bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of VAC temporization following the excision of microinvasive sarcomas pending negative formal pathologic margins.
Authors: Fourman Mitchell Stephen , Ramsey Duncan C. , Newman Erik T. , Schwab Joseph H. , Chen Yen-Lin , DeLaney Thomas F. , Mullen John Thomas , Raskin Kevin , Lozano-Calderon Santiago 
Published: June 2021

e23559 Background: Microinvasive sarcomas can yield a high number of false negative intraoperative pathology margin analyses. Additional oncologic resection after soft tissue coverage is technically challenging and oncologically inaccurate. As a result the rate of local recurrence for these histologies can be 25% or higher. In select patients we have temporized the sarcoma tumor bed with a wound VAC pending final pathologic margins. If positive, the patient can return to the OR for a tumor bed excision. If negative, soft tissue coverage can proceed. Here we evaluate our outcomes using this approach. Methods: We retrospectively studied patients with primary sarcomas managed with a VAC temporizing approach from from 1/1/2003 to 12/1/2019 with a minimum of 2 years of oncologic follow-up. Patients with unplanned ("oopsie") excisions were also included. Our primary outcome was local recurrence. Data is presented as percentages or mean ± standard deviation where appropriate. Results: Sixty-three patients were included (Table). Mean age was 62.3 ± 22.3 (median 67.3) years, 23 (36.5%) were female, and mean age-adjusted charlson comorbidity index was 5.3 ± 1.9. Twenty-four (38.1%) had undergone “oopsie” excisions. R0 margins were achieved in 59 (93.7%) patients, while the other 4 were known R1 resections due to patient tolerance or anatomy. Five local recurrences (7.9%) were diagnosed 3.2 ± 1.5 years after surgery, of which 3 had known positive margins. Free flaps were needed in 17 (27.0%) patients. Metastatic disease was diagnosed in 8 (12.7%) patients, who all died of disease. Mean follow-up was 4.4 ± 2.9 years. Conclusions: VAC temporization results few local recurrences in patients with formally confirmed negative margins. This technique is particularly useful in the treatment of microinvasive disease or in the management of vulnerable hosts who may not be able to tolerate additional surgery in the future.[Table: see text]
Impact of the geriatric assessment on clinical treatment decision in older Indian persons with cancer.
Authors: Noronha Vanita , Ramaswamy Anant , Patil Vijay Maruti , Gattani Shreya , Menon Nandini , Mahajan Sarika , Castelino Renita , Dhekle Ratan , Daptardar Anuradha , Gota Vikram , Banavali Shripad Dinanath , Prabhash Kumar , Badwe Rajendra A. 
Published: June 2021

e24015 Background: The geriatric assessment (GA) is a multidimensional evaluation of an older person. Identification of the non-oncologic vulnerabilities, estimation of life expectancy and chemotherapy risk prediction aid the clinicians in the therapeutic risk-benefit ratio analysis. Globally, GA leads to changes in oncologic decisions in 28% of patients. Methods: An observational study with a retrospective and prospective cohort of patients who underwent a GA in the geriatric oncology clinic at the Tata Memorial Hospital in Mumbai, India. The study was approved by the institutional ethics committee (IEC) and registered with Clinical Trials Registry of India-CTRI/2020/04/024675. Written informed consent was obtained from the patients enrolled in the prospective part of the study; the IEC granted a consent waiver for the retrospective portion of the study. Patients aged 60 years and older with a diagnosis of malignancy were evaluated in the geriatric oncology clinic. The results of the GA were entered in the electronic medical records (EMR). The systemic therapy plan prior to the GA and the actual therapy plan made were retrospectively captured from the EMR. The primary objective was to determine the proportion of patients in whom the systemic therapy plan was changed following the GA. Results: Between June 2018 and Feb 2021, 340 patients were evaluated in the geriatric oncology clinic for whom the pre-GA and post-GA systemic therapy plans were available. The median age was 70 years (range, 60-100); 264 (78%) were men. The common malignancies were lung cancer in 134 (39.4%) and gastrointestinal in 119 (35%). The intent of therapy was palliative in 190 (56%) patients. Following the GA, the systemic therapy plan was changed in 125 (36.8%) patients. The most common change was deintensification of therapy in 106 patients (31.2%), including dose reduction in 41 (12%), decrease in the number of chemotherapy medicines in 8 (2.4%), substitution of chemotherapy by targeted therapy (4, 1.2%)/oral hormonal therapy (4, 1.2%)/oral TKI (11, 3.2%)/immunotherapy (2, 0.6%) and withholding systemic therapy in 36 (10.6%) patients. Withholding systemic therapy consisted of a change from chemoradiotherapy to radical radiation alone in 17 (5%), withholding neoadjuvant or adjuvant chemotherapy in 5 (1.5%) and a change to best supportive care in 14 (4.1%). Conclusions: The results of the GA led to a change in the management plan in over one-third of older Indian patients with cancer. GA is an important tool in the oncologic decision-making process for older persons with cancer. Clinical trial information: CTRI/2020/04/024675.
Psychometric properties of patient reported outcome (PRO) instruments in patients with small cell lung cancer (SCLC) in RESILIENT part 1.
Authors: Kokhreidze Jaba , Allen Veleka , Ivanescu Cristina , Yao Xiaopan Valerie , Zhang Bin , Harrow Brooke 
Published: June 2021

e24027 Background: The ongoing two-part phase 2/3 RESILIENT study (NCT03088813) is investigating the efficacy and safety of liposomal irinotecan monotherapy in patients with SCLC who have progressed on or after first line platinum-based chemotherapy. This exploratory analysis from RESILIENT part 1 was conducted to confirm the psychometric properties of established PRO instruments that had not previously been validated in patients with SCLC. Methods: Patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) Core 30 (C30) and the EORTC QLQ Lung Cancer 13 (LC13) before treatment assignment (baseline), every 6 weeks thereafter, at treatment discontinuation and at the 30-day follow-up visit. Psychometric methods included descriptive statistics (items and scales), correlations (item-to-item and item-to-total), internal consistency (Cronbach’s α), test-retest reliability (intraclass correlation coefficient [ICC], two-way random effects model), construct validity and sensitivity to change. The analysis included patients who received at least one dose of study drug and completed at least one PRO assessment. Results: Thirty patients were enrolled in RESILIENT part 1 and included in the analysis. At baseline, 68% of patients reported ‘not severe’ or ‘mild’ symptoms. Floor effects (i.e. more than 25% of responses of ‘not at all’) were observed for several of the functioning/impact and symptom scales of the EORTC QLQ C30 and LC13. Moderate to strong correlations were found among most questionnaire items within their respective scales. Acceptable evidence for internal consistency and good test-retest reliability were observed. Selected results for the EORTC QLQ LC13, including dyspnea scales, are shown in the Table. The magnitude of correlations among PRO instruments supported evidence for convergent validity in this sample. Conclusions: In RESILIENT part 1, patients experienced low and tolerable symptoms at enrollment, limiting the potential for further improvement. Overall, these PRO instruments had acceptable psychometric properties (e.g. construct validity, reliability and ability to detect change) in this sample. However, these analyses should be repeated in a larger sample using data from RESILIENT part 2. Clinical trial information: NCT03088813. [Table: see text]
COVID-19 and cancer: Strategic health promotion for indigenous Australians during a pandemic.
Authors: Der Vartanian Carolyn , Milch Vivienne , Garvey Gail , Anderiesz Cleola , Salisbury Jane , Woods Candice-Brooke , Austen Melissa , Wang Rhona , Keefe Dorothy Mary Kate 
Published: June 2021

e24028 Background: Given the impact of COVID-19 on Indigenous and ethnic minority populations observed globally, keeping COVID-19 out of vulnerable Aboriginal and Torres Strait Islander (Indigenous Australian) communities remains a priority. Compared to non-Indigenous Australians, Indigenous Australians experience disparities in cancer incidence and outcomes due to social disadvantage, increased cancer-related modifiable risk factors, poorer access to health services and lower participation in screening. During the pandemic, cancer-related investigations and treatment reduced significantly in Australia, leading to potential decreases in cancer diagnoses and consequences for future survival outcomes. Concerned about the risk of morbidity and mortality due to COVID-19 for Indigenous Australians, as well as worsening cancer outcomes, Cancer Australia undertook strategic health promotion initiatives, to inform and support optimal cancer care. Methods: In consultation with respected Indigenous colleagues to ensure cultural appropriateness of language and information, we published a dedicated webpage titled ‘ Cancer and COVID-19 – what it means for our Mob*’ with tailored information, advice, and links to key resources and support services for Indigenous Australians. We also released a video titled ‘ Act early for our Mob’s Health’, providing targeted, culturally appropriate, consumer-friendly information to encourage Indigenous Australians to see their doctor or Aboriginal Health Worker with symptoms that may be due to cancer. Results: The information hub has been well-received among the Indigenous Australian community, receiving over 3,200 visits, and the social media campaigns have received over 1.4 million impressions and 46,000 video views between mid-March 2020 to mid-February 2021. This campaign has supported proactivity among the Indigenous population in keeping their communities safe during the pandemic, maintaining a population rate of COVID-19 of less than one percent of all confirmed cases in Australia. Conclusions: Culturally appropriate information and resources developed through the process of co-design can help to influence positive health behaviour change in Indigenous populations. We predict that our strategic, multi-channel health promotion campaign is contributing to keeping the Indigenous Australian community safe and informed during the pandemic, with additional work needed to monitor cancer rates and outcomes and address the ongoing information needs of the community. *Mob is a colloquial term to identify a group of Indigenous Australians associated with a family or community from a certain place.
An analysis of content of lay-press articles focused on cancer from leading U.S. newspapers from 2010 to 2019.
Authors: Adwetewa-Badu Abena A. , O'Keefe Ryan M , Callahan Joseph X. , Taylor Catherine A. , Gjino Chris P. , Hill-Kayser Christine E. 
Published: June 2021

e24032 Background: Newspaper coverage of cancer-related topics has historically focused on research, treatment, survival, and impact of tobacco and diet on risk, with less coverage of prevention, death, and palliation/hospice. Coverage tends to be driven by celebrity and other seminal events, and highest during awareness-months, with over and under representation of breast and lung cancers, respectively, based on incidence. We sought to understand evolving trends in coverage over the last decade at 3 major U.S newspapers to identify areas for improvement for education, inclusion, and public health messaging. Methods: On 10/13/20, Factiva was queried with the keyword “cancer” for articles > 150 words published by NYTimes, Washington Post, and Wall Street Journal between 2010-2019. The top 100 articles by “relevance” were selected for each, representing 14.9% of all the 2016 hits. A coding scheme was created using articles from the same query for 2020; inter-rater reliability analysis between coders was conducted with a sample of 30 articles (10% of final set), and kappa-fleiss scores were calculated. Articles were excluded if they did not focus on cancer, or were an obituary, financial report, or editorial. Results: 230 articles were included. Kappa-fleiss scores were 0.74 - 1, suggesting excellent agreement between coders. 102 (44.3%) focused on research, 50 (21.7%) individual disease narratives, 22 (9.6%) drug development, 15 (6.5%) policy or regulation. 136 articles focused on one sub-type; breast (53, 39.0%) was most common, followed by colorectal (13, 9.6%), leukemia/ lymphoma (12, 8.8%), prostate (11, 8.1%), pancreatic (9, 6.6%), and lung (8, 5.9%). 154 articles discussed research; 22 (14.3%) non-human research. Commonly covered topics included pharmaceuticals (128, 55.7%), risk factors (71, 30.9%), cost of care (66, 28.7%) and adverse effects (58, 25.2%). Risk factors discussed included smoking (22, 31.0%), diet (21, 29.5%), and alcohol (7, 9.9%). Less common topics were radiation (18.7%), insurance coverage (13.9%), celebrities (12.6%), death (8.7%), race (4.3%), and disparities (3.9%). 156 (67.8%) provided quotes from HCPs/researchers, 59 (25.7%) patients, 17 (7.4%) families or other supports. 22 (9.6%) titles had “war” terminology; 13 (5.7%) had the word “may”. Conclusions: Most articles focused on research or personal narratives, most commonly in context of breast, colorectal, and leukemia/lymphoma. Pharmaceutical treatments were the most discussed content topic. Compared with previous analyses, risk factors, adverse effects, and cost of care were discussed more often. However, race, disparities, death, and end-of-life topics remain uncommon. There was good representation from the healthcare and scientific community; opportunities exist to include more educational information on risk and adverse events, as well as patient and family perspectives.
Knitting to improve cognition and reduce stress in cancer survivors: A pilot study.
Authors: Hartzell Jennifer W , Yaguda Susan , Boselli Danielle 
Published: June 2021

e24049 Background: Cancer-related cognitive impairment (CRCI), or “chemo brain,” is defined by mild cognitive changes before, during or after cancer treatment. Objective deficits on neuropsychological tests are mild, while distress about cognitive issues is often high and interventions are lacking. Skill learning, which relies upon implicit memory, promotes functional and structural neuroplasticity. This has not been explored in CRCI. We designed a standardized protocol for learning to knit over 8 weeks and recruited consecutive cancer patients with subjective cognitive concerns. Cognition and perceived stress were assessed before and after learning to knit. Methods: Sixteen cancer survivors (N=16) without any known central nervous system disease or prior knitting experience completed the study. All were female and >80% were Caucasian. Mean age was 54 (SD=7) years. Mean education was 16 (SD=2) years. Neuropsychological tests were selected based on sensitivity to frontal lobe functions and memory and resistance to practice effects. Cognition and perceived stress were measured before and after the intervention, summarized, and compared using paired t-tests. P<0.1 was considered statistically significant. Clinically significant cognitive change was defined by ≥1 standard deviation change between pre- and post-intervention standardized scores. Results: Baseline cognitive function was average across domains. Baseline perceived stress was moderately high. At post-testing, there were statistically significant improvements in perceived stress, cognitive flexibility, and psychomotor speed. After controlling for demographic factors, clinically significant improvements in attention and memory were seen in 38% and 25% of subjects, respectively. 69% had clinical improvement in at least one cognitive domain. Conclusions: Learning to knit produced statistically and clinically significant improvements in cognition and perceived stress in cancer survivors in 8 weeks. Most had clinical improvement in at least one cognitive domain. This skill-based pilot study suggests functional neuroplastic change is possible in selected female, college-educated cancer survivors in a short timeframe and without technology use. Future research on the impact of skill learning on cognition and stress in larger, more diverse samples of cancer survivors may yield much needed interventions for CRCI.[Table: see text]
A cross-sectional study on the effectiveness of antiemetic regimens for chemotherapy-induced nausea and vomiting: A single center retrospect study of 1,000 patients.
Authors: Cong Luo , Shang Mingge , Chen Lei , Qi Xu , Jingjing Li , Wei Qing , Ying Jieer 
Published: June 2021

e24055 Background: Chemotherapy-induced nausea and vomiting (CINV) is a common symptom in patients who undergoing chemotherapy, it is very important to control CINV to maintain dose intensity and patients' quality of life. To analyse the current situation of CINV for the tumor patients who undergoing chemotherapy, we used a cross-sectional survey to assess CINV status in those patients, and whether the drugs used by doctors in each department met the guidelines, and compared the efficacy of different antiemetic regimens on acute and delayed CINV overall post-chemotherapy periods. Methods: 1,000 patients were randomly selected from 5,468 patients with chemotherapy discharged from different departments of Zhejiang cancer hospital in China between April 1 and April 30, 2019, and there were 87 responses totally. Medical records were collected on patient’s department (internal medicine, surgery, radiotherapy, interventional) , chemotherapy regimens, anti-vomiting program, etc. Patients' feedbacks were recorded by CTCAE4.03 standard using MASCC antiemetic tool (Mat). Participants reported the frequency, severity, and impact on daily life of CINV from the day of chemotherapy administration up to 5 days thereafter and nausea and vomiting, as well as pharmacologic and chemotherapy used. Results: A total of 66 antineoplastic drugs were investigated, of which 52 were given intravenously and 14 orally.There were 9, 7, 50 drugs with high, moderate and low emetic risk respectively.The most prescribed prophylactic regimens for the management of CINV were aprepitant, 5-HT3R, H1-RA and dexamethasone and metoclopramide. The overall incidence of CINV were 44.34%, 24.57% and 39.66% patients reported nausea or vomiting in the acute and delayed phases. 19.89% patients had both acute and delayed CINV. The consistency rate of antiemetic with guideline was 63.19% in internal medicine department, 61.41% in surgery department and 52.91% in radiotherapy department, which showed a significant gap between the actual use of drugs and the recommended guidelines(P = 0.001). In 875 patients, 518 patients received guideline recommended antiemetic regimen, the CINV rates of complete response (CR), defined as no vomiting with no rescue medication, were 61.58%. While the CR rates in other 357 patients were 47.06%(P < 0.001). Nausea was more frequent across the overall observation period(43.77% VS 18.86%). However, vomiting was more sever and had a greater impact on life than nausea. Conclusions: Overall, adherence to the guideline recommendations in different departments were poor with varying degrees. Future studies should set hard outcomes, such as the absence of any symptoms, as a primary end point.The standardized management of CINV in patients needs to be further strengthened and doctors need to use drugs more regularly to reduce the occurrence of CINV in patients.
State variation in marijuana use among U.S. adults with cancer.
Authors: Lee Min Jee , Adjei Boakye Eric 
Published: June 2021

e24064 Background: The number of cancer survivors in the United States (U.S.) is projected to exceed 20 million by 2024. More and more U.S. states are legalizing marijuana use for both recreational and medicinal purposes. This study estimated the prevalence of marijuana use by state among adult cancer survivors. Methods: U.S nationally representative, cross-sectional data from the 2018-2019 Behavioral Risk Factor Surveillance System Survey (BRFSS) Marijuana Use module were used. A total of 13,174 cancer survivors in 17 states was included. Analyses were weighted to account for BRFSS’s complex survey design with results generalizable to 5.7 million cancer survivors. The outcome variable was marijuana use in the past 30 days. Weighted prevalence estimates were computed. Weighted, multivariable logistic regression model estimated the association between state and marijuana use, adjusting for sociodemographic, health, and healthcare factors. Analyses were performed in January 2021. Results: The prevalence of past-month marijuana use among adult cancer survivors in these states was 9.2%. States varied widely in terms of the prevalence of marijuana use. Marijuana use was higher among those who resided in Guam (15.9%), followed by New Hampshire (13.1%), and lowest for those in Puerto Rico (3.3%) ( p< 0.0001). In the adjusted models, compared with the adult cancer survivors residing in California, those living in Maryland, Minnesota, North Dakota, Ohio, South Carolina, Tennessee, Utah, West Virginia, and Wyoming were significantly less likely to use marijuana. Conclusions: Nearly 9% of adult cancer survivors used marijuana, and those who resided in Guam, New Hampshire, Florida, and California are at higher risk for marijuana use. Given the increasing number of cancer survivors and the proliferation of marijuana legalization, identifying high-risk cancer survivors for marijuana use and informing physicians and patients about safe uses and doses and the potential adverse effects of marijuana use is critical.
A national survey on cancer pain management among medical oncologists in the Philippines.
Authors: Mendoza Marvin Jonne Limbo , Chua Alfredo Viray , Tan Patricia Grace Chua , Dofitas Carla Bonifacio , Villano Emmanuell , Santos Maria Dolma Gudez , Strebel Heinrik Martin Jude Sampedro 
Published: June 2021

e24071 Background: Pain is one of the most burdensome symptoms of cancer. Although cancer pain management is an integral component in the practice of oncology, many patients still complain of insufficient pain control. Therefore, there is a need to pursue and strengthen strategies on how to adequately and effectively manage cancer pain. This study aimed to determine the knowledge and attitudes of Filipino medical oncologists regarding cancer pain management. It also examined the practices and perceived barriers in managing cancer pain. Methods: This was a cross-sectional study which utilized a validated questionnaire designed to assess a physician’s knowledge on pain management and opioid therapy, perceptions of the adequacy of cancer pain management, and significance of various potential barriers in optimal cancer pain management. Results: Out of the 280 PSMO members practicing in the Philippines, 85 responded to the survey. Using numeric rating scales of 0 to 10, medical oncologists appeared to agree on their knowledge about opioid therapy as well as in their perceptions of pain management. Respondents have rated themselves highly (Med: 8; IQR 6-8) in their ability to manage cancer pain. There were similar responses to ascribing all potential barriers as significant in rendering optimal cancer pain management, with cost as the most considerable factor (Med: 8, IQR: 7-10). However, given two challenging clinical scenarios, 66% and 90%, respectively endorsed treatment decisions that were unacceptable to pain experts. Conclusions: In this study, Filipino medical oncologists have shown agreement on their knowledge but perceived significant barriers in cancer pain management, with cost as the most considerable factor. Educational strategies, positive attitudinal change, and multidisciplinary collaboration with pain or palliative care specialists should be strengthened to improve patient care.