Forum of Clinical Oncology最新文献

{"title":"Patient-reported outcomes for immediate identification of dental care needs","authors":"P. Güneri, J. Epstein, J. Raber-Durlacher, H. Çankaya, H. Boyacıoğlu, A. Barasch","doi":"10.1515/fco-2015-0006","DOIUrl":"https://doi.org/10.1515/fco-2015-0006","url":null,"abstract":"Abstract Aim: Dental treatment is necessary in oncology patients since pre-existing oro-dental disease may influence cancer treatment and prognosis. This study investigated the applicability of two indices in reflecting the actual oral health status of 100 non-cancer patients who were admitted for dental complaints/routine controls. Methods: The radiographic examination results and the decayed, missed, filled teeth score represented the ‘actual oro-dental status’. The simplified oral hygiene index was utilised for oral hygiene determination, and general oral health assessment index was used to establish the self-perceived oral health. Results: No correlation was observed between actual oro-dental status and the simplified oral hygiene index (p = 0.27), but the relationship between oro-dental status and general oral health assessment index was significant (p = 0.026). Items 9, 5 and 1 (How often were you concerned about problems with your teeth, gums or dentures? How often were you able to eat anything without feeling discomfort? How often did you limit the kinds or amounts of food you eat because of problems with your teeth or dentures?) presented correlation (r = −0.285, r = 0.268, and r = −0.248). Conclusion: Three items of GOHAI (Geriatric Oral Health Assessment Index) may be used to identify the requisite of dental treatment in patients and to aid in immediate dental treatment planning.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"116 1","pages":"1 - 7"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of EGFR Mutation and EML4-ALK fusion gene in Arab Patients with Adenocarcinoma of the Lung","authors":"H. Shafik, M. Ashour","doi":"10.1515/fco-2015-0009","DOIUrl":"https://doi.org/10.1515/fco-2015-0009","url":null,"abstract":"Abstract Introduction: Improvement in the clinical outcome of lung cancer is likely to be achieved by identification of the molecular events that underlie its pathogenesis. The frequency of epidermal growth factor receptor (EGFR) mutations is ethnicity-dependent, with a higher proportion in Asian populations than in whites, while the incidence of EML4-ALK (echinoderm microtubule-associated-protein like 4-anaplastic lymphoma kinase) fusion gene ranged from 1.6% to 16.4% in patients with NSCLC and these individuals were distinct from those harbouring mutations in the epidermal growth factor receptor gene. This study was conducted to determine the frequency of EGFR mutation and EML4-ALK fusion gene in our population and to determine the effect of different clinicopathological features on the expression of those mutations in patients with lung adenocarcinoma. Results: EGFR mutations were detected in approximately 33% of our patients in this series; the most frequently detected mutation was exon 19 deletion. EML4-ALK fusion gene was detected in 7.3% of patients. Conclusion: Our population exhibited the incidence of EGFR mutation approximately similar to that reported in East Asia and Japanese patients, higher than that recorded in USA, and Australia. However, more studies with larger patients’ numbers are needed to verify this finding.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"19 - 23"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Thyrotropin Suppression Therapy in Treatment of Differentiated Thyroid Cancer after Total Thyroidectomy","authors":"Niveen Abotouk, D. Zayed","doi":"10.1515/fco-2015-0010","DOIUrl":"https://doi.org/10.1515/fco-2015-0010","url":null,"abstract":"Abstract Background: The aim of this prospective study was to assess the effect of the TSH suppression on both disease-free and overall survivals in patients with nonmetastatic differentiated thyroid cancer (DTC) after total thyroidectomy. Patients & Methods: One hundred and forty eight patients with pathologically proved operable differentiated thyroid carcinoma were enrolled in this prospective study. Levothyroxin (L-T4) therapy was started in doses according to treatment groups. Patients were randomly assigned to receive either postoperative TSH suppression therapy in group I (76 patients) or nonsuppression therapy in group II (72 patients). Results: During the period of follow up with a median 54 months, the disease-free survival for patients without TSH suppression therapy did not reach statistically significant difference comparing with those for patients with the suppression therapy (p=0.09). However, the difference was statistically significant for high-risk patients (p=0.04). On comparing both groups there was no statistically significant difference with regard to overall survival (p=0.17). The age of the patients more than 45 years, tumour size more than 4 cm and high-risk group were significant independent predictors for thyroid carcinoma-related relapse in univariate analysis. However, tumour size was the only significant factor in multivariate analysis. Conclusion: Suppressive treatment with L-T4 therapy in patients with differentiated thyroid carcinoma should be individualised and balanced against the adverse effects. TSH suppression is indicated in patients with high-risk disease or recurrent tumour. Normalisation of serum TSH is preferred for long-term treatment of disease-free elderly patients with DTC and comorbidities.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"24 - 33"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of plasma osteopontin level in breast cancer patients","authors":"H. Nassar, A. Namour, H. Shafik, A. E. El Sayed, S. Kamel, M. Moneer, N. Zakhary","doi":"10.1515/fco-2015-0005","DOIUrl":"https://doi.org/10.1515/fco-2015-0005","url":null,"abstract":"Abstract Many studies have demonstrated that osteopontin (OPN) contributes functionally to aggressive behaviour in many tumours including breast cancer. This study aims to investigate its role as a simple biochemical marker easily measured in plasma of breast cancer patients to give an early signal for metastases and to detect its relationship to clinicopathological findings and survival. We measured plasma OPN, CA15.3 and serum alkaline phosphatase (ALP) activity in 55 patients, 28 with early stage breast cancer and 27 with bone metastasis out of whom 20 had metastasis in other sites. The median age at diagnosis for non-metastatic cases was 60 years (range 35-85) and for metastatic cases was 45.5 years (range 32-59). In the non-metastatic group, 78.57% of the patients were histologically graded as grades I and II and 21.43% as grade III tumours. In the metastatic group, 81.48% of the patients had grades I and II and 18.52% had grade III tumours; 54% of patients in the non-metastatic group were at stage II and 46% were at stage III at presentation. All patients of group II had bone metastasis, 33% had liver metastases, 25.9% had lung metastasis and 14.8% had lymph node metastasis. Patients with non-metastatic disease had a median OPN level of 55 ng/ml (range 54-150 ng/l), while those in the metastatic group had a median of 148.0 ng/l (range 56.0-156.0 ng/l), a difference which was statistically significant (P = 0.001). There was no statistically significant difference in the median levels of CA15.3 and ALP between both groups. The median OPN level was significantly higher with serum ALP level above 90, progesterone receptor (PR) status, bone and visceral metastasis. Median OPN was not affected significantly by menopausal status (P-value 0.3), tumour grade (P-value 0.3), estrogen receptor (ER) status (P-value 0.7), pathological type (P-value 0.42) or serum CA15.3 level (P-value 0.6). At the end of 12-year follow-up, 83% of the patients survived (92.3% in the non-metastatic versus 74.1% in the metastatic group). The estimated median survival for the whole study population at 12 years was 13 years (95% CI 8.144-17.856). The estimated median survival was 13 years (95% CI 0) and 12 years (95% CI 4.893-19.11) in patients with median OPN levels of <142 and ≥142, respectively, a difference which was not statistically significant (P = 0.343). No statistically significant difference in overall survival OS was noticed in relation to menopausal status (P = 0.7), pathological type (P = 0.4) and hormone receptor status (P = 0.3). At 6-year follow-up, it was found that OS was affected by the presence of visceral metastasis, tumour grade, serum plasma level of ALP and the serum level of CA15.3 (P = 0.0006, 0.007, 0.001 and 0.03, respectively). However, the presence of bone metastasis did not affect OS (P = 0.6). Osteopontin level can be a simple biochemical marker easily measured in plasma of breast cancer patients to give early signals for metastases, but not a","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"27 - 32"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Langerhans cell histiocytosis following treatment for testicular cancer. A case report and literature review","authors":"Pistamaltzian Nikolaos, Nikolaidi Adamantia, R. Maria, Economou Aggelos, Mourtzoukos Spryridon, Athanasiadis Ilias","doi":"10.1515/fco-2015-0002","DOIUrl":"https://doi.org/10.1515/fco-2015-0002","url":null,"abstract":"Abstract A 35 year old male patient received treatment for testicular cancer of pure seminoma histology. He underwent initially a right inguinal orchiectomy and afterwards he received 3 cycles of BEP chemotherapy, as his imaging studies showed enlarged para-aortic lymph nodes. Five months after completion of chemotherapy treatment, a thoracic CT revealed multiple micronodular lesions in both lungs. The patient was advised about the need of salvage chemotherapy, but he opted to undergo further investigation. A lung lesion biopsy was performed, and histology was compatible with diagnosis of Langerhans cell histiocytosis (LCH). LCH is quite an unusual clinical entity that affects usually -but not solely- the lungs of young adults. The hallmark of the disease, is the presence of the activated Langerhans cells. As its clinical, laboratory and radiological findings are nonspecific, a transbronchial biopsy is sometimes necessary to establish diagnosis. Treatment is generally symptomatic and reserved for patients with multisystem organ involvement. LCH’s relationship with cancer is complex and no certain correlation is evident. More troublesome can be its differential diagnosis from a cancer with metastatic spread to the lungs or other affected organs, and although rare, it has to be kept in mind when suspicious signs arise","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"6 - 9"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localised gastrointestinal diffuse large B cell lymphomas; Does surgical approach still exist?","authors":"A. Ibrahim, A. Zedan, Alia M. A. Attia","doi":"10.1515/fco-2015-0003","DOIUrl":"https://doi.org/10.1515/fco-2015-0003","url":null,"abstract":"Abstract Background: Diffuse large B-cell lymphoma (DLBCL) is the commonest pathological type of gastrointestinal lymphoma and its management was changed from surgery to combined chemoimmunotherapy in the last decade; however, this strategy is questionable, especially if rituximab is not available. Methods: Seventy-nine files were reviewed retrospectively. We divided the patients into two groups; group 1 included 37 patients who underwent surgery followed by chemotherapy and group 2 included 42 patients who received chemotherapy. The indication of surgery was mainly due to obstruction/perforation. We compared the outcomes of PFS and OS between the two groups and according to primary anatomical site. Results: We found that the outcomes for the surgery group before chemotherapy was superior to chemotherapy alone in terms of DFS, p = 0.012 and OS p = 0.037. But in the anatomical subgroups analysis, it did not show any significant difference in primary gastric lymphoma (PGL) regarding DFS and OS, p = 0.706, p = 0.858, respectively; On the contrary, we found significant improvement in PFS and OS, p = 0.032, p = 0.025, respectively, in primary intestinal lymphoma (PIL) favouring the use of the surgical approach. Conclusion Surgery is still an important strategy in the case of DLBCL in PIL intestinal lymphoma; however, in the case of PGL, the use of chemotherapy even without rituximab achieves similar results. Our conclusions are limited by the small numbers of the study","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"10 - 17"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal obstruction in palliative care: a review","authors":"Amrallah A. Mohammed, H. Ghanem, Amr M El Saify","doi":"10.1515/fco-2015-0001","DOIUrl":"https://doi.org/10.1515/fco-2015-0001","url":null,"abstract":"Abstract Many symptoms are experienced by dying patients. Any symptom can be debilitating and affect the patient’s and the family’s quality of life. Symptom research is complicated, especially in patients receiving palliative care because the studies needed are methodologically challenging. Symptoms management is the essential goal in palliative care. Many people rate this as one of the most important issues whether they are at home, in a hospital or at other assisted care. Bowel obstruction is rarely an emergency, and usually evaluated by multidisciplinary teams. Tailored management is based on the underlying aetiology and pathophysiology. When several symptoms occur together, they can be interrelated and management can be complex. This article discusses the management of intestinal obstruction experienced by palliative care patients","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"1 - 5"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67373961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reorganisation of Oncologic Care in Greece: A Proposal","authors":"C. Emmanouilides","doi":"10.1515/fco-2015-0018","DOIUrl":"https://doi.org/10.1515/fco-2015-0018","url":null,"abstract":"Abstract Cancer is becoming a major public health issue as patients enjoy longer survivals than ever before due to the introduction innovative but expensive drugs in the clinic. In addition, the ageing of the population in Greece is expected to increase the absolute incidence of cancer. The National Health System should rapidly and efficiently adapt to the new challenges, including increased pharmaceutical costs. Resources ought to be allocated rationally and efficiently while maintaining adequate coverage for the insured population. Economising due to large-scale operations should be pursued by the governmental single payor (EOPYY), so that affordable coverage remains feasible. Establishment of mechanisms to deal with new and very costly drugs should be put in place. The major changes in anchor oncologic hospitals are needed in order to play a role as regional leaders in oncologic care, including merging of similar divisions, subspecialisation of services and promotion of clinical research. These major centres could coordinate a host of satellite oncology services in other urban hospitals and in the provinces. In addition, joint operations in training and patient care should be pursued with major private centres, without mutual mistrust or obsolete inflexibilities. The current financial crisis represents an excellent opportunity for revisioning and restructuring oncologic care in Greece, taking into account the societal needs and based on flexibility and efficiency.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"28 - 34"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/fco-2015-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living with breast cancer: Patients’ journey within the Greek National Health System","authors":"D. Kaitelidou, M. Kalogeropoulou, T. Katostaras, O. Konstantakopoulou, P. Minogiannis, A. Skitsou, O. Siskou, G. Charalampous, A. Ardavanis, L. Liaropoulos","doi":"10.1515/fco-2015-0016","DOIUrl":"https://doi.org/10.1515/fco-2015-0016","url":null,"abstract":"Abstract Background: Process mapping (a patient-centred method) and recording the medical, nursing and administrative staff’s views involved in the provision of care help us understand patients’ experience regarding the constraints, delays and bottlenecks of healthcare service processes and identify areas of improvement. Patients and Methods: Time information and data were collected through time and motion study with regard to the path patients with breast cancer follow in two public hospitals (sample of 86 patients) and a semi-structured questionnaire was administered to medical, nursing and administrative staff (sample of 14 employees). Results: The amount of time required in total for the prescription process was increased up to seve7 times compared to the beneficial amount of time, and the longest delays in patients’ waiting time were observed with regard to the process of chemotherapy (more than 2 hours and 40 minutes, in some cases). About 92.3% of the staff of the two hospitals prioritized the malfunctioning of theCcentralIinformationSsystem as the most important factor and more than 75% of the study participants mentioned that several administrative and technical aspects have a negative and significant effect on the time required to prescribe the necessary medicines for the treatment of patients. Conclusions: The lack of understanding of the hospital’s processes and spatial infrastructure by most patients, the lack of an electronic patient record system and central information system are highlighted as the main issues that contribute decisively to the increase in the non-beneficial time that patients with breast cances have to spend nowadays in hospitals of the NHS in Greece.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"6 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Survival of Patients with Breast Cancer and Brain Metastases: ‘The experience of the 2nd Oncology Department of Metropolitan Hospital and a brief review of the literature’","authors":"A. E., Skarlos D, K. G, G. E, C. C.","doi":"10.1515/fco-2015-0004","DOIUrl":"https://doi.org/10.1515/fco-2015-0004","url":null,"abstract":"Abstract Background: Novel therapeutic approaches and new compounds during the last decade have prolonged survival of breast cancer patients with metastatic disease, resulting in higher incidence of central nervous system (CNS) metastases. Many of these patients live longer than expected. Patients and methods: We reviewed breast cancer patients with brain metastases from our department, living longer than 1 year. Our purposes were to present patient and treatment characteristics and correlate them with disease outcome. Moreover, we aimed at reviewing the current literature. Results: We detected 20 women with brain metastases from breast cancer, living longer than 1 year. The mean age was 41 years (range 22-61 years). One (5%) woman had luminal A breast cancer type, four (20%) patients had luminal B and HER2 negative, nine (45%) patients luminal B and HER2 positive, four (20%) patients HER2 enriched and two (10%) patients had triple-negative breast cancer. Most of them (70%) had infiltrating ductal histological type and grade 3. Moreover, the majority had known metastatic disease when brain metastases appeared. The most common sites of disease were lung, liver and bone. Median time from breast cancer diagnosis until the presence of CNS metastases was 44 months (range 6-204 months). The progression free survival (PFS) of the most chemotherapeutic schedules was according to the literature. However, PFS of some compounds exceeded all expectations. Median time of survival was 25 months (range 13-116 months). Ten patients are still alive, having achieved a median survival rate of 35 months (range 17-78 months). Conclusion: The combination of surgery, radiotherapy, chemotherapy and anti HER2 treatments is at present the best way to extend the OS and improve the quality of life of breast cancer patients with brain metastases. Prognostic markers for assessing brain metastases are required. Application of prophylactic treatment for these patients is under consideration.","PeriodicalId":38592,"journal":{"name":"Forum of Clinical Oncology","volume":"113 1","pages":"18 - 26"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67374046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}