Cancer Control最新文献

IntroductionCombined with the characteristics of adenocarcinoma and squamous cell carcinoma, lung adenosquamous carcinoma (ASC) is an uncommon histological subtype of lung cancer with more aggressive biological behavior. This study aimed to quantify the 90-day mortality rate in patients with ASC, identify associated features, and develop a predictive machine learning model.MethodsThis retrospective study obtained data from the Surveillance, Epidemiology, and End Results (SEER) program database, covering the period from 2000 to 2018. Through univariate logistic regression and Lasso analyses, significant prognostic features were determined. We developed predictive models using XGBoost, logistic regression, and AJCC staging algorithms, assessing their performance via metrics such as the Area Under the Receiver Operating Characteristic Curve (AUC), Decision Curve Analysis (DCA), Kolmogorov-Smirnov (KS) statistic, and calibration plots. Restricted Cubic Splines (RCS) were employed to assess potential non-linear relationships between continuous features and survival outcomes.ResultsOur analysis of 2820 eligible patients identified 6 clinical features significantly affecting outcomes. The XGBoost model exhibited exceptional discriminatory power, with AUC scores of 0.97 in the training set and 0.84 in the validation set, surpassing other models in all datasets according to AUC, KS score, DCA, and calibration analyses. RCS analysis showed a non-linear association between tumor size and prognosis, with a cutoff size of 44 mm. Moreover, we integrated the model into a web-based platform to enhance its accessibility.ConclusionsWe present a novel machine learning model, supported by an easily accessible web-based platform, to guide personalized clinical decision-making and optimize treatment strategies for patients with ASC.

IntroductionLow-grade endometrial stromal sarcoma (LG-ESS) is a rare malignant mesenchymal neoplasm for which there is no consensus regarding the role of radiotherapy in treatment. This study aimed to evaluate the prognostic significance of external beam radiotherapy (EBRT) using data from the Surveillance, Epidemiology, and End Results (SEER) database.MethodsThis retrospective study evaluated the role of EBRT in 1254 patients with LG-ESS using SEER data (2000-2021). Propensity score matching (PSM) was applied to compare outcomes between EBRT and non-EBRT groups. Cox and competing risk models assessed overall survival (OS) and cancer-specific survival (CSS).ResultsEBRT showed no survival benefit in either unmatched or matched cohorts. Post-PSM, OS (HR = 1.21, 95% CI 0.61-2.39) and CSS (HR = 1.75, 95% CI 0.69-4.43) remained unaffected by EBRT (P > 0.05). Lymphadenectomy and bilateral salpingectomy and oophorectomy (BSO) also demonstrated no significant associations with survival outcomes. Key prognostic factors included older age, larger tumor size, advanced stage, and chemotherapy use, all linked to poorer OS and CSS.ConclusionEBRT, lymphadenectomy, and BSO do not offer significant survival benefits for patients with LG-ESS. Prognosis was independently influenced by age, tumor size, stage, and chemotherapy use (associated with poorer outcomes). These findings support a more individualized, risk-adapted approach to LG-ESS management and highlight the need for prospective studies to define the optimal role of comprehensive treatment strategies.

IntroductionOropharyngeal Squamous Cell Carcinoma (OPSCC) etiology involves environmental and genetic factors, with Human Papillomavirus (HPV) being a key ecological driver. This study evaluated the relative importance of environmental factors, particularly HPV status, and the genetic polymorphism NKG2D rs1049174 in OPSCC among a Vietnamese population.MethodsA retrospective case-control study was conducted with 279 OPSCC patients and 250 healthy controls. HPV DNA was screened and typed using PCR and Sanger sequencing. Genotyping of NKG2D rs1049174 was performed using TaqMan assays. Logistic regression, Kaplan-Meier survival analysis, Cox proportional hazards regression, and Random Forest analysis were employed to assess associations between risk factors, genotype, clinical stage, survival, and HPV status.ResultsHPV status strongly predicted overall survival (OS), with HPV-positive patients exhibiting significantly longer survival (adjusted Hazard Ratio (aHR) = 0.32, P < 0.001). Univariate Kaplan-Meier analysis further suggested differential survival among specific HPV types, with HPV16 infection trending toward prolonging OS. In predicting advanced-stage OPSCC, Random Forest analysis identified HPV status as the most critical predictor (Mean Decrease Accuracy = 5.47). Males constituted the vast majority of OPSCC patients in both HPV-negative (97.4%) and HPV-positive (84.6%) subgroups. A statistically significant difference in alcohol consumption patterns was also observed between HPV-positive and HPV-negative patients. Furthermore, the NKG2D rs1049174 polymorphism was significantly associated with OPSCC risk, though not with advanced-stage disease or OS.ConclusionHPV infection plays a critical role in OPSCC in this Vietnamese cohort, influencing patient characteristics, clinical presentation, and survival outcomes. The NKG2D rs1049174 polymorphism was identified as a significant factor in OPSCC risk; however, it did not appear to be a significant factor in disease progression or survival in this population. Further research is needed to explore the complex interplay of environmental and genetic factors in OPSCC etiology in Vietnam.

IntroductionAchieving health literacy is a primary goal of Healthy People 2030 due to the increasing recognition of its role to improve the health and well-being of all populations. Shared decision-making (SDM), a recognized process between patients and health care providers to discuss which health care decision is best for the patient considering the pros and cons, patient preferences, and circumstances, can improve health outcomes. Specifically, SDM can increase patient knowledge and the quality of decision-making, resulting in patients feeling more empowered, demonstrating less decisional regret, and more motivation. Yet, limited health literacy (LHL) can hinder a patient's ability to engage in the SDM process. Patients' ability to engage in SDM can be helped by improving health literacy levels, and by the suitability of the tools available to support them. Decision aids (DA) are educational tools that can help with SDM. SDM provides patients with the necessary skills, which, when paired with DAs designed with and for populations with LHL, can improve communication with health care providers.MethodsGuided by elements of the Ottawa Decision Framework and principles of human-centered design, in this retrospective study we aimed to develop a novel and current brief colon cancer screening DA, "Making a Decision: Should I Stop or Continue Colon Cancer Screening - Ages 75-85," based on feedback from adults ≥75 years at risk for LHL in two focus groups and a comprehensive health literacy demand assessment of the "Making a Decision About Colon Cancer Screening" using four tools to determine its readability, understandability, and actionability.ResultsFindings include a DA that was viewed favorably by older adult participants who were at risk for LHL.ConclusionsWith feedback from older adults at risk for LHL, we have developed a DA that can be tested in a larger randomized control trial.

IntroductionEmployment changes among cancer caregivers are common and can result in financial hardship. Lesbian, gay, bisexual, transgender, queer, and other identities outside of cisgender heterosexual (LGBTQ+) individuals are more likely to live in poverty and experience workplace discrimination than non-LGBTQ+ individuals. This study aimed to assess the impact of caregiving-related employment changes and anti-LGBTQ+ stigma on financial hardship and describe lived experiences with financial hardship and related employment changes among LGBTQ+ cancer caregivers.MethodsAn explanatory mixed-methods study was conducted and included a national survey and individual interviews with survey participants. Multivariable logistic regression models were used to test the association of employment changes with financial hardship. An inductive qualitative analysis guided by two of the three domains of financial hardship (ie, material and behavioral) was conducted. Quantitative and qualitative data were integrated throughout the study.ResultsA total of N = 332 LGBTQ+ cancer caregivers participated in the survey, and N = 14 participated in an interview. The average modified COmprehensive Score for financial Toxicity and Caregiver Reaction Assessment financial sub-scale were 25.6 (SD: 9.9, Range: 1-44) and 2.99 (SD: 1.0, Range: 1-5). Employment changes (OR: 3.32, 95% CI: 1.73-6.36) and anti-LGBTQ+ stigma (OR: 2.21, 95% CI: 1.47-3.32) were associated with high financial hardship. Three overarching themes from the qualitative analysis included: 1) Financial Hardship: Increased Costs, Strained Finances, and Lost Wages; 2) Caregiving as an LGBTQ+ Person: Stigma, Outness, and Expectations; and 3) Financial Unmet needs and Recommendations.ConclusionLGBTQ+ cancer caregivers experience substantial financial hardship that is associated with employment changes and anti-LGBTQ+ stigma. LGBTQ + cancer caregivers reported varying levels of outness and acceptance that directly influenced their access to financial support. Cancer-related financial hardship interventions tailored to the needs of LGBTQ+ individuals are needed.

Background: Macrophages are a critical component of the innate immune system, derived from monocytes, with significant roles in anti-inflammatory and anti-tumour activities. In the tumour microenvironment, however, macrophages are often reprogrammed into tumour-associated macrophages (TAMs), which promote tumour growth, metastasis, and therapeutic resistance.

Purpose: To review recent advancements in the understanding of macrophage polarisation and reprogramming, highlighting their role in tumour progression and potential as therapeutic targets.

Research design: This is a review article synthesising findings from recent studies on macrophage polarisation and reprogramming in tumour biology.

Study sample: Not applicable (review of existing literature).

Data collection and/or analysis: Key studies were identified and summarised to explore mechanisms of macrophage polarisation and reprogramming, focusing on M1/M2 polarisation, metabolic and epigenetic changes, and pathway regulation.

Results: Macrophage reprogramming in the tumour microenvironment involves complex mechanisms, including phenotypic and functional alterations. These processes are influenced by M1/M2 polarisation, metabolic and epigenetic reprogramming, and various signalling pathways. TAMs play a pivotal role in tumour progression, metastasis, and therapy resistance, making them prime targets for combination therapies.

Conclusions: Understanding the mechanisms underlying macrophage polarisation and reprogramming offers promising avenues for developing therapies to counteract tumour progression. Future research should focus on translating these insights into clinical applications for effective cancer treatment.

Objectives: This study aims to examine the correlation between four distinct Epstein-Barr virus (EBV) antibodies (EA-D, EBNA-1, VCA-p18, and ZEBRA) and the likelihood of developing prostate cancer (PCa) using the Mendelian Randomization (MR) technique. The primary objective is to determine whether a causal relationship exists between these EBV antibodies and prostate cancer.

Methods: Genome-wide association study (GWAS) data for EBV antibodies were sourced from the UK Biobank cohort, and prostate cancer data were obtained from the PRACTICAL consortium, which includes 79148 cases and 61106 controls. Univariable Mendelian Randomization (MR) analysis was conducted to evaluate the associations, while reverse Mendelian Randomization was employed to assess causality. Additionally, Multivariable Mendelian Randomization analysis was performed to identify independent risk factors.

Results: Univariable MR analysis revealed significant associations between EBV EA-D (OR = 1.084, 95% CI = 1.012-1.160, IVW_P = 0.021) and EBNA-1 (OR = 1.086, 95% CI = 1.025-1.150, IVW_P = 0.005) antibodies and an increased risk of prostate cancer. Reverse MR analysis did not establish a causal relationship. Multivariable MR analysis identified the EBV EBNA-1 antibody as an independent risk factor for prostate cancer (OR = 1.095, 95% CI = 1.042-1.151, IVW_P = 0.00036).

Conclusion: The study highlights the association between EBV antibody levels, particularly EBNA-1, and prostate cancer risk, suggesting EBNA-1 as an independent risk factor. Future research is needed to elucidate the biological pathways linking EBV antibody levels to prostate cancer. These insights could be instrumental in developing targeted prevention strategies and therapeutic interventions for prostate cancer.

IntroductionDrug-induced myelosuppression (DIM) is a serious side effect of several medications, particularly chemotherapy, immunosuppressants, and targeted therapies, which can lead to infections, anemia, and bleeding. While these drugs are effective, their adverse effects can disrupt treatment plans and reduce quality of life. However, early identification of DIM remains challenging, as many associated drugs do not explicitly list this risk, complicating clinical monitoring.MethodsThis study utilized the FDA Adverse Event Reporting System (FAERS) database to perform signal mining and assess the risks of DIM. Reports from the first quarter of 2004 to the third quarter of 2024 were analyzed using signal detection algorithms such as Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM). These methods helped identify drug signals related to DIM and explore risk factors and occurrence patterns.ResultsThe study analyzed 21 380 adverse event reports related to DIM, showing a significant increase in the number of reports since 2019, peaking at 3501 in 2021. Among patients, 50.2% were female, 35.5% were male, and the majority (44.42%) were aged between 18 and 65. Breast cancer patients had the highest DIM incidence (10.6%). Geographically, China reported the most cases (57.4%), followed by Japan (12.4%), and the United States (6.76%). The drugs most frequently linked to DIM included trastuzumab, bevacizumab, venetoclax, methotrexate, and pertuzumab. Additionally, 12 new drug signals were identified that were not labeled for DIM risk, including PERTUZUMAB, SODIUM CHLORIDE, and MESNA, which showed particularly strong or unexpected associations.ConclusionThis study identifies new DIM-related drug signals and emphasizes the need for early detection to improve clinical management and optimize treatment regimens. The findings provide valuable evidence for drug safety monitoring and can help reduce DIM-related risks in cancer treatment.

ObjectiveTo develop a prognostic model for optimizing management of colorectal liver oligometastases (CLOM) patients with different primary tumor locations who underwent thermal ablation (TA).Materials and MethodsThe reporting of this retrospective study conforms to STROBE guidelines. A total of 525 CLOM patients who underwent TA from 3 hospitals between 2011 and 2021 were enrolled. Firstly, intra and extrahepatic disease-free survival (DFS) and overall survival (OS) for CLOM patients with different primary tumor locations were analyzed. Then, cox regression models were used to identify independent factors predicting OS. Finally, a prognostic score was developed to identify CLOM patients benefiting from TA. All patient details were de-identified.ResultsA total of 423 eligible patients were identified, with 762 CLOM (121 male, median age 59 years) and a median follow-up of 45.8 (IQR, 7.3-114.8) months. Independent predictors of OS were identified, including multiple liver metastases (P = .0085), right-sided colon cancer (P = .0210), tumor size ≥2 cm (P = .0273), and lymph node metastasis of primary colorectal cancer (P = .0302), termed as the "MRSL" score. On the basis of the best separation of MRSL score, patients were divided into high-risk (cutoff value ≥8) and low-risk groups (cutoff value <8). Further stratified analysis indicated that right-sided CLOM patients had shorter OS than left-sided patients in the high-risk group (54.9 vs 92.5 months, P = .0156). However, no significant difference in OS was observed between right-sided and left-sided CLOM patients in the low-risk group (97.7 vs 102.2 months, P = .28).ConclusionThe MRSL score-based model helps in selecting potential right-sided CLOM patients who benefit from TA.

IntroductionLung adenocarcinoma is the leading cause of cancer-related mortality worldwide. Understanding the clinicopathological profiles and genomic drivers of its metastatic patterns is a crucial step for risk stratification. Herein, we investigated the clinicogenomic features of bone metastases in lung adenocarcinoma and their prognostic value.MethodsA retrospective cohort study with a total of 4064 patients with various metastatic patterns of lung adenocarcinoma were included, obtaining relevant clinical data and genomic profiles. Patients were categorized based on the presence or absence of bone metastases. A comparative analysis of both groups in terms of demographics, disease status, somatic mutations, and microsatellite instability was carried out. Significantly different variables were tested for their association with bone metastases. Cox regression analyses were utilized to identify independent survival prognostic variables in the bone metastases sub-cohort.ResultsGender, concomitant metastases (to adrenal gland, nervous system, lymph nodes, liver, lung, mediastinum, pleura, and skin), and aberrations in TP53, EGFR, KEAP1, and MYC were associated with bone metastases in lung adenocarcinoma. Survival analyses within the bone metastases sub-cohort have illustrated the following variables to possess poor prognostic signature including age > 75, female gender, White ethnicity, distant metastases (adrenal gland, central nervous system, intra-abdominal, and liver), EGFR (wild type), KEAP1 (mutant), MYC (mutant), KRAS (mutant), and SMARCA4 (mutant).ConclusionKey clinical and genomic factors associated with lung adenocarcinoma bone metastases have been highlighted, providing exploratory insights into high-risk individuals. Future studies should be directed to validate these prognostic variables in larger, more diverse cohorts to enhance generalizability.