Cancer Clinic Research Articles

The impact of a web-based prognostic calculator on prognostic confidence in outpatient palliative care.

Clinicians are often uncertain about their prognostic estimates, which may impede prognostic communication and clinical decision-making. We assessed the impact of a web-based prognostic calculator on physicians' prognostic confidence. In this prospective study, palliative care physicians estimated the prognosis of patients with advanced cancer in an outpatient clinic using the temporal, surprise, and probabilistic approaches for 6m, 3m, 2m, 1m, 2 w, 1 w, and 3 d. They then reviewed information from www.predictsurvival.com , which calculated survival estimates from seven validated prognostic scores,including the Palliative Prognostic Score, Palliative Prognostic Index, and Palliative Performance Status, and again provided their prognostic estimates after calculator use. The primary outcome was prognostic confidence in temporal CPS (0-10 numeric rating scale, 0 = not confident, 10 = most confident). Twenty palliative care physicians estimated prognoses for 217 patients. The mean (standard deviation) prognostic confidence significantly increased from 5.59 (1.68) before to 6.94 (1.39) after calculator use (p < 0.001). A significantly greater proportion of physicians reported feeling confident enough in their prognosis to share it with patients (44% vs. 74%, p < 0.001) and formulate care recommendations (80% vs. 94%, p < 0.001) after calculator use. Prognostic accuracy did not differ significantly before or after calculator use, ranging from 55-100%, 29-98%, and 48-100% for the temporal, surprise, and probabilistic approaches, respectively. This web-based prognostic calculator was associated with increased prognostic confidence and willingness to discuss prognosis. Further research is needed to examine how prognostic tools may augment prognostic discussions and clinical decision-making.

The use of incisional negative pressure wound therapy on high-risk breast cancer mastectomy patients

BackgroundThe main complications seen in patients who have undergone modified radical mastectomy (MRM) are seroma, surgical site infection, hematoma, wound dehiscence, flap necrosis, and nerve damage. While these complications lead to some problems the most feared effect in the early period is that they cause a delay in adjuvant treatment. Incisional Negative Pressure Wound Therapy (iNPWT) decreases wound dehiscence by reducing oedema and tension, especially in the incision line. This study aim to compare recovery times and wound site complications between patients treated with conventional wound dressings and patients treated with iNPWT after MRM. MethodsA retrospective screening was made of the data of 50 patients who underwent MRM because of breast cancer in the General Surgery Clinic of XXX Hospital between 2018 and 2022, and were at high-risk of wound site complications. Two groups were formed as 30 patients applied with iNPWT and 20 patients applied with conventional dressings. ResultsThe mean age of the 50 female patients was 53.58 years (range, 30–80 years). The most frequently seen complications were seroma (20 patients) and partial flap ischaemia (14 patients). The mean number of iNPWT applications was 1.30 (range, 1–2), and the mean number of days of application was 4.47 (range, 2–9). Postoperative seroma was observed in 8 patients in the iNPWT group and in 12 patients in the conventional dressings group (p = 0.018). Flap ischaemia and the probability of dehiscence was determined at a statistically significantly higher rate in the patients in the conventional dressings groups (p = 0.005, p = 0.021). ConclusionThe results of this study demonstrated that the use of iNPWT significantly reduced the amount of postoperative drainage, thereby contributing to early drain removal. Furthermore, iNPWT significantly reduced postoperative seroma, flap ischaemia, and flap dehiscence compared to conventional dressings.

Educational Initiatives to Improve the Cancer-Related Disparities Facing Transgender and Gender Diverse (TGD) Individuals.

Transgender and gender diverse (TGD) individuals face discrimination and experience disparate healthcare, and cancer care, in particular. Our team has developed four initiatives to start to mitigate the disparities facing TGD individuals, including (1) improving identification of TGD individuals with cancer in oncology clinics, (2) identifying rates and predictors of cancer screening among TGD individuals, (3) building a TGD patient-centric oncology clinic, and (4) developing prospective research that is dedicated to addressing the needs of TGD Individuals with cancer. Clinician-focused educational initiatives are integral aspects of this work to improve cancer care for TGD individuals.

The effect of COVID-19 disease on patients diagnosed with skin cancer in the dermatology clinic

Objective: We aimed to define the impact of the pandemic on patients presenting to dermatology clinic with skin cancer. Methods: In our study, the characteristics of patients who attended our dermatology clinic before six months and after six months of March 11, 2020, and whose biopsies diagnosed as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) were evaluated and compared regarding before and after COVID-19 pandemic Results: Patients with BCC attending to the dermatology clinic were found to be younger in the pandemic period (p&lt;0.05). Gender, duration of skin tumors, primary lesions, and their locations were found to be not statistically significant (p&gt;0.05). Conclusion: Patients with suspicious skin lesions could be encouraged to visit a hospital with appropriate COVID-19 protection. Alternatively, teledermatology could be used to evaluate whether the lesions should be excised or biopsied.

Targeting EGFR degradation by autophagosome degraders

Several generations of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors have been developed for the treatment of non-small cell lung cancer (NSCLC) in clinic. However, emerging drug resistance mediated by new EGFR mutations or activations by pass, leads to malignant progression of NSCLC. Proteolysis targeting chimeras (PROTACs) have been utilized to overcome the drug resistance acquired by mutant EGFR, newly potent and selective degraders are still need to be developed for clinical applications. Herein, we developed autophagosome-tethering compounds (ATTECs) in which EGFR can be anchored to microtubule-associated protein-1 light chain-3B (LC3B) on the autophagosome with the assistance of the LC3 ligand GW5074. A series of EGFR-ATTECs have been designed and synthesized. Biological evaluations showed that these compounds could degrade EGFR and exhibited moderate inhibitory effects on certain NSCLC cell lines. The ATTEC 12c potently induced the degradation of EGFR with a DC50 value of 0.98 μM and a Dmax value of 81% in HCC827 cells. Mechanistic exploration revealed that the lysosomal pathway was mainly involved in this degradation. Compound 12c also exhibited promising inhibitory activity, as well as degradation efficiency in vivo. Our study highlights that EGFR-ATTECs could be developed as a new expandable EGFR degradation tool and also reveals a novel potential therapeutic strategy to prevent drug resistance acquired EGFR mutations.

Abstract 6581: DX126-262 combined with chemotherapy (Cisplatin and 5-Fu) demonstrates promising antitumor efficacy in HER2-positive gastric cancer

Abstract Gastric cancer is a common malignant tumor of the digestive system, and its morbidity and mortality rank among the top five in the world. Although significant progress has been made in cytotoxic chemotherapy, immunotherapy and targeted therapy in recent years, the long-term prognosis of patients with advanced or metastatic gastric cancer is still poor. Trastuzumab combined with chemotherapy is the first-line standard of care (SOC) for HER2-positive advanced or metastatic gastric cancer. Two ADC drugs targeting HER2, DS-8201 and RC-48, have also been approved for the treatment of gastric cancer. However, their limited clinical benefits and occurrence of adverse events still present a significant challenge. Therefore, minimizing the off-target toxicity and collateral damage while achieving significant chemotherapy efficacy has become the focus of gastric cancer treatment. DX126-262 is a novel HER2-targeting antibody-drug conjugate (ADC), generated by conjugating a Tubulysin B analogue to a recombinant humanized anti-HER2 monoclonal antibody through a linker containing branched hydrophilic polyethylene glycol, using thiol-maleimide chemistry to achieve drug antibody ratio (DAR) of 3.8. Previous studies have confirmed that DX126-262 monotherapy showed excellent efficacy in HER2-positive gastric cancer NCI-N87 cells in vitro and in vivo. And the efficacy has also been demonstrated in clinical trials (now in phase II, CTR20211871). Based on above results, we intended to further explore whether combination therapy of DX126-262 with Cisplatin and 5-FU can improve the anti-tumor efficacy compared with SOC (Herceptin plus Cisplatin and 5-FU) or DS-8201 monotherapy. The triple-drug combination therapy demonstrated much better therapeutic efficacy than single drug (DX126-262, Cisplatin, 5-FU, Herceptin, or DS-8201) or double-drug combination (Cisplatin plus 5-FU) or SOC (Herceptin plus Cisplatin and 5-FU) on human gastric cancer cells in vitro and in vivo. Meanwhile, triple-drug combination therapy did not exhibit superimposed toxicity, judging by the body weight of mice and hemal biochemistry assays. These results suggested that DX126-262 plus Cisplatin and 5-FU might be a promising strategy for treatment of HER2-positive advanced or metastatic gastric cancer in clinic. Citation Format: Xiaobo Cai, Min Cao, Huihui Guo, Qingliang Yang, Xiangfei Kong, Yong Du, Zhicang Ye, Zhixiang Guo, Lingli Zhang, Lu Bai, Junxiang Jia, Yunxia Zheng, Yongxiang Chen, Miaomiao Chen, Wei Zheng, Jun Zheng, Wenjun Li, Yuanyuan Huang, Mengmeng Liu, Zhongliang Fan, Hangbo Ye, Yifang Xu, Binbin Chen, Meng Dai, Robert Y. Zhao. DX126-262 combined with chemotherapy (Cisplatin and 5-Fu) demonstrates promising antitumor efficacy in HER2-positive gastric cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6581.

Tumor microenvironment-activated hollow vanadium-based nanoplatform for precise therapy of lung cancer through synergistically reversing cisplatin resistance

The resistance and side effect of cisplatin (CDDP) were still great challenges for highly efficient therapy of lung cancer in clinic. The studies indicated that the CDDP resistance mainly involved GSH-mediated inactivation and the damaged DNA repair. Herein, a novel vanadium-based nanoplatform was designed via platelet-derived growth factor receptor-β (PDGFR-β)-recognizing cyclic peptide (PDGFB)-labeled liposomes coating onto the hollow vanadium-doped mesoporous silica nanoparticle (HVMSN) loaded Pt (IV) prodrugs (pLi-HVMSN-Pt). This nanoplatform actively targeted tumor tissue, and then effectively responded to weakly acidic and high GSH of tumor microenvironment, making Pt (IV) prodrugs and vanadium ions be precisely delivered and intelligently released. Moreover, the vanadium ions significantly downregulated the expression of glutamyl cysteine ligase (GCL) and excision repair cross-complementing 1 (ERCC1), which inhibited the synthesis of GSH in cells and the damaged DNA repair. These synergistic actions dramatically increased the sensitivity of tumor cells to Pt-based drug, and then reversed CDDP resistance. Furthermore, in vivo experiment results demonstrated highly efficient suppression of tumor growth induced by the pLi-HVMSN-Pt. Therefore, this work provided a novel strategy for reversing CDDP-resistance and the precise therapy of lung cancer.

Meme Kanserine Bağlı Beyin Metastazlarında Difüzyon Ağırlıklı Görüntüleme ile Histopatolojik Tip Arasında Bir İlişki Var mı?

Aim: The aim of this study is to evaluate the relationship between diffusion-weighted imaging (DWI) properties and apparent diffusion coefficient (ADC) values of metastases with the histological type of breast cancer in patients with breast cancer-related brain metastasis.&#x0D; Material and Methods: Between May 2008 - April 2011, 57 female patients who had been previously diagnosed with breast cancer in the radiology clinic were included in the study. Cases with invasive ductal carcinoma were considered group 1 (46 patients, 89 lesions) and cases with invasive lobular, comedo carcinoma and papillary cribriform carcinoma were considered group 2 ( 11 patients, 25 lesions). ADC values in both groups were compared by statistical analysis methods.&#x0D; Results: In group 1; 37 lesions (41.57%) and in group 2; 13 lesions (52%) included cystic component. In the group of invasive ductal carcinoma 48 lesions (53.92%) and 18 lesions (72%) of second group included peritumoral edema. The mean ADC value of the solid component of metastases (group1: 1.105x10-3mm2/ s, group2: 1.099x10-3mm2/ s) was higher than the average ADC value of normal brain parenchyma (group1: 0.790x10-3mm2/s, group2: 0.801x10-3mm2/s), and was statistically significant (p

Effect of surface modification on the distribution of magnetic nanorings in hepatocellular carcinoma and immune cells.

Magnetic nanomaterial-mediated magnetic hyperthermia is a localized heating treatment modality that has been applied to treat aggressive cancer in clinics. In addition to being taken up by tumor cells to function in cancer therapy, magnetic nanomaterials can also be internalized by immune cells in the tumor microenvironment, which may contribute to regulating the anti-tumor immune effects. However, there exists little studies on the distribution of magnetic nanomaterials in different types of cells within tumor tissue. Herein, ferrimagnetic vortex-domain iron oxide nanorings (FVIOs) with or without the liver-cancer-targeting peptide SP94 have been successfully synthesized as a model system to investigate the effect of surface modification of FVIOs (with or without SP94) on the distribution of tumor cells and different immune cells in hepatocellular carcinoma (HCC) microenvironment of a mouse. The distribution ratio of FVIO-SP94s in tumor cells was 1.3 times more than that of FVIOs. Immune cells in the liver tumor microenvironment took up fewer FVIO-SP94s than FVIOs. In addition, myeloid cells were found to be much more amenable than lymphoid cells in terms of their ability to phagocytose nanoparticles. Specifically, the distributions of FVIOs/FVIO-SP94s in tumor-associated macrophages, dendritic cells, and myeloid-derived suppressor cells were 13.8%/12%, 3.7%/0.9%, and 6.3%/1.2%, respectively. While the distributions of FVIOs/FVIO-SP94s in T cells, B cells, and natural killer cells were 5.5%/0.7%, 3.0%/0.7%, and 0.4%/0.3%, respectively. The results described in this article enhance our understanding of the distribution of nanomaterials in the tumor microenvironment and provide a strategy for rational design of magnetic hyperthermia agents that can effectively regulate anti-tumor immune effects.

Choosing contralateral prophylactic mastectomy for unilateral breast cancer in an urban South African breast cancer clinic

Abstract Background: International trends have shown that female patients with unilateral breast cancer are electing bilateral mastectomies as a prophylactic measure. The study aimed to determine the prevalence of unilateral mastectomies (UM) with and without contralateral prophylactic mastectomy (CPM) and to identify whether demographic and pathological characteristics predict the choice of CPM. Methods: A record review of demographic details and pathological results of all female patients undergoing mastectomy for unilateral breast cancer from 2013-2015 was conducted at the Helen Joseph Breast Care Clinic in Johannesburg, South Africa. Results: A total of 299 women who had mastectomies for unilateral breast cancer were included in the study. Of these, 59 had CPM (19.7%). Significantly more White women opted for a CPM than Black women (43.5% vs 10.6%, p♯αμπ;λτ;0.0001). Women who underwent CPM were significantly younger, and there was a trend for higher median breast weight than patients who only underwent UM (p = 0.03 and p = 0.09, respectively). There was no difference between the two groups with regard to patient income status, tumour histology, TNM stage or neoadjuvant chemotherapy. Conclusion: The demographic and histopathological characteristics of breast cancer which influence the choice of CPM in the South African context have some similarities to those in the international literature in that White and younger women more often choose CPM compared to other racial groups. The more advanced stages of breast cancer presentation in our study suggest that public health awareness and screening measures need to be significantly strengthened in South Africa.

Evaluation of the clinical and prognostic importance of infection parameters in thyroid cancers: A cross-sectional study.

Thyroid cancers are among the most common endocrine cancers. An inflammation is associated with many stages of cancer. Therefore, in this study, we aimed to evaluate whether it has a prognostic significance inflammation marker. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, systemic inflammation response, systemic immune-inflammation index, and neutrophils to lymphocytes and platelets ratio (N/LP) in patients diagnosed with thyroid cancer in the internal medicine outpatient clinic and operated between March 1, 2017 and May 1, 2022 were evaluated retrospectively. Three hundred forty patients were diagnosed with thyroid cancer; 275 (80.9%) of them were women and the mean age was 44.6 ± 13.5 years. Multifocality (P = .02) was significant in patients with invasion. High N/LP ratio (odds ratio: 1.4, 95% confidence interval: 1.0-2.0, p: 0.003) and high invasion (odds ratio: 0.2, 95% confidence interval: 0.1-0.4, P < .01) was found to be significant in patients with tumor size ≥2 cm. There is a relationship between multifocality and invasion, and the risk of invasion increases as the tumor size increases in thyroid cancer. The N/LP ratio was significant as it could be a new marker in showing the relationship between thyroid cancer and its prognosis. Further studies are needed in which the prognosis is followed up, longer-term, more comprehensive, and confounding factors are excluded.

Identifying tumor cell-released extracellular vesicles as biomarkers for breast cancer diagnosis by a three-dimensional hydrogel-based electrochemical immunosensor

Tumor cell-released LC3+ extracellular vesicles (LC3+ EVs) participate in immunosuppression during autophagy and contribute to the occurrence and development of breast cancer. In view of the strong association between the LC3+ EVs and breast cancer, developing an effective strategy for the quantitative detection of LC3+ EVs levels with high sensitivity to identify LC3+ EVs as new biomarkers for accurate diagnosis of breast cancer is crucial, but yet not been reported. Herein, an ultrasensitive electrochemical immunosensor is presented for the quantitative determination of LC3+ EVs using a three-dimensional graphene oxide hydrogel-methylene blue composite as a redox probe, showing a low detection limit and a wide linear range. With this immunosensor, the expression levels of LC3+ EVs in various practical sample groups including different cancer cell lines, the peripheral blood of tumor-bearing mice before and after immunotherapy, and the peripheral blood from breast cancer patients with different subtypes and stages were clearly distinguished. This study demonstrated that LC3+ EVs were superior as biomarkers for the accurate diagnosis of breast cancer compared to traditional biomarkers, particularly for cancer subtype discrimination. This work would provide a new noninvasive detection tool for the early diagnosis and prognosis assessment of breast cancer in clinics.

Correction to: Improving Access and Timeliness of Early Palliative Care Specialist Assessment for Patients With Advanced Lung Cancer in a Rapid Assessment Clinic by O'Neill et al. Journal of Palliative Medicine 2023;26(10):1365–1373; doi: 10.1089/jpm.2022.0544

<i>Correction to:</i> Improving Access and Timeliness of Early Palliative Care Specialist Assessment for Patients With Advanced Lung Cancer in a Rapid Assessment Clinic by O'Neill et al. Journal of Palliative Medicine 2023;26(10):1365–1373; doi: 10.1089/jpm.2022.0544

Abstract A065: “He didn’t tell me anything” – A qualitative analysis of patient-provider communication and treatment decision-making among Latino prostate cancer patients

Abstract BACKGROUND: Prostate cancer is the second most diagnosed cancer among Latino men in the United States. There are disparities in prostate cancer patterns of care and adherence to active surveillance among Latino men. However, little is known about the reasons for these disparities, including patient-provider communication, knowledge, attitudes, and beliefs. PURPOSE: This single institution study explored how patient-provider communication influences treatment decision-making for Latino patients and show how these experiences might contribute to knowledge and beliefs about prostate cancer and prostate cancer treatment. METHODS: We conducted semi-structured focus groups and individual interviews in Spanish or English with 26 Latino prostate cancer patients, lasting between 30 – 60 minutes from July 2021 to October 2022. Patients were men recently diagnosed with prostate cancer in Urology clinics at the USC Norris Comprehensive Cancer Center and Los Angeles General Medical Center. Interviews were audio-recorded, transcribed, translated, and uploaded into Dedoose software for analysis. Using thematic analysis, two independent coders analyzed the interview transcripts utilizing both deductive and inductive approaches. RESULTS: Participants included 26 Latino prostate cancer patients aged 53 to 85 years old (mean = 65.3; SD = 8.42), 65% were monolingual Spanish speakers. Patients described the interactions they had with their physicians at the time of diagnosis and the role that these providers played in their decision-making for prostate cancer treatment. A large proportion of patients described negative experiences during the diagnosis and treatment of their prostate cancer, such as the physician “not explaining anything”, “not telling them anything”, or having “crude” tones. Patients who experienced these negative patient-provider relationships often reported poor communication, mistrust of their provider, and subsequently had limited knowledge about their prostate cancer and treatment. On the other hand, patients who described a shared decision-making process with their provider shared that this resulted in increased knowledge of prostate cancer and treatment. Moreover, patients who described a positive patient-provider relationship stated this resulted in having full confidence and trust in their provider’s treatment decision and/or recommendation. CONCLUSIONS: Themes of patient-provider relationships, decision-making, and knowledge of prostate cancer identified in this study support possible mechanisms that may contribute to disparities in treatment patterns and adherence to active surveillance among Latino men. Our results indicate that positive patient-provider relationships shape shared treatment decision-making and knowledge about prostate cancer and prostate cancer treatment for Latino men. Thus, healthcare providers and staff should ensure culturally competent and patient-centered communication and care to support the knowledge and outcomes of prostate cancer among Latino men. Citation Format: Victoria E. Rodriguez, Briseyda Mendoza-Aguayo, Janet Rodriguez, Carla M. Ramirez, Daniel Soto, Jennifer B. Unger, Jamal Nabhani, Andre Luis Abreu, Rojine Ariani, Lourdes Baezconde-Garbanati, Leslie Ballas, Mariana C. Stern. “He didn’t tell me anything” – A qualitative analysis of patient-provider communication and treatment decision-making among Latino prostate cancer patients [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A065.

Results of a cluster randomized trial testing the Systems Analysis and Improvement Approach to increase cervical cancer screening in family planning clinics in Mombasa County, Kenya

BackgroundCervical cancer is the leading cause of cancer death in Kenyan women. Integrating cervical cancer screening into family planning (FP) clinics is a promising strategy to improve health for reproductive-aged women. The objective of this cluster randomized trial was to test the efficacy of an implementation strategy, the Systems Analysis and Improvement Approach (SAIA), as a tool to increase cervical cancer screening in FP clinics in Mombasa County, Kenya.MethodsTwenty FP clinics in Mombasa County were randomized 1:1 to SAIA versus usual procedures. SAIA has five steps: (1) cascade analysis tool to understand the cascade and identify inefficiencies, (2) sequential process flow mapping to identify bottlenecks, (3) develop and implement workflow modifications (micro-interventions) to address identified bottlenecks, (4) assess the micro-intervention in the cascade analysis tool, and (5) repeat the cycle. Prevalence ratios were calculated using Poisson regression with robust standard errors to compare the proportion of visits where women were screened for cervical cancer in SAIA clinics compared to control clinics.ResultsIn the primary intent-to-treat analysis in the last quarter of the trial, 2.5% (37/1507) of visits with eligible FP clients at intervention facilities included cervical cancer screening compared to 3.7% (66/1793) in control clinics (prevalence ratio [PR] 0.67, 95% CI 0.45–1.00). When adjusted for having at least one provider trained to perform cervical cancer screening at baseline, there was no significant difference between screening in intervention clinics compared to control clinics (adjusted PR 1.14, 95% CI 0.74–1.75).ConclusionsThe primary analysis did not show an effect on cervical cancer screening. However, the COVID-19 pandemic and a healthcare worker strike likely impacted SAIA’s implementation with significant disruptions in FP care delivery during the trial. While SAIA’s data-informed decision-making and clinic-derived solutions are likely important, future work should directly study the mechanisms through which SAIA operates and the influence of contextual factors on implementation.Trial registrationClinicalTrials.gov, NCT03514459. Registered on April 19, 2018.

A sandwich electrochemiluminescence immunoassay based on 1T-MoS2@dual MOFs for detecting CA153

A “signal-on” electrochemiluminescence (ECL) immunosensor has been proposed for detecting carbohydrate antigen 153 (CA153) based on the dual MOFs sandwich strategy. The conductive and porous substrate consisting of 1T-MoS2 and two-dimensional conductive metal-organic framework (MOF, Ni-HAB) was anchored onto the glassy carbon electrode (GCE) to label the capture antibody (Ab1), and the luminescence-functionalized MOF (Ru(bpy)32+@UiO-66-NH2) was utilized to immobilize the detection second antibody (Ab2) to construct a “signal-on” responsive sandwich-type electrochemiluminescence immunoassay. Meanwhile, tripropylamine (TPA) acts as the co-reactant and provides a luminescence system for Ru(bpy)32+@UiO-66-NH2. The luminescence-functionalized MOFs showed excellent ECL activity owing to the tunable structure of MOFs. The remarkable enhancement in ECL intensity was obtained by the immunoreaction of antigen and antibody. Under the optimized conditions, the biosensor exhibited a detection limit of 0.0001 U mL−1 (S/N = 3) with a wide range from 0.001 to 50 U mL−1. The proposed ECL immunosensor was applicable for detecting human serum samples with a recovery of 99.83 ∼ 101 % (RSD < 5 %). This work demonstrates that the advantage of multifunctional MOFs could be applied to construct highly selective ECL immunosensor, and it may facilitate the diagnosis of breast cancer in clinics.

Effects of delayed diagnosis on tumor size, stage and grade in bladder cancer.

This study is planned based on the hypothesis that if bladder cancer is detected early, the disease would be less advanced and the possibility of treatment will increase, at least the recurrence-free survival will be longer. Regarding this hypothesis, it is aimed to investigate the effect of delayed diagnosis primarily on the disease factors. The study included 169 patients, who underwent TUR-BT with the suspicion of bladder cancer in the urology clinic of Afyonkarahisar Faculty of Medicine between April 2018 and April 2023. Demographic and clinical data of the patients were recorded and compared. It was observed that the delay in diagnosis was significantly longer in patients with tumors larger than 3cm compared to patients with tumors smaller than 3cm (p < 0.001). In the correlation analysis between tumor size, duration of diagnosis delay, age, T stage, and tumor grade, a low level of positive correlation was observed between tumor size and duration of diagnosis delay, and it was statistically significant (r = 0.215, p = 0.005). In our study, it was shown that the tumor size increases as the duration of diagnosis delay increases and this increase causes an increase of 0.088mm in the pathological size of the tumor in the 1-day delay period. Considering that tumor size changes the risk group of the disease in bladder tumors, and relatedly the follow-up and treatment process changes, we believe that these data will be valuable in the management of bladder cancer.

Recurrence and characteristics of endometrial cancer in elderly patients

Aim: In this study, evaluated the treatment options of patients of advanced age (≥70 years) with recurrence, survival results were analyzed. Methods: The data of patients diagnosed with endometrial cancer (EC) in the Gynecological Oncology Clinic between 2001 and 2020 were evaluated retrospectively. Seventy six cases with advanced age and relapse were evaluated. Patients who underwent hysterectomy surgery in our center and continued their follow-up regularly were included in the study. Results: The mean age at the time of recurrence was 74.6 ± 3.9 years. The endometrioid type, seen in half of the patients, was the most common histological type. Pelvic paraaortic lymph node (LN) sampling/dissection was performed in 84.2% of the patients. Deep myometrial invasion was detected in 56 (73.7%) patients, and LVSI was found in 42 (56.8%) patients. The mean time to recurrence was found to be 25.1 ± 17.8 months. Total survival times were calculated as 47.2 ± 28.2 months. The five-year overall survival (OS) rate was analyzed as 35.7%. The most common site of recurrence was lung, and isolated lung recurrence was seen in 14 (18.5%) patients. There was no significant difference for OS among patients with pelvic recurrence and extra-pelvic/multiple recurrences (P= 0.723). Conclusion: Survival outcomes in recurrences are worse in advanced age endometrial cancer patients. This may be due to more limited treatment options for recurrence due to additional internal problems.

TransDose: Transformer-based radiotherapy dose prediction from CT images guided by super-pixel-level GCN classification.

Radiotherapy is a mainstay treatment for cancer in clinic. An excellent radiotherapy treatment plan is always based on a high-quality dose distribution map which is produced by repeated manual trial-and-errors of experienced experts. To accelerate the radiotherapy planning process, many automatic dose distribution prediction methods have been proposed recently and achieved considerable fruits. Nevertheless, these methods require certain auxiliary inputs besides CT images, such as segmentation masks of the tumor and organs at risk (OARs), which limits their prediction efficiency and application potential. To address this issue, we design a novel approach named as TransDose for dose distribution prediction that treats CT images as the unique input in this paper. Specifically, instead of inputting the segmentation masks to provide the prior anatomical information, we utilize a super-pixel-based graph convolutional network (GCN) to extract category-specific features, thereby compensating the network for the necessary anatomical knowledge. Besides, considering the strong continuous dependency between adjacent CT slices as well as adjacent dose maps, we embed the Transformer into the backbone, and make use of its superior ability of long-range sequence modeling to endow input features with inter-slice continuity message. To our knowledge, this is the first network that specially designed for the task of dose prediction from only CT images without ignoring necessary anatomical structure. Finally, we evaluate our model on two real datasets, and extensive experiments demonstrate the generalizability and advantages of our method.

Changing the Surgical Approach to Breast Diseases During the COVID-19 Pandemic Period.

Background Postponing elective surgeries during the COVID-19 pandemic has also affected the approach to both malignant and benign breast diseases. This paper aims to share how the COVID-19 pandemic affects our approach to breast cancer, benign breast cases, and the procedures' results. Methodology A cross-sectional study was conducted in a tertiary-level public hospital in Istanbul, Turkey. We retrospectively analyzed our treatment options for patients diagnosed with breast cancer and benign breast disease in the general surgery clinic of a tertiary hospital that declared a pandemic status between March 11, 2020, and June 1, 2020. Results The number of patients who visited the breast outpatient clinic and received a diagnosis of breast cancer was 23. Among the benign diseases, no intervention was made except for abscess (eight patients, 40%) and mastitis (12 patients, 60%). Conclusions Patients with acute abscesses and mastitis were treated for both diagnostic and therapeutic purposes. Chemotherapy and hormone therapy were chosen for those diagnosed with cancer. Priority was given to oncology protocols rather than surgical approaches during the pandemic. We think that different approaches will be defined as the pandemic continues.