Current Issue : July - September Volume : 2019 Issue Number : 3 Articles : 6 Articles
Background: The association of ABO blood groups with gastric cancer risk was proposed decades ago, but the\nresults have been inconsistent.\nMethods: We used two single nucleotide polymorphisms to determine ABO genotype in 4932 gastric cancer cases\nand 6158 controls of Chinese descent, and evaluated the associations of ABO blood groups and genotypes with\nrisk of gastric cancer using multivariable logistic regression models. We also systematically reviewed published\nliterature and performed a meta-analysis of all relevant studies.\nResults: In the case-control study, compared with blood group O, both blood group A and AB were associated\nwith increased gastric cancer risk (for group A, odds ratio (OR) = 1.13, 95% confidence interval (CI): 1.02-1.24; for\ngroup AB, OR = 1.18, 95% CI: 1.02-1.36, respectively). Analyses of ABO genotypes revealed associations of AO and AB\nwith risk of gastric cancer compared with OO genotype. Consistent with the case-control study, meta-analysis of 40\nstudies including 33,613 cases and 2,431,327 controls demonstrated that blood group A (OR = 1.19, 95% CI: 1.13-1.\n25) and AB (OR = 1.09, 95% CI: 1.03-1.16) were associated with increased risk of gastric cancer.\nConclusions: Our analyses validated the association of blood group A with risk of gastric cancer, and suggested\nthat blood group AB was also associated with gastric cancer risk. Functional investigations are warranted to\nelucidate the exact mechanism of ABO blood groups in gastric carcinogenesis....
Purpose: Endocrine therapy is one of the main treatment options for hormone\nreceptor (HR)-positive advanced breast cancer (ABC). However, whether\nthe combination of endocrine therapy with chemotherapy is practicable and\nmore effective than endocrine therapy alone remains unknown. The aim of\nthis study was to investigate the clinical efficacy of the aromatase inhibitors\n(AIs) combined with metronomic capecitabine to provide the clinical evidence\nfor further research in patients with HR-positive ABC. Methods: Data\nfrom 407 patients with HR-positive ABC were retrospectively analyzed. A total\nof 305 patients were given AIs alone, and 102 patients were given AIs plus\ncapecitabine as first-line treatment. Progression-free survival (PFS) was the\nprimary endpoint. Results: The median follow-up for all patients was 47.0\nmonths (range, 3 - 119 months). The median overall survival (OS) and PFS\nwere 52.0 months and 24.2 months, respectively. The median PFS in the\ncombination group was significantly longer than that in the AIs group (22.0\nmonths vs. 14.0 months, p = 0.002). Additionally, patients in the combination\ngroup had significantly longer OS than patients in the AI group (66.0 months\nvs. 49.0 months, p = 0.003). Multivariate analysis showed that combination\ntherapy was a significant favorable predictor for PFS and OS. Furthermore,\nyoung age (<40 years), low estrogen receptor (ER) expression level (<40%),\npresence of visceral metastasis, prior adjuvant AI use and long disease-free\ninterval (DFI) (>24 months) improved the benefit from combination therapy.\nConclusions: AIs plus metronomic capecitabine significantly improves PFS\nand OS in patients with HR-positive ABC. Thus, chemo-endocrine therapy\nshould be further explored....
Backgrounds/Aims. Watson for Oncology (WFO) is a cognitive technology that processes medical information by analyzing the\nlatest evidence and guidelines. However, studies of the concordance rate betweenWFO and clinicians for advanced gastric cancer\n(AGC) are lacking. Methods.We retrospectively reviewed 65 patients with AGC who consultedWFO and the Gachon Gil Medical\nCenter multidisciplinary team (GMDT) in 2016 and 2017. The recommendations of WFO were compared with the opinions of\nthe GMDT. WFO provided three treatment options: recommended (first treatment option), for consideration (second treatment\noption), and not recommended. Results. In total, 65 patients (mean age 61.0 years; 44 males and 21 females) were included in the\nstudy. Theconcordance rate betweenWFO and theGMDTwas 41.5% (27/65) at the recommended level and 87.7% (57/65) at the for\nconsideration level.Themain causes of discordance betweenWFO and theGMDTwere as follows. First,WFO did not consider the\nmedical history. Second,WFO recommended the use of agents that are considered outdated in Korea. Third, some patients wanted\nto be involved in a clinical trial. Fourth, some patients refused to use the biologic agents recommended byWFO for financial reasons\nas they were not covered by medical insurance. Conclusions.The concordance rate at the recommended level was relatively low but\nwas higher at the for consideration level. Discordances arose mainly from the different medical circumstances at the Gachon Gil\nMedical Center (GMC) and theMemorial Sloan Kettering Cancer Center (MSKCC), the mainWFO consulting center.The utility\nof WFO as a tool for supporting clinical decision making could be further improved by incorporating regional guidelines....
Background: Diabetes is related with increased cancer mortality across multiple cancer types. Its role in lung cancer\nmortality is still unclear. We aim to determine the prognostic value of fasting plasma glucose (FPG) and diabetes mellitus\nin patients with locally advanced non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy.\nMethods: One-hundred seventy patients with stage III NSCLC received definitive concurrent chemoradiotherapy from\n2010 to 2014. Clinico-pathological data and clinical outcome was retrospectively registered. Fifty-six patients (33%), met\ncriteria for type 2 diabetes mellitus (T2DM) at baseline. The prognostic value of FPG and other clinical variables was\nassessed. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplanâ??Meier method and\nCox proportional models and log-rank test were used.\nResults: With a median follow-up of 36 months, median PFS was 8.0 months and median OS was 15.0 months in\npatients with...........................
Prediction models are only sparsely available for metastatic oesophagogastric cancer.\nBecause treatment in this setting is often preference-based, decision-making with the aid of a\nprediction model is wanted. The aim of this study is to construct a prediction model, called\nSOURCE, for the overall survival in patients with metastatic oesophagogastric cancer. Data from\npatients with metastatic oesophageal (n = 8010) or gastric (n = 4763) cancer diagnosed during 2005-\n2015 were retrieved from the nationwide Netherlands cancer registry. A multivariate Cox regression\nmodel was created to predict overall survival for various treatments. Predictor selection was\nperformed via the Akaike Information Criterion and a Delphi consensus among experts in palliative\noesophagogastric cancer. Validation was performed according to a temporal internal-external\nscheme. The predictive quality was assessed with the concordance-index (c-index) and calibration.\nThe model c-indices showed consistent discriminative ability during validation: 0.71 for\noesophageal cancer and 0.68 for gastric cancer. The calibration showed an average slope of 1.0 and\nintercept of 0.0 for both tumour locations, indicating a close agreement between predicted and\nobserved survival. With a fair c-index and good calibration, SOURCE provides a solid foundation\nfor further investigation in clinical practice to determine its added value in shared decision making....
Background: Uterine cervical cancer (UCC) represents a public health problem\nin many part of the world. The use of new technologies is leading to increased\ntreatment costs, resulting in a substantial economic impact worldwide.\nStandardization of economic evaluation methods is needed to improve\ncomparisons between jurisdictions. Objective: To identify the methods used\nto measure the cost of treating invasive UCC, and to search for correlations\nbetween cancer treatment expenditures and local economies. Methods: We\nsearched articles in MEDLINE, LILACS, and SciELO with no language restrictions,\nand included publications from January 01, 2007 to December 31,\n2016. Studies were included if they described the annual direct cost of invasive\ncervical cancer and detailed the costing method. Complete economic\nevaluations were excluded. Results were described in 2016 international dollars.\nResults: Of 1581 studies initially reviewed, 13 articles were included in\nthe analysis. Six articles used a bottom-up; six used a top-down approach\nand one used both. Annual cost per patient varied from 2146.22 (Poland)\nto 34,351.54 (Sweden) International Dollars. Middle-income countries (MIC) spent median\n72.52% of its GDP per capita on the treatment of invasive cervical cancer,\nwhile high-income countries (HIC) spent median 30.12% (p = 0.032). No significant\ndifference was found when separated by costing method. Conclusions:\nWe found that, for the treatment costs of invasive UCC, the percentages\nof GDP per capita were statistically higher in MIC than in HIC. However,\nno significant difference was found between costing methods, and the\ntop-down approach could be used....
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