bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genomic signatures in young and old Chinese patients with bone and soft tissue tumors.
Authors: Jin Gu , Yu Yangyang , Zhao Lele , Xiao Mingzhe , Qi Chuang 
Published: June 2022

e23516 Background: The tumor onset of bone and soft tissue at young or old age was associated with different clinical features. However, the genomic differences between young and old patients with bone and soft tissue tumors were not well elucidated. Therefore, a comprehensive molecular profile in young and old patients should be defined, which will enhance our understanding of the unique biology of bone and soft tissue tumors and help to improve the treatment options for this population. Methods: Tumor tissue samples from 103 young (age < = 50 years) and 81 old (age > 50 years) patients with bone and soft tissue tumors were enrolled, between 2019 to 2021. Targeted sequencing of 539 cancer-related genes was conducted to characterize the genomic landscape. Genomic alterations including single nucleotide variation (SNV), insertions/deletions, copy number variations (CNV) and gene fusions were assessed and germline alterations were excluded. Tumor mutation burden (TMB) was calculated by counting all nonsynonymous mutations per megabase of coding sequences. Results: The most common mutant genes in the younger and elderly groups were TP53 (20%), MUC16 (13%), KRT2 (8%) and TP53 (37%), MUC16 (19%), LRP1B (10%), FAT3 (7%), respectively. KRT2 mutations were significantly higher in the younger group (7.8% vs. 1.2%, p = 0.041), while TP53 mutations were more common in the elderly group (20.4% vs. 37%, p = 0.012). MUC4 and FADS6 mutations were only observed in the younger group (5.8% and 4.9%). Mutation of some genes were observed simultaneously in certain patients, for instance, TRIOBP/ KRT2, GATSL3 / KRT2, GATSL3 / SSUH2 in the younger group and P53 / LRP1B, MUC16 / PTEN, MUC16 / FAT2, MUC16 / LRP1B, APC / CARD11 in the elderly group. The most frequently affected pathways in the younger and elderly groups were TP53(23.3% vs 37%), RTK-RAS (16.5% vs. 29.6%), NOTCH (16.5% vs.16%), PIK3 (7.8% vs18.5%), Hippo (8.7% vs. 17.2%), respectively. The tumor mutation burden (TMB) was positively correlated with age (Pearson's r = 0.33, p < 0.001), and the old patients had higher TMB. Up to 97.8% (180/184) evaluated samples were microsatellite stable. Conclusions: These findings revealed different molecular characterization between young and old Chinese patients with bone and soft tissue tumors, which may further provide novel insights for the personalized treatment.
Predictive value of cystatin c in methotrexate elimination in patients with osteosarcoma.
Authors: Liu Zengjun , Wang Yonggang , Xu Jing , Hu Wenyu , Yang Changsheng , Zhu Dongyuan , Zhou Lei , Liu Mengyao , Li Hongtao 
Published: June 2022

e23522 Background: High-dose methotrexate (HDMTX) is a renally eliminated and nephrotoxic therapy for osteosarcoma (OS). Serum cystatin C (Cys C) has emerged as an alternative to serum creatinine (Scr) for estimation of glomerular filtration rate (GFR). We aim to analyze the value of the baseline Cys C in predicting MTX elimination in patients with OS. Methods: All consecutive patients who were treated with HDMTX in Shanghai Jiao Tong University Affiliated Sixth People¡¯s Hospital, between November 2011 and April 2018, were retrospectively reviewed. The baseline GFR was calculated by three different equations based on the Scr, Cys C and their combination. MTX concentrations at 24, 48 and 72 hours after the termination of infusion were routinely monitored using high performance liquid chromatography. Results: A total of 158 courses of MTX infusion were administered. The incidences of delayed excretion of MTX at 24, 48, and 72 hours (serum concentrations at 24 h > 10 μmol/L, 48h > 1 μmol/L, 72h >0.1 μmol/L) were 62.3%, 44.9% and 29.7%, respectively. The baseline Scr in the delayed excretion (DE) group were significantly lower than that in the normal excretion (NE) group at all three time points (24h: 58.8 µmol/L vs 47.86 µmol/L, P£¼0.05; 48h: 59.02 µmol/L vs 47.48 µmol/L, P£¼0.05; 72h: 62.29 µmol/L vs 51.51 µmol/L, P£¼0.05). However, the baseline Cys C in the DE group were similar to that in the NE group at all three time points (24h: 0.96 mg/L vs 0.90 mg/L, P = 0.11; 48h: 0.96 mg/L vs 0.92 mg/L, P = 0.17; 72h: 0.96 mg/L vs 0.93 mg/L, P£¾0.05). The Scr-based estimated GFR in the DE group were significantly lower than that in the NE group at all three time points (24h: 148.42 mL/min vs 186.79 mL/min, P£¼0.05; 48h: 147.24 mL/min vs 188.82 mL/min, P£¼0.05; 72h: 142.95 mL/min vs 171.04 mL/min, P£¼0.05). The Scr- and Cys C-based estimated GFR in the DE group were also significantly lower than that in the NE group at all three time points (24h: 140.33 mL/min vs 161.39 mL/min, P£¼0.05; 48h: 141.69 mL/min vs 159.04 mL/min, P£¼0.05; 72h: 138.33 mL/min vs 152.31 mL/min, P£¼0.05). However, the Cys C based estimated GFR in the DE group were similar to that in the NE group at all three time points (24h: 95.95 mL/min vs 101.31 mL/min, P = 0.183; 48h: 97.49 mL/min vs 98.64 mL/min, P = 0.763; 72h: 95.30 mL/min vs 99.06 mL/min, P = 0.375). Conclusions: Baseline Cys C alone is unable to predict MTX elimination in patients with OS.[Table: see text]
Prognostic value of vessels encapsulating tumor clusters (VETC) in sarcoma.
Authors: Renne Salvatore Lorenzo , Tassan-Mangina Marta , Santori Ilaria , Ruspi Laura , Sicoli Federico , Colombo Piergiuseppe , Cammelli Manuela , Quagliuolo Vittorio , Terracciano Luigi , Di Tommaso Luca , Cananzi Ferdinando 
Published: June 2022

e23523 Background: How sarcoma metastasize is unknown. VETC has been described as an epithelial-to-mesenchymal-transition independent process of metastasis: endothelium covers neoplastic clusters allowing tumor dissemination. It has also been shown to be a predictive of tyrosine kinase inhibitors (TKI) response. The objectives of the present study are: 1) to assess the presence of VETC in sarcoma; 2) to model its prognostic role. Methods: The study was retrospective. We selected 54 cases of sarcomas (6 DDLPS, 10 GIST, 6 retroperitoneal LMS, 9 MLPS, 8 MPNST, 10 SFT, 5 UPS); of them 31 were metastatic (M1 group), 23 were not (M0 group, defined as least 5 years of negative follow-up). High risk GIST and SFT, and grade 3 FNCLCC were considered high grade. VETC was assessed with CD31 immunohistochemistry and defined as a continuous endothelial lining around tumor clusters. We used Bayesian probabilistic modeling to detect small effects and multilevel hierarchical modeling to reduce overfitting. Models were fit using Stan and R. CI were computed with the HPDI method for 89%. The whole posterior probability (PP) was used for calculations. Results: The two groups (M0 & M1) were substantially homogeneous: the CI of the contrast PP (CPP) included 0 in each histology for sex, age, size, and grade; VETC was more expressed in M1 SFT cases with almost all the CPP mass above the 0. Also, UPS and GIST showed VETC to be more present in metastatic diseases with 79% and 78% respectively of the CPP mass above 0 (see table). Metastasis free survival (MFS) analysis showed that VETC in SFT and UPS with a coefficient of 2.42 (CI 0.73 – 4.65) and 1.94 (CI 0.16 – 3.67); for the latter the median was reached with a PP density of median MFS of 65 months (mo) (standard deviation, SD: 74 mo) for VETC- Vs 11 mo (SD: 14 mo) for VETC+. Similarly, disease specific survival analysis showed – in SFT and UPS – that VETC was negatively associated with prognosis with coefficients of 1.24 and 2.34; however the CI covered slightly the 0 (-0.54 – 3.96 and -0.09 – 5.73, respectively). Conclusions: We found VETC in sarcoma and highlighted its prognostic role in SFT and UPS. [Table: see text]
Quality of life in caregivers of cancer patients in Colombia.
Authors: Castro-Martinez Daniela A. , Ruiz-Cabrera Laura X. , Mariño-Ramírez Leonardo , Idrobo Henry 
Published: June 2022

e24000 Background: It is well known that improvements in caregiver quality of life (QOL) could significantly impact the clinical outcome of cancer patients, which is why it is essential to study this population. Caregivers have extensive responsibilities, making them vulnerable to emotional, physical, social, and financial distress. Evaluation of cancer patient caregiver QOL in Latin America and validation of QOL metrics, such as the Caregiver Quality of Life Index-Cancer (CQOLC), has not yet been done in large populations. We sought to evaluate these characteristics in 5 regions in Colombia. Methods: Cancer patients (n = 165) receiving active treatment and their respective adult caregivers were evaluated. Both caregivers and patients completed a sociodemographic survey, along with the CQOLC, which was translated to Colombian Spanish and validated in a pilot cohort. CQOLC is composed of five subcategories with a total max score of 140. Higher scores are associated with better QOL. Internal consistency was determined by Cronbach’s alpha. Results: The patient’s median age was 63 years (58.8% females). The primary cancer diagnoses were breast, cervical, and lung cancer, with a median ECOG-PS of 1. 6.3% of patients did not have a caregiver, and their responses were also evaluated. The median caregiver age was 53 years (range 19-75 years, 60% females). 4.7% of caregivers were unemployed, and 59% reported financial or psychological distress. 93.8% of caregivers were family members, most frequently spouses or children. The median CQOLC score was 90 ± 15.2. The median score for each of the five subcategories “burden,” “disruptiveness,” “positive adaption,” “financial concern,” and “other” were as follows: 2, 3, 3, 3, and 3 (max score of 4). Conclusions: Most patients and caregivers were interested in participating in the study and reported no issues comprehending or answering the questions. This suggests no potential problems adapting the Spanish-translated CQOLC to future studies. Despite most caregivers reporting financial distress and low family income status, their overall CQOLC scores were relatively high compared to developing countries like the USA, potentially due to cross-cultural differences. The higher median score in the “disruptiveness” category suggests that Colombian caregivers feel strongly committed to caregiving and do not feel this activity interferes significantly with their daily life, possibly related to a sense of family responsibility and moral duty. However, the lower median score in the “burden” category indicates that caregivers feel a heavy emotional toll as a result of their caregiving role. Our results can help identify caregiver QOL areas of improvement, where government policies can be implemented to benefit both the caregiver and the patient.Keywords: caregiver burden, quality of life, Colombia, validation, CQOLC, cancer patients
Need of pretreatment support of breast cancer patient caregivers compared to patients.
Authors: Kim Terri , Lee Dasom , Lee Hajin , Ock Chan-Young , Yang Hyungkook , Kim Ki Hwan , Shin Jane , Paek Anthony S , Park Jamie Eunsu , Lee Yerin , Son Hyejin , Choi Hongseok , Shim Hyemin 
Published: June 2022

e24001 Background: Through this research, Lunit is seeking to understand how the needs of breast cancer patient caregivers differ from those of patients. Moreover, we seek to gain insights into the potential impact of fulfilling such needs for caregivers through remote nurse support that can provide evidence-based information. Methods: We asked 330 breast cancer patients and 53 caregivers to participate in an online survey in Korea from 10/2021- 11/2021 to understand various needs throughout their cancer journey. Eight breast cancer patients and caregivers asked 25 questions through a remote nurse support model. Interactions took place either via phone or text, starting 12/20/2021 and is ongoing. The answers to asked questions were drafted by nurses and reviewed by a team of medical doctors to ensure delivery of clinically sound information. Results: While the top areas needing support during the entire cancer journey (prior, during, post treatment) were generally consistent for both caregivers and patients, caregivers showed a pronounced need for support that would help make treatment decisions specifically during the pre-treatment phase. (See table below) This difference was also reflected in the distribution of questions asked during the remote nurse support service. Caregivers asked questions about treatment options that required significant clinical knowledge to answer. In contrast, questions from patients were concentrated in understanding their cancer and in seeking dietary recommendations to keep their cancer at bay. Conclusions: We observed early evidence that improving access to evidence-based information for caregivers will not only contribute to improved outcomes for the patient but also have a positive impact on the well-being of caregivers, which again in turn is expected to have a positive impact on the patient.[Table: see text]
Unmet psycho-social needs of parents of children who die from cancer.
Authors: Josephs Isabel , Welch Jennifer JG , Mannix Margaret 
Published: June 2022

e24005 Background: Cancer is the leading disease-related cause of death for children in the United States, but there is limited data on the needs of caregivers who have lost a child to cancer, and few evidence-based bereavement interventions exist. Parents whose children die from cancer have increased rates of depression, anxiety, and health problems. Prior studies have shown that bereaved parents desire continued contact with their child’s medical team and to connect with parents who have had similar losses. Methods: This is a cross sectional survey of primary caregivers of pediatric patients who died from cancer and were cared for at a moderate size pediatric oncology program (50 new diagnoses per year) from 2010 to 2020. Participation was solicited by mail in English and Spanish. Research packets contained five surveys: Demographic Survey, The Needs Assessment for Family Caregivers Bereaved to Cancer, Quality of Life Survey (SF-36), Brief Grief Assessment, and Social Support Questionnaire (SSQ-6). Interested subjects also participated in a semi-structured, in-depth qualitative interview. Results: One hundred six potentially eligible families were identified. 27 families consented, 10 were without a known address, and 2 opted out. Twenty research packets and 9 interviews were completed, representing 19% of the population of interest and 23% of the invited population. The sample was diverse in gender, age, income, and education level, but not race. The greatest unmet needs were finding meaning in the death, personal wellness, and social activities. Caregivers reported good physical functioning but poor emotional well-being and fatigue. Complicated grief was most profound in the interference (grief interfering with life) and intrusion (images and thoughts of the child) domains. Quantity of social support correlated with satisfaction with social support (P = 0.02). Bereaved parents with greater unmet needs were found to have poorer quality of life in the following domains: energy/fatigue (P = 0.005), role limitations due to emotional problems (P = 0.01), pain (P = 0.01), and emotional well-being (P = 0.02). Greater unmet needs did not correlate to more complicated grief (P = 0.30) or satisfaction with social support (P = 0.08). Interview themes elicited were inadequate current bereavement services, necessary support for siblings, desired contact with the medical team, and connections to other bereaved caregivers. Conclusions: Findings support the need for implementation of more intensive evidence-based bereavement programs for families of children who died from cancer. The data suggests that interventions targeting emotional well-being and increased social supports, in the form of connections to the medical team and other bereaved families, will be the most efficacious in mitigating poor bereavement-related outcomes.
Pilot study of the implementation of G8 screening tool, cognitive screening assessment and chemotherapy toxicity assessment in older adults with cancer in a tertiary University Hospital in Ireland.
Authors: AlSendi Maha , Flynn Calvin , Khan Muhammad Raheel , Selvadurai Paul , Crown John , McDermott Raymond S. , Walshe Janice Maria , Fennelly David William , Hanrahan Emer O. , Doherty Mark , Higgins Michaela Jane 
Published: June 2022

e24019 Background: 11% of Ireland’s population is above the age of 65. This is projected to double to 1.4 million by 2040 corresponding to doubling of cancer cases. Clinical trials often exclude patients (pts) ≥70; therefore, it can be challenging to apply evidence based treatment (tx) to this population. Data from the National Cancer Registry of Ireland suggests under tx of older patients (pts). Comprehensive Geriatric assessment (CGA) is recommended by the National Comprehensive Cancer Network (NCCN) and the International Society of Geriatric Oncology (SIOG). In practice, CGA is limited by time constraints, lack of resources and expert interpretation. Geriatric screening tools can help identify frail pts who are most likely to benefit from CGA. The primary objective of this pilot study was to establish the prevalence of frailty (assessed by G8), presence of cognitive impairment (assessed by Mini-Cog), and risk of chemo-toxicity (assessed by Chemo-Toxicity Calculator) among pts ≥ 65 years (yrs) starting systemic anti-cancer tx. Methods: Pts ≥65yrs starting new systemic anticancer tx were identified between 1st of December 2020 to 31ST of September 2021 in St. Vincent’s University Hospital. Verbal consent was obtained. Printed versions of the G8 screening tool and Mini-Cog were used. CARG chemo-toxicity score was conducted online ( www.mycarg.org/tools ). .The assessment was conducted by consultants, specialist registrars and registrars. Data including pts’ age, type of malignancy, stage of cancer, and planned treatment were recorded. Analysis was conducted by SPSS statistical software, V.25(SPSS Institute, IBM Corp., 2017). Results: We identified 56 pts ≥65 years.27 (48.1%) were females and 29 (50.8%) were males. The majority of treated pts, N = 33 (58.1%) had metastatic cancer. The median G8 score was 12 (IQR 9.6-14). 83.9% of pts had a G8 score ≤14. Mini-Cog was found to be positive in 11 pts (19.6%). The median CARG score was 7 (IQR 6-11) and the median risk of toxicity 51% (IQR 44-78%). Of these, 44 (78.2%) received chemotherapy and 12 pts (21.4%) received non-chemotherapy systemic tx. In multi-variate analyses, age, type of cancer, planned treatment, and stage of disease did not impact G8, Min-cog, and CARG scores. Conclusions: In this single center study of elderly pts, more than 80% of pts had a positive G8 score representing a need for formal CGA assessment. The risk of toxicity was substantial with almost 50% risk of grade ≥ 3 toxicity in this cohort. Chronological age was not found to negatively impact patient’s frailty, cognition, or risk of toxicity. Interpretation of this pilot study is limited by small sample size, possible inter-operator variability, and lack of self-reported assessment.
Association of time intervals in cancer screenings and older participants’ characteristics, in a U.S. nationally representative sample.
Authors: Razavi Marianne , Bergerot Cristiane Decat , Philip Errol James , Dale William 
Published: June 2022

e24020 Background: Various guidelines regarding cancer screening intervals for older adults exist. They often differ based on age cut-offs. There is limited national data about factors impacting adherence to these guideline-based intervals. Using a national-representative dataset, self-reported screening rates between men and women for breast (Mammogram) or prostate (PSA) cancer were explored. The demographic and lifestyle characteristics associated with screening time intervals were also investigated. Methods: Data from the nationally representative National Social Life Health and Aging Project Wave 3 (NSHAP-W3, 2015) was used. Individuals with no history of cancer were asked: How long has it been since you last had a screening (Mammogram or PSA). Responses ranged from 1 = within the past year, 2 = between one and five years ago , 3 = more than five but less than ten years ago, 4 = ten or more years ago, 5 = never. Age groups consisted of 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, ≥80. Ordinal Logistic regression was used to study the association between screening time intervals (Mammogram or PSA) and participants’ characteristics (demographic, emotional, self-reported physical health, and physical activity). Results: Community-dwelling older adults (n = 2,320) were included (52% women, 48% men, with mean age of 66.9 years). There was a curvilinear response by age. The middle-age groups (60 thru 79) were significantly more likely to report shorter screening intervals, compared to the youngest group (50-54) and oldest group (≥80): ORs ranging from 0.30 to 0.61. No significant differences were observed between the oldest and youngest groups. Higher household income was associated with shorter time intervals (Mammogram: OR = 0.77; PSA: OR = 0.78, p < 0.001). African Americans were more likely to report shorter intervals between Mammograms (OR = 0.43, p < 0.001), compared to white women. More physically active men were likely to report shorter intervals (OR = 0.92, p = 0.021). Conclusions: Participants who are in their 60s or 70s, are more likely to have shorter time intervals between cancer screenings. African American women, and men performing frequent exercise are also more likely to have shorter intervals. These results emphasize the importance of sociodemographic and lifestyle factors, when seeking to impact cancer screening timing.