The incidence of anal squamous cell carcinoma (SCC) has increased, and treatment has shifted from surgery to chemoradiotherapy (CRT), with salvage abdominoperineal resection being reserved for persistent/recurrent cases. This study evaluates the utility of different tumor regression scoring systems in predicting survival in anal SCC patients, using pathologists' observations and digital pathology. Data of cases managed surgically from 2005 to 2019 were collected.
View Article and Find Full Text PDFKey Points: Serotonin receptor antagonists reduce the incidence of AKI in patients receiving cisplatin as chemotherapy. New-generation serotonin receptors do not offer any additional advantage in terms of protection from cisplatin induced AKI.
Background: Cisplatin is an effective first-line therapy for a variety of cancers.
Purpose: To report distinctive clinical and imaging features of iris freckles to differentiate them from iris nevi.
Design: Retrospective observational study.
Subjects: 53 patients (277 freckles) with incidental iris freckles and 102 patients (104 nevi) with iris nevi that are either clinically stable or pathologically confirmed.
Purpose: to evaluate the effectiveness of enhanced surveillance protocols (EP) utilizing high frequency (HF) or enhanced modality (EM) compared to the standard protocol (SP) in detecting metastasis and determining their impact on overall survival (OS) in high-risk uveal melanoma (UM) patients.
Methods: A total of 87 consecutive patients with Class 2 (high risk) primary UM were enrolled, with negative baseline systemic staging. The patients underwent systemic surveillance with either SP (hepatic ultrasonography [US] every 6 months) or EP (either HF [US every 3 months] or EM [incorporation hepatic computed tomography/magnetic resonance imaging]) following informed discussion.
Observational studies often dance around the issue of causality. We propose guidelines to ensure that papers refer to whether or not the study aim is to investigate causality, and suggest language to use and language to avoid.
View Article and Find Full Text PDFImportance: Despite improvements in perioperative mortality, the incidence of postoperative surgical site infection (SSI) remains high after pancreatoduodenectomy. The effect of broad-spectrum antimicrobial surgical prophylaxis in reducing SSI is poorly understood.
Objective: To define the effect of broad-spectrum perioperative antimicrobial prophylaxis on postoperative SSI incidence compared with standard care antibiotics.
Introduction: Efforts to develop biomarker-targeted anti-cancer therapies have progressed rapidly in recent years. With efforts to expedite regulatory reviews of promising therapies, several targeted cancer therapies have been granted accelerated approval on the basis of evidence acquired in single-arm phase II clinical trials. And yet, in the absence of randomization, patient prognosis for progression-free survival and overall survival may not have been studied under standard of care chemotherapies for emerging biomarker subpopulations prior to the submission of an accelerated approval application.
View Article and Find Full Text PDFBackground: Mediastinal radiation is associated with increased risk of myocardial infarction (MI) among non-Hodgkin lymphoma (NHL) survivors.
Objective: To evaluate how preexisting cardiovascular risk factors (CVRFs) modify the association of mediastinal radiation and MI among a national population of NHL survivors with a range of CVRFs.
Material And Methods: Using Danish registries, we identified adults diagnosed with lymphoma 2000-2010.
This article discusses and compares statistical designs of basket trial, from both frequentist and Bayesian perspectives. Baskets trials are used in oncology to study interventions that are developed to target a specific feature (often genetic alteration or immune phenotype) that is observed across multiple tissue types and/or tumor histologies. Patient heterogeneity has become pivotal to the development of non-cytotoxic treatment strategies.
View Article and Find Full Text PDFDeep learning (DL) from electronic health records holds promise for disease prediction, but systematic methods for learning from simulated longitudinal clinical measurements have yet to be reported. We compared nine DL frameworks using simulated body mass index (BMI), glucose, and systolic blood pressure trajectories, independently isolated shape and magnitude changes, and evaluated model performance across various parameters (e.g.
View Article and Find Full Text PDFBackground: Post-mastectomy radiation therapy (PMRT) in women with pathologic stage T1-2N1M0 breast cancer is controversial.
Methods: Data from five North American institutions including women undergoing mastectomy without neoadjuvant therapy with pT1-2N1M0 breast cancer treated from 2006 to 2015 were pooled for analysis. Competing-risks regression was performed to identify factors associated with locoregional recurrence (LRR), distant metastasis (DM), overall recurrence (OR), and breast cancer mortality (BCM).
Advances in biology and immunology have elucidated genetic and immunologic origins of cancer. Innovations in sequencing technologies revealed that distinct cancer histologies shared common genetic and immune phenotypic traits. Pharmacologic developments made it possible to target these alterations, yielding novel classes of targeted agents whose therapeutic potential span multiple tumor types.
View Article and Find Full Text PDFPurpose: The customary approach to early-phase clinical trial design, where the focus is on identification of the maximum tolerated dose, is not always suitable for noncytotoxic or other targeted therapies. Many trials have continued to follow the 3 + 3 dose-escalation design, but with the addition of phase I dose-expansion cohorts to further characterize safety and assess efficacy. Dose-expansion cohorts are not always planned in advance nor rigorously designed.
View Article and Find Full Text PDFAm J Ophthalmol
September 2022
Purpose: To quantify potential loss (loss of vision) and gain (freedom from metastasis) in patients with small choroidal melanoma treated after a period of surveillance to document growth.
Methods: A total of 167 patients with small choroidal melanoma (size: 5.0-16.
Ocul Oncol Pathol
February 2022
Objective: This study aimed to develop a validated machine learning model to diagnose small choroidal melanoma.
Design: This is a cohort study.
Subjects Participants And/or Controls: The training data included 123 patients diagnosed as small choroidal melanocytic tumor (5.
Introduction: The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor osimertinib was recently approved for resected EGFR-mutant stages IB-IIIA non-small cell lung cancer due to improved disease-free survival (DFS) in this population compared with placebo. This study aimed to evaluate the cost-effectiveness (CE) of this strategy.
Materials And Methods: We constructed a Markov model using post-resection health state transitions with digitized DFS data from the ADAURA trial to compare cost and quality-adjusted life years (QALYs) of 3 years of adjuvant osimertinib versus placebo over a 10-year time horizon.
Background: Recent advances in developing "tumor agnostic" oncology therapies have identified molecular targets that define patient subpopulations in a manner that supersedes conventional criteria for cancer classification. These successes have produced effective targeted therapies that are administered to patients regardless of their tumor histology. Trials have evolved as well with master protocol designs.
View Article and Find Full Text PDFImportance: Diagnosis of small choroidal melanoma is based upon clinical features and presence of factors predictive of local malignant growth. Prognostic biopsy quantifies risk of metastasis.
Objective: The aim of this study is to explore relationship between clinical characteristics and metastatic potential of a small choroidal melanoma.