Cancer Control最新文献

ObjectiveTo investigate the risk factors for complications in breast cancer patients with totally implantable access ports (TIAPs).MethodsThis retrospective case-control study involved 471 breast cancer (BC) patients who received TIAPs during chemotherapy. We compared the demographic and clinical characteristics of patients with complications to those without, analyzed independent risk factors using binary logistic regression, and identified differences in complication rates based on catheterization site.ResultsThe most frequent complication was catheter malposition, followed by infection, thrombosis, hemothorax, and port rotation. Complications were more common in right-side BC cases (P = .026) and with left-side insertions (P = .012). Binary logistic regression identified independent risk factors for complications: catheter tip location (OR = 0.599, P = .013), and catheterization site (OR = 0.319, P = .019). Notably, left-side insertion significantly increased the risk of overall complications and catheter malposition compared to right-side insertion (OR = 3.534, P = .008; OR = 5.624, P = .004, respectively).ConclusionCatheter tip location and catheterization site independently affect complications and catheter malposition. For TIAPs implantation, particularly on the left side, a lower catheter tip location is advised to reduce complications and enhance safety.

BackgroundLimited-stage small cell lung cancer (LS-SCLC) is a highly aggressive tumor characterized by a poor prognosis. While concurrent chemoradiotherapy (CCRT) remains the standard treatment, the high rates of recurrence and poor long-term survival highlight the pressing need for novel therapeutic approaches.PurposeIn recent years, the introduction of immunotherapy, particularly immune checkpoint inhibitors (ICIs), has opened new avenues for the treatment of LS-SCLC. This review highlights the clinical advancements of ICIs in CCRT, consolidation therapy, and neoadjuvant therapy, emphasizing their potential to improve progression-free survival (PFS) and overall survival (OS). This review also discusses management of immunotherapy-related side effects.Research DesignThis is a review article that synthesizes recent research findings on immunotherapy for LS-SCLC.Study SampleNot applicable (review of existing literature).Data Collection and/or AnalysisThis review summarizes key studies exploring the application of immunotherapy in limited-stage small cell lung cancer.Additionally, it examines the role of the tumor microenvironment, tumor mutation burden (TMB), and Programmed cell death 1 ligand 1(PD-L1) as biomarkers for predicting the efficacy of immunotherapy.ResultsThis review emphasizes their potential to improve PFS and OS.ConclusionsDespite the significant advancements in research, the use of ICIs in LS-SCLC continues to face challenges, including the identification of optimal treatment regimens, validation of long-term efficacy, and development of personalized predictive biomarkers. Future research should prioritize large-scale, multicenter clinical trials to refine combination therapy strategies, establish customized treatment approaches, and enhance patient outcomes.

BackgroundThe incidence and prevalence of early-onset colorectal cancer (EO-CRC), defined as colorectal cancer diagnosed before the age of 50, are increasing globally. However, the current status and trends of the disease burden of EO-CRC in China, including incidence, prevalence, mortality, and disability-adjusted life-years (DALYs), are not well understood. This study aimed to analyze the epidemiological trends of EO-CRC in China from 1990 to 2021 and to project its future burden.MethodsWe analyzed data from the Global Burden of Disease (GBD) 2021 study to assess the trends in incidence, prevalence, mortality, and DALYs of EO-CRC in China from 1990 to 2021. Joinpoint regression analysis was used to identify significant changes in trends. Age-period-cohort (APC) analysis was conducted to disentangle the effects of age, period, and birth cohort. The Bayesian APC model was employed to project the burden of EO-CRC up to 2036.ResultsFrom 1990 to 2021, the absolute number of EO-CRC incident and prevalent cases in China increased substantially. The age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) also rose significantly, with an accelerated increase after 2007 in men and after 2015 in women. In contrast, the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (AS-DALYs) generally declined; however, a concerning reversal of this trend has been observed in recent years. Incidence, prevalence, mortality and DALYs rates all showed significant age, period, and cohort effects. Projections indicate that ASIR and ASPR will continue to rise until 2036, especially in males, and the disparity in disease burden between men and women is expected to widen.ConclusionThe disease burden of EO-CRC in China has increased significantly and is rising rapidly, particularly among males. Further research is essential to fully understand the factors contributing to the increased incidence of EO-CRC and to develop effective mitigation strategies.

Background: This cohort study aimed to evaluate the impact of tumor burden (TB) on the efficacy of immunotherapy in patients with advanced non-small cell lung cancer (NSCLC).

Materials and methods: Data from the POPLAR and OAK trials were extracted as the training and validation cohorts, respectively. TB was defined as the sum of the longest dimensions (blSLD) of measurable target lesions as per RECIST v1.1. The Kaplan-Meier curves and multivariate Cox regression analyses were performed to assess the association between TB with blood-tested tumor mutation burden (bTMB), PD-L1 expression, and survival outcomes. Additionally, random forest algorithms analysis was performed to evaluate the accuracy of TB in predicting 12-month mortality of NSCLC patients received atezolizumab.

Results: A total of 105 patients from the POPLAR trial and 322 patients from the OAK trial were recruited in the training and validation sets, respectively. Patients with TB-L have significantly better OS than those with TB-H in the training (mOS: 15.8 months vs 6.93 months) as well as the validation (mOS: 16.0 months vs 7.59 months) cohort. The multivariate Cox regression analysis indicated that TB is an independent biomarker for OS prediction, regardless of bTMB, PD-L1 expression, and number of metastasis sites. The impact of TB on 12-month mortality was expected to be stronger with the increase of TB, suggesting that patients with a high tumor burden experienced a detrimental effect on 12-month mortality.

Conclusion: TB may act as a prognostic biomarker for clinical benefit in NSCLC patients treated with immunotherapy alone. This may be potentially effective for predicting the efficacy of immunotherapy-based regimens.

Background: "Crawling-type" early gastric carcinoma (EGC) is a rare subtype of gastric cancer (GC) that is challenging to diagnose at an early stage due to its low-grade nuclear heterogeneity and morphology that mimics intestinal metaplasia. This study aimed to explore the clinical characteristics and pathological features of patients with crawling-type EGC.

Methods: This case series study retrospectively included patients with crawling-type EGC who underwent endoscopic submucosal dissection (ESD) or gastrectomy at the East Hospital Affiliated to Tongji University between January 2019 and March 2022.

Results: 8 patients (mean age 63.5 ± 7.8 years) were included: 4 underwent ESD, and 4 underwent partial gastrectomy. In 4 patients, the tumors were primarily located in the gastric cardia and the basal gland area of the upper stomach, while the other 4 patients had tumors in the antral region. Preoperative gastroscopy revealed atrophic gastritis and intestinal metaplasia in all patients. The lesions were generally flat in morphology. Submucosal infiltration was found in only one case. Signet ring cells were present in the tumors of 5 patients. The mucinous type was observed in 7 patients. Seven tumors were of the gastrointestinal mixed type. Curative resection was achieved in all patients. No recurrence events were observed in any patient at 1 year after surgery.

Conclusions: The crawling-type EGC may exhibit distinct clinical characteristics and pathological features compared with classical GC. Curative resection was achieved in all patients. The short-term prognosis of surgical treatment may be favorable.

Background: This study compared anatomical imaging features between high-risk and non-high-risk groups in neuroblastoma with at least one image-defined risk factor (IDRF). It also assessed the diagnostic performance of these features in identifying the high-risk group.

Methods: A retrospective analysis of neuroblastoma patients with at least one IDRF was conducted. Imaging features, including estimated tumor volume and IDRFs, were compared between the two groups. The diagnostic performance of these features was assessed using receiver operating characteristic (ROC) curves, and the areas under the ROC curves (AUCs) along with their 95% confidence intervals (CIs) were calculated. Additionally, to internally validate their diagnostic performance, the bootstrap resampling method with 1000 bootstrap resamples was employed.

Results: The study included 255 patients (185 high-risk cases, 70 non-high-risk cases). Significant differences were found in estimated tumor volume and IDRF number between the high-risk and non-high-risk groups (P < 0.001). The estimated tumor volume and the IDRF number-based cluster were independent risk factors, and their combination achieved an AUC of 0.801 (95% CI: 0.747-0.848) for high-risk group diagnosis, with the average AUC of the 1000 bootstrap samples of 0.800 (95% CI: 0.798-0.802). In abdominal lesions, specific IDRF categories differed between high-risk and non-high-risk groups (P < 0.05).

Conclusion: Our study reveals anatomical imaging differences between high-risk and non-high-risk groups in neuroblastoma with at least one IDRF.

Background: Despite significant progress in diagnosis and therapeutics, hepatocellular carcinoma (HCC) is still among the most commonly occurring and life-taking human cancers globally, raising an urgent need for discovering effective therapeutic targets.Purpose: Chronic hepatitis B virus (HBV) infection is a major etiological factor associated with HCC development, progression, and prognosis. Pre-S mutants are naturally occurring mutated forms of HBV large surface proteins and predict a higher risk of HCC development and recurrence. Moreover, pre-S mutants function as important HBV oncoproteins which can promote HCC tumorigenesis through initiating a variety of oncogenic signaling pathways. Targeting pre-S mutant-induced oncogenic signaling pathways displays therapeutic potential in HCC.Research Design: This review summarizes the underlying molecular mechanisms of pre-S mutant-associated HCC tumorigenesis and highlights their potential in serving as therapeutic targets for HCC.

ObjectivesCurrently, prostate cancer (PC) is the most common medical problem endangering men's health and life worldwide. We tested the association of detected germline variants in BRCA2 with PC risk and estimated their impact on the clinical course of the disease, including overall survival time, in Polish men with localized PC that qualified for radical prostatectomy (RP).Materials and MethodsDNA of 97 PC patients from various age groups and with different disease stages was analyzed. Control DNA samples consisted of 100 male volunteers without PC that were age-matched to the study group. Next Generation Sequencing (NGS) and Sanger sequencing were used for variant detection.ResultsFive rare variants of the BRCA2 gene were detected in single PC patients. There were four substitutions (c.8010G>C, c.682-32A>G, c.9257-75G>C, c.516+17G>C) and one deletion (c.6393_6396del). Among the detected variants, one was pathogenic, one was a variant of uncertain significance (VUS), and three were likely benign. The c.8010G>C was a new variant. In the carrier of the c.6393_6396del pathogenic variant, PC was diagnosed at the T3 stage and the patient survived 48 months after PC confirmation (the date of biopsy).ConclusionsThe BRCA2 c.6393_6396del pathogenic variant demonstrates an association with clinical features of the disease (GS and TNM) and shorter survival of patients with localized prostate cancer that qualified for RP. Additionally, our findings suggest that multi-organ cancer aggregation in a family, including prostate cancer aggregation in close relatives, and young age at cancer onset should be taken into consideration by clinicians as an indication to refer patients to molecular testing.

IntroductionCigarette smoking and alcohol drinking are well-known risk factors for various cancers. We aimed to determine a comprehensive profile of cancer risk associated with these lifestyle factors in predominantly low-income Americans.MethodsWe prospectively investigated the associations between cigarette smoking, alcohol drinking, and the risk of twelve cancer types among over 74 000 low-income Black and White adults from the Southern Community Cohort Study in the United States. We used the Cox proportional hazards models to estimate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for these associations.ResultsCompared to never smokers, current smokers had an increased HR for cancers of lung (HR: 14.14, 95% CI: 11.47-17.42), liver and bile duct (HR: 3.19, 95% CI: 2.40-4.25), kidney (HR: 1.47, 95% CI: 1.10-1.96), pancreas (HR: 1.88, 95% CI: 1.41-2.50), oral and pharynx (HR: 3.83, 95% CI: 2.70-5.42), and bladder (HR: 2.81, 95% CI: 1.92-4.11), and a reduced risk of prostate cancer (HR: 0.78, 95% CI: 0.68-0.89) and uterine cancer (HR: 0.45, 95% CI: 0.32-0.63); former smokers also exhibited elevated risks for cancers of lung, liver and bile duct, kidney, and bladder; however, a decreased risk for the lung, liver and bile duct, and bladder cancers was observed with longer durations of smoking cessation, with HRs from 9.71, 2.26, and 2.28 for a duration of <10 years down to 4.28, 1.58, and 1.42 for a duration of 10-19 years, respectively. Compared to never-drinkers, participants who consumed more than 2 drinks per day had increased risks of liver and bile duct cancer (HR: 1.66, 95% CI: 1.29-2.13) and oral and pharynx cancer (HR: 2.15, 95% CI: 1.58-2.91).ConclusionCigarette smoking and alcohol drinking were associated with an increased risk of multiple cancers. Our findings support efforts to control cigarette and alcohol consumption for cancer prevention in low-income U.S. populations.