Journal of the National Comprehensive Cancer Network : JNCCN最新文献

{"title":"Gender, Productivity, and Philanthropic Fundraising in Academic Oncology.","authors":"Subha Perni,&nbsp;Danielle Bitterman,&nbsp;Jennifer Ryan,&nbsp;Julie K Silver,&nbsp;Eileen Mitchell,&nbsp;Sarah Christensen,&nbsp;Megan Daniels,&nbsp;Mara Bloom,&nbsp;Ephraim Hochberg,&nbsp;David Ryan,&nbsp;Daphne Haas-Kogan,&nbsp;Jay S Loeffler,&nbsp;Nancy J Tarbell,&nbsp;Aparna R Parikh,&nbsp;Jennifer Wo","doi":"10.6004/jnccn.2021.7008","DOIUrl":"https://doi.org/10.6004/jnccn.2021.7008","url":null,"abstract":"<p><strong>Background: </strong>Philanthropic donations are important funding sources in academic oncology but may be vulnerable to implicit or explicit biases toward women. However, the influence of gender on donations has not been assessed quantitatively.</p><p><strong>Methods: </strong>We queried a large academic cancer center's development database for donations over 10 years to the sundry funds of medical and radiation oncologists. Types of donations and total amounts for medical oncologists and radiation oncologists hired prior to April 1, 2018 (allowing ≥2 years on faculty prior to query), were obtained. We also obtained publicly available data on physician/academic rank, gender, specialty, disease site, and Hirsch-index (h-index), a metric of productivity.</p><p><strong>Results: </strong>We identified 127 physicians: 64% men and 36% women. Median h-index was higher for men (31; range, 1-100) than women (17; range, 3-77; P=.003). Men were also more likely to have spent more time at the institution (median, 15 years; range, 2-43 years) than women (median, 12.5 years; range, 3-22 years; P=.025). Those receiving donations were significantly more likely to be men (70% vs 30%; P=.034). Men received significantly higher median amounts ($259,474; range, $0-$29,507,784) versus women ($37,485; range, $0-$7,483,726; P=.019). On multivariable analysis, only h-index and senior academic rank were associated with donation receipt, and only h-index with donation amount.</p><p><strong>Conclusions: </strong>We found significant gender disparities in receipt of philanthropic donations on unadjusted analyses. However, on multivariable analyses, only productivity and rank were significantly associated with donations, suggesting gender disparities in productivity and promotions may contribute to these differences.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1401-1406"},"PeriodicalIF":13.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39723387","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":"A Case of Microsatellite Instability-High Colon Cancer in a Young Woman With Familial Adenomatous Polyposis.","authors":"Steven M Blum,&nbsp;William R Jeck,&nbsp;Lindsay Kipnis,&nbsp;Ronald Bleday,&nbsp;Jonathan A Nowak,&nbsp;Matthew B Yurgelun","doi":"10.6004/jnccn.2021.7073","DOIUrl":"https://doi.org/10.6004/jnccn.2021.7073","url":null,"abstract":"<p><p>Two major molecular pathways of colorectal carcinogenesis, chromosomal instability (CIN) and microsatellite instability (MSI), are considered to be mutually exclusive. Distinguishing CIN from MSI-high tumors has considerable therapeutic implications, because patients with MSI-high tumors can derive considerable benefit from immune checkpoint inhibitors, and tumors that evolved through the CIN pathway do not respond to these agents. Familial adenomatous polyposis (FAP) is a genetic syndrome that is defined by a mutation in the APC gene and is thought to lead to carcinogenesis through the CIN pathway. Here, we report a case of a young woman with FAP who was treated for medulloblastoma as a child and developed advanced MSI-high colon cancer as a young adult. Her response to second-line immunotherapy enabled resection of her colon cancer, and she is free of disease >10 months after surgery. This case highlights the potential for overlap between the CIN and MSI carcinogenic pathways and associated therapeutic implications.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1377-1381"},"PeriodicalIF":13.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39584213","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":"Thank You, Santa!","authors":"Margaret Tempero","doi":"10.6004/jnccn.2021.0060","DOIUrl":"https://doi.org/10.6004/jnccn.2021.0060","url":null,"abstract":"","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1365"},"PeriodicalIF":13.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39723384","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":"Benefit of Postoperative Radiotherapy for Patients With Nonmetastatic Adrenocortical Carcinoma: A Population-Based Analysis.","authors":"Kan Wu,&nbsp;Xu Liu,&nbsp;Zhihong Liu,&nbsp;Yiping Lu,&nbsp;Xianding Wang,&nbsp;Xiang Li","doi":"10.6004/jnccn.2021.7035","DOIUrl":"https://doi.org/10.6004/jnccn.2021.7035","url":null,"abstract":"<p><strong>Background: </strong>Adrenocortical carcinoma (ACC) is an aggressive cancer with high recurrence rates and poor prognosis, even after radical surgery. The survival benefit of adjuvant radiotherapy (RT) in patients with ACC has not been well explored. The aim of this study was to evaluate the effect of adjuvant RT on the survival outcome of patients with ACC.</p><p><strong>Patients and methods: </strong>All patients with nonmetastatic ACC who underwent complete resection were identified from the SEER database (2004-2016). Overall survival (OS) was estimated using the Kaplan-Meier method. Multivariable Cox regression analysis was performed to identify prognostic factors associated with survival.</p><p><strong>Results: </strong>Of 365 patients with nonmetastatic ACC, 55 (15.1%) received adjuvant RT and the remainder underwent surgery alone. Patient characteristics were similar between the 2 groups, but those with a higher disease stage were more likely to receive adjuvant RT. Overall, patients receiving RT seemed to have better survival compared with the non-RT group (3-year OS rate, 63.1% vs 52.8%; P<.062). After adjustment for confounding factors, adjuvant RT was indeed associated with a 48% decreased risk of death (hazard ratio, 0.52; 95% CI, 0.29-0.91; P=.023) for all patients. In addition, adjuvant RT may confer a survival benefit only in patients with a high risk of recurrence (3-year OS rate, 55.1% vs 40.0%; P=.048) rather than in those with low/moderate-risk ACC (P=.559).</p><p><strong>Conclusions: </strong>Our findings suggest that adjuvant RT may be associated with improved survival in patients with nonmetastatic ACC who underwent radical surgery, especially those with high risk of recurrence.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1425-1432"},"PeriodicalIF":13.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39723388","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":"NCCN Guidelines® Insights: Squamous Cell Skin Cancer, Version 1.2022.","authors":"Chrysalyne D Schmults,&nbsp;Rachel Blitzblau,&nbsp;Sumaira Z Aasi,&nbsp;Murad Alam,&nbsp;James S Andersen,&nbsp;Brian C Baumann,&nbsp;Jeremy Bordeaux,&nbsp;Pei-Ling Chen,&nbsp;Robert Chin,&nbsp;Carlo M Contreras,&nbsp;Dominick DiMaio,&nbsp;Jessica M Donigan,&nbsp;Jeffrey M Farma,&nbsp;Karthik Ghosh,&nbsp;Roy C Grekin,&nbsp;Kelly Harms,&nbsp;Alan L Ho,&nbsp;Ashley Holder,&nbsp;John Nicholas Lukens,&nbsp;Theresa Medina,&nbsp;Kishwer S Nehal,&nbsp;Paul Nghiem,&nbsp;Soo Park,&nbsp;Tejesh Patel,&nbsp;Igor Puzanov,&nbsp;Jeffrey Scott,&nbsp;Aleksandar Sekulic,&nbsp;Ashok R Shaha,&nbsp;Divya Srivastava,&nbsp;William Stebbins,&nbsp;Valencia Thomas,&nbsp;Yaohui G Xu,&nbsp;Beth McCullough,&nbsp;Mary A Dwyer,&nbsp;Mai Q Nguyen","doi":"10.6004/jnccn.2021.0059","DOIUrl":"https://doi.org/10.6004/jnccn.2021.0059","url":null,"abstract":"<p><p>The NCCN Guidelines for Squamous Cell Skin Cancer provide recommendations for diagnostic workup, clinical stage, and treatment options for patients with cutaneous squamous cell carcinoma. The NCCN panel meets annually to discuss updates to the guidelines based on comments from panel members and the Institutional Review, as well as submissions from within NCCN and external organizations. These NCCN Guidelines Insights focus on the introduction of a new surgical recommendation terminology (peripheral and deep en face margin assessment), as well as recent updates on topical prophylaxis, immunotherapy for regional and metastatic disease, and radiation therapy.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1382-1394"},"PeriodicalIF":13.4,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39723381","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":"A Case of Lung Adenocarcinoma Response to Alectinib Harboring a Rare EML4-ALK Variant, Exon 6 of EML4 Fused to Exon 18 of ALK.","authors":"Lirong Liu,&nbsp;Fangfang Hou,&nbsp;Yufeng Liu,&nbsp;Wenzhu Li,&nbsp;Haibo Zhang","doi":"10.6004/jnccn.2021.7077","DOIUrl":"https://doi.org/10.6004/jnccn.2021.7077","url":null,"abstract":"<p><p>More than 20 types of ALK fusion variant subtypes have been identified, including different fusion partner genes or EML4-ALK fusions with different breakpoints. However, different ALK fusions show different sensitivities to ALK-tyrosine kinase inhibitors (ALK-TKIs) and the emergence of rare fusions brings great challenges to the target therapy in clinic. We report a rare EML4-ALK (E6;A18) fusion in a patient with lung adenocarcinoma that responded well to alectinib. This is the second case of this rare variant reported but the first report of response to an ALK-TKI. This evidence is the first to show that alectinib may be effective for this rare fusion type of non-small cell lung cancer, and these findings have important implications for drug selection in patients with this subtype. Further studies are needed to understand the function of this variant.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"2-6"},"PeriodicalIF":13.4,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39612057","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":"Challenges in the Histopathologic Diagnosis of Histiocytic Neoplasms.","authors":"Karen L Rech,&nbsp;Rong He","doi":"10.6004/jnccn.2021.7098","DOIUrl":"https://doi.org/10.6004/jnccn.2021.7098","url":null,"abstract":"<p><p>Histiocytic neoplasms, including Langerhans cell histiocytosis (LCH), Erdheim-Chester disease (ECD), and Rosai-Dorfman disease (RDD), present a diagnostic challenge due to nonspecific fibroinflammatory infiltrates and a diverse clinical presentation. The pathologist can play a key role in classification of these disorders through multidisciplinary collaboration and correlation of pathologic features with clinical and radiologic findings. The histopathologic differential diagnosis is broad, requiring knowledge of the possible diagnoses at each specific anatomic site, and a careful assessment to exclude other inflammatory and neoplastic disorders. An immunohistochemistry panel including CD163, CD1a, langerin, S100, Factor XIIIa, OCT2, and BRAF V600E can provide definitive diagnosis in LCH and RDD, whereas ECD requires classic clinical features as well as confirmation of an activating MAPK pathway mutation by genetic studies.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1305-1311"},"PeriodicalIF":13.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39626614","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":"Further Proof of the Oncologic Safety of Transanal Total Mesorectal Excision.","authors":"Steven D Wexner","doi":"10.6004/jnccn.2021.7106","DOIUrl":"https://doi.org/10.6004/jnccn.2021.7106","url":null,"abstract":"In the manuscript titled “Local Recurrence and Disease-Free Survival After Transanal Total Mesorectal Excision: Results From the International TaTME Registry,” elsewhere in this issue, Roodbeen et al presented the largest series of transanal total mesorectal excision (taTME) cases published to date: 2,803 operations with a median follow-up of 24 months. This study was very well conducted and had excellent follow-up, and is critically important because of the constant evolution in the management schema of rectal cancer. Rectal cancer resection was traditionally associated with unacceptably high rates of local recurrence. Thanks to the pioneering work of Professor Richard J. Heald, the concept of TME was introduced. Surgeons around the world began to embrace the concept of achieving tumor-free circumferential resection margins with complete or near-complete mesorectal specimens. The debate shifted from the advisability, and in fact requirement, of TME when surgery with intent to cure was performed to how to best achieve that result. A combination of preoperative imaging allowing appropriate assignment of neoadjuvant chemoradiotherapy combined with a variety of surgical approaches became the work of multidisciplinary teams. The importance of the multidisciplinary team in the United States was ultimately codified by the launch in 2018 of the American College of Surgeons Commission on Cancer National Accreditation Program for Rectal Cancer. The surgical aspect of this dialogue has centered around methods of best achieving a circumferential resection margin free of tumor to produce a complete or near-complete TME specimen. Techniques have shifted from open surgery to a variety of minimally invasive platforms. During the 1990s and early 2000s, a variety of randomized controlled and other studies clearly demonstrated the oncologic acceptability of laparoscopic TME. Subsequent to those studies, other investigations, in turn,demonstratedequivalence between laparoscopic and robotic minimally invasive surgical techniques. The most newly introduced method of attempted surgical cure of rectal cancer is taTME. The common denominator among all of these types of minimally invasive surgery is to offer patients with rectal cancer the advantages of minimally invasive surgery; specifically, the well-known short-term benefits relative to recovery, which have been proven repeatedly over the last.30 years, along with the longer-term benefits, such as decreased rates of intra-abdominal adhesions and hernias, and, according to some studies, possibly even oncologic benefits. The reluctance of some surgeons to learn and/or implement laparoscopic rectal cancer surgery has been an impetus for the increased performance of robotic rectal cancer surgery. Whether minimally invasive rectal cancer surgery is performed by a robotic or a laparoscopic approach is immaterial, given that the outcomes are virtually identical in almost every published study. The goal is to ‘HELP’ our pati","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1320-1322"},"PeriodicalIF":13.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39735046","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":"Histiocytic Neoplasms, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.","authors":"Ronald S Go,&nbsp;Eric Jacobsen,&nbsp;Robert Baiocchi,&nbsp;Ilia Buhtoiarov,&nbsp;Erin B Butler,&nbsp;Patrick K Campbell,&nbsp;Don W Coulter,&nbsp;Eli Diamond,&nbsp;Aron Flagg,&nbsp;Aaron M Goodman,&nbsp;Gaurav Goyal,&nbsp;Dita Gratzinger,&nbsp;Paul C Hendrie,&nbsp;Meghan Higman,&nbsp;Michael D Hogarty,&nbsp;Filip Janku,&nbsp;Reem Karmali,&nbsp;David Morgan,&nbsp;Anne C Raldow,&nbsp;Alexandra Stefanovic,&nbsp;Srinivas K Tantravahi,&nbsp;Kelly Walkovich,&nbsp;Ling Zhang,&nbsp;Mary Anne Bergman,&nbsp;Susan D Darlow","doi":"10.6004/jnccn.2021.0053","DOIUrl":"https://doi.org/10.6004/jnccn.2021.0053","url":null,"abstract":"<p><p>Histiocytic neoplasms are rare hematologic disorders accounting for less than 1% of cancers of the soft tissue and lymph nodes. Clinical presentation and prognosis of these disorders can be highly variable, leading to challenges for diagnosis and optimal management of these patients. Treatment often consists of systemic therapy, and recent studies support use of targeted therapies for patients with these disorders. Observation (\"watch and wait\") may be sufficient for select patients with mild disease. These NCCN Guidelines for Histiocytic Neoplasms include recommendations for diagnosis and treatment of adults with the most common histiocytic disorders: Langerhans cell histiocytosis, Erdheim-Chester disease, and Rosai-Dorfman disease.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1277-1303"},"PeriodicalIF":13.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39626612","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":"Reimagining Professional Meetings: Another Lesson From COVID-19.","authors":"Margaret Tempero","doi":"10.6004/jnccn.2021.0055","DOIUrl":"https://doi.org/10.6004/jnccn.2021.0055","url":null,"abstract":"","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1211"},"PeriodicalIF":13.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39626613","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}