Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 5 Articles
Background: Breast cancer screening mammography is widespread in industrialised countries within the\nframework of public health program or opportunist form. Only few data exist on the comparison of effectiveness\nbetween organised and opportunistic screening. The aim of this study is to compare organised and opportunistic\nscreening using population-based data from the Fribourg cancer registry, Switzerland.\nMethods: We included all first primary breast adenocarcinoma diagnosed between 2006 and 2014 in women aged\n50â??69 years resident in the canton of Fribourg. We considered only breast cancer discovered by mammography\nscreening. We compared patients, tumour characteristics and treatment modalities between breast cancer detected\nby the organised screening program versus opportunistic screening using logistic regression.\nResults: Out of 989 patients diagnosed with breast cancer, 402 (40.6%) were diagnosed by organised and 205 (20.\n7%) by opportunistic screening. Women with breast cancer detected within the screening program were more\nlikely to be from rural areas (P = 0.035) and lived less frequently in high favoured regions (P = 0.020). They presented\nmore frequently in situ than invasive cancer (P = 0.022). For patients with invasive breast cancer, those detected by\nthe program were less likely to undergo mastectomy (P = 0.06) and consequently, they were more likely to undergo\nradiation therapy (P = 0.003). Adjustment for area of residence and financial context of the region did not modify\nthe results presented.\nConclusions: The present study reports an increased rate of detection of carcinoma in situ in organised screening\nprogram as compared to opportunistic screening mammographies, an indirect evidence of a higher radiologic\nsensitivity. Furthermore, the results show a trend towards more mastectomies among patients with breast cancer\ndiscovered after opportunistic than after organized mammography screening, reflecting lower treatment burden.\nThose results were independent of socio-economic factors which differed across screening groups....
Background : NCCNâ??s guidelines for the diagnosis and treatment of rectal\ncancer suggest that accurate preoperative clinical staging of rectal cancer is\nvery important. Reliable preoperative evaluation is the key to the development\nof surgical protocols, in order to investigate the diagnostic value of digital\nrectal diagnosis for lymph node metastasis of middle and low rectal cancer.\nMethods : We prospectively performed digital rectal examination in 258\npatients with mid-low rectal cancer before operation, to analyze the distance\nfrom the lower margin of the tumor to the margin of the anus, the diameter\nof the invasion of the intestinal wall of the tumor, the accuracy between the\ngeneral type and depth of invasion of the tumor and the pathological results\nof the postoperative specimen, and the predictability of the lymph node metastasis\nrate of the rectal digital examination. Results : The results of the analysis\nshowed that the above indicators and postoperative pathological findings\nhave high accuracy. Conclusions : It is concluded that accurate and detailed\ndigital rectal examination before operation can predict lymph node metastasis\nrate of mid-low rectal cancer at a higher level and accurately....
Background: Only a few patients with pancreatic ductal adenocarcinoma (PDAC) recurring after curative resection\nand peri-operative (neoadjuvant and adjuvant) therapy are included in clinical trials of metastatic PDAC. As such,\nthere is a paucity of data to guide treatment after relapse, and patients are treated similarly to those with de novo\nmetastatic PDAC (mPDAC). We evaluated the patterns of chemotherapy use and over-all survival (OS) in patients\nwith recurrent PDAC (rPDAC) following curative therapy.\nMethods: In this retrospective study, the Indiana University pancreatic cancer database was used to identify\npatients with PDAC who underwent curative resection and subsequently developed recurrence. Demographics,\ntumor and treatment characteristics were collected. Patients were broadly divided into those who received\nchemotherapy for rPDAC and those who did not. Patients in the former category were further subdivided into\nthose who received single agent therapy, any standard combination therapy (5-fluorouracil/irinotecan/oxaliplatin\ncombination or gemcitabine/nab-paclitaxel) and those who received non-standard combinations. Survival analysis\nwas performed by the Kaplan-Meier method. Log rank tests were used to determine differences in survival between\ntreated rPDAC patients and those not treated. Cox regression analysis was employed to evaluate factors associated\nwith OS.\nResults: We identified 435 patients with resected PDAC treated between 2008 and 2014. Two hundred and twentythree\npatients (51.2%) were diagnosed with rPDAC. Of these, 140 patients (63%) received chemotherapy whereas 71\npatients (32%) did not receive chemotherapy. The 74 patients (53%) who received any standard, approved\nmultiagent combination regimen had a median OS of 14 months compared to 8 months for the 47 patents (34%)\nwho received other non-standard combinations and the 19 (13%) who received single agent therapy (P = 0.029).\nMultivariate cox regression analysis showed that margin negative resection, peri-operative therapy, radiotherapy\nand the use of any chemotherapy for rPDAC were associated with improved OS.\nConclusion: Our findings support the use of standard approved multi-agent therapy in rPDAC. Patients derive\nsignificant benefit from these standard combination therapies with median OS that is comparable to what is\nobserved with treatment for de novo mPDAC....
Background: Several accomplishments have been achieved in triple-negative breast cancer (TNBC) research over\nthe last year. The phase III IMpassion130 trial comparing chemotherapy plus atezolizumab versus chemotherapy\nplus placebo brought breast cancer into the immunotherapy era. Nevertheless, despite encouraging results being\nobtained in this trial, many open questions remain.\nMain body: A positive overall survival outcome was achieved only in PD-L1+ TNBC patients, suggesting a need to enrich\nthe patient population more likely to benefit from an immunotherapeutic approach. Moreover, it remains unknown\nwhether single-agent immunotherapy might be a good option for some patients. In this context, the discovery and\nimplementation of novel and appropriate biomarkers are required. Focusing on the early onset of TNBC, neoadjuvant\ntrials could represent excellent in vivo platforms to test immunotherapy agents and their potential combinations, allowing\nthe performance of translational studies for biomarker implementation and improved patient selection.\nConclusion: The aim of our review is to present recent advances in TNBC treatment and to discuss open issues in order\nto better define potential future directions for immunotherapy in TNBC....
Background: To explore prognostic value of the pre-treatment primary lesion apparent diffusion coefficient (ADC)\nin locoregionally advanced nasopharyngeal carcinoma (LA-NPC).\nMethods: A total of 843 patients with newly diagnosed LA-NPC were enrolled from January 2011 to April 2014 and\ndivided into two groups based on ADC values: the low-ADC group and high-ADC group. The 3-year local relapsefree\nsurvival (LRFS), distant metastasis free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates\nbetween two groups were compared using Kaplan-Meier curve, and Cox regression analyses were performed to\ntest prognostic value of the pretreatment ADC in LA-NPC..........................
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