Cancer Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Δευτέρα 30 Οκτωβρίου 2017
Survival in Neuroendocrine Neoplasms: A Report from a large Norwegian Population-based Study
Abstract
Neuroendocrine neoplasms (NENs) are heterogeneous tumors originating from neuroendocrine cells. Their malignant potential varies from indolence to high-grade malignancy (carcinomas). We studied the survival of all NENs in Norway according to malignant potential and different primary sites. We identified all NEN cases diagnosed in 1993-2015 and reported to the national population-based Cancer Registry of Norway. We included 62 morphological types. According to morphological characteristics and known disease behavior, we stratified the tumors into two different groups: low/intermediate aggressiveness and high aggressiveness. A total of 17,128 NENs were analyzed. Median age was 67 years and 47.6% were females. The most common primary sites were in the lungs and the gastroenteropancreatic (GEP) system. The 5-year relative survival in patients with low/intermediate aggressive NENs was 64.8% (95% CI, 63.3-66.2) and high aggressive NENs 8.4% (95% CI, 7.8-9.1). Females had higher survival rates than males (p <0.001). The relative 5-year survival rate in patients younger than 50 years was 89.1% (95% CI, 87.4-90.7) vs 41.0% (95% CI, 34.9-46.9) in patients ≥ 80 years. In multivariable analysis gender, age at diagnosis, time of diagnosis, stage and primary sites were all predictors of outcome both in patients with low/intermediate tumors and high aggressive tumors. Survival improved significantly over time, regardless of sex, age and tumor stage. This article is protected by copyright. All rights reserved.
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Determinants of physical, affective, and cognitive fatigue: During breast cancer therapy and 12 months follow-up
Abstract
Fatigue is common in cancer survivors but often insufficiently treated. Due to its complexity a one-size-fits-all treatment seems not appropriate. To gain more information on influencing factors and sub-dimensions of fatigue we investigated potential determinants and correlates of physical, affective, and cognitive fatigue in breast cancer survivors during and after adjuvant therapy. Within the follow-up of two randomized controlled trials physical, affective, and cognitive fatigue were repeatedly assessed during and up to 12 months after cancer therapy with the 20-item Fatigue Assessment Questionnaire in 255 breast cancer survivors. Determinants of the different fatigue dimensions over time were explored with linear mixed models. Chemotherapy appeared as significant precipitating factor for physical fatigue. However, type of cancer therapy had no impact on fatigue one year post-treatment. Obesity was significantly associated with increased physical fatigue throughout all time points (Δ=15.5 at 12 months) whereas exercise appeared to be beneficial (Δ=-6.3). In contrast, affective fatigue was significantly associated with poor social support and worries about the future. In addition, poor sleep quality and previous use of psychopharmaceuticals were significantly associated with physical, affective, as well as cognitive fatigue. Further, hot flashes were associated with increased physical and cognitive fatigue. In conclusion, the broad diagnosis "fatigue" in cancer survivors needs to be recognized as a diversity of symptoms determined by specific characteristics and likely different etiologies. Taking potential influencing factors such as obesity, physical inactivity, sleep problems, hot flashes, lack of social support, or psychological disorders into consideration might enable a better, individually-tailored fatigue treatment. This article is protected by copyright. All rights reserved.
http://ift.tt/2yXDhhD
Survival in Neuroendocrine Neoplasms: A Report from a large Norwegian Population-based Study
Abstract
Neuroendocrine neoplasms (NENs) are heterogeneous tumors originating from neuroendocrine cells. Their malignant potential varies from indolence to high-grade malignancy (carcinomas). We studied the survival of all NENs in Norway according to malignant potential and different primary sites. We identified all NEN cases diagnosed in 1993-2015 and reported to the national population-based Cancer Registry of Norway. We included 62 morphological types. According to morphological characteristics and known disease behavior, we stratified the tumors into two different groups: low/intermediate aggressiveness and high aggressiveness. A total of 17,128 NENs were analyzed. Median age was 67 years and 47.6% were females. The most common primary sites were in the lungs and the gastroenteropancreatic (GEP) system. The 5-year relative survival in patients with low/intermediate aggressive NENs was 64.8% (95% CI, 63.3-66.2) and high aggressive NENs 8.4% (95% CI, 7.8-9.1). Females had higher survival rates than males (p <0.001). The relative 5-year survival rate in patients younger than 50 years was 89.1% (95% CI, 87.4-90.7) vs 41.0% (95% CI, 34.9-46.9) in patients ≥ 80 years. In multivariable analysis gender, age at diagnosis, time of diagnosis, stage and primary sites were all predictors of outcome both in patients with low/intermediate tumors and high aggressive tumors. Survival improved significantly over time, regardless of sex, age and tumor stage. This article is protected by copyright. All rights reserved.
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Determinants of physical, affective, and cognitive fatigue: During breast cancer therapy and 12 months follow-up
Abstract
Fatigue is common in cancer survivors but often insufficiently treated. Due to its complexity a one-size-fits-all treatment seems not appropriate. To gain more information on influencing factors and sub-dimensions of fatigue we investigated potential determinants and correlates of physical, affective, and cognitive fatigue in breast cancer survivors during and after adjuvant therapy. Within the follow-up of two randomized controlled trials physical, affective, and cognitive fatigue were repeatedly assessed during and up to 12 months after cancer therapy with the 20-item Fatigue Assessment Questionnaire in 255 breast cancer survivors. Determinants of the different fatigue dimensions over time were explored with linear mixed models. Chemotherapy appeared as significant precipitating factor for physical fatigue. However, type of cancer therapy had no impact on fatigue one year post-treatment. Obesity was significantly associated with increased physical fatigue throughout all time points (Δ=15.5 at 12 months) whereas exercise appeared to be beneficial (Δ=-6.3). In contrast, affective fatigue was significantly associated with poor social support and worries about the future. In addition, poor sleep quality and previous use of psychopharmaceuticals were significantly associated with physical, affective, as well as cognitive fatigue. Further, hot flashes were associated with increased physical and cognitive fatigue. In conclusion, the broad diagnosis "fatigue" in cancer survivors needs to be recognized as a diversity of symptoms determined by specific characteristics and likely different etiologies. Taking potential influencing factors such as obesity, physical inactivity, sleep problems, hot flashes, lack of social support, or psychological disorders into consideration might enable a better, individually-tailored fatigue treatment. This article is protected by copyright. All rights reserved.
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Κυριακή 29 Οκτωβρίου 2017
Systematic analysis reveals a lncRNA-mRNA co-expression network associated with platinum resistance in high-grade serous ovarian cancer
Summary
Resistance to platinum-based chemotherapy is the major barrier to treating high-grade serous ovarian cancer (HGS-OvCa). To improve HGS-OvCa patient prognosis, it is critical to identify the underlying mechanisms that promote platinum resistance. The goal of the present study was to identify a lncRNA-mRNA co-expression network and key lncRNAs that predict resistance to platinum-based chemotherapy in ovarian cancer patients. By systematically analyzing the expression profiles of lncRNAs and mRNAs in HGS-OvCa samples from the Cancer Genome Atlas (TCGA), we revealed that lncRNAs play important roles in platinum resistance in HGS-OvCa patients and delineate a lncRNA-mRNA co-expression network in HGS-OvCa patients who exhibit platinum resistance. Within the platinum resistance-specific lncRNA-mRNA network, 35 lncRNAs and 270 mRNAs showed 124 significant lncRNA-mRNA co-expression relationships. Pathway analysis revealed that lncRNAs in the platinum resistance network may participate in platinum resistance by regulating metabolic pathways. Moreover, HGS-OvCa patients with low lncRNA RP5-1120P11.1 expression showed a poorer prognosis than those with high lncRNA RP5-1120P11.1 expression in TCGA dataset (P = 2.74 × 10−5, log rank test), which was also validated in the GSE63885 dataset (P = 0.0242, log rank test). Network and function analysis revealed that lncRNA RP5-1120P11.1 regulates many cancer-related signaling pathways, such as the PI3K-AKT signaling pathway (P = 1.02 × 10−5, hypergeometric test) and the Jak-STAT signaling pathway (P = 1.71 × 10−4, hypergeometric test). Particularly, lncRNA RP5-1120P11.1 expression is significantly positively correlated with ABCC10 gene expression (P = 3.89 × 10−3, Pearson correlation test). Both lncRNA RP5-1120P11.1 and ABCC10 were down-regulated in platinum-resistant HGS-OvCa patients, and RP5-1120P11.1 is located near ABCC10 on chromosome 6. Gene ABCC10 has been implicated in resistance to docetaxel treatment. The present study paves the way for investigating lncRNA functions in platinum drug resistance and identifying lncRNAs with prognostic and therapeutic potential in HGS-OvCa.
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