Long-term oncological outcomes following emergency resection of colon cancer.

Purpose: The relationship between emergency colon cancer resection and long-term oncological outcomes is not well understood. Our objective was to characterize the impact of emergency resection for colon cancer on disease-free and overall patient survival.

Methods: Data on patients undergoing resection for colon cancer from 2006 to 2015 were collected from a prospectively maintained clinical and administrative database.

The Potential Clinical and Economic Value of Primary Tumour Identification in Metastatic Cancer of Unknown Primary Tumour: A Population-Based Retrospective Matched Cohort Study.

Purpose: Several genomic tests have recently been developed to identify the primary tumour in cancer of unknown primary tumour (CUP). However, the value of identifying the primary tumour in clinical practice for CUP patients remains questionable and difficult to prove in randomized trials.

Objective: We aimed to assess the clinical and economic value of primary tumour identification in CUP using a retrospective matched cohort study.

Patient-perceived barriers to radiation therapy for breast cancer.

Studies have shown that a number of women do not receive adjuvant radiation therapy following breast-conserving surgery; the reasons have not been well investigated. We reviewed the charts of 267 patients in our institution who did not receive radiation therapy following surgery in order to determine patient-stated reasons for nonreceipt. We found that 43% of patients did not receive radiation because they received a completion mastectomy.

COX-2 induces oncogenic micro RNA miR655 in human breast cancer.

We show that Cyclooxygenase-2 over-expression induces an oncogenic microRNA miR655 in human breast cancer cells by activation of EP4. MiR655 expression positively correlated with COX-2 in genetically disparate breast cancer cell lines and increased in all cell lines when grown as spheroids, implicating its link with stem-like cells (SLCs). Ectopic miR655 over-expression in MCF7 and SKBR3 cells resulted in increased proliferation, migration, invasion, spheroid formation and Epithelial to Masenchymal transition (EMT).

Training Canadian surgeons in oncoplastic breast surgery: Where do we stand?

Breast-conserving surgery with adjuvant radiation therapy is widely accepted as a universal standard of care for women with early-stage breast cancer. Oncoplastic breast-conserving surgery (OPS) techniques have emerged in recent years, facilitating the achievement of better cosmetic results while adhering to good oncological principles. Compared with the rest of the international community, Canada has been fairly slow in its clinical uptake of OPS.

Patient-perceived barriers to radiation therapy for breast cancer.

Studies have shown that a number of women do not receive adjuvant radiation therapy following breast-conserving surgery; the reasons have not been well investigated. We reviewed the charts of 267 patients in our institution who did not receive radiation therapy following surgery in order to determine patientstated reasons for nonreceipt. We found that 43% of patients did not receive radiation because they received a completion mastectomy.

Do Moderate Surgical Treatment Delays Influence Survival in Colon Cancer?

Background: Studies examining treatment delay and survival after surgical treatment of colon cancer have varied in quality and outcome, with little evidence available regarding the safety of longer surgical treatment wait times.

Objective: Our study examined the effect of surgical treatment wait times on survival for patients with stage I to III colon cancer.

Design: A subset cohort analysis was performed using data from a prospectively maintained database.

Training oncoplastic breast surgeons: the Canadian fellowship experience.

Background: Oncoplastic breast surgery combines traditional oncologic breast conservation with plastic surgery techniques to achieve improved aesthetic and quality-of-life outcomes without sacrificing oncologic safety. Clinical uptake and training remain limited in the Canadian surgical system. In the present article, we detail the current state of oncoplastic surgery (ops) training in Canada, the United States, and worldwide, as well as the experience of a Canadian clinical fellow in ops.

The clinical significance of occult gynecologic primary tumours in metastatic cancer.

Objective: We estimated the frequency of occult gynecologic primary tumours (gpts) in patients with metastatic cancer from an uncertain primary and evaluated the effect on disease management and overall survival (os).

Methods: We used Manitoba administrative health databases to identify all patients initially diagnosed with metastatic cancer during 2002-2011. We defined patients as having an "occult" primary tumour if the primary was classified at least 6 months after the initial diagnosis.

Concurrent Neoadjuvant Chemotherapy and Radiation Therapy in Locally Advanced Breast Cancer.

Purpose: To evaluate whether concurrent neoadjuvant radiation added to standard chemotherapy could increase the pathologic complete response (pCR) to treatment for locally advanced breast cancer (LABC).

Methods And Materials: This prospective phase 2 trial recruited 32 LABC patients from 2009 to 2011. Patients received neoadjuvant every-3-weekly 5-fluorouracil (500 mg/m), epirubicin (100 mg/m), and cyclophosphamide (500 mg/m) for 3 cycles, followed by weekly docetaxel (35 mg/m) for 9 cycles.

G protein-coupled KISS1 receptor is overexpressed in triple negative breast cancer and promotes drug resistance.

Triple-negative breast cancer (TNBC) lacks the expression of estrogen receptor α, progesterone receptor and human epidermal growth factor receptor 2 (HER2). TNBC patients lack targeted therapies, as they fail to respond to endocrine and anti-HER2 therapy. Prognosis for this aggressive cancer subtype is poor and survival is limited due to the development of resistance to available chemotherapies and resultant metastases.

The Clinical Significance of Occult Gastrointestinal Primary Tumours in Metastatic Cancer: A Population Retrospective Cohort Study.

Purpose: The purpose of this study was to estimate the incidence of occult gastrointestinal (GI) primary tumours in patients with metastatic cancer of uncertain primary origin and evaluate their influence on treatments and overall survival (OS).

Materials And Methods: We used population heath data from Manitoba, Canada to identify all patients initially diagnosed with metastatic cancer between 2002 and 2011. We defined patients to have "occult" primary tumour if the primary was found at least 6 months after initial diagnosis.

Enhancing accrual to chemotherapy trials for patients with early stage triple-negative breast cancer: a survey of physicians and patients.

Purpose: The optimal chemotherapy regimen for patients with early stage triple-negative breast cancer (TNBC) remains unknown. The purpose of the study is to survey physicians and breast cancer patients about preferred chemotherapy regimens for early stage TNBC and clinical trial strategies.

Methods: A standardised online questionnaire was developed and circulated to medical oncologists known to treat breast cancer.

The effect of surgery type on survival and recurrence in very young women with breast cancer.

Background: The impact of surgical treatment on outcomes in breast cacner in very young women remains unclear. We sought to determine the effect of surgery type on risk of recurrence and survival in a population-based cohort.

Methods: All women diagnosed with breast cancer aged ≤35 (1994-2003) were identified from the Ontario Cancer Registry.

A review of the literature and discussion: establishing a consensus for the definition of post-mastectomy pain syndrome to provide a standardized clinical and research approach.

Chronic pain presents a management challenge for physicians and patients alike, and post-mastectomy pain is no exception. In this issue, Waltho and Rockwell present a review of post-mastectomy pain syndrome (PMPS) and propose a standard definition that should allow future studies to be comparable. The proposed definition of "post-breast surgery pain syndrome" includes pain after any type of breast surgery that is of at least moderate intensity and comprises neuropathic qualities, that is present in the ipsilateral breast/chest/arm, that lasts longer than 6 months and is present at least half the time.

Predicting which patients actually receive radiation following breast conserving therapy in Canadian populations.

Canadian women with breast cancer may choose breast conserving therapy as their course of treatment, requiring both breast conserving surgery and adjuvant radiation therapy. However, more than 15% of Canadian women fail to receive the appropriate radiation therapy, putting them at increased risk for recurrence. Age, distance from their radiation therapy centre and stage of disease affect patients' likelihood of receiving prescribed radiation therapy.

The Microbiota of Breast Tissue and Its Association with Breast Cancer.

Unlabelled: In the United States, 1 in 8 women will be diagnosed with breast cancer in her lifetime. Along with genetics, the environment contributes to disease development, but what these exact environmental factors are remains unknown. We have previously shown that breast tissue is not sterile but contains a diverse population of bacteria.

A Single Institution Consensus on the Use of Sequential or Concurrent Hormonal Therapy for Breast Cancer Patients Receiving Radiation Therapy.

Background And Objectives: For hormone-sensitive breast cancers, treatment with breast-conserving surgery, tamoxifen, or aromatase inhibitors, along with adjuvant radiation, is the mainstay of therapy. The ideal timing of hormonal and radiation treatment is not well defined, and there is a significant degree of practice variability between concurrent and sequential treatment regimes. This variability can cause confusion amongst the clinical team resulting in contradictory recommendations, loss of patient trust, and the potential for missed initiation of hormonal therapy.

Cost-effectiveness of using a gene expression profiling test to aid in identifying the primary tumour in patients with cancer of unknown primary.

We aimed to investigate the cost-effectiveness of a 2000-gene-expression profiling (GEP) test to help identify the primary tumor site when clinicopathological diagnostic evaluation was inconclusive in patients with cancer of unknown primary (CUP). We built a decision-analytic-model to project the lifetime clinical and economic consequences of different clinical management strategies for CUP. The model was parameterized using follow-up data from the Manitoba Cancer Registry, cost data from Manitoba Health administrative databases and secondary sources.

Longitudinal control behaviour: Analysis and modelling based on experimental surveys in Italy and the UK.

This paper analyses driving behaviour in car-following conditions, based on extensive individual vehicle data collected during experimental field surveys carried out in Italy and the UK. The aim is to contribute to identify simple evidence to be exploited in the ongoing process of driving assistance and automation which, in turn, would reduce rear-end crashes. In particular, identification of differences and similarities in observed car-following behaviours for different samples of drivers could justify common tuning, at a European or worldwide level, of a technological solution aimed at active safety, or, in the event of differences, could suggest the most critical aspects to be taken into account for localisation or customisation of driving assistance solutions.

Nostalgia fosters self-continuity: Uncovering the mechanism (social connectedness) and consequence (eudaimonic well-being).

Nostalgia, a sentimental longing for one's past, is an emotion that arises from self-relevant and social memories. Nostalgia functions, in part, to foster self-continuity, that is, a sense of connection between one's past and one's present. This article examined, in 6 experiments, how nostalgia fosters self-continuity and the implications of that process for well-being.

Daily Incision Cleansing with Alcohol Reduces the Rate of Surgical Site Infections: A Pilot Study.

Surgical site infections (SSIs) represent a significant source of preventable patient morbidity and hospital expense. Our objective was to assess the role of postoperative incisional alcohol cleansing in decreasing the rates of SSI as compared with standard care (control). Patients undergoing clean-contaminated abdominal operations at a single center were included.

CJS debate: Is mammography useful in average-risk screening for breast cancer?

Given recent the debate over breast cancer screening that was reignited by the 25-year follow-up data from the Canadian National Breast Screening Study, the Canadian Journal of Surgery commissioned a group of Canadian experts to debate the value of screening mammography. We discuss the Canadian study and summarize the arguments in favour of and against screening mammography for average-risk patients. We also provide summary recommendations for the use of mammography.