyiola, Megan Kennedy","doi":"10.3389/or.2024.1427441","DOIUrl":"10.3389/or.2024.1427441","url":null,"abstract":"<p><strong>Background: </strong>Underserved populations both globally and in Canada face serious cancer inequities that result from systemic economic, environmental, and social conditions. These pose barriers in access to cancer care and lead to suboptimal cancer care experiences and outcomes. Knowledge of effective interventions to improve access to cancer care is needed to inform the design of tailored interventions for these populations.</p><p><strong>Aim: </strong>To identify interventions and programs to improve access to cancer care for underserved populations in high income countries with universal health coverage (UHC) and the United States (US) throughout the cancer care continuum.</p><p><strong>Methods: </strong>We conducted a systematic review following the PRISMA standards. We searched Medline, EMBASE, PsycINFO, CINAHL, Scopus, and the Cochrane Library. Inclusion criteria: quantitative and qualitative studies published in English in the last 10 years (2013-2023), describing interventions/programs to improve access to cancer care for underserved populations (18 years and over). We included studies in the US given the body of scholarship on equity in cancer care in that country. Screening, data extraction and analysis were undertaken by two independent reviewers.</p><p><strong>Results: </strong>Our search yielded 7,549 articles, and 74 met the inclusion criteria. Of these, 56 were conducted in the US, 8 in Australia, 6 in Canada, and 4 in the United Kingdom. Most (90.5%) were quantitative studies and 47.3% were published between 2020-2023. Seven types of interventions were identified: patient navigation, education and counselling, virtual health, service redesign, financial support, improving geographical accessibility and multicomponent interventions. Interventions were mainly designed to mitigate language, distance, financial, lack of knowledge and cultural barriers. Most interventions focused on access to cancer screening, targeted rural populations, racialized groups and people with low socioeconomic status, and were conducted in community-based settings. The majority of interventions or programs significantly improved access to cancer care.</p><p><strong>Conclusion: </strong>Our systematic review findings suggest that interventions designed to remove specific barriers faced by underserved populations can improve access to cancer care. Few studies came from countries with UHC. Research is required to understand tailored interventions for underserved populations in countries with UHC.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"18 ","pages":"1427441"},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The prevalence of non-sentinel lymph node metastasis among breast cancer patients with sentinel lymph node involvement and its impact on clinical decision-making: a single-centred retrospective study. 前哨淋巴结受累的乳腺癌患者中非前哨淋巴结转移的发生率及其对临床决策的影响:一项单中心回顾性研究。
IF 3.1 Q2 ONCOLOGY Pub Date : 2024-10-31 eCollection Date: 2024-01-01 DOI: 10.3389/or.2024.1495133
Jingxian Ding, Xiaoliu Jiang, Zhaohui Huang, Qiao Ji, Jie Long, Yali Cao, Yonghong Guo

Background: Sentinel lymph node biopsy (SLNB) has become standard procedure for early breast cancer patients with clinically node negative disease. The patients with SLN metastasis normally underwent axillary lymph node dissection (ALND). However, the metastatic status of non-sentinel Lymph nodes (non-SLNs) varied significantly in different reports. Here, we evaluated the prevalence of non-SLNs metastasis among breast cancer patients with sentinel lymph node metastasis and its impact on clinical decision-making.

Materials and methods: We identified 892 female patients with operable cT1-3N0 invasive breast cancer who underwent ALND in our center due to SLN metastasis from 2017 to 2023, retrospectively. The prevalence of non-SLN metastasis among different clinicopathological traits and its correlation with the number of positive SLNs were analyzed. The optimal clinical decision-making was generalized.

Results: The median number of SLN+, SLN, non-SLN+ and non-SLN was 2, 4, 1 and 14 among the enrolled 892 female patients, respectively. 504 (56.50%) patients with SLN + had at least one metastatic lymph node in the harvested non-SLNs. Among the enrolled 892 female patients, 435 (48.77%) patients with 1 positive SLN, of which 180 (41.38%) had at least one additional metastatic non-SLNs. 242 (27.13%) patients with 2 positive SLNs, of which 146 (60.33%) had at least one metastatic non-SLNs. For the rest 215 (24.10%) patients with at least 3 metastatic SLNs, 178 (82.79%) had at least one metastatic non-SLNs. In the univariate analysis, the non-SLNs metastatic status was correlated with the number of SLNs+, tumor size, tumor grade, lymphovascular invasion (LVI) and molecular subtypes, but not histopathologic type. In the multivariate analysis, the risk of additional non-SLNs metastasis correlated with the number of SLNs+, SLNs, non-SLNs and LVI.

Conclusion: Omiting ALND in patients with higher non-SLNs + rate outside the American College of Surgeons Oncology Group (ACSOG) Z0011 and the European Organization for Research and Treatment of Cancer (EORTC) 10,981-22023 AMAROS criteria should be considered with caution in clinical decision-making. To evaluate whether axillary radiotherapy and ALND provides equivalent regional control in breast cancer patients with obvious residual metastatic lymph nodes undesected in the axilla, a well-matched prospective randomized controlled trial is an urgent need.

背景:前哨淋巴结活检(SLNB)已成为临床结节阴性的早期乳腺癌患者的标准手术。有前哨淋巴结转移的患者通常会接受腋窝淋巴结清扫术(ALND)。然而,在不同的报告中,非前哨淋巴结(non-SLNs)的转移状态差异很大。在此,我们评估了前哨淋巴结转移的乳腺癌患者中非前哨淋巴结转移的发生率及其对临床决策的影响:我们对2017年至2023年在本中心因SLN转移而接受ALND的892例可手术的cT1-3N0浸润性乳腺癌女性患者进行了回顾性研究。分析了非SLN转移在不同临床病理特征中的发生率及其与SLN阳性数量的相关性。对最佳临床决策进行了归纳:入组的 892 名女性患者中,SLN+、SLN、非 SLN+ 和非 SLN 的中位数分别为 2、4、1 和 14。504例(56.50%)SLN+患者在收获的非SLN中至少有一个转移淋巴结。在登记的 892 名女性患者中,435 名(48.77%)患者有 1 个阳性 SLN,其中 180 名(41.38%)患者有至少一个额外的转移性非 SLN。242名(27.13%)患者有2个SLN阳性,其中146名(60.33%)患者至少有一个转移性非SLN。其余 215 名(24.10%)患者至少有 3 个转移性 SLN,其中 178 名(82.79%)患者至少有一个转移性非 SLN。在单变量分析中,非SLNs转移状态与SLNs+数量、肿瘤大小、肿瘤分级、淋巴管侵犯(LVI)和分子亚型相关,但与组织病理学类型无关。在多变量分析中,额外的非淋巴结转移风险与淋巴结数目+、淋巴结、非淋巴结和LVI相关:结论:对于非SLNs+率高于美国外科学院肿瘤学组(ACSOG)Z0011和欧洲癌症研究与治疗组织(EORTC)10,981-22023 AMAROS标准的患者,在临床决策中应慎重考虑放弃ALND。要评估腋窝放疗和ALND是否能为腋窝未检测到明显残留转移淋巴结的乳腺癌患者提供同等的区域控制效果,迫切需要进行匹配良好的前瞻性随机对照试验。
{"title":"The prevalence of non-sentinel lymph node metastasis among breast cancer patients with sentinel lymph node involvement and its impact on clinical decision-making: a single-centred retrospective study.","authors":"Jingxian Ding, Xiaoliu Jiang, Zhaohui Huang, Qiao Ji, Jie Long, Yali Cao, Yonghong Guo","doi":"10.3389/or.2024.1495133","DOIUrl":"10.3389/or.2024.1495133","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) has become standard procedure for early breast cancer patients with clinically node negative disease. The patients with SLN metastasis normally underwent axillary lymph node dissection (ALND). However, the metastatic status of non-sentinel Lymph nodes (non-SLNs) varied significantly in different reports. Here, we evaluated the prevalence of non-SLNs metastasis among breast cancer patients with sentinel lymph node metastasis and its impact on clinical decision-making.</p><p><strong>Materials and methods: </strong>We identified 892 female patients with operable cT1-3N0 invasive breast cancer who underwent ALND in our center due to SLN metastasis from 2017 to 2023, retrospectively. The prevalence of non-SLN metastasis among different clinicopathological traits and its correlation with the number of positive SLNs were analyzed. The optimal clinical decision-making was generalized.</p><p><strong>Results: </strong>The median number of SLN+, SLN, non-SLN+ and non-SLN was 2, 4, 1 and 14 among the enrolled 892 female patients, respectively. 504 (56.50%) patients with SLN + had at least one metastatic lymph node in the harvested non-SLNs. Among the enrolled 892 female patients, 435 (48.77%) patients with 1 positive SLN, of which 180 (41.38%) had at least one additional metastatic non-SLNs. 242 (27.13%) patients with 2 positive SLNs, of which 146 (60.33%) had at least one metastatic non-SLNs. For the rest 215 (24.10%) patients with at least 3 metastatic SLNs, 178 (82.79%) had at least one metastatic non-SLNs. In the univariate analysis, the non-SLNs metastatic status was correlated with the number of SLNs+, tumor size, tumor grade, lymphovascular invasion (LVI) and molecular subtypes, but not histopathologic type. In the multivariate analysis, the risk of additional non-SLNs metastasis correlated with the number of SLNs+, SLNs, non-SLNs and LVI.</p><p><strong>Conclusion: </strong>Omiting ALND in patients with higher non-SLNs + rate outside the American College of Surgeons Oncology Group (ACSOG) Z0011 and the European Organization for Research and Treatment of Cancer (EORTC) 10,981-22023 AMAROS criteria should be considered with caution in clinical decision-making. To evaluate whether axillary radiotherapy and ALND provides equivalent regional control in breast cancer patients with obvious residual metastatic lymph nodes undesected in the axilla, a well-matched prospective randomized controlled trial is an urgent need.</p>","PeriodicalId":19487,"journal":{"name":"Oncology Reviews","volume":"18 ","pages":"1495133"},"PeriodicalIF":3.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11560433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Oncology Reviews
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