Oncology最新文献

{"title":"Long-Term Survival of Node-Positive Breast Cancer with Complete Nodal Response to Neoadjuvant Chemotherapy Treated with Sentinel Lymph Node Biopsy Alone: A Meta-Analysis.","authors":"Yunfeng Ding, Wanbo Wu, Xiaofeng Ni, Zhanwei Wang","doi":"10.1159/000543662","DOIUrl":"10.1159/000543662","url":null,"abstract":"<p><strong>Introduction: </strong>There exist concerns regarding the use of sentinel lymph node (SLN) biopsy alone in node-positive breast cancer patients who have a clinical/radiological complete response in the axilla and are negative on histopathology after neoadjuvant chemotherapy (NACT). We hereby conducted a meta-analysis examining 5-year overall survival (OS) and disease-free survival (DFS) of such patients.</p><p><strong>Methods: </strong>PubMed, the Cochrane CENTRAL Library, Embase, Web of Science, and Scopus were searched up to July 30, 2024, for studies reporting survival data. OS and DFS were pooled in a meta-analysis. Subgroup analysis was conducted based on the location of the study, pre-NACT node assessment, and SLN mapping technique. Random-effects meta-regression was conducted for the following moderators: age, initial T3-4, initial N2-3, breast-conserving surgery, breast pathological complete response (pCR), number of SLN removed, adjuvant radiotherapy, endocrine therapy, and follow-up.</p><p><strong>Results: </strong>Sixteen studies with 5,249 patients were included. Meta-analysis showed that node-positive breast cancer patients showing nodal pCR after NACT and undergoing only SLN biopsy had a 5-year OS and DFS of 94% (95% CI: 92%, 96%) and 89% (95% CI: 87%, 92%), respectively. There was not much variation in the survival rate on sensitivity and subgroup analyses. Meta-regression showed that OS and DFS were higher in studies with a greater number of patients receiving endocrine therapy.</p><p><strong>Conclusion: </strong>Breast cancer patients with cN+ who achieve a complete clinical/radiological axillary response after NACT and subsequently become SLN biopsy negative may have high rates of DFS and OS after 5 years. Given the high degree of heterogeneity, results should be interpreted with caution. We do not recommend change in treatment plans given the high risk of bias and large heterogeneity in the patient population included in the studies. Only high-quality large multicentric randomized trials can provide better evidence.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-15"},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Immune-Related Adverse Events of Pembrolizumab Using FAERS Database.","authors":"Feilong Tan, Li Zhou, Guijiang Huang, Yanhua Li, Wenjie Yin, Hongying Xia","doi":"10.1159/000543520","DOIUrl":"10.1159/000543520","url":null,"abstract":"<p><strong>Introduction: </strong>Pembrolizumab is a PD-1 inhibitor that has been approved for the treatment of melanoma, non-small cell lung cancer, esophageal cancer and other malignant tumors. The safety profile of pembrolizumab across a broad patient population over an extended timeframe remains unverified. This study aims to investigate the adverse events (AEs) related to pembrolizumab and provide references for its safe and rational clinical use.</p><p><strong>Methods: </strong>The study used FDA Adverse Event Reporting System (FAERS) data reported from July 2014 to September 2023, Risk estimation was conducted using the proportional reporting ratio (PRR). AEs were classified and analyzed according to the system organ class (SOC) and preferred term (PT) from the Medical Dictionary for Regulatory Activities (MedDRA).</p><p><strong>Results: </strong>A total of 37,511 AE reports were identified, involving 5,259 PTs and 22 SOCs. Using the PRR method, 931 positive signals were detected. The top 10 risk signals were all immune-related AEs (irAEs) and important medical events (IMEs). The five PTs with the highest signal intensity were immune-mediated hypothyroidism, immune-mediated renal disorder, immune-mediated hepatic disorder, immune-mediated gastritis, and immune-mediated hyperthyroidism. The leading SOCs involved in AE reports were general disorders and administration site conditions, investigations, gastrointestinal disorders, respiratory, thoracic, and mediastinal disorders, and injury, poisoning, and procedural complications. The median time to onset of AE was 25 days (interquartile range [IQR] 6-85 days), with the Weibull distribution test indicating an early failure-type curve. Gender and age analysis revealed that women were more likely to develop hypertension, alopecia, headache, hypothyroidism, and palmar-plantar erythrodysesthesia syndrome, whereas men were more likely to develop interstitial lung disease, renal impairment, and death. Additionally, neutropenia was more prevalent in patients under 65 years of age, while interstitial lung disease and renal impairment were more common in patients aged 65 and above.</p><p><strong>Conclusion: </strong>Significant age- and gender-related differences were observed in AE signals with pembrolizumab, particularly for irAEs. Clinical attention should be directed toward the potential occurrence of irAEs at the initial stages of drug administration, with appropriate measures implemented as necessary.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of Surgery versus Radiation Therapy on the Risk of Cardiovascular Disease Mortality in Patients with Early Stage Non-Small Cell Lung Cancer.","authors":"Zijian Shen, Guogang Gao, Chuanping Liu, Ge Yu","doi":"10.1159/000543164","DOIUrl":"10.1159/000543164","url":null,"abstract":"<p><strong>Introduction: </strong>Non-small cell lung cancer (NSCLC) lung cancer continues to be a substantial issue in public health, and cardiovascular disease (CVD) is also an important cause of death in NSCLC patients. There is a lack of studies comparing the effects of surgery and radiation therapy on the risk of CVD mortality in patients with early stage NSCLC. This study planned to compare the effects of surgery alone and radiation therapy alone on the risk of CVD mortality in patients with early stage NSCLC.</p><p><strong>Methods: </strong>In this cohort study, the data of 32,896 participants with NSCLC at stage I or stage II in 2010-2015 were retrieved from the surveillance, epidemiology, and end results (SEER) database. The primary endpoint of this study was CVD mortality, indicating patients died of CVDs and the follow-up was ended in 2020. Univariable Cox regression model was applied to identify covariates. The associations of surgery or radiation therapy with CVD mortality in in patients with early stage NSCLC were evaluated via univariable and multivariable Cox regression models and Fine-Gray competitive risk model. Hazards ratio (HR) and confidence interval (CI) were computed.</p><p><strong>Results: </strong>The median follow-up time was 48.00 (17.00, 60.00) months. There were 854 (6.45%) participants died of CVD in the radiation therapy group and 729 (5.35%) participants died of CVD in the surgery group. After adjusting for confounding factors, the elevated risk of CVD mortality in patients with early stage NSCLC was observed in patients receiving radiation therapy compared to those receiving surgery (HR = 2.33, 95% CI: 2.02-2.69). In the competing risk model, the risk of CVD mortality in patients with early stage NSCLC was also increased in patients receiving radiation therapy (HR = 1.37, 95% CI: 1.2.6-1.55). In the PSM group, the risk of CVD mortality in patients with early stage NSCLC was also increased in patients who underwent radiation therapy (HR = 2.62, 95% CI: 2.12-3.24). Subgroup analysis also revealed that radiation therapy was correlated with increased risk of CVD mortality in NSCLC patients with tumor size ≥50 mm or <50 mm, the original primary site in the left or right, histologic types of squamous cell NSCLC or adenocarcinoma NSCLC, stage I and II, and patients ≥65 years or <65 years.</p><p><strong>Conclusions: </strong>Radiation therapy was associated with elevated risk of CVD mortality compared to surgery in patients with early stage NSCLC.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden Resources for Cancer Patients: Interactions between Spirituality, Religiosity, and Selected Factors Influencing Patient's Self-Care.","authors":"Sebastian Ruhe, Helmut Orawa, Jutta Hübner, Jens Büntzel","doi":"10.1159/000543312","DOIUrl":"10.1159/000543312","url":null,"abstract":"<p><strong>Introduction: </strong>Religiosity and spirituality (SpR) can be vital in helping people face life's challenges. While spiritual care (SpC) is used in palliative care, this study explores effects for cancer patient's self-care (SC) in earlier stages.</p><p><strong>Methods: </strong>Using validated instruments, we surveyed patients about SpR (SpNQ-20, GrAw-7, SpREUK), and factors of SC: well-being (WHO-5, L-1), self-efficacy (ASKU), ability to change (PIAC), as well as lay etiology and the use of complementary and alternative medicine (CAM). Data were analyzed using SPSS according to a three-step plan with descriptive methods, Spearman correlations, and mediation analysis.</p><p><strong>Results: </strong>We included 108 patients (41 female, 63 males, four no data) with a median age of 66 years (range 30-89). Welch tests show a less well-being, self-efficacy and ability to change in our study population (p < 0.05) compared to non-cancer controls. The Mann-Whitney U test documented that patients who described themselves as spiritual and/or religious (S/R+) had a higher level of well-being and CAM use (p < 0.05) compared to those who did not. S/R self-categorization had no impact on PIAC and ASKU. Perceptual spirituality (GrAw-7) correlates with all factors of SC (p < 0.05): WHO-5 (rs = 0.25), PIAC (rs = 0.25), ASKU (rs = 0.30), L-1 (rs = 0.35), and CAM use (rs = 0.39, p < 0.001). Mediation analysis demonstrates that the impact of spirituality on SC (CAM use) is mediated by religiosity, GrAw-7, and spiritual needs.</p><p><strong>Conclusion: </strong>Spirituality and hidden spiritual needs are a valuable resource. By integrating SpC early in the treatment, we can create support ways and improve SC, well-being, and coping.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Mirogabalin Therapy for Paclitaxel-Induced Peripheral Neuropathy (MICHEL Study): A Pilot Study.","authors":"Aya Sawa, Hiroko Bando, Riko Sato, Tomohei Matsuo, Mai Okazaki, Sachie Hashimoto, Akiko Iguchi-Manaka, Hisato Hara","doi":"10.1159/000543798","DOIUrl":"10.1159/000543798","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent adverse event without an established, standard treatment. As mirogabalin is a gabapentinoid confirmed useful for diabetic, peripheral neuropathic pain, we examined the efficacy of mirogabalin for CIPN using quantitative sensory and pain analytical devices.</p><p><strong>Methods: </strong>This was a single-arm, open-label, prospective study conducted at the University of Tsukuba Hospital between April 2022 to April 2024. Patients with grade 2 or higher CIPN during weekly paclitaxel treatment for primary breast cancer were enrolled and received mirogabalin orally for 4 weeks. The primary endpoint was the Visual Analogue Scale (VAS) for peripheral neuropathy. Patient Neurotoxicity Questionnaire (PNQ) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-NTX) scores were obtained, and PainVision was used as an objective CIPN evaluation.</p><p><strong>Results: </strong>A total of 20 patients were enrolled. The median VAS score before starting mirogabalin was 13.50 for the hands and 25.00 for the feet. After 4 weeks of treatment, there was significant worsening in the hands (VAS score of 37.00) but no significant difference was observed for the feet. There were no significant differences in PNQ of the limbs between before and 4 weeks after the mirogabalin treatment, although the mean of the Neurotoxicity Subscale of FACT/GOG-NTX significantly worsened. Median PainVision scores for feet also significantly worsened from 50.30 to 89.40, but no significant change was observed for hands. PainVision feet score changes negatively correlated with FACT/GOG-NTX total scores. In the patient satisfaction survey, 14 patients (70%) were satisfied with mirogabalin and 15 patients (75%) wanted to continue.</p><p><strong>Conclusions: </strong>Although mirogabalin was not wholly effective for CIPN caused by paclitaxel treatment in breast cancer patients, the satisfaction survey suggests some patient-perceived benefits which cannot be detected by conventional evaluation methods.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current Status of Tumor Markers as Biomarkers in the Era of Immunotherapy for Hepatocellular Carcinoma: Alpha-Fetoprotein Alone Is Not Sufficient.","authors":"Atsushi Hiraoka, Masatoshi Kudo, Toshifumi Tada, Takeshi Hatanaka, Satoru Kakizaki, Kazuya Kariyama, Hideko Ohama, Kunihiko Tsuji, Toru Ishikawa, Koichi Takaguchi, Ei Itobayashi, Hidenori Toyoda, Tomomitsu Matono, Yutaka Yata, Chikara Ogawa, Atsushi Naganuma, Joji Tani, Masanori Atsukawa, Takashi Nishimura, Kazuto Tajiri, Kazuhito Kawata, Hisashi Kosaka, Hidekatsu Kuroda, Masashi Hirooka, Hiroki Nishikawa, Fujimasa Tada, Shinichiro Nakamura, Yuki Kanayama, Kazuhiro Nouso, Hironori Tanaka, Kazunari Tanaka, Michitaka Imai, Akemi Tsutsui, Takuya Nagano, Tomoko Aoki, Yuichi Koshiyama, Asahiro Morishita, Norio Itokawa, Tomomi Okubo, Taeang Arai, Shinya Fukunishi, Hidenao Noritake, Yoshiko Nakamura, Osamu Yoshida, Hirayuki Enomoto, Masaki Kaibori, Yoichi Hiasa, Takashi Kumada","doi":"10.1159/000543405","DOIUrl":"10.1159/000543405","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid development of systemic treatments has resulted in improved prognosis for unresectable hepatocellular carcinoma (uHCC) patients. Since immune therapy shows a favorable therapeutic efficacy, use of tumor markers as biomarkers for monitoring treatment response is necessary. This study aimed to elucidate changes in positive rates of 3 available tumor markers in Japan, including alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin (DCP), and lens culinaris agglutinin-reactive AFP (AFP-L3) in uHCC patients treated with systemic therapies over time.</p><p><strong>Methods: </strong>From 2009 to 2023, 1,470 uHCC patients with data of tumor markers before starting treatment were enrolled. The positivity cutoff value for AFP was 20 ng/mL, for AFP-L3 was 10%, and for DCP was 40 mAU/mL. After dividing the 15 years examined into three periods of 5 years each (period I, II, and III), clinical features of the enrolled patients were evaluated, retrospectively.</p><p><strong>Results: </strong>The percentage of Barcelona Clinic Liver Cancer stage B patients who received systemic therapy increased from period I to III (27.7%, 38.5%, 46.6%, respectively, p < 0.001), which was also seen for HCC patients with a nonviral etiology (alcohol and others) (29.9%, 39.7%, 49.6%, respectively p < 0.001). Positive rates for AFP (67.8%, 62.1%, 50.8%, respectively) and DCP (84.1%, 80.5%, 72.7%, respectively) were decreased (each p < 0.001), while the AFP-L3 rate did not show a significant change (54.4%, 57.7%, 51.9%, respectively, p = 0.390). Among the AFP-negative patients, the rate of positive for DCP or AFP-L3 was increased (24.4%, 28.1%, 35.4%, respectively, p = 0.002).</p><p><strong>Conclusion: </strong>Based on introduction of systemic treatment in an early stage and increasing numbers of HCC cases with a nonviral etiology, the positive rate of AFP level has been declining. Thus, determination of DCP and AFP-L3 in addition to AFP as markers should be more actively utilized in clinical practice, as well as clinical trials for monitoring and evaluating treatment response in this era of combination immunotherapy as a powerful treatment.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Chemotherapy (Anthracyclin, Cyclophosphamide following Docetaxel Regimen) on Sleep, Anxiety, Depression, and Quality of Life in Patients with Breast Cancer.","authors":"Suhyun Ju, Youn Joo Jung, Seungju Lee, Seok Kyeong Kang, Miri Ryu, Jee Yeon Kim, Kyung Jin Nam, Kyeyoun Lee, Ji Hyeon Joo, Youngkyung Jeon, Jae Joon Kim, Ji Hoon Kim, Su Bong Nam, Mi Sook Yun, Hyun Yul Kim","doi":"10.1159/000543730","DOIUrl":"10.1159/000543730","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy can cause sleep disorders, anxiety, depression, and decreased quality of life (QoL). This study aimed to compare sleep, anxiety, depression, and QoL during chemotherapy in patients with breast cancer to provide appropriate treatment at the appropriate time.</p><p><strong>Methods: </strong>This prospective study included patients with breast cancer who received chemotherapy at Pusan National University Yangsan Hospital. We used three self-reporting questionnaires regarding quality of sleep (QoS), anxiety, depression, and QoL. QoL was measured using the Pittsburgh Sleep Quality Index, anxiety using the Beck Anxiety Inventory, depression using the Beck Depression Inventory, and QoL using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form. Patients were assessed before, after, and during chemotherapy.</p><p><strong>Results: </strong>In total, 55 patients were enrolled in this study, of whom 49 completed three self-reporting questionnaires. Anxiety, depression, QoS, and QoL varied during the study. Anxiety, depression, and QoL scores were lowest at the end of chemotherapy (p < 0.005). However, QoS scores were lowest at the beginning of chemotherapy (p < 0.005). Cancer subtype (triple-negative vs. luminal type), T stage, type of breast surgery (breast-conserving surgery vs. mastectomy), and chemotherapy type (adjuvant vs. neoadjuvant) did not show a relationship with QoL, anxiety, depression, or QoS; however, age exhibited differences in all four areas. Patients aged >50 years experienced more sleep disturbances, anxiety, depression, and a decreased QoL. In addition, anxiety was increased during chemotherapy in patients with lymph node metastasis.</p><p><strong>Conclusions: </strong>Patients with breast cancer experience sleep disturbances, anxiety, depression, and low QoL during chemotherapy. During chemotherapy, these symptoms are often overlooked owing to the side effects of chemotherapy. Proper treatment and emotional support will help patients improve their QoL, anxiety, depression, and QoL.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Real-World Pharmacovigilance Analysis for Demethylation Drug: Findings from the FDA Adverse Event Reporting Database.","authors":"Shupeng Chen, Jie Liu, Yao Gao, Nana Tang, Yingjian Zeng","doi":"10.1159/000543519","DOIUrl":"10.1159/000543519","url":null,"abstract":"<p><strong>Introduction: </strong>The real-world safety profiles of the demethylating agents azacitidine and decitabine remain inadequately characterized despite their widespread clinical use. Both drugs are extensively employed for the treatment of hematologic malignancies such as myelodysplastic syndromes and acute myeloid leukemia. This study aimed to evaluate their adverse event profiles by leveraging data from the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database.</p><p><strong>Methods: </strong>All adverse drug event (ADE) data related to azacitidine and decitabine were collected from the FAERS database from its inception through the second quarter of 2024 (Q2). After standardizing the data, four disproportionality methods were applied to evaluate the association between azacitidine, decitabine, and ADEs. The Weibull shape parameter was used to analyze the time-to-onset curves.</p><p><strong>Results: </strong>Among the 15,538 ADEs where azacitidine was the primary suspect drug, a total of 439 preferred terms (PTs) and 2 system organ classes (SOCs) showed significant disproportionality across all four algorithms. These SOCs included infections and infestations (n = 7,328, ROR 3.78) and blood and lymphatic system disorders (n = 5,613, ROR 8.92). Compared with the azacitidine label, 52 previously unreported ADEs were identified at the PT level. Among the 3,064 ADEs where decitabine was the primary suspect drug, a total of 200 PTs and two SOCs exhibited significant disproportionality across all four algorithms. These SOCs included blood and lymphatic system disorders (n = 1,284, ROR 6.53) and surgical and medical procedures (n = 571, ROR 3.41). Compared with the decitabine label, 29 previously unreported ADEs were identified at the PT level. Furthermore, the Bayesian Confidence Propagation Neural Network (BCPNN) algorithm revealed that the highest IC025 values for both azacitidine and decitabine were concentrated in SOCs related to benign, malignant, and unspecified tumors.</p><p><strong>Conclusion: </strong>In summary, using the FAERS database, we compared the real-world safety profiles of two demethylating agents, azacitidine and decitabine. The results indicate that adverse drug reactions related to these two agents are concentrated in the hematologic, respiratory, circulatory, and digestive systems, as well as in neoplasms of unspecified nature, warranting close clinical attention.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-18"},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatocellular Carcinoma with Multiple Primary Malignancies: A Retrospective Study of 106 Cases.","authors":"Yifei Li, Liuxing Feng, Chundong Lin, Lupeng Wu","doi":"10.1159/000543799","DOIUrl":"10.1159/000543799","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple primary malignancies (MPMs) are a rare scenario, particularly in patients with hepatocellular carcinoma (HCC). Research addressing MPM patients with HCC is limited. Therefore, we conducted a retrospective study to explore the clinical features and outcomes of MPM patients involving HCC.</p><p><strong>Methods: </strong>We retrospectively analyzed records of patients diagnosed with HCC from January 2013 to October 2023 in the First Affiliated Hospital of Xiamen University. HCC patients with extrahepatic tumors were identified. Their clinical characteristics and survival data were further analyzed.</p><p><strong>Results: </strong>Among the 1,556 patients with HCC, 106 (6.8%) were identified with EHPM, of which 29 were synchronous and 77 were metachronous. A total of 96 patients had double primary cancers, and 10 patients had triple primary cancers. The most common EHPMs were lung cancer (15%), followed by colorectal tumors and stomach cancer. Compared with the synchronous group, the curative treatment rate of HCC and EHPM in the metachronous group is higher. During follow-up period, 29 patients died, of which 20 (69%) died from HCC-related causes. The median overall survival (OS) time was 88 months, with 1-, 3-, 5-, and 10-year cumulative survival rates of 92.4%, 88%, 82.5%, and 69.6%, respectively. The 1-, 3-, and 5-year HCC-specific OS (HOS) rates were 81.8%, 75.8%, and 71.9%, respectively. Univariate analysis revealed that Child-Pugh class (B-C), HCC tumor size >5 cm, non-radical treatment for HCC or EHPM, HCC recurrence, BCLC staging (C-D), and synchronous appearance were significantly associated with shorter OS and HOS. Factors such as Childs class, tumor size, treatment modality, and synchronous presentation were identified as independent predictors of OS through Cox analysis. Childs class, tumor size, non-radical treatment, BCLC staging, and HCC recurrence were found to be independent factors affecting HOS.</p><p><strong>Conclusion: </strong>The occurrence of extrahepatic primary tumors is not rare, underscoring the importance for oncologists being alert to the development of secondary tumor development in HCC patients. However, the co-occurrence of other primary tumors alongside HCC does not appear to worsen patient prognosis. Notably, curative resection, where feasible, emerges as a vital factor in extending patient survival.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constructing and Validating Models for Predicting Gleason Grade Group Upgrading following Radical Prostatectomy in Localized Prostate Cancer: A Comparison between Machine Learning Algorithms and Conventional Logistic Regression.","authors":"Qian Gui, Xin Wang, Dandan Wu, Yonglian Guo","doi":"10.1159/000543492","DOIUrl":"10.1159/000543492","url":null,"abstract":"<p><strong>Introduction: </strong>The occurrence of Gleason grade group upgrading (GGU) significantly impacts treatment strategy developments. We aimed to develop an optimal predictive model to assess the risk of GGU in patients with localized prostate cancer (PCa), by comparing traditional logistic regression (LR) with seven machine learning algorithms.</p><p><strong>Methods: </strong>A retrospective collection of clinical data was conducted on patients who underwent radical prostatectomy at Wuhan Central Hospital (January 2017 to December 2023, n = 177) and Jiangxi Cancer Hospital (July 2019 to February 2024, n = 87). The least absolute shrinkage and selection operator regression was employed to filter the clinical characteristics of patients. Subsequently, models were conducted using multivariate LR, along with seven diverse machine learning algorithms: extreme gradient boosting, decision tree, multilayer perceptron, naive Bayes, K-nearest neighbors, random forest, and support vector machine. By employing the receiver operating characteristic curves, accuracy, brier score, recall, calibration curves, and decision curve analysis (DCA), we compared the predictive capabilities and clinical utility of eight models to identify the optimal one.</p><p><strong>Results: </strong>In the evaluation of eight models, the LR model demonstrated superior performance. In the modeling set, it achieved an area under curve (AUC) of 0.826 (95% CI: 0.808-0.845), accuracy of 0.765, and a brier score of 0.167. In the validation set, it kept good results with an AUC of 0.819 (95% CI: 0.758-0.880), accuracy of 0.725, and a brier score of 0.180. The calibration curves, brier score, and DCA also demonstrated the excellent calibration and net benefit of the LR model.</p><p><strong>Conclusions: </strong>After conducting a comprehensive multi-model comparison, we concluded that the LR model was optimal for predicting GGU, which was confirmed by external validation. Our study also revealed percent free prostate-specific antigen density as a predictive factor for GGU, offering a novel approach for managing localized PCa patients.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-11"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}