bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends of metastasectomy for metastatic renal cell carcinoma and their impact on overall survival.
Authors: Meyer Christian P , Sun Maxine , de Velasco Guillermo , Trinh Quoc-Dien , Choueiri Toni K. 
Published: February 2017

620 Background: The treatment of metastatic renal cell carcinoma (mRCC) has profoundly changed over the last decade. There is little comprehensive evidence evaluating the role of metastasectomy (MSx) in in this context. We assessed trends and predictors of MSx and their impact on overall survival in a large national cohort. Methods: The National Cancer Data Base from 1998-2012 was queried to identify 25,455 mRCC patients with 5,315 undergoing MSx. Covariates included the application of targeted chemotherapy (CTX) and immunotherapy (ITX). Baseline descriptive and multivariable logistic regression analyzes for prediction of MSx were conducted. Trends for chemo- (CTX) and immunotherapy (ITX) as well as MSx were assessed using the annual percent change linear regression technique (EAPC). Kaplan-Meier curves and adjusted Cox-proportional hazard models assessed the impact of MSx on overall survival. Results: Compared to controls, MSx patients were significantly younger (p<0.001), had a lower CCI (p=0.03), more often private insurance (p=0.04) and a higher income (p<0.001). They were more often treated at an academic center (p<0.001), but less often received ITX/CTX (both p<0.001). The rates of MSx increased significantly over the years (9.9-24.5%, EAPC 4.52, p<0.001) while CTX (EAPC 3.08, p<0.001) increased and ITX decreased (EAPC -12.9, p<0.001). Diagnosis after 2006 (OR 1.21, 95%CI 1.02-1.23) and private insurance (OR 1.43, 95% CI 1.14-1.79) were positive predictors of MSx, whereas increasing age (OR0.98, 95%CI 0.98-0.99), black race (OR 0.73, 95%CI 0.63-0.84), ITX (OR 0.8, 95%CI 0.68-0.94) and CTX (OR 0.75, 95% 0.69-0.82) were negatively associated with MSx. The combined treatment with MSx conferred a survival benefit compared to no MSx (HR 0.75, 95%CI 0.72-0.78) and CTX alone (HR 0.82, 95%CI 0.74-0.90). Conclusions: The addition of MSx to CTX conferred a survival benefit in our study despite lower usage of MSx after CTX. This suggests a potential underutilization, which might be a consequence of underlying health care access disparities as implied by lower odds of receiving MSx in blacks and higher odds in privately insured patients.
Differential side effects profile in mCRPC patients treated with abiraterone or enzalutamide: A meta-analysis of randomized controlled trials.
Authors: Moreira Raphael Brandao , Debiasi Marcio , Maluf Fernando C. , Bellmunt Joaquim , Fay Andre Poisl , Choueiri Toni K. , Schutz Fabio Augusto Barros 
Published: February 2017

73 Background: Abiraterone and enzalutamide are currently approved for mCRPC patients. Both drugs have distinct mechanisms of action and may have different toxicity profile. There are limited data comparing the side effects of abiraterone and enzalutamide. We performed a meta-analysis of randomized controlled trials (RCT) to better characterize the risk of adverse events associated with both drugs. Methods: We performed a literature search on MEDLINE for studies reported from January 1966 to July 31, 2015. Abstracts presented at ASCO meetings from 2004 to 2015 were selected manually. Phase III RCT were included in analysis. We assessed the risk of adverse events reported in RCT by performing two meta-analysis: abiraterone-prednisone vs. placebo-prednisone (2,283 pts) and enzalutamide vs. placebo (2,914 pts). Summary of incidence, relative-risks (RR), and 95% confidence intervals (CI) were calculated using random-effects or fixed-effects models based on the heterogeneity of included studies. Results: Overall, enzalutamide was not associated with all-grade (RR 1.06 - 95% CI 0.67-1.65) or grade ≥3 (RR 0.81 - 95% CI 0.28-2.33) cardiovascular events, but was associated with increased risk of all-grade fatigue (RR 1.29 - 95% CI 1.15-1.44). On the other hand, abiraterone was associated with increased risk of all-grade (RR 1.28 - 95% CI 1.06-1.55) and grade ≥3 (RR 1.76 - 95% CI 1.12-2.75) cardiovascular events, but was not associated with all-grade (RR 0.85 - 95% CI 0.58-1.23) or grade ≥3 (RR 1.07 - 95% CI 0.97-1.19) fatigue. No evidence of publication bias was observed. Conclusions: In this meta-analysis, abiraterone was associated with an increased risk of cardiovascular events, while enzalutamide was associated with an increased risk of fatigue.
Increased cholesterol synthesis via squalene monooxygenase to predict lethal prostate cancer.
Authors: Stopsack Konrad Hermann , Gerke Travis , Cerhan James Robert , Mucci Lorelei A. , Rider Jennifer R. 
Published: February 2017

77 Background: Prostate cancer cells rely on cholesterol for proliferation and androgen production. We recently demonstrated that increased expression of the second key enzyme of cholesterol synthesis, squalene monooxygenase (SQLE), is associated with higher prostate cancer-specific mortality (PCSM). We here validate findings in two additional prospective studies and investigate putative mechanisms. Methods: We analyzed the prospective prostatectomy cohorts within the Health Professionals Follow-up Study (HPFS) and the Physicians’ Health Study (PHS) as well as initially expectantly managed patients in the Swedish Watchful Waiting Study (SWWS). 258 lethal cancer cases and 469 patients who survived > 8 years without metastases were included. SQLE mRNA was measured in tumor specimens at diagnosis of all patients and in benign prostate tissue of 197 patients. Markers of tumor angiogenesis were assessed via immunohistochemistry in 169 HPFS patients. We estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. Results: Higher SQLE expression was confirmed to be predictive of higher PCSM in the validation prostatectomy cohort PHS. Combining the two prostatectomy cohorts, men with high SQLE expression ( > 1 standard deviation above the mean) were 6.7 times (95% CI, 2.9 to 15.8; p < 0.001) more likely to die from their cancer compared to men with the mean level of SQLE expression. A 10% higher ratio of SQLE mRNA expression in tumor vs. benign prostate tissue of the same patient was predictive of 42% higher PCSM (95% CI, 15% to 74%). Higher SQLE expression was strongly associated with increased angiogenesis markers (all p ≤ 0.001). This increased risk associated with high SQLE expression was not modified by statin use (p ≥ 0.52). In initially untreated patients in SWWS, a more modest association of tumor SQLE expression with PCSM was observed (p = 0.047). Conclusions: SQLE, the second rate-limiting enzyme of cholesterol synthesis, is associated with prostate cancer progression. Its expression at cancer diagnosis is predictive of lethal disease both after curative-intent prostatectomy and in a watchful waiting setting, possibly by facilitating micrometastatic disease.
Predicting return of erectile function following external beam radiotherapy or brachytherapy for prostate cancer using EPIC-CP.
Authors: Mihalcik Stephen A. , Chipman Jonathan , Sanda Martin G. , Kaplan Irving D. , Crociani Catrina , Chang Peter ,   PROST-QA Consortium
Published: February 2017

87 Background: EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) is a one page, 16-item questionnaire designed and validated to measure patient-reported health related quality of life in prostate cancer (PC) patients at the point of care in the clinical setting. We previously developed and externally validated models predictive of intact sexual function (i.e. achieving an erection firm enough for intercourse) at two years following external beam radiation (EBRT) or brachytherapy (BT) using EPIC-26, the parent tool from which EPIC-CP was derived. We aimed to enable the use of these models in clinical practice by recalibrating them for use with EPIC-CP. Methods: Using a previously described multicenter longitudinal cohort (PROST-QA), we identified 217 men treated with EBRT and 230 with BT with complete sexual domain and model covariate information. We used the established covariates predictive of functional erections in the EPIC-26-based models (baseline sexual score, neoadjuvant hormonal therapy, and baseline PSA for EBRT, and baseline sexual score, age, race, and BMI for BT) to recalibrate the multivariable logistic regression models for use with EPIC-CP. We examined Pearson residuals to determine goodness of fit and compared the individual predictions based on the revised models with those generated by the EPIC-26-based models. Results: The recalibrated EPIC-CP-based models demonstrated excellent discrimination (AUC 0.81 for EBRT, AUC 0.87 for BT). Odds ratio estimates for the EPIC-CP models changed by no more than 0.2 from their EPIC-26 counterparts, and remained statistically significant. EPIC-CP and EPIC-26-based predictions had good concordance: the mean ± SD difference in predicted probability between EPIC-26 and EPIC-CP models was 0.0 ± 0.08 in each treatment group. Predicted probabilities were within 15.4% and 15.8% for 95% of the subjects treated with EBRT and BT, respectively. Conclusions: EPIC-CP-based nomograms predicting erectile function two years after EBRT or BT are in good agreement with established EPIC-26-based tools and offer an easily applied and accurate prediction regarding a common and impactful side effect of PC treatment.
Partner’s survivorship care needs: Multivariable analysis in head and neck cancer patients.
Authors: Giuliani Meredith Elana , McQuestion Maurene , Sampson Lorna , Le Lisa W , Jones Jennifer M. , Cheng Terry , Waldron John N. , Ringash Jolie 
Published: February 2017

120 Background: The purpose of this study was to determine the number and predictors of head and neck cancer (HNC) survivors’ partners unmet needs and how they correspond to the unmet needs of the survivor. Methods: This study accrued consenting partners from among 158 patients with HNC who had completed a onetime survey including demographic information and the Cancer Survivors’ Unmet Needs Measure (CaSUN) between January 2013 and May 2014. Patients’ caregivers were invited to complete the Cancer Survivors’ Partners Unmet Needs Survey (CaSPUN). The mean (± standard deviation) number and proportion of unmet needs on the CaSPUN was calculated. Multivariable analyses (MVA) were performed to determine factors associated with greater unmet needs using linear regression. Kappa co-efficient was calculated to examine the agreement between the unmet needs of patients and their partners on 22 corresponding items. Results: The CaSPUN survey was completed by 44 partners of head and neck cancer survivors. At least one unmet need was reported by 29 partners and 4 had a very high number of needs between 31 and 35. The most common unmet needs were “I need help to manage my concerns about the cancer coming back” (41%), “I need more accessible hospital parking” (34%), “ I need help to cope with others not acknowledging the impact of having a partner experience cancer has had on my own life” (30%), “ I need help dealing with changes that cancer has caused in my partner” (27%) and “I need to know all my partners doctors talk to each other to coordinate my partner’s care” (27%). Of the 5 most common items, 3 were in the Relationships domain. On MVA increasing number of unmet needs in patients was significantly associated with increased unmet needs in their partners (p < 0.01). Of the 22 paired items there was fair agreement in 12 items, moderate agreement in 8 items and good agreement in 2 items between patients and partners. Conclusions: A significant proportion of partners of cancer patients experience unmet needs which may differ from those of the patient themselves. Survivorship program should consider independent needs assessment and program development for partners.
Financial and work related impact of cancer in young adult (YA) survivors.
Authors: Baker Kevin Scott , Ambrose Kelly , Arvey Sarah R. , Casillas Jacqueline N. , Ganz Patricia A. , Jacobs Linda A. , McCabe Mary S. , Overholser Linda , Partridge Ann H. , Rajotte Emily Jo , Risendal Betsy C , Rosenstein Donald , Syrjala Karen 
Published: February 2017

15 Background: YA survivors face challenges unique from those of survivors of childhood cancer or of older adults. The potential impact of cancer or its treatment upon employment and finances for YA survivors is unknown. Methods: Eligibility included diagnosis of malignancy between ages 18-39, 1-5 years from diagnosis and > 1 year from therapy completion. Participants (see Table) were randomly selected from tumor registries of 7 academic institutions; 875 (41% of attempted contacts) enrolled and completed online patient reported outcomes survey related to the effects of cancer/treatment on employment, finances, and cancer-related distress. Results: Overall 84% were employed sometime between cancer diagnosis and study enrollment. Of those, 76% took paid time off (40% < 2 mo, 29% 2-5 mo, 31% > 6 mo). Unpaid time off was required by 39% (37% < 2 mo, 25% 2-5 mo, 38% > 6 mo). Other impairments included inability to carry out physical (59%) or mental (55%) tasks required for their job, being less productive (67%), and not pursuing an advancement/promotion (21%). Financial impacts were substantial: 61% worried about medical bills, 31% went into debt related to their cancer/treatment. Of those incurring debt, most (53%) reported this amount to be < $10,000, 29% $10,000-$24,999, and 18% > $25,000; 13 (4.8%) filed for bankruptcy. Chi squares comparing those receiving extensive treatment vs. surgery only indicated greater likelihood of financial debt (10.6, P=.001) and residual distress (13.9, P < .001) if treated with more than surgery. Conclusions: Most YA survivors experience a significant negative impact on employment and finances related to their cancer and treatment, which occurs at a critical time in their careers and at a life phase inherently more financially unstable. Longitudinal follow-up is required to better quantify the long-term burden on work and finances from cancer diagnosed in young adulthood. [Table: see text]
Adolescent and young adult (AYA) survivors of childhood cancers: A challenge in after completion of therapy (ACT) clinic in resource-constrained country.
Authors: Kurkure Purna Arun , Panda Saroj Prasad , Prasad Maya , Goswami Savita 
Published: February 2017

19 Background: To assess the evaluation of late effects in childhood cancer survivors who have transitioned to AYA age group on longitudinal follow up in After Completion of Therapy (ACT) clinic at Tata Memorial Hospital, Mumbai. Methods: ACT clinic database was analyzed for childhood cancer survivors who have attained age 15-30 yrs at last follow up in the clinic for demographics, grade of late effects &pattern of follow up. Results: Of 1720 childhood cancer Survivors ( > , 2 yrs off therapy & disease free) registered in ACT clinic from Feb 91-Feb15, 976(56.7%) are in AYA group, M.F = 707/269 (2.6:1), Hematolymphoid : Solid tumours = 543/433 (1.3:1), Mumbai based: Non Mumbai = 306/670 (1:2.2).Median age at diagnosis 8 yrs, current median age 20 yrs, median duration of ACT clinic follow up is 6 yrs. At registration 448 (47%) had no late effects. 230(24%) had grade I, 81(8.4%) grade II 195 (20%) had grade III. Only 9(1%) had grade IV late effects which increased to 53 (6%) at last follow up due to recurrence & second neoplasia. Only 29(3%) were at low risk of developing potential late effects. 466(48.5%) were in intermediate risk & 48.5% (466) fell in high risk category requiring at least annual follow up. 72% of survivors registered in ACT clinic from 1991-2001 had stopped follow up as compared to 36% registered in subsequent decade (p < 0.01). Conclusions: AYA survivors of childhood cancers form major (56.7%) group in Long Term Follow up clinic. The increasing incidence of life threatening late effects on longitudinal follow up combined with statistically significant increasing trend of stopping follow up over period of time since ACT registration is alarming & calls for innovative approaches for maintaining good follow up through survivor centric approaches such as use of IT based communication technologies & formation of childhood cancer survivors support groups like Ugam.
Caregiver work modifications: A hidden cost of cancer care.
Authors: Blackmon Emma , Bell Janice , Whitney Robin L. , Reed Sarah C. , Kim Katherine , Joseph Jill 
Published: February 2017

190 Background: Recent national reports highlight the dramatically rising costs of cancer care and its impact on financial hardship among survivors. Comparatively little attention, however, has been paid to the contributions of family and friends in unpaid caregiving roles—specifically, the impact of caregiving on caregivers jobs and work life. Methods: Using data collected in the 2012 LIVESTRONG Survey of People Affected by Cancer, we examined the prevalence of cancer survivors reporting that they had a friend or family member providing care to them during or after cancer treatment. Then, among those reporting they had a caregiver employed at that time, we used logistic regression to examine caregiver work modifications (i.e., paid time, unpaid time off, changing hours or duties, or making a change in employment status. All models controlled for survivor age at diagnosis, sex, race/ethnicity, income, education and employment status as potential predictors. Results: Of the respondents (n = 6310), 88% reported a family member or friend provided care as follows (in non-mutually exclusive categories): spouses (64%), friends (47%), parents (40%), siblings (31%), children (28%) or other family member (14%). Among survivors with employed caregivers (n = 4,984), 41% reported that their caregiver made a work modification; of these 57% took paid time off, 41% took unpaid time off, 4% switched from full time to part time and 3% took early retirement. Caregivers were more likely to make work modifications for survivors with low (versus high) income or education and for unemployed (versus employed) survivors. The age of the survivor was also a significant factor, with caregivers making more work modifications for younger survivors (ages 18-64) compared to older survivors (age > 65)—with ORs of caregiver work modfications increasing from 1.70 to 6.92 in a dose response by survivor age. Conclusions: Family and friends provide care to a majority of individuals with cancer and many make substantial modifications to their work—contributions which are not routinely counted in estimates of the cost of cancer care. Interventions may be warranted to support caregivers, particular those of survivors with lower income, less education and those of younger age.
Influence of clinical and psychological variables on coping strategies and quality of life of cancer patients: NEOCOPING study.
Authors: Rodriguez Rubi David , Calderon Caterina , Beato Carmen , Garcia Teresa , Ramchandani Avinash , Castelo Beatriz , Soriano Carmen , de la Morena Pilar , Sanchez Mar Munoz , Fernandez Sanchez Ana , Mangas Montserrat , Martinez de Castro Eva , Carrion Galindo Rafael , Donnay Olga , Cumplido Buron Jose David , San Gil Raquel Hernández , Carmona Bayonas Alberto , Jiménez-Fonseca Paula , Ayala Francisco , Jara-Sanchez Carlos ,   Grupo de Cuidados Continuos de la Sociedad Española de Oncología Médica (SEOM)
Published: February 2017

205 Background: NEOCOPING study analyzes the influence of clinicopathological, personal and social variables on coping strategies and quality of life (QoL) in patients with resected tumors at the time of starting adjuvant chemotherapy. Methods: NEOCOPING is a prospective, multicenter, observational study that involves 19 centers and 34 researchers. Applied main questionnaires were: Mini-Mental Adjustment to Cancer (MAC), EORTC QLQ-C30, Brief Symptom Inventory (BSI-18), Shared Decision Making Questionnaire (SDM-Q) patient and doctor, and Multidimensional Scale of Perceived Social Support (MSPSS). Results: Table summarizes the characteristics of the first 71 patients enrolled. The most used coping strategies were fighting spirit (X=75.8, SD=25.9) and avoidance (X=64.6, SD=25); most patients were found to have good QoL (X=76.5, SD=16.6). Most did not have psychiatric symptoms, and were pleased with family and social support perceived. Patients were very satisfied with the information received (X=83, SD=19.9), and shared opinions with the doctor (X=90, SD=22.9). QoL was significantly negatively correlated with depression (r=-.688, r=.0001), anxiety (r=.-655, p=.0001), somatization (r=-.638, p=.0001) and hopelessness (r =-.287, p =.033). Depression and somatization predicted 54.8% of the QoL of this sample (F=23,636, p=.0001). Conclusions: Even though patients have a good QoL, adaptative coping strategies and no noticeable psychopathological symptoms at baseline, these symptoms may influence the well-being perception and modulate personal adaptations to the diagnosis and treatment of cancer at a curable stage. [Table: see text]
Psychosocial well-being assessment in women with breast cancer.
Authors: Gnanajothy Rosana , Correll Jennifer Aileen , Peterson Lindsay Leuthen 
Published: February 2017

207 Background: A breast cancer (BC) diagnosis can affect psychosocial wellbeing. The goal of the current study is to identify the severity of and specific risk factors for depression, anxiety, and quality of life impairment in a sample of BC patients. Early identification of at risk individuals can expedite appropriate referrals and interventions. Methods: Data from 53 female BC patients referred to a Behavioral Medicine service at a large academic medical center in 2013-2015 by medical providers who identified distress at routine clinic visits were analyzed. Patients completed the Center for Epidemiology Studies Depression Scale, State Trait Anxiety Inventory, McGill Pain Questionnaire, and the Short Form 12 Quality of Life Inventory as part of their initial assessment following referral. Demographic factors, disease and treatment related factors were analyzed for correlation with psychosocial wellbeing. Results: Mean age was 52. The majority of the population were Caucasian (79%), and 53% were married. All stages of disease were represented. Significant depression, anxiety and psychological quality of life impairment were seen in 53%, 50%, and 39% of patients respectively. There was a trend towards a significant difference in higher anxiety scores in patients who were not on chemotherapy (M=44.2, SD 5.4) compared to those on chemotherapy at the time of assessment (M=38.54, SD 9.3; t (51) = -1.94 p=0.077). A positive correlation was seen between depression and pain scores (r 0.294, p=0.038). Depression and psychological quality of life scores were negatively correlated (r -0.632 p<0.001), as were pain and physical quality of life scores (r -.343, p 0.024). There was no correlation between higher rates of depression or anxiety with type of surgical intervention or stage of disease. Conclusions: Significant depression, anxiety and quality of life impairment were seen in a large percentage of BC patients referred to Behavioral Medicine for perceived distress, regardless of type of surgery and disease stage. Higher rates of anxiety were seen in patients referred while not on chemotherapy compared to patients who were on chemotherapy at the time of referral. Early referral is the key to proper identification and treatment of high risk individuals.