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Cancer AND comorbidity

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https://www.readbyqxmd.com/read/28731946/treatment-minimization-in-older-patients-with-early-stage-breast-cancer
#1
Tara M Hansen, Richard C Zellars
The management of early-stage breast cancer in older patients is complex and requires a careful balance of the risk of cancer death with the competing risks of comorbidities and treatment-related toxicity in women with largely favorable disease. As the US population continues to age, oncologists will increasingly encounter this clinical challenge. Several strategies involving each core component of breast cancer therapy have been investigated to minimize treatment in these patients while still maintaining acceptable outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731942/geriatric-assessment-and-tools-for-predicting-treatment-toxicity-in-older-adults-with-cancer
#2
Daneng Li, Enrique Soto-Perez-de-Celis, Arti Hurria
Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The geriatric assessment is a multidisciplinary evaluation that provides detailed information about a patient's functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#3
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28731397/anaplastic-meningioma-an-analysis-of-the-national-cancer-database-from-2004-to-2012
#4
Andrew Orton, Jonathan Frandsen, Randy Jensen, Dennis C Shrieve, Gita Suneja
OBJECTIVE Anaplastic meningiomas represent 1%-2% of meningioma diagnoses and portend a poor prognosis. Limited information is available on practice patterns and optimal management. The purpose of this study was to define treatment patterns and outcomes by treatment modality using a large national cancer registry. METHODS The National Cancer Database was used to identify patients diagnosed with anaplastic meningioma from 2004 to 2012. Log-rank statistics were used to compare survival outcomes by extent of resection, use of adjuvant radiotherapy (RT), and use of adjuvant chemotherapy...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28730775/charlson-comorbidity-index-for-evaluati%C3%AE-n-%C3%AE-f-the-outcomes-of-elderly-patients-undergoing-laparoscopic-surgery-for-colon-cancer
#5
Yun Huang, Yuxing Zhang, Jianjun Li, Gang Liu
PURPOSE: We investigated the effectiveness of the Charlson comorbidity index (CCI) for predicting postoperative 30-day complications and long-term survival outcomes of elderly patients who underwent laparoscopic surgery for colon cancer with radical intent. METHODS: We reviewed 178 patients aged ≥70 years who underwent laparoscopic surgery for colon cancer with radical intent between January 2008 and December 2015. Patients were divided into high CCI (CCI ≥ 3; n=71) and low CCI (CCI < 3; n=107) groups for comparative analyses of differences in their short- and long-term outcomes...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730678/prognosis-following-cancer-surgery-during-holiday-periods
#6
Jesper Lagergren, Fredrik Mattsson, Pernilla Lagergren
Surgery is the mainstay curative treatment in most cancer. We aimed to test the new hypothesis that cancer surgery performed during holiday periods is associated with worse long-term prognosis than for non-holiday periods. This nationwide Swedish population-based cohort study included 228,927 patients during 1997-2014 who underwent elective resectional surgery for a cancer where the annual number of resections was over 100. The 16 eligible cancer sites were grouped into 10 cancer groups. The exposure, holiday periods, was classified as wide (14-weeks) or narrow (7-weeks)...
July 21, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28730291/electrolyte-disorders-with-platinum-based-chemotherapy-mechanisms-manifestations-and-management
#7
REVIEW
Bryan Oronsky, Scott Caroen, Arnold Oronsky, Vaughn E Dobalian, Neil Oronsky, Michelle Lybeck, Tony R Reid, Corey A Carter
Platinum chemotherapy, particularly cisplatin, is commonly associated with electrolyte imbalances, including hypomagnesemia, hypokalemia, hypophosphatemia, hypocalcemia and hyponatremia. The corpus of literature on these dyselectrolytemias is large; the objective of this review is to synthesize the literature and summarize the mechanisms responsible for these particular electrolyte disturbances in the context of platinum-based treatment as well as to present the clinical manifestations and current management strategies for oncologists and primary care physicians, since the latter are increasingly called on to provide care for cancer patients with medical comorbidities...
July 20, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28729178/elevated-cardiovascular-disease-risk-in-patients-with-chronic-myelogenous-leukemia-seen-in-community-based-oncology-practices-in-the-united-states
#8
Anna D Coutinho, Dinara Makenbaeva, Eileen Farrelly, Pamela B Landsman-Blumberg, Daniel Lenihan
INTRODUCTION: Current National Comprehensive Cancer Network guidelines recommend that comorbidities, including cardiovascular disease (CVD), be considered when selecting tyrosine kinase inhibitors for the treatment of chronic myelogenous leukemia (CML). We report here the prevalence of CVD and its risk factors in patients with CML treated by community-based United States (US) oncologists. PATIENTS AND METHODS: Adult patients with a confirmed diagnosis of CML and ≥ 1 encounter after the first date of CML diagnosis in an electronic medical record database between January 1, 2005 and October 31, 2014 were enrolled...
June 17, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28728799/-mental-health-determines-the-quality-of-life-in-patients-with-cancer-related-neuropathic-pain-in-quito-ecuador
#9
Fernando Gordillo Altamirano, María José Fierro Torres, Nelson Cevallos Salas, María Cristina Cervantes Vélez
OBJECTIVE: To identify the main factors determining the health related quality of life (HRQL) in patients with cancer-related neuropathic pain in a tertiary care hospital. METHODS: A cross-sectional analytical study was performed on a sample of 237 patients meeting criteria for cancer-related neuropathic pain. Clinical and demographic variables were recorded including, cancer type, stage, time since diagnosis, pain intensity, physical functionality with the Palliative Performance Scale (PPS), and anxiety and depression with the Hospital Anxiety and Depression Scale (HADS)...
July 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28728168/lung-cancer-prognostic-index-a-risk-score-to-predict-overall-survival-after-the-diagnosis-of-non-small-cell-lung-cancer
#10
Marliese Alexander, Rory Wolfe, David Ball, Matthew Conron, Robert G Stirling, Benjamin Solomon, Michael MacManus, Ann Officer, Sameer Karnam, Kate Burbury, Sue M Evans
INTRODUCTION: Non-small-cell lung cancer outcomes are poor but heterogeneous, even within stage groups. To improve prognostic precision we aimed to develop and validate a simple prognostic model using patient and disease variables. METHODS: Prospective registry and study data were analysed using Cox proportional hazards regression to derive a prognostic model (hospital 1, n=695), which was subsequently tested (Harrell's c-statistic for discrimination and Cox-Snell residuals for calibration) in two independent validation cohorts (hospital 2, n=479 and hospital 3, n=284)...
July 20, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28726159/diagnosis-and-treatment-delays-among-elderly-breast-cancer-patients-with-pre-existing-mental-illness
#11
Kristy Iglay, Melissa L Santorelli, Kim M Hirshfield, Jill M Williams, George G Rhoads, Yong Lin, Kitaw Demissie
PURPOSE: This study aimed to compare diagnosis and treatment delays in elderly breast cancer patients with and without pre-existing mental illness. METHODS: A retrospective cohort study was conducted using the Surveillance, Epidemiology and End Results-Medicare data including 16,636 women 68+ years, who were diagnosed with stage I-IIIa breast cancer in the United States from 2005 to 2007. Mental illness was identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes recorded on inpatient and outpatient claims during the 3 years prior to breast cancer diagnosis...
July 19, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28726138/trainee-associated-outcomes-in-laparoscopic-colectomy-for-cancer-propensity-score-analysis-accounting-for-operative-time-procedure-complexity-and-patient-comorbidity
#12
Kevin R Kasten, Adam C Celio, Lauren Trakimas, Mark L Manwaring, Konstantinos Spaniolas
BACKGROUND: Surgical trainee association with operative outcomes is controversial. Studies are conflicting, possibly due to insufficient control of confounding variables such as operative time, case complexity, and heterogeneous patient populations. As operative complications worsen long-term outcomes in oncologic patients, understanding effect of trainee involvement during laparoscopic colectomy for cancer is of utmost importance. Here, we hypothesized that resident involvement was associated with worsened 30-day mortality and 30-day overall morbidity in this patient population...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726018/association-of-vagotomy-and-decreased-risk-of-subsequent-ischemic-stroke-in-complicated-peptic-ulcer-patients-an-asian-population-study
#13
Chu-Wen Fang, Chun-Hung Tseng, Shih-Chi Wu, William Tzu-Liang Chen, Chih-Hsin Muo
OBJECTIVES: The primary management of peptic ulcers is medical treatment. Persistent exacerbation of a peptic ulcer may lead to complications (perforation and/or bleeding). There has been a trend toward the use of a less invasive surgical simple suture, simple local suture or non-operative (endoscopic/angiography) hemostasis rather than acid-reducing vagotomy (i.e., vagus nerve severance) for treating complicated peptic ulcers. Other studies have shown the relationship between high vagus nerve activity and survival in cancer patients via reduced levels of inflammation, indicating the essential role of the vagus nerve...
July 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28725249/two-years-results-of-electronic-brachytherapy-for-basal-cell-carcinoma
#14
Rosa Ballester-Sánchez, Olga Pons-Llanas, Cristian Candela-Juan, Blanca de Unamuno-Bustos, Francisco Javier Celada-Alvarez, Alejandro Tormo-Mico, Jose Perez-Calatayud, Rafael Botella-Estrada
PURPOSE: The use of radiation therapy (RT) for non-melanoma skin cancer (NMSC) has been changing throughout the last century. Over the last decades, the use of radiotherapy has surged with the development of new techniques, applicators, and devices. In recent years, electronic brachytherapy (eBT) devices that use small x-ray sources have been introduced as alternative to radionuclide dependence. Nowadays, several devices have been incorporated, with a few series reported, and with a short follow-up, due to the recent introduction of these systems...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28723854/use-of-colorectal-cancer-screening-among-people-with-mobility-disability
#15
Miriam Gofine, Thelma J Mielenz, Sowmya Vasan, Benjamin Lebwohl
GOALS: We aimed to assess use of colorectal cancer screening (CRCS) as per United States Preventive Task Force guidelines among people with mobility disability using a nationally representative data set. BACKGROUND: Individuals with mobility disability have decreased access to health care services, but the impact of mobility disability on CRCS has not been investigated. STUDY: Data from the 2013 National Health Interview Survey were used to estimate sociodemographic characteristics of adults with mobility disability, prevalence of CRCS, and odds of CRCS given mobility disability among Americans aged 50 to 75...
July 18, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28723504/active-surveillance-for-small-renal-masses-when-less-is-more
#16
REVIEW
Benjamin T Ristau, Alexander Kutikov, Robert G Uzzo, Marc C Smaldone
CONTEXT: A marked increase in incidentally detected small renal masses (SRMs) has occurred over the past decade. Active surveillance (AS) has emerged as an initial management option for these patients. OBJECTIVE: (1) To determine selection criteria, assess appropriate imaging modalities and surveillance frequencies, and define triggers for delayed intervention (DI) for patients on AS. (2) To describe oncologic outcomes for patients on AS protocols. EVIDENCE ACQUISITION: The PubMed database was queried for English language articles using the keywords "surveillance" and "renal mass" or "renal cell carcinoma" or "kidney cancer...
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28722466/assessing-the-generalizability-of-the-national-lung-screening-trial-comparison-of-stage-1-patients
#17
Nichole T Tanner, Lin Dai, Brett C Bade, Mulugeta Gebregziabher, Gerard A Silvestri
RATIONALE: The findings of the National Lung Screening Trial (NLST) is the basis for screening high risk individuals based on age and smoking history. While screening is covered for eligible Medicare beneficiaries, the generalizability of the NLST in the elderly population has been questioned. OBJECTIVE: Compare outcomes of patients diagnosed with stage 1 non-small cell lung cancer(NSCLC) in the NLST to a nationally representative cohort of elderly patients Methods: Analysis of SEER-Medicare and NLST datasets for stage 1 patients ages 65-74 Measurements and Main Results: Lung cancer-specific mortality, all-cause mortality, and 30-60-90 day treatment mortality were measured...
July 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28721897/adjuvant-chemoradiation-therapy-for-cervical-cancer-and-effect-of-timing-and-duration-on-treatment-outcome
#18
Sachin Jhawar, Lara Hathout, Mohamed A Elshaikh, Sushil Beriwal, William Small, Omar Mahmoud
PURPOSE: Worse treatment outcomes can be expected with prolongation of the overall treatment time (OTT) during definitive chemoradiation therapy (CRT) for cervical cancer. In the adjuvant setting, data on the relative importance of the OTT and the importance of RT and chemotherapy synchronization are scarce. Using the National Cancer Database, we evaluated the effect of these treatment variables on overall survival in the adjuvant CRT setting. METHODS AND MATERIALS: The present analysis included nonmetastatic cervical cancer patients undergoing hysterectomy followed by adjuvant CRT...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28721894/predictors-of-positive-margins-after-definitive-resection-for-gastric-adenocarcinoma-and-impact-of-adjuvant-therapies
#19
Ryan M Rhome, Erin Moshier, Umut Sarpel, Nisha Ohri, Madhu Mazumdar, Michael H Buckstein
PURPOSE: Positive margins after definitive resection in gastric adenocarcinoma are associated with inferior outcomes. There are few randomized data to guide optimal adjuvant therapy after positive margins. METHODS: Using the National Cancer Database, we identified 24,619 nonmetastatic gastric adenocarcinoma patients who received diagnoses from 2004 to 2013 and underwent definitive resection to analyze for predictors of positive surgical margins. Of these patients, 2754 had positive margins (11...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28721893/multicenter-phase-2-study-of-peri-irradiation-chemotherapy-plus-intensity-modulated-radiation-therapy-with-concurrent-weekly-docetaxel-for-inoperable-or-medically-unresectable-nonmetastatic-gastric-cancer
#20
Yong Liu, Guoqi Zhao, Yi Xu, Xia He, Xiaodong Li, Hui Chen, Qin Wu, Shengyu Yao, Ge Yan, Tingfeng Chen
PURPOSE: To assess the efficacy and feasibility of concurrent chemoradiation therapy (CCRT) plus preradiation and postradiation chemotherapy for patients with nonmetastatic gastric carcinoma who do not undergo surgery. METHODS AND MATERIALS: Patients with inoperable (due to medical comorbid conditions or patient's refusal to undergo surgery) or unresectable gastric cancer received up to 2 21-day cycles of preradiation and postradiation chemotherapy (docetaxel 37...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
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