bluuebunny/crossref_metadata_2025_split huggingface dataset:
Claims-based analysis of treatment practices of patients with metastatic gastroenteropancreatic neuroendocrine tumors (mGEP-NET) in the USA.
Authors: Pavel Marianne , Abraham Ivo , Halfdanarson Thorvardur Ragnar , Princic Nicole , Bernhardt Dirk 
Published: July 2024

e16286 Background: GEP-NET is a rare disease with variable tumor biology. An indolent disease course with subtle symptoms renders timely diagnosis difficult; 2/3 of patients (pts) are diagnosed at locally advanced or metastasized stage. In clinical decision-making, disease-specific factors, patient (pt) age and long-term disease control must be balanced against the aggressiveness of therapies. NCCN, NANETS and ENETS guidelines recognize the diversity of mGEP-NET by recommending individualized treatment approaches. We aimed to describe treatment (Tx) utilization patterns in mGEP-NET. Methods: Retrospective cohort study using MarketScan® Commercial and Medicare Databases spanning 07/01/2017-01/31/2023. Eligible were GEP-NET pts with ≥1 inpatient or ≥2 outpatient claims, a subsequent new diagnosis of metastatic disease (index), no secondary malignancy, and follow-up time of ≥12 months (m) after index. Results: Of 16218 GEP-NET pts, 2002 (mean age 60y; 50% female) met inclusion criteria. Mean follow-up time after index was 17m, with 49%, 27% and 15% followed up for ≥12, 24 and 36m, resp. Medical history (12m baseline before index) included mean Charlson Comorbidity Index of 2.62, with hypertension (HTN), type 2 diabetes (T2DM), chronic liver disease (CLD), asthma/COPD, cardiovascular disease (CVD), and chronic kidney disease (CKD) present in 56, 26, 22, 18, 17 and 10% of pts, resp.; 5% had carcinoid syndrome. In total, 949 pts (47.4%) received first-line (1L) systemic Tx: somatostatin analogs (SSA; 61.6%) of either very short or long duration (median 116d vs 775d), chemotherapy (38.8%), targeted therapies (3.4%) and PRRT (0.5%). Relative to NCCN cancer surveillance guidelines, 49.5% received more and 36.8% received fewer than 4 scans in the first year of treatment. Conversely, 1053 (52.6%) did not receive any 1L systemic Tx. With the exception of CLD, pts with vs without 1L Tx had similar proportions of medical conditions during the 12m baseline and during follow-up (HTN 72.4 vs 66.5%; T2DM 34.0 vs 30.3%; asthma/COPD 16.5 vs 19.3%; CVD 27.3 vs 36.9%; CKD 18.9 vs 17.9%; however, CLD 54.0 vs 36.7%). See Table comparing both cohorts on insurance, treatments, and health care utilization during follow-up. Conclusions: This claims analysis reveals treatment differences among mGEP-NET pts that cannot be explained by the parameters assessed herein. Further research should investigate factors influencing diagnosis and treatment decision-making, applying also pt-level health record data; and analyze economic barriers to diagnosis and treatment. [Table: see text]
The factors associated with all-cause in-hospital mortality in patients with malignant well-differentiated gastroenteropancreatic neuroendocrine tumors: A retrospective analysis of National Inpatient Survey (NIS) 2020 dataset.
Authors: Obomanu Elvis , Verinumbe Tarfa , Elom Hilary 
Published: July 2024

e16292 Background: Neuroendocrine tumors (NET) affect less than 200,000 (52 per 100,000) of the US population, with malignant well-differentiated gastroenteropancreatic (GEP) NETs accounting for about 65% of the cases. Owing to its rarity, the evidence on factors associated with all-cause mortality is limited. To address this gap, this study aims to identify socio-demographic and clinical factors associated with all-cause in-hospital mortality for patients with malignant well-differentiated GEP NET. Methods: We analyzed data from 2020 Nationwide Inpatient Sample survey on patients hospitalized with malignant well-differentiated GEP NET. Using ICD10 code, we identified patients hospitalized with any diagnosis of malignant well-differentiated GEP NET. In-hospital mortality was assessed based on the patient final disposition on discharge and dichotomized. Exposure variables analyzed included age, sex, tumor site, history of essential hypertension, COVID-19, hyperlipidemia, insurance status, length of hospital stay, and number of comorbidities present on the patients record. Multivariable logistic regression was used to assess for factors associated with mortality. Results: Of the 956 patients in this study, most were white (73.43%), male (48.28%) and mean age was 65 years (SD 13.59). Affected sites include small intestine (57.25%), pancreas (13.56%), colon (8.47%), appendix (8.26%), stomach (8.68%) and rectum (3.51%). Our results revealed that females were less likely to die in the hospital compared to their male counterpart hospitalized with malignant well-differentiated GEP NET (aOR = 0.42; 95% CI: 0.19 - 0.95). The presence of hyperlipidemia was significantly associated with in-hospital mortality (aOR = 0.24; 95% CI: 0.08 - 0.75). For every unit increase in the number of comorbidities, there is 12% increased risk of mortality (aOR = 1.12; 95% CI: 1.05 -1.19). The associations of age, race, tumor site, history of hypertension, insurance status or length of stay with in-hospital mortality were not statistically significant. Conclusions: Our study found significant associations of sex, hyperlipidemia, number of comorbidities and in-hospital mortality among patients with malignant well-differentiated GEP NET. Findings from this study highlight that factors such as sex, hyperlipidemia and number of comorbidities may be critical when developing prognostic tools that can be used to determine the risk of mortality among hospitalized patients hospitalized with these tumors.
Extra-adrenal paraganglioma demographic data: A NCDB study.
Authors: Peterson Michael , Ramos Brianna Eillen , Grover Jasika , Nakshbandi Noureen , Silberstein Peter T. , Heise Craig , Hsia Beau 
Published: July 2024

e16293 Background: Extra-adrenal paragangliomas are rare neuroendocrine tumors that form near blood vessels and nerves outside of adrenal glands. Despite their rare occurrence, these tumors have higher rates of malignancy and varying survival rates compared to other paragangliomas. To better understand its epidemiology, there may be clinical value in analyzing the diagnostic trends of these tumors. This study utilized information provided by the National Cancer Database (NCDB) to examine the demographic factors of patient populations diagnosed with extra-adrenal paragangliomas. Methods: A retrospective cohort analysis using the 2004–2020 National Cancer Database (NCDB) included 133 patients with a histologically-confirmed diagnosis of extra-adrenal paraganglioma (ICD-O-3 code 8693). Demographic factors (age, sex, race, Hispanic status, educational attainment, insurance status, facility type, distance from facility, and Charles/Deyo score) were analyzed by descriptive statistics. Incidence trends were interpreted via regression analysis. Results: In the NCDB, 133 patients were identified with a confirmed diagnosis of extra-adrenal paraganglioma between 2004 and 2020. This database suggested a relatively stable number of patients diagnosed per year (R² = 0.022). Men (67%) were more likely to be diagnosed than women (35%), with an average age at diagnosis of 45.7 years (SD = 17.7, range = 11-83). Patients were most commonly non-Hispanic (88%), White (68%), and had a primary site of diagnosis in the retroperitoneum (35%). Treatment was primarily surgical resection (84%) followed by radiation (17%) and chemotherapy (8%). Most patients did not receive palliative care (98%). A majority of patients (77%) had a Charlson-Deyo comorbidity score of 0, with a 2 year survival rate of 92%, a 5 year survival rate of 79%, and a 10 year survival rate of 50%. Most patients were privately insured (65%) and received treatment in an academic research facility (56%). Many individuals lived in large metropolitan counties with a population larger than 1 million (56%), and resided a mean distance of 41.6 miles (SD = 74.4, range = 0.8 - 559.3) from the treatment facility. Conclusions: To the best of our knowledge, this is the first analysis of extra-adrenal paragangliomas utilizing the NCDB, and thus addresses a significant lack of knowledge on the subject. The majority of patients are non-Hispanic White men, with a primary site of diagnosis in the retroperitoneum. This is the first time that the socioeconomic factors of extra-adrenal paraganglioma patients have been described in the literature: patients tend to be privately insured, live in large metropolitan counties, and have 10 survival rate of 50%. Continued research is necessary to gain a deeper insight on the impact of socioeconomic and demographic factors that influence the diagnosis, treatment, and survivability of extra-adrenal paraganglioma patients.
Positive psychology interventions in patients with prostate cancer: A systematic review.
Authors: Xu Eleanor , Phung Quan , Runcie Karie , Liu Michael A. 
Published: July 2024

e17005 Background: Prostate cancer is the most common malignancy in men and often results in psychiatric symptoms due to the direct disease effects, hormonal treatments, functional losses, and psychological responses of patients to the cancer. Positive psychology interventions have shown promise in alleviating psychological symptoms in patients with chronic diseases but are infrequently studied in patients with prostate cancer. Therefore, our systematic review aimed to examine the benefits of positive psychology interventions for patients with prostate cancer. Methods: Using PRISMA guidelines, a systematic literature search was conducted using the Medline, PubMed/Medline, and PsycInfo databases using a combination of MeSH terms and free text words, including publications up to November 2023. Studies were eligible if they included at least one positive psychology therapy intervention and the title or abstract mentioned the inclusion of patients with prostate cancer. Two individuals independently reviewed reports identified by the search to meet the above criteria and performed a quality assessment scale of studies based on standardized criteria that were adapted from those used in prior systematic reviews. The study was pre-registered on the Open Science Framework (OSF) repository. Results: The database searches yielded 1244 initial studies, 10 of which met inclusion criteria. Of the 10 included studies, 2 were randomized clinical trials, 2 were pilot feasibility trials, 3 were single-arm interventional studies, and 3 were cross-sectional studies. Manuscripts focused on older adults, with reported mean ages ranging from 54.5 to 72.0. Positive psychology interventions consisted of mindfulness-based therapies, meditation, hope and resilience therapies, and well-being therapies. Most studies showed a positive effect on improving outcomes for patients with early to advanced stage prostate cancers, including psychological distress, mood disorders, anxiety, quality of life, happiness, and life satisfaction. However, most of the studies were limited by small sample size, qualitative findings, loss to follow-up, and observational data. Most studies also excluded patients with severe psychiatric disorders, who may potentially benefit most from these interventions. Conclusions: This systematic review demonstrates that positive psychology approaches may have benefit in patients with prostate cancer. However, further larger prospective studies and clinical trials are needed to determine whether these interventions have proven benefit in this understudied population.
Treatment analysis of patients diagnosed with intraductal carcinoma of the prostate (IDC-P) in the US from 2000 to 2018.
Authors: Stamey Taylor , Armel Kristen , Ju Andrew W , Chen Shoujun , Navaid Musharraf , Larkins Michael Casmer , Bhatt Arjun 
Published: July 2024

e17011 Background: Intraductal carcinoma of the prostate (IDC-P), considered both a distinct entity (found alone in ~3% of prostate biopsies) and negative prognostic factor of prostatic cancer (identified in ~20% of all patients with prostate cancer). IDC-P represents aggressive disease, and is associated with increased metastasis, recurrence, and prostate cancer-specific death. Given the mortality and rarity of this disease, we analyzed demographic and treatment trends of patients diagnosed with IDC-P in the US. Methods: A retrospective cohort study utilizing the Surveillance, Epidemiology, and End Results (SEER) database sponsored by the National Cancer Institute (NCI) was conducted for patients with a diagnosis of IDC-P between 2000 and 2018. Univariate, multivariate, and survival analyses were performed on demographic and treatment characteristics using 95% confidence intervals [CI] and a p-value < 0.05 indicating significance. Results: 1003 patients with complete follow-up and survival data were identified. Patients with local disease that underwent radical prostatectomy without radiotherapy (RT) had increased five-year overall survival (OS) compared those that only received RT (99% vs 75%; p<0.001); those with regional disease did not (p=0.617). No survival benefit was seen among patients that received RT in addition to radical prostatectomy compared to those treated with radical prostatectomy solely (p=0.770 for local disease and 0.909 for regional disease). Lymph node (LN) examination, performed in 33.1% of patients, yielded increased five-year OS compared to absence thereof (99% versus 73%; p<0.001). 45% of patients that had LN examined were found in a single SEER registry (California). The 2.7% of patients that received chemotherapy (CTX) saw no survival benefit in the setting of distant disease (n=14; 0% versus 78%, respectively; p<0.001). No difference was seen in five-year OS with respect to race (p=0.967) though single patients saw decreased OS compared to married ones (hazard ratio (HR)=0.83; p=0.050) and patients younger than 65 years saw increased survival (HR=0.89; p=0.002). On multivariate analysis, the interaction between stage, surgical treatment, and receipt of RT demonstrated a difference in five-year OS (p=0.020). Conclusions: This analysis demonstrates survival benefit with radical prostatectomy solely versus treatment with RT among patients with local IDC-P, and did not find benefit with CTX in patients with distant disease. The survival benefit found with LN examination may be a center- or region-specific outcome. Patient age and marital status may have implications for patient outcomes. Further investigation into specific treatments, socioeconomic factors, and disease surveillance measures for patients with prostate cancer is warranted.
Long term sequelae of testicular cancer and treatment: A point prevalence observational study.
Authors: Khan M Raheel , Kearney Sheehan Patrice , Bazin Ashley , Leonard Christine , Aleem Umair , Trainor Sebastian , Corrigan Lynda , McDermott Raymond S. 
Published: July 2024

e17015 Background: Testicular cancer (TC) is a highly curable solid organ tumour, which usually occurs in the early years of life. Recent studies have observed an increase in the incidence of TC coupled with improvement in cure rates all around the world, especially in Western Europe and North America. Consequently, we have a growing population living in the survivorship phase. Many researchers have highlighted the late complications in TC survivors, linked with the different treatment modalities used for treatment. In this study, we aim to determine the point prevalence of morbidity and mortality in TC survivors at a tertiary care cancer centre in Ireland. Methods: Participants were assessed in a purpose built survivorship clinic and informed consent was obtained. All participants were 18 years or more of age at the time of assessment with a histologically confirmed diagnosis of testicular cancer over 5 years ago. Assessments included a thorough symptom review, clinical examination, blood tests and other investigations (e.g., X-ray, ECG) if required. Results: A total of 81 patients were recruited in the study from March 2023 to January 2024, with a median follow up of more than a 10 years (129 months). Chemotherapy had been given to 85% of patients and radiotherapy to 5%. All except one patient underwent orchiectomy while RPLND was performed in 17% of patients. There were 3 deaths in the survivorship phase, all related to second malignant neoplasms (SMNs). Hyperlipidaemia was the most common condition found in 55% of TC survivors, followed by raised gonadotropins (47%), low testosterone (34%) and hypertension (40%). Other conditions prevalent in our cohort were hearing impairment (26%), abnormal high glucose (8%) and renal impairment(7%). The majority of these co-morbidities were previously undiagnosed before assessment in our survivorship clinic, including 2 cases of coronary artery disease. Over 70% of hypogonadism, hyperlipidaemia, hypertension, renal impairment and high abnormal glucose were initially diagnosed in our clinic. Conclusions: Results from our study are comparable to the studies conducted in other cancer centres across Europe and the US. Second malignant neoplasms remain the major cause of mortality in this cohort but many modifiable risk factors can be diagnosed early and potentially treated to prevent morbidity. Our data strongly supports the need for specialised survivorship clinics to improve the prognosis and quality of life in TC survivors. [Table: see text]
Prognostic factors and survival in men with testicular germ cell tumors (GCT).
Authors: Zagoruiko Valentina , Semenova Anna , Abdullaeva Sheyda , Ekaterina Mureiko , Karina Khidishyan , Teletaeva Gulfiya , Novik Alexey , Latipova Dilorom , Nosov Alexandr , Semiglazova Tatiana , Protsenko Svetlana 
Published: July 2024

e17018 Background: The International Germ Cell Cancer Collaborative Group (IGCCCG) has recently discovered new factors for GCT in 2021. We have estimated previously known and new prognostic factors in patients with nonseminomatous germ cell tumors (NSGCT) and seminoma treated at N.N. Petrov NMRC of Oncology. Methods: From 2011 to 2021, the study included 273 adult patients receiving standard cisplatin-based chemotherapy. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Survival was estimated using the Kaplan-Meier and Cox methods. Results: 5-year OS rates were 94%, 85% and 70% in the good, intermediate, and poor prognosis groups, respectively for NSGCT and 95% and 86% in good and intermediate prognosis groups for seminoma (p<0.05). 5-year PFS rates were 74%, 51%, and 41% for NSGCT and 76% and 62% for seminoma of the above-mentioned prognostic groups, respectively (p<0,05). Presence of pulmonary metastases (mts) (HR 0.177; 95% CI: 0.051-0.612; p=0.006), non-pulmonary visceral mts (HR 4.636; 95% CI: 1.710-12.570; p= 0.003), elevated LDH of ≥ 2.5 limit of normal (≥ 2.5 × ULN) (HR 4.107; 95% CI: 1.614-10.451; p= 0.003), treatment in high-experienced clinic (HR 0.37; 95% CI: 0.147-0.919; p=0.0032), and non-compliance with guidelines (HR 3.731; 95% CI: 1.456-9.564; p= 0.006) was significantly associated with OS in NSGCT. The presence of pulmonary mts (HR 0.15; 95% CI: 0.024-0.877; p=0.035) and elevated LDH ≥ 2.5 × ULN (HR 0.109; 95% CI: 0.015-0.775; p=0.027) were the only factors associated with poor OS in seminoma. The presence of pulmonary mts (HR 0.446; 95% CI: 0.247-0,804; p=0.007), non-pulmonary visceral mts (HR 2.668; 95% CI: 1.390-5,120; p=0.003) and treatment in high-experienced clinic (HR 1.852; 95% CI: 1.059-3.238; p=0.031), were significantly associated with inferior PFS in NSGCT. Pulmonary mts were the only significant (HR 0.301; 95% CI: 0.100-0.910; p=0.033) factor in the multivariate OS analysis for all testicular GCT. The absence of non-pulmonary visceral mts (HR 0.522: 95% CI: 0.265-0.963; p=0.019) and compliance with guidelines (HR 0.565; 95% CI: 0.309-0.910; p=0.038) were significant factors in the multivariate PFS model for all patients with testicular GCT. Conclusions: The original IGCCCG classification remains the reference for treatment decisions for testicular GCT in daily practice. Non-compliance with guidelines and treatment in high-experienced clinic could become additional poor prognostic factors.
Differences in clinical features between CA-125 and RECIST progression in patients with ovarian cancer treated with PARP inhibitors.
Authors: Ma Yana , Lv Weiwei , Bu Hualei , Kong Beihua , Song Kun 
Published: July 2024

e17568 Background: The clinical features of disease progression (PD) based on Response Evaluation Criteria in Solid Tumors (RECIST) and carbohydrate antigen (CA)-125 criteria, and the impact on prognosis in ovarian cancer patients treated with poly (ADP-ribose) polymerase inhibitors (PARPi) were ambiguous. Methods: All ovarian cancer patients included in this retrospective analysis were treated with PARPi monotherapy and regularly assessed with RECIST and CA-125 criteria until disease progression was confirmed by RECIST criteria. According to the presence or absence of CA-125 PD within a 28-day period before and after RECIST PD, patients were categorized into two groups: RECIST PD group (no CA-125 PD within 28 days) and CA-125 PD group (CA-125 PD present within 28 days). Subsequently, the differences in clinical features and progression-free survival (PFS) of subsequent treatment after PARPi resistance between the two groups were analyzed. Results: A total of 139 patients were included, with 71 (51.1%) in RECIST PD group and 68 (48.9%) in CA-125 PD group. Patients in RECIST PD group had a lower proportion of lymph nodes progression (22.5% vs. 52.9%, p=0.000), and multi-sites progression (28.2% vs. 45.6%, p=0.033). Patients in CA-125 PD group had poorer benefit to subsequent chemotherapy after progression of PARPi, with a median PFS of 5.5 and 7.9 months, respectively (HR=1.44, p=0.019). The multivariate analysis showed that PARPi treatment time less than 6 months (HR=2.218, p=0.001) and RECIST PD accompanied by CA-125 PD (HR=1.766, p=0.024) were the main risk factors for PFS of subsequent treatment. Conclusions: Patients with RECIST PD but without CA125 PD have a reduced likelihood of experiencing lymph nodes progression or multi-sites progression. Conversely, patients with RECIST PD and CA125 PD simultaneously demonstrate poorer outcomes in subsequent treatment after PARPi resistance.