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https://www.readbyqxmd.com/read/28918550/advance-care-planning-challenges-at-the-emergency-department-of-a-cancer-care-center
#1
Maria T Cruz-Carreras, Patrick Chaftari, Jayne Viets-Upchurch
INTRODUCTION: Code status discussions form an important part of advance care planning (ACP) as it enables physicians to respect the patient's wishes for end-of-life care. However, in some cases, code status discussions can be challenging causing the physician to go against the patient's wishes and the code of medical ethics. This is especially true in an emergency setting. In this paper, we will discuss three cases of advanced cancer patients, where code status discussions posed challenges to healthcare providers...
September 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28918544/tumor-regression-grading-of-gastrointestinal-cancers-after-neoadjuvant-therapy
#2
REVIEW
Rupert Langer, Karen Becker
Neoadjuvant therapy has been successfully introduced in the treatment of locally advanced gastrointestinal malignancies, particularly esophageal, gastric, and rectal cancers. The effects of preoperative chemo- or radiochemotherapy can be determined by histopathological investigation of the resection specimen following this treatment. Frequent histological findings after neoadjuvant therapy include various amounts of residual tumor, inflammation, resorptive changes with infiltrates of foamy histiocytes, foreign body reactions, and scarry fibrosis...
September 16, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28918542/current-chemotherapeutic-regimens-for-brain-metastases-treatment
#3
Joo Yeon Nam, Barbara J O'Brien
Brain metastasis is a common complication in advanced systemic cancer, with an increasing incidence. The diagnosis of brain metastasis historically portended a dismal prognosis. The successful development of effective treatments for patients with brain metastasis is complicated by the differences among cancer subtypes, the limited understanding of the underlying pathophysiology of BM, the impact of the blood-brain barrier, and other factors. There is now renewed interest in treating this often devastating complication of cancer, and in understanding the underlying mechanisms of disease in this "sanctuary" site...
September 16, 2017: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/28918424/systemic-inflammatory-response-is-a-prognostic-marker-in-hiv-infected-patients-with-hepatocellular-carcinoma
#4
David J Pinato, Marco Merli, Alessia Dalla Pria, Shiraz Jamshaid, Kizzy Parker, Nicole Pagani, Hamid Hasson, Caterina Uberti Foppa, Emanuela Messina, Rohini Sharma, Mark Nelson, Mark Bower
BACKGROUND: Hepatocellular carcinoma (HCC) is increasingly prevalent in people living with HIV. Systemic inflammation is a prognostic factor requiring validation in HIV-associated HCC. AIMS: Using a multi-centre database of consecutive HCC cases, we investigated the prognostic role of a panel of inflammatory markers, including neutrophil to lymphocyte ratio (NLR), using univariate and multivariate survival analyses. RESULTS: Fifty-nine patients with HIV-associated HCC secondary to hepatitis C (69%) or B virus infection (32%) were identified...
September 16, 2017: Oncology
https://www.readbyqxmd.com/read/28918178/using-imaging-to-predict-treatment-response-in-genitourinary-malignancies
#5
REVIEW
Amir H Lebastchi, Matthew J Watson, Christopher M Russell, Arvin K George, Alon Z Weizer, Baris Turkbey
CONTEXT: Over the previous2 decades, there have been numerous advancements in the diagnostic evaluation, therapeutic management, and postoperative assessment of genitourinary malignancies. OBJECTIVE: To present a review of current and novel imaging modalities and their utility in the assessment of therapeutic response in the systemic management of renal, testicular, and prostate cancers. EVIDENCE ACQUISITION: A PubMed/Medline search of the current published literature inclusive of prospective and retrospective original research, systematic reviews, and meta-analyses was conducted evaluating imaging modalities for renal cell carcinoma, prostate cancer, and testicular cancer...
September 13, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28918047/long-noncoding-rna-bc032913-as-a-novel-therapeutic-target-for-colorectal-cancer-that-suppresses-metastasis-by-upregulating-timp3
#6
Jiaxin Lin, Xin Tan, Lin Qiu, Long Huang, Yi Zhou, Zhizhong Pan, Ranyi Liu, Shuai Chen, Rong Geng, Jiangxue Wu, Wenlin Huang
Long noncoding RNAs (lncRNAs) have been shown to play critical roles in the biology of various cancers. However, their expression patterns and biological functions in human colorectal cancer (CRC) remain largely unknown. The aim of this study was to explore lncRNA profiles in CRC and investigate key lncRNAs involved in CRC tumorigenesis and progression. The microarray data of six CRC and matched non-cancerous tissues revealed distinct lncRNA profiles, including 899 upregulated and 1,646 downregulated lncRNAs (p < 0...
September 15, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28918035/lncrna-hotair-contributes-to-5fu-resistance-through-suppressing-mir-218-and-activating-nf-%C3%AE%C2%BAb-ts-signaling-in-colorectal-cancer
#7
Peilong Li, Xin Zhang, Lili Wang, Lutao Du, Yongmei Yang, Tong Liu, Chen Li, Chuanxin Wang
One major reason for the failure of advanced colorectal cancer (CRC) treatment is the occurrence of chemoresistance to fluoropyrimidine (FU)-based chemotherapy. Long non-coding RNA HOTAIR has been considered as a pro-oncogene in multiple cancers. However, the precise functional mechanism of HOTAIR in chemoresistance is not well known. In this study, we investigated the biological and clinical role of HOTAIR in 5FU resistance in CRC. Our results showed that HOTAIR negatively regulated miR-218 expression in CRC through an EZH2-targeting miR-218-2 promoter regulatory axis...
September 15, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28917648/challenges-of-conducting-a-prospective-clinical-trial-for-older-patients-lessons-learned-from-ncctg-n0949-alliance
#8
Nadine J McCleary, Joleen Hubbard, Michelle R Mahoney, Jeffrey A Meyerhardt, Daniel Sargent, Alan Venook, Axel Grothey
OBJECTIVES: While the risk of developing colorectal cancer increases with age, there are limited prospective data regarding best treatment in the older adult population. We launched a phase III trial to evaluate difference in treatment outcome for older adults (aged ≥70years) with advanced colorectal cancer. Here we review the challenges faced and reasons for poor accrual to N0949. MATERIALS AND METHODS: We describe the conceptualization, development and limited results of N0949, a randomized phase III study of fluoropyrimidine/bevacizumab with or without oxaliplatin (mFOLFOX7 or XELOX) as first line chemotherapy for metastatic colorectal cancer...
September 13, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28917291/intraoperative-raman-spectroscopy
#9
REVIEW
Michelle Brusatori, Gregory Auner, Thomas Noh, Lisa Scarpace, Brandy Broadbent, Steven N Kalkanis
Surgical excision of brain tumors provides a means of cytoreduction and diagnosis while minimizing neurologic deficit and improving overall survival. Despite advances in functional and three-dimensional stereotactic navigation and intraoperative MRI, delineating tissue in real time with physiologic confirmation is challenging. Raman spectroscopy has potential to be an important modality in the intraoperative evaluation of tissue during surgical resection. In vitro experimental studies have shown that this technique can be used to differentiate normal brain tissue from tissue with infiltrating cancer cells and dense cancerous masses with high specificity, indicating the feasibility of this method for in vivo application...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28917273/mechanisms-and-risk-factors-of-thrombosis-in-cancer
#10
REVIEW
Anna Falanga, Laura Russo, Viola Milesi, Alfonso Vignoli
The close relationship between cancer and thrombosis is known since more than a century. Venous thromboembolism (VTE) may be the first manifestation of an occult malignancy in an otherwise healthy individual. Cancer patients commonly present with abnormalities of laboratory coagulation tests, indicating an ongoing subclinical hypercoagulable condition. The results of laboratory tests demonstrate that a process of fibrin formation and removal parallels the development of malignancy, which is of particular interest since fibrin and other clotting products are important for both thrombogenesis and tumor progression...
October 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28917272/towards-personalized-medicine-of-colorectal-cancer
#11
REVIEW
Mohammad Azhar Aziz, Zeyad Yousef, Ayman M Saleh, Sameer Mohammad, Bandar Al Knawy
Efforts in colorectal cancer (CRC) research aim to improve early detection and treatment for metastatic stages which could translate into better prognosis of this disease. One of the major challenges that hinder these efforts is the heterogeneous nature of CRC and involvement of diverse molecular pathways. New large-scale 'omics' technologies are making it possible to generate, analyze and interpret biological data from molecular determinants of CRC. The developments of sophisticated computational analyses would allow information from different omics platforms to be integrated, thus providing new insights into the biology of CRC...
October 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28917268/targeting-androgen-independent-pathways-new-chances-for-patients-with-prostate-cancer
#12
REVIEW
C Cattrini, E Zanardi, G Vallome, A Cavo, L Cerbone, A Di Meglio, C Fabbroni, M M Latocca, F Rizzo, C Messina, A Rubagotti, P Barboro, F Boccardo
Androgen deprivation therapy (ADT) is the mainstay treatment for advanced prostate cancer (PC). Most patients eventually progress to a condition known as castration-resistant prostate cancer (CRPC), characterized by lack of response to ADT. Although new androgen receptor signaling (ARS) inhibitors and chemotherapeutic agents have been introduced to overcome resistance to ADT, many patients progress because of primary or acquired resistance to these agents. This comprehensive review aims at exploring the mechanisms of resistance and progression of PC, with specific focus on alterations which lead to the activation of androgen receptor (AR)-independent pathways of survival...
October 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28917265/olaratumab-pdgfr-%C3%AE-inhibition-as-a-novel-tool-in-the-treatment-of-advanced-soft-tissue-sarcomas
#13
REVIEW
Bruno Vincenzi, Giuseppe Badalamenti, Andrea Napolitano, Mariella Spalato Ceruso, Francesco Pantano, Giovanni Grignani, Antonio Russo, Daniele Santini, Massimo Aglietta, Giuseppe Tonini
Advanced soft tissue sarcomas are aggressive cancers with limited therapeutic options. Recently, inhibition of platelet-derived growth factor receptor (PDGFR)-α by the monoclonal antibody olaratumab showed promising clinical activity. If confirmed, this would be one of the first examples of targeted therapy effective in advanced soft tissue sarcomas therapy independently of the histologic subtype. Here, we reviewed the biology of the PDGF/PDGFR axis, particularly focusing on its role in cancer, and then we discussed on the effects of PDGFR-α inhibition in the therapy of advanced soft tissue sarcomas...
October 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28917258/stereotactic-body-radiotherapy-for-early-stage-lung-cancer-historical-developments-and-future-strategies
#14
Kevin L M Chua, Iris Sin, Kam W Fong, Melvin L K Chua, Hiroshi Onishi
The application of radiosurgery dose escalation extra-cranially in a moving target, surrounded by critical normal tissue, presents unique dosimetric and clinical challenges. Building on a strong foundation of robust technological advancements and well-planned clinical studies, lung stereotactic body radiotherapy (SBRT) has firmly established its place in the management of early stage non-small cell lung cancer (NSCLC). Nevertheless, favourable outcomes and long-term survival still evade a substantial proportion of patients, especially for central and larger peripheral lung tumours...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28917251/advances-in-external-beam-stereotactic-body-radiotherapy-principle-concerns-in-implementing-a-liver-radiation-program
#15
Stewart Gaede, Michael I Lock
Despite significant advances in diagnosis, surgery and medical oncology, patients with primary and secondary liver cancer have some of the worst prognoses in oncology. In addition, the incidence of liver cancer is expected to increase. For this reason, centres are seeking new treatments and establishing specialized multidisciplinary teams. This article will focus on the evidence and practical data to assist in setting up or improving current process pathways, to provide an efficient and safe radiotherapy program for liver...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28917248/stereotactic-body-radiation-therapy-for-prostate-cancer-a-review
#16
Waqar Haque, E Brian Butler, Bin S Teh
Prostate cancer can be managed with external beam radiation therapy, delivered with either protons or photons, brachytherapy, surgery, or active surveillance. Advances in imaging and radiation therapy delivery have allowed treatment of prostate cancer using ultra-hypofractionated radiation therapy with a high dose per fraction using a technique called stereotactic body radiation therapy (SBRT). While no randomized trials have compared the efficacy of SBRT to conventionally fractionated radiation therapy (CFRT), numerous prospective trials and retrospective reviews have demonstrated the safety and efficacy of SBRT for localized prostate cancer, used either definitively or as a boost along with CFRT...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28916978/tumor-biology-predicts-pathologic-complete-response-to-neoadjuvant-chemotherapy-in-patients-presenting-with-locally-advanced-breast-cancer
#17
Lori F Gentile, George Plitas, Emily C Zabor, Michelle Stempel, Monica Morrow, Andrea V Barrio
BACKGROUND: Neoadjuvant chemotherapy (NAC) is used to convert patients with inoperable locally advanced breast cancer (LABC) to operability, but has not traditionally been used to avoid mastectomy or axillary dissection in this subset. OBJECTIVE: The purpose of this study was to determine the rates of pathologic complete response (pCR) in LABC patients, and identify factors predictive of pCR to determine if responding patients might be suitable for limited surgery...
September 15, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28916906/neoadjuvant-versus-definitive-chemoradiotherapy-for-locally-advanced-esophageal-cancer-outcomes-and-patterns-of-failure
#18
Matthias Felix Haefner, Kristin Lang, Vivek Verma, Stefan Alexander Koerber, Lorenz Uhlmann, Juergen Debus, Florian Sterzing
PURPOSE: Randomized trials examining neoadjuvant chemoradiotherapy followed by surgical resection (nCRT-S) and definitive CRT (dCRT) for esophageal cancer (EC) patients are hampered by use of nonstandard treatment paradigms. Outcomes of nCRT-S versus dCRT in a more common patient population are lacking. We investigated local control and survival, evaluated clinical factors associated with endpoints, and assessed patterns of failure between these cohorts. METHODS: We retrospectively analyzed 130 patients with locally advanced EC receiving either dCRT or nCRT-S at our institution from 2000-2012...
September 15, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28916903/merkel-cell-carcinoma-epidemiology-pathogenesis-diagnosis-and-therapy
#19
REVIEW
Teresa Amaral, Ulrike Leiter, Claus Garbe
Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a neuroendocrine phenotype. Incidence varies according to the geographic regions but is overall increasing. Different risk factors have been identified namely advanced age, immunosuppression, and ultraviolet light exposure. An association between MCC and polyomavirus infection is known. However, the exact mechanism that leads to carcinogenesis is yet to be fully understood. Surgery when feasible is the recommended treatment for localized disease, followed by adjuvant radiation or chemoradiation...
September 16, 2017: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/28916893/safety-and-prognostic-impact-of-prophylactic-laparoscopic-superior-mesenteric-vein-no-14v-lymph-node-dissection-for-lower-third-gastric-cancer-a-propensity-score-matched-case-control-study
#20
Qi-Yue Chen, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Chang-Ming Huang
AIM: To investigate oncologic efficacy of prophylactic laparoscopic superior mesenteric vein (No. 14v) lymph node (LN) dissection for lower-third gastric cancer (LTGC). METHODS: We retrospectively collected data from 757 patients who underwent laparoscopic-assisted distal gastrectomy for LTGC. Of these patients, 102 underwent 14v LN dissection (14vD+ group), and the remaining 655 patients did not undergo 14v LN dissection (14vD- group). The outcomes were compared using a 1:1 propensity score matching method...
September 15, 2017: Surgical Endoscopy
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