Aging and cancer最新文献

Background

Allostatic load (AL) has been linked to an increased risk of death in various populations. However, to date, there is no research specifically investigating the effect of AL on mortality in older cancer survivors.

Aims

To investigate the association between AL and mortality in older cancer survivors.

Method

A total of 1291 adults aged 60 years or older who survived for ≥1 year since cancer diagnoses were identified from the 1999 to 2010 National Health and Nutrition Examination Survey. AL was the exposure of interest incorporating nine clinical measures/biomarkers; one point was added to AL if any of the measures/biomarkers exceeded the normal level. The sum of points was categorized as an ordinal variable to reflect low, moderate, and high ALs. Our outcomes of interest were all-cause, cancer-specific, and cardiovascular disease–specific mortality. Death was identified by linkage to the National Death Index. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratio (aHR) and 95% confidence intervals (CI) of mortality by AL category.

Results

Overall, 53.6% of participants were male and 78.4% were white. The mean age of study participants at interview was 72.8 years (standard deviation = 7.1). A total of 546 participants died during the follow-up (median follow-up time: 8.0 years). Among them, 158 died of cancer, and 106 died of cardiovascular events. Results from multivariable Cox proportional hazards models showed that higher ALS was positively associated with higher all-cause mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.52, 95% CI = 1.17–1.98, p-trend < 0.01) and higher cancer-specific mortality (ALS = 4–9 vs. ALS = 0–1: aHR = 1.80, 95% CI = 1.12–2.90, p-trend = 0.01). The association between ALS and cardiovascular mortality was positive but nonsignificant (ALS = 4–9 vs. ALS = 0–1: aHR = 1.59, 95% CI = 0.86–2.94, p-trend = 0.11).

Conclusions

Our study suggests that older cancer survivors can have a higher risk of death if they have a high burden of AL.

Introduction

This study aims to compare the real-world effectiveness and safety of Endostar in combination with chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) in different age groups.

Methods

Electronic medical records of patients with NSCLC who received Endostar combined with chemotherapy from June 2012 to August 2019 in 7 cancer centers were retrospectively collected. Baseline characteristics before and after propensity score matching (PSM), effectiveness evaluation, and safety data of two age groups were analyzed. Tumor response was evaluated according to RECIST v1.1. Adverse events (AEs) were graded according to NCI-CTCAE 5.0.

Results

In this study, 554 and 571 patients were assigned to ≤60 years non-aged group and >60 years aged group, respectively. After propensity score matching (PSM) was introduced, 166 patients in each age group were analyzed. The median PFS for the two groups was 8.9 and 8.0 months, with the overall response rate was 24.7% and 26.5% (p = 0.7060), disease control rate was 64.5% versus 68.7% (p = 0.4600), respectively. Cox regression result showed that advanced age has no significant influence on PFS (hazard ratio = 1.02, 95% CI: 0.98−1.06, p = 0.3034) in contrast with younger patients. The most common AEs in both age groups were myelosuppression, gastrointestinal reactions, and hepatic impairment. The total incidence for the above AEs in the two groups was 18.67% versus 24.10%, 22.89% versus 21.69%, 12.05% versus 7.23%, with no statistically significant difference.

Conclusion

Compared with treating patients with NSCLC younger than 60 years old, the effectiveness of Endostar combined with chemotherapy in treating advanced patients showed no significant differences, with tolerable adverse events.

Background and objectives

Research about the effect of surgery in geriatric patients with early stage pancreatic ductal adenocarcinoma (PDAC) is limited, and it remains a subject of much debate. The purpose of this study was to evaluate the role of surgery on the survival of elderly patients with T1-3N0M0 PDAC and to further investigate the prognosis of these patients undergoing different surgical methods.

Methods

Patients aged ≥65 with T1-3N0M0 PDAC diagnosed in 2004–2016 were collected from the Surveillance, Epidemiology, and End Results database. The imbalance of baseline characteristics was reduced by propensity score matching. We used the log-rank tests to evaluate overall survival (OS) and cancer-specific survival (CSS) among different groups. Univariate and multivariate Cox regression analysis was utilized to explore prognostic factors in PDAC.

Results

In total, 6363 patients were enrolled. After matching, 1110 patients were paired. We found that surgery could provide better survival (p < 0.001). Moreover, compared with those who underwent partial resection or larger resection, patients who underwent local tumor destruction had poorer OS and CSS (p < 0.001). However, no statistically significant survival differences were shown between the partial resection group and the larger resection group (p < 0.001).

Conclusion

Surgical intervention could confer a survival benefit to elderly patients with early stage PDAC. Additionally, these patients could benefit from more radical operations, and radical operations with reasonable extents are advocated rather than too aggressive methods.

Introduction

Cancer screening programs are routinely available in high-income countries, but participation rates are low, especially among men. This narrative review aims to identify male-specific access barriers to cancer-related healthcare in high-income countries that offer statutory insurance/subsidized health care.

Methods

We searched PubMed, Science Direct, and Web of Science for peer-reviewed journal articles published within the past 10 years on cancer healthcare access, help-seeking behavior, and men. Step-wise screening of title, abstract, and full text resulted in 23 studies that fit the selection criteria for findings in high-income countries. The results were analyzed descriptively using qualitative thematic synthesis.

Results

In the reviewed studies, barriers for men in accessing cancer-related healthcare offers could be broadly categorized under sociocultural norms, personal behaviors, and structural problems. The most common barriers were related to sociocultural influences and included notions of masculinity, distrust in the medical system, and personnel/social commitments. Major personal barriers included fear of getting cancer or screening methods, lack of awareness about cancer, and problems in communication with healthcare professionals. Accessibility and lack of insurance were reported as common structural barriers.

Conclusions

The reluctance of men in approaching medical help was rooted in sociocultural norms of traditional masculinity with direct and indirect consequences such as fear, lack of awareness, distrust of medical personnel, and problems in communicating with healthcare professionals. Gender-specific, male-oriented information via digital, anonymous interventions may be helpful for increasing participation of men in cancer care.

Background

The coronavirus disease 2019 (COVID-19) pandemic resulted in enormous medical and economic burden worldwide during the past 3 years. The vaccination was deemed the effective option to prevent the severe symptoms, and especially recommended among cancer patients. Shanghai experienced the first lockdown during the recent Omicron pandemic since 2019. How patients with pancreatic adenocarcinoma (PAC) suffered from the pandemic and how vaccination influenced their oncological outcomes were unexplored yet.

Method

The retrospective study was carried out in a high-volume referral center including 1157 consecutively enrolled patients with PAC experiencing the COVID-19 pandemic. The primary outcome was the overall survival (OS).

Results

Limited postoperative patients (9.21%) received the vaccination. The lockdown in Shanghai (April to May, 2022) was not observed impacting the survival prognoses of patients with PAC. Though vaccination was not significantly associated with OS itself (adjusted hazard ratio (aHR): 2.032 [0.940–4.391], p = 0.071), it was discovered to synergistically improve the chemotherapy effect in the multivariate analyses (interaction p = 0.023).

Conclusion

The vaccination itself did not influence the survival prognoses of patients with PAC. A potential positive interaction was observed between chemotherapy and vaccination despite the limited follow-up time. The postoperative patients should consider the vaccination more. The patients with PAC did not suffer worse prognostic outcomes from the strict sanitary policy during the wave of COVID-19 pandemic in Shanghai.

Background

The intersection of cancer and aging is an emerging public health challenge in developed countries because of the aging and expansion of the population.

Aims

We convened a panel of experts to share their insights on this topic at the inaugural University of Florida Health Cancer Center's (UFHCC's) Cancer and Aging Symposium, which was held virtually in February 2022.

Methods

We featured presentations from four leading scientists, whose research spans multiple disciplines including basic science, translational research, geriatric oncology, and population science.

Results

Each speaker offered their unique perspective and insight on the intersection between cancer and aging and discussed their current and ongoing research in this field. In addition to this panel of experts, scientists from the National Institutes of Health and the National Cancer Institute, as well as a UFHCC-affiliated citizen scientist, shared their perspectives on strategies to move the field forward. Some of the key open questions and opportunities for future research offered by these presenters in aging and cancer include but are not limited to infusing health disparities research into the field of cancer and aging, assessing the value of geriatric assessment in identifying early vulnerabilities that may affect response to emerging cancer therapies in older patients, and assessing biological age and other biomarkers (e.g., clonal hematopoiesis) in relation to clinical endpoints and the development of primary, secondary, and tertiary cancer prevention interventions.

Conclusion

Research is needed to accelerate knowledge regarding the dynamic interplay of cancer and aging and optimize care in diverse older adults to achieve equity in cancer outcomes.

Biliary tract cancer (BTC) that contains cholangiocarcinoma, gallbladder cancer, and ampullary cancer is highly malignant and mostly diagnosed in elderly patients. Over the past decades, human life has globally risen; thus, aging emerges as the primary risk factor for BTC. However, an effective treatment for this vulnerable population remains a large clinical challenge. As a result, the incidence and mortality of TBC remains high. Here, we discuss the potential link between aging and BTC from the aspects of molecular and cellular mechanisms, surgical resection, and chemotherapy. In addition, we update a number of clinical trials that are currently ongoing in elderly patients. The overview of BTC in elderly patients is expected to help develop a new therapeutic strategy tailored to this elderly population, ultimately improving their life quality.