bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prognostic value of rapid screening tests (RST) in geriatric assessment of patients with cancer over 70.
Authors: Bononi Antonio , Inno Alessandro , Borghi Massimo , Tesi Paolo , Barile Carmen , Crepaldi Giorgio , Menon Daniela , Modena Yasmina , Fraccon Anna Paola , Gusella Milena , Raschella' Guido , Pasini Felice 
Published: March 2020

9554 Background: Comprehensive Geriatric Assessment (CGA) may help to evaluate the functional status of elderly patients, but, because time-consuming, RST have been proposed. However, whether these instruments may predict survival is still unclear. The aim of this study was to correlate overall survival (OS) with the results of 3 rapid tests: G8 (1), VES-13 (2, aCGA (3) in patients over 70. Methods: From April 2009 to April 2012, 530 unelected outpatients over 70, 263 males and 267 females, were evaluated. During the first oncologic visit, they were homogeneously assessed by a trained oncogeriatric team using a dedicated, expressly developed web-based software (www: oncoger.ro.it) including all of the 3 rapid tests. Survival curves were drawn using Kaplan-Meier method and compared with log rank test; multivariate analysis was performed according to Cox regression method. Results: The tests identified frail patients as follows: VES-13 69%, aCGA 50%, G8 68.5%. Frailty was significantly associated with poor OS, with different hazard ratios (HR) for each test. HRs for death of frail vs non-frail pts were for aCGA 1.45 (95%CI 1.09-1.89, p=0.008), for VES-13 1.55 (95%CI 1.12-2.00, p=0.005) and for G8 2.57 (95%CI 1.66-2.93, p<0.0001). In the multivariate analysis including the 8 items of the G8 test, appetite loss (HR 1.44, p=0.002), weight loss (HR 1.28, p=0.003), and personal perception of poor health (HR 1.58, p=0.002) were significantly associated with a higher risk of death. Conclusions: i) Frailty, as identified by RST (VES-13, aCGA, G8), is statistically associated with poor OS; ii) G8 presents the most meaningful HR for OS; iii) appetite loss, weight loss and personal perception of poor health are significantly associated with lower OS.Our data show that RST and in particular G8 represent a useful prognostic tool for the assessment of geriatric patients with cancer.
Integrated oncopalliative care versus standard care for patients with metastatic lung cancer: A single institution retrospective review.
Authors: King Jonathan Douglas , Retseck Janet , Eickhoff Jens C. , Hoang Tien , Traynor Anne M. , Campbell Toby Christopher 
Published: March 2020

9566 Background: Patients with metastatic non-small cell lung cancer (NSCLC) receiving early palliative care (PC) demonstrated improved anxiety, quality of life, and survival compared to standard oncology care (SOC). ASCO clinical practice guidelines recommend concurrent PC and SC be offered to patients with metastatic NSCLC. Our lung cancer clinic is partially integrated with PC. We performed retrospective chart review comparing patients seen in our integrated clinic with SOC patients for survival, trial participation, chemotherapy and hospice utilization. Methods: Charts of all patients with advanced lung cancer from July 2007-June 2011 were reviewed. Eligible patients were those who received any care at our center. Demographic, treatment details, survival, and hospice utilization data were obtained. Overall survival and length of hospice enrollment were calculated for patients treated with PC compared to SOC. Results: Of 207 patients, 82 received PC. Overall survival favored PC (11.9 months vs. 10.1 months, p=0.032). Hospice length of stay (LOS) favored PC (38.5 days vs. 24 days in SOC, p=0.047). There was not a significant difference in lines of chemotherapy, chemotherapy in the last 30 days of life, or trial participation. Conclusions: Our chart review provides confirmatory evidence that early integrated PC in lung cancer patients increases survival and hospice LOS without affecting chemotherapy utilization or trial participation. [Table: see text]
Spiritual/religious struggle in hematopoietic cell transplant survivors.
Authors: King Stephen Duane Watkins , Fitchett George , Pargament Kenneth I. , Peterson Do , Harrison David A. , Johnson Rebecca H. , Martin Paul J. , Loggers Elizabeth Trice 
Published: March 2020

9573 Background: Spiritual/religious (SR) struggle (e.g., feeling abandoned or punished by God) has been associated with poorer coping and quality of life (QOL), greater depression and pain, and health declines in general cancer populations. Few studies have been conducted among survivors of hematopoietic cell transplantation (HCT). This study examined the prevalence and predictors of SR struggle in HCT survivors. Methods: Data were collected as part of an annual questionnaire of adult (age >18 years) survivors of HCT at Fred Hutchinson Cancer Research Center in Seattle, WA. The 2011 survey included a SR module that incorporated the following items: Negative Religious Coping subscale of Brief RCOPE, subscales from the McGill QOL Questionnaire and the SF-36, Patient Health Questionnaire-8, disease information and socio-demographics. SR struggle was defined as any non-zero response on the Negative Religious Coping subscale of the Brief RCOPE. A multi-variable logistic regression model was used to determine factors associated with SR struggle. Results: Of 2113 returned surveys (52% response rate), 83% returned the SR module (n=1745) and of those 1586 were included in this analysis. Subjects were 49% female; 67% Christian and 20% Agnostic/Atheist/No preference; and 91% white. Mean age was 55 years; survivors ranged from 6 months to 40 years post-transplant. Primary indications for transplant were leukemia (49%), lymphoma (20%), and multiple myeloma (15%). Twenty-eight percent indicated SR struggle. In a multi-variable model, SR struggle showed statistically significant associations with age >=65 years (odds ratio [OR] .57, p=.02); patient report of being religious only (OR 3.5, p<.001) or spiritual only (OR 1.8, p<.001) compared to being both religious and spiritual; depression (OR 1.1, p<.001); and better social support (OR 0.77, p<.001). Time since HCT, religious affiliation and race/ethnicity did not show statistically significant associations with SR struggle. Conclusions: SR struggle is common among HCT survivors, even years after HCT.Further study is needed to determine causal relations, longitudinal trajectory, impact of struggle intensity, and effects of SR struggle on health, mood and social roles for HCT survivors.
Assessment of executive function (EF) among pediatric survivors of acute lymphoblastic leukemia (ALL).
Authors: Balsamo Lyn M , Sint Kyaw J , Neglia Joseph Philip , Kadan-Lottick Nina 
Published: March 2020

9584 Background: Childhood ALL survivors are at increased risk of impaired EF. Both parent ratings and performance-based measures are used to identify vulnerable patients. We seek to assess the association between these modalities to 1) each other, and 2) need for special education and stimulants. Methods: This 22-site cross-sectional study included 256 children in remission for standard-risk precursor-B ALL previously enrolled on legacy Children's Oncology Protocols from 1993 - 2000. Patients had no history of CNS leukemia, cranial radiation, or pre-existing neurodevelopmental disorders; were ≥1 year off-therapy; and were 6-16 years at evaluation. Patients were administered performance-based measures of working memory, Digit Span (DS) and Letter-Number Sequencing (LNS) comprising the Working Memory Index (WMI) from the Wechsler Intelligence Scales for Children - Fourth Edition. Patients completed the Controlled Oral Word Association Test (COWAT). Parents completed demographic surveys and a Likert-scale assessment of executive processes, Behavior Rating Inventory of Executive Function (BRIEF). Results: There were modest correlations between BRIEF-WM scale and WMI (r=-0.20, p<0.01) and subscales, DS (r=-0.17, p<0.01) and LNS (r=-0.19, p<0.01). BRIEF-Initiate and COWAT (r=-0.22, p<0.01) were correlated. However, impaired classification based on performance-based measures was a poor predictor of parent assessment classification. The WMI and BRIEF-WM independently predicted receipt of special education (p=0.0017 and 0.0003). The BRIEF-WM and Initiate scales predicted stimulant medication use (p<0.0001 and p=0.0037); however, performance-based measures did not. Conclusions: Rater and performance-based measures provide related, but different information about EF indicating the need for both. Both measurement modalities capture educational difficulties; however, only parent ratings are associated with stimulants. This may reflect the medication's success in modifying cognition in controlled environments and the BRIEF's sensitivity to the child's ability to execute tasks in the real-world setting.
Thromboembolic events in breast cancer patients: A large series.
Authors: Reboucas Danilo Souza , Thuler Luiz Claudio Santos , Costa Maria Eduarda Ferro , Garces Alvaro Henrique Ingles , Aquino Luciana Carla Martins de , Bines Jose 
Published: March 2020

9589 Background: Breast cancer is frequently associated with thromboembolic events (TEE). TEE may result in significant morbidity, a substantial economic burden and they represent a leading cause of death. Methods: We conducted a case-control study to analyze patients’ baseline and treatment characteristics in predicting TEE occurrence as well as the prognosis of breast cancer patients with thromboembolic events. We identified all breast cancer patients with a TEE at INCA (Brazilian National Cancer Institute), between January 2007 and December 2011. The control group consisted of breast cancer patients that had a doppler ultrasound with normal findings during the same period. Variables found to be significant (P <0.10) by univariate analysis were subsequently entered into a multivariate logistic regression model. We used Kaplan-Meier and Cox regression for survival analysis. Results: Overall, 225 patients that developed TEE were compared to 225 matched controls. The majority of events were deep vein thrombosis of the lower extremity (78.7%) and unilateral (94.2%). Most TEE occurred within the first 3 years after the diagnosis of cancer (66.2%), with the highest incidence observed in the initial 6 months. Factors associated with the development of TEE were: age above 50 years (OR 1.85, 95% CI: 1.16 to 2.95), ECOG performance status (PS) equal to or above 3 (OR 2.01, CI 95%: 1.24 to 3.26) and the presence of a central venous catheter (CVC) (OR 2.56, 95% CI: 1.42 to 4.62). The occurrence of TEE led to systemic treatment changes (44.9%) and, most importantly, it was associated with decreased survival (HR = 1.34, 95% CI: 1.01 to 1.77, p = 0.041). Conclusions: This large retrospective analysis of TEE in breast cancer patients confirms that most events occur early in the treatment course. The incidence of TEE was associated with patients’ age, PS, and the presence of CVC. Prospective studies are needed to evaluate outpatient thromboprophylaxis for selected groups of patients.
Five-year trajectories of financial recovery in low-income breast cancer survivors.
Authors: Blinder Victoria Susana , Patil Sujata , Gany Francesca , Maly Rose C. 
Published: March 2020

9597 Background: Breast cancer may have devastating consequences on the financial stability of low-income families due to its impact on employment and limited duration of emergency Medicaid coverage. Methods: A consecutive sample of 921 low-income, uninsured/underinsured, English/Spanish-speaking women diagnosed with breast cancer through the California Breast and Cervical Cancer Treatment Program was surveyed 6 months after diagnosis. Previously uninsured women were enrolled in MediCal. Follow-up surveys were administered at 18, 36, and 60 months. Our primary outcome was self-reported adequacy of financial resources. Trajectories of financial adequacy were compared by ethnicity and by trajectories of employment and insurance status. Results: 6 months after diagnosis, 38% said they had adequate financial resources to meet their needs, compared to 39%, 49%, and 55% at 18, 36, and 60 months, respectively. Trajectories of financial adequacy varied by ethnicity and by trajectories of employment and insurance status (Table). Of 549 who reported on financial resources in all 4 surveys the most common trajectory was inadequate resources in all surveys (n=120) followed by adequate resources in all surveys (n=83). Of 208 who had adequate resources at 6 months, 60% reported inadequate resources in ≥1 subsequent survey. Of 341 who had inadequate resources at 6 months, 87% reported inadequate resources in ≥1 subsequent survey. Conclusions: Low-income breast cancer survivors are at risk of long-term financial instability. Latinas and survivors who are not working and/or are uninsured are at highest risk. Additional research is needed to better understand the factors that impact financial recovery after treatment. [Table: see text]
Young adult cancer survivors' (CS) follow-up care expectations of their primary care providers (PCPs) and oncologists.
Authors: Kumar Divjot Singh , Moghaddamjou Ali , Cheung Winson Y. 
Published: March 2020

9598 Background: The delivery of cancer survivorship care can be complicated by a lack of clarity surrounding physician roles during follow-up. This can be particularly challenging for young adult CS who face unique needs. Our aim was to characterize young CS’ follow-up care expectations of their PCPs and oncologists. Methods: A self-administered survey was mailed to all CS diagnosed with cancer from 2005 to 2009, aged 20 to 39 years at the time of diagnosis, evaluated at any 1 of 5 regional cancer centers in British Columbia, and lived beyond 2 years. The questionnaire focused on demographics, prior treatment, and CS attitudes regarding physician responsibilities during survivorship, specifically their views about their PCPs’ and oncologists’ roles. Descriptive statistics and regression analyses were used to summarize these expectations and to determine if they differed based on physician type. Results: A total of 426 patients were included (response rate 59%): current median age was 40 years (range 24-45) and 301 (71%) were women. Common tumor sites were breast (48%), testicular (27%), and gynecological (18%). Most patients (63 and 65%, respectively) expected PCPs to be responsible for following their most recent cancer and screening for future cancers. Nearly all (85 and 93%, respectively) indicated that PCPs should also provide preventive care and manage their co-morbidities. Conversely, a significant proportion (65%) felt that oncologists should remain responsible for addressing side effects of cancer treatments throughout survivorship. In terms of fertility discussions, half of patients viewed this as a role for oncologists whereas the remainder perceived this to be more suitable for PCPs. Interestingly, neither PCPs nor oncologists were seen to have any significant role in addressing social reintegration, interpersonal relationships, or sexual function, with <30% of respondents expecting these to be discussed by either physician. Conclusions: Young adult CS expect PCPs to be responsible for most aspects of their ongoing care. More clarity regarding physician roles is required with respect to specific survivorship issues, such as fertility, sexual function and psychosocial health.
Discriminatory power of a 25-item distress screening tool CancerSupport Source: A cross-sectional study of 251 cancer survivors.
Authors: Miller Melissa F , Mullins C. Daniel , Onukwugha Ebere , Gayer Christopher , Golant Mitch , Buzaglo Joanne S. 
Published: March 2020

9599 Background: Distress screening and integrated psychosocial care is imperative for cancer patients, yet no tools are specifically tailored for the community provider setting where the majority of US patients are treated. Any screening tool must be validated and effective at discriminating those at risk for greater distress and the associated poorer health outcomes. The study objective was to test the discriminatory power of a 25-item distress screening tool CancerSupportSource for use among cancer survivors. Methods: A total of 251 members (90% female, median age 57 years; mixed diagnoses, 46% breast, 9% gynecologic, 7% blood, 6% colorectal, 32% other) of a community-based cancer support network completed a web-based distress screening tool. Participants were asked to rate each of 25 items according to the question “Today, how concerned are you about…?” using a five-point scale (0 not at all to 4 very seriously concerned). A summary score was calculated as the count of items rated ≥2 and the item discrimination index (IDI) as the difference between proportions of high and low scorers rating an item≥2. Cut-points at 13 and 4 yielded equal-sized groups and were used to classify participants as high (n=59) and low scorers (n=60). Results: Items with the greatest discriminatory power (IDI≥0.8) were: changes or disruptions in work, school or home life; worrying about the future and what lies ahead; feeling too tired to do the things you need or want to do; feeling sad or depressed; ability to exercise or be physically active; and feeling nervous or afraid. Conversely, items with the lowest IDI included: eating and nutrition; tobacco or substance use; transportation to treatment and appointments; considering taking your own life. Conclusions: The results highlight, among 25 items of a distress screening tool, those items with the greatest discriminatory power to identify cancer survivors with psychosocial distress. Results suggest priority areas for distress screening and referral for support services.
Bridging to survivorship in breast cancer: Learning how treatment impacts mental health among early-stage breast cancer survivors.
Authors: Patt Debra A. , Espirito Janet L. , Turnwald Brian , Harrell Robyn K. , Bhowmik Debajyoti , Hoverman J. Russell , Brooks Barry Don , Denduluri Neelima , Beveridge Roy A. 
Published: March 2020

9604 Background: Depression (D) and anxiety (A) complicate survivorship in breast cancer (BC) patients (pts). The prevalence of D and A after BC treatment (Tx) in the community and concordance with BC Tx type is poorly described, but vitally important to characterize risks of Tx and optimize support for BC pts and goals for survivorship care planning. Methods: We queried the electronic health record (EHR), iKnowMed, from a a large network of community oncology practices for pts treated with stage I-III breast cancer from 2007-2010 with at least 5 visits and follow up through 2012 for our retrospective study. We excluded pts who developed metastatic disease or died. We stratified pts by chemotherapy (CT) utilization (yes/no),hormone receptor (HR) status, age, and documented body mass index (BMI) at diagnosis, and post diagnosis development of D (y/n), A (y/n) or utilization of venlafaxine (E) like antidepressants (Ads), non-E like Ads or anti-A medications within the study period. Time to onset of A or D was analyzed using Cox proportional hazard methodology. Results: We identified 8,506 patients with a documented BMI at 1, 2, and 3 years (yrs) post diagnosis. 4369(51%) of patients received adjuvant CT and 4137 (49%) did not. Baseline characteristics were similar between tx groups, and active D or A was low at the time of dx, but as a whole rose to 41% during the study period. Pts with pre-existing D or A at the time of diagnosis were excluded. CT increases the risk of D or A (HR: 1.23, CI: 1.15-1.33). HR+ status also increases the risk of D or A (HR: 1.21, CI:1.11-1.32). Age conveyed a small diminished risk of D or A (HR: 0.98, CI: 0.98-0.99) while baseline BMI conveyed a small increased risk (HR: 1.02, CI 1.01-1.3). When excluding E like compounds that are often used to treat hot flashes in BC pts, CT was still found to have an increased risk of D or A (HR: 1.28, CI: 1.18-1.39), and HR+ was still associated with higher risk of D or A as well (HR: 1.11, CI: 1.01-1.22). Conclusions: Mental health disorders such as D and A are common among BC survivors, and more prevalent among BC survivors who received CT and have HR+ disease. This warrants further investigation on how to evaluate and support the mental health needs of BC survivors.
Who is receiving survivorship care plans? Findings from the 2012 Livestrong survey.
Authors: Rechis Ruth , Bann Carla , Nutt Stephanie , Squiers Linda , Rao Naveen 
Published: March 2020

9608 Background: There are more than 14 million cancer survivors in the US – a number that is on the rise. Care coordination resources will be essential to provide support to this growing population. Key stakeholders, including the Commission on Cancer (CoC) and the Institute of Medicine, have proposed survivorship care plans (SCPs) as a way to extend support. However, limited research has been conducted to date on SCPs. Methods: In 2012, the LIVESTRONG Foundation (LIVESTRONG) administered a survey to understand the role of a treatment summary (TS) and SCPs and how they fit into survivors’ care. Logistic regression models were conducted to identify factors associated with receiving SCPs or TS. Results: 5,303 survivors responded to these questions (Table). While 92% of these respondents received information about where to return to for cancer check-ups, only 51% reported receiving a TS and 17% reported receiving a SCP. Survivors who were more likely to receive SCPs if they had a navigator (p<.001) and if they were male, Black, had finished treatment within the past year, or received care at a university-based medical center or community cancer center (p < 0.05). Also, those receiving a SCP were significantly more likely to have had a detailed discussion with a provider regarding long-term side effects, emotional needs, and lifestyle recommendations. Specifically, 60% of those with a SCP discussed long-term effects compared to 39% who did not. Conclusions: Results here indicate that few survivors receive SCPs but survivors reported benefits from receiving them. Currently many workflow barriers impede delivering SCPs, and LIVESTRONG is working with key stakeholders including the CoC to automate the LIVESTRONG Care Plan powered by Penn Medicine’s OncoLink through a registry and EMR system to understand how to address this issue. [Table: see text]