Management Of Oncology Patients Research Articles

Relationship between mindfulness, meaning in life and post-traumatic growth among Nigerian cancer patients

ABSTRACT Understanding the psychosocial factors that predict recovery and promote growth from trauma is critical to effective management of oncology patients. Although previous studies have shown that mindfulness and meaning in life could be predictors of post-traumatic growth (PTG), no study to date has explored the combined role of mindfulness and meaning in life in the development of PTG among cancer patients. Using a cross-sectional design, data were collected from 957 cancer patients (46.8% male, 53.2% female) who completed relevant self-report measures. Results showed that the presence of meaning in life mediated the relationship between mindfulness and PTG. However, the mediation effect of search for meaning in life was not significant. These findings indicate that the presence of meaning in life is an essential mechanism of mindfulness in facilitating PTG. Therefore, psychosocial interventions geared towards promoting PTG should consider mindfulness as a potential effective component in improving cancer patients’ ability to find meaning in life and possibly promote recovery.

The Relationships between Frailty and Quality of Life in Elderly Women with Breast Cancer

Background: It is well known that oncologic management of elderly patients is complicated, and physicians should well define the ultimate goals when choosing treatment modalities. Cancer treatment should not necessarily focus on survival but aim for a good quality of life for the patient in light of their frailty.
 Patients and Methods: This is a retrospective cross-sectional survey study. One hundred fifty-eight women with breast cancer participated in this study. The PRISMA-7 Frailty Index and WHOQOL-OLD Module assessed participants’ frailty and quality of life. SPSS 26.0 and Medcalc 14 [Acacialaan 22, B-8400 Ostend, Belgium] programs were used for statistical analyses. Statistically significant associations between the PRISMA-7 scale and the WHOQOL-OLD Module were assessed.
 Results: Of the158 participants, the median age [min-max] was 71 [65-96] years, and 61.2% had stage I and II breast cancer. Lumpectomy was 61.1%, and 75% received chemotherapy-radiotherapy and hormone therapy. For the WHOQOL-OLD domains; financial status [p=0.001] with the sensory ability domain, work status [p<0.001] and education status[p=0.004] with the autonomy domain, education status [p=0.002] with PPF activity domain, education status [p=0.001] and work status [p=0.007] with the social participation domain, treatment modality [p=0.003] with death &dying domain, number of comorbidities [p=0.004] with intimacy domain statistically significant. The total score was associated with education status [p=0.005] and the number of comorbidities [p=0.010]. Frailty correlated positively with age [cut-off age 68 years; p<0.001]. Education status was inversely associated with increased frailty [p=0.003]. The relationship between the PRISMA-7 scale and the WHOQOL-OLD Module correlated negatively in five out of six dimensions except for the Intimacy domain.
 Conclusions: It is necessary to design customized cancer management programs to improve specific components of elderly women with breast cancer with increased frailty by revealing the associations in domains of QoL.

A remote evaluation of NAVIFY guidelines using simulation-based research methods.

e13605 Background: This pilot study was designed to explore the use of remote simulation-based research methods to assess NAVIFY Guidelines, including data collection procedures. NAVIFY Guidelines is a software application that digitizes NCCN Guidelines and allows the user to navigate guidelines in a stepwise manner to support clinical decisions. The application has been designed to simplify access and improve adherence to guidelines in the management of oncology patients. Methods: A total of 10 board-certified oncologists were recruited to participate from large academic centers (5), community hospitals (3) and specialist oncology centers (2). Each oncologist reviewed clinical information for 10 synthetic breast cancer patient cases (i.e., 100 case reviews). The cases were developed by a medical oncologist, a surgical oncologist, a radiologist and a histopathologist. Participants were tasked to select the most appropriate clinical decision as per guidelines in two conditions: 1) using a PDF of the NCCN Guidelines (control), and 2) using NAVIFY Guidelines (experimental). Outcome measures were compared across conditions. Sessions were conducted via Google Meet, with participants using the share screen feature to allow the session to be recorded. The cognitive burden of each method was measured via a psychometric test conducted before and after each method (the Stroop Colour and Word Test). After each session, a post-simulation survey gathered feedback on 1) study methods, 2) use of synthetic patient cases, 3) workload effort required (via the NASA Task Load Index), and 4) usability of NAVIFY Guidelines (via the System Usability Scale). A short interview was conducted after each session to gather feedback on the benefits and challenges of using NAVIFY Guidelines and to discuss the participant’s experience of the simulation session. Results: All data collection procedures were successful including 1) assessment of time taken to reach a clinical decision, 2) psychometric testing, 3) survey data, and 4) user feedback. All participants felt the synthetic patient cases were either ‘very similar’ (7 of 10) or ‘somewhat similar’ (3 of 10) to cases seen in routine clinical practice, and the majority felt the task completed during the sessions was ‘very similar’ (3 of 10) or ‘somewhat similar’ (4 of 10). Conclusions: Remote evaluations can be conducted quickly helping to keep pace with product development cycles. The method is easily repeated therefore supporting evaluation of product development over time. In addition, managing simulations remotely enables the possibility of simultaneous evaluations across multiple geographies, and the use of synthetic patient data eliminates data protection concerns. This study suggests that simulation-based research can be used to assess digital health solutions remotely in a timely fashion.

Iron surveillance and management in gastrointestinal oncology patients: A national survey of physician practice.

e13644 Background: In 2018, there were an estimated 4.8 million new cases of gastrointestinal (GI) cancers worldwide and 3.4 million related deaths. Iron deficiency (ID) is a frequent complication of GI malignancy that eventually manifests as iron deficiency anemia (IDA). Early recognition and treatment of ID/IDA in GI oncology patients is an important aspect of care. Traditional serum ferritin monitoring and oral iron supplementation hold limited diagnostic and therapeutic value in this population as it may be falsely elevated and confounded by poor absorption and blood loss, respectively. Therefore, we conducted a survey of Canadian physicians to assess disparities in IDA surveillance and management practices in GI cancer patients. Methods: From February 2020 to September 2021, a 20-question electronic survey was sent to Canadian medical oncologists (MO), surgical oncologists (SO), and gastroenterologists (GE). The survey collected information on four domains: demographics, screening practices, treatment practices, and knowledge of the latest guidelines of ID/IDA. Analysis was conducted using descriptive statistics. Results: A total of 108 (55 GE, 19 SO, and 34 MO) of the 872 (12.4%) invited physicians completed the survey. A greater proportion of GE (70.9% compared to 36.8% of SO, and 26.5% of MO) measured baseline iron parameters. Of these, a slight trend of iron parameters were being measured mainly at initial consult (61.5% of GE, 85.7% of SO, and 44.4% of MO), with little continuing surveillance throughout treatment course. Most physicians who measured iron parameters relied on ferritin mainly (82.1% of GE, 100% of SO), while MO were evenly distributed in their evaluation of ferritin (88.9%), serum iron (100%), total iron binding capacity (100%) and iron saturation (88.9%). The majority supplemented iron if ID/IDA was identified prior to systemic/surgical oncologic treatment (94.2% of GE, 85.7% SO, and 66.7% of MO). Of these, parenteral iron was the preferred modality for SO (85.7%), while oral iron was preferred among GE (82.8%) and MO (55.6%). The majority of physicians (81.3%) were not aware of the ASH/ASCO guidelines regarding the use of erythropoiesis stimulating agents in conjunction with parenteral iron supplementation for treatment anemia in this setting (92% of GE, 66.7% of SO, and 80.9% of MO). Conclusions: Results from this Canadian survey suggests a disparity in practice pattern for IDA management between different specialties caring for GI oncology patients. Moreover, there appears to be a gap in knowledge and thus a gap in care surrounding evidence-based IDA management principles which may be contributing to poor clinical outcomes. Focused knowledge translation and exchange efforts are required to improve treatment of ID/IDA in patients with GI cancer nationally.

Expectations of private nurses in the care management of oncology and haematology patients

Toxicities from chemotherapy administered in an outpatient department occur mostly when patients return home. Support treatment prescriptions are given to them in order to prevent or limit these toxicities. The cancer plans also specify the need for collaboration between the city and the hospital. In this sense, it is interesting to take stock of the knowledge of private nurses caring for these patients and to identify their expectations.

P-42 Iron surveillance and management in gastrointestinal oncology patients: A national survey of physician practice

In 2018, there were an estimated 4.8 million new cases of gastrointestinal (GI) cancers worldwide and 3.4 million related deaths. Iron deficiency (ID) is a frequent complication of GI malignancy that eventually manifests as iron deficiency anemia (IDA). Early recognition and treatment ofID/IDA in GI oncology patients is an important aspect of care. Traditional serum ferritin monitoring and oral iron supplementation hold limited diagnostic and therapeutic value in this population as it may be falsely elevated and confounded by poor absorption and blood loss, respectively. Therefore, we conducted a survey ofCanadian physicians to assess disparities in IDA surveillance and management practices in GI cancer patients. From February 2020 to September 2021, a 20-question electronic survey was sent to Canadian medical oncologists (MO), surgical oncologists (SO), and gastroenterologists (GE). The survey collected information on four domains: demographics, screening practices, treatment practices, and knowledge of the latest guidelines of ID/IDA. Analysis was conducted using descriptive statistics. A total of 108 (55 GE, 19 SO, and 34 MO) of the 872 (12.4%) invited physicians completed the survey. A greater proportion of GE (70.9% compared to 36.8% of SO, and 26.5% of MO) measured baseline iron parameters. Of these, a slight trend of iron parameters were being measured mainly at initial consult (61.5%of GE, 85.7% of SO, and 44.4% of MO), with little continuing surveillance throughout treatment course. Most physicians who measured iron parameters relied on ferritin mainly (82.1% of GE, 100% of SO), while MO were evenly distributed in their evaluation of ferritin (88.9%), serum iron (100%), total iron binding capacity (100%) and iron saturation (88.9%). The majority supplemented iron if ID/IDA was identified prior to systemic/surgical oncologic treatment (94.2% of GE, 85.7% SO, and 66.7% of MO). Of these, parenteral iron was the preferred modality for SO (85.7%), while oral iron was preferred among GE (82.8%) and MO (55.6%). The majority of physicians (81.3%) were not aware of the ASH/ASCO guidelines regarding the use of erythropoiesis stimulating agents in conjunction with parenteral iron supplementation for treatment anemia in this setting (92% of GE,66.7% of SO, and 80.9% of MO). Results from this Canadian survey suggests a disparity in practice pattern for IDA management between different specialties caring for GI oncology patients. Moreover, there appears to be a gap in knowledge and thus a gap in care surrounding evidence-based IDA management principles which may be contributing to poor clinical outcomes. Focused knowledge translation and exchange efforts are required to improve treatment of ID/IDA in patients with GI cancer nationally.

PET-CT in Clinical Adult Oncology-V. Head and Neck and Neuro Oncology.

Simple SummaryPositron emission tomography (PET), typically combined with computed tomography (CT) has become a critical advanced imaging technique in oncology. With PET-CT, a radioactive molecule (radiotracer) is injected in the bloodstream and localizes to sites of tumor because of specific cellular features of the tumor that accumulate the targeting radiotracer. The CT scan, performed at the same time, provides information to facilitate attenuation correction, so that radioactivity from deep or dense structures can be better visualized, but with head and neck malignancies it is critical to provide correlating detailed anatomic imaging. PET-CT has a variety of applications in oncology, including staging, therapeutic response assessment, restaging, and surveillance. This series of six review articles provides an overview of the value, applications, and imaging and interpretive strategies of PET-CT in the more common adult malignancies. The fifth report in this series provides a review of PET-CT imaging in head and neck and neuro oncology.PET-CT is an advanced imaging modality with many oncologic applications, including staging, assessment of response to therapy, restaging, and longitudinal surveillance for recurrence. The goal of this series of six review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for specific oncologic indications, and the potential pitfalls and nuances that characterize these applications. In addition, key tumor-specific clinical information and representative PET-CT images are provided to outline the role that PET-CT plays in the management of oncology patients. Hundreds of different types of tumors exist, both pediatric and adult. A discussion of the role of FDG PET for all of these is beyond the scope of this review. Rather, this series of articles focuses on the most common adult malignancies that may be encountered in clinical practice. It also focuses on FDA-approved and clinically available radiopharmaceuticals, rather than research tracers or those requiring a local cyclotron. The fifth review article in this series focuses on PET-CT imaging in head and neck tumors, as well as brain tumors. Common normal variants, key anatomic features, and benign mimics of these tumors are reviewed. The goal of this review article is to provide the imaging professional with guidance in the interpretation of PET-CT for the more common head and neck malignancies and neuro oncology, and to inform the referring providers so that they can have realistic expectations of the value and limitations of PET-CT for the specific type of tumor being addressed.

Global Effect of COVID-19 Pandemic on Cancer Patients and its Treatment: A Systematic Review.

BackgroundAt a global level, the COVID-19 disease outbreak has had a major impact on health services and has induced disruption in routine care of health institutions, exposing cancer patients to severe risks. To provide uninterrupted tumor treatment throughout a pandemic lockdown is a major obstacle. Coronavirus disease (COVID-19) and its causative virus, SARS-CoV-2, stance considerable challenges for the management of oncology patients. COVID-19 presents particularly severe respiratory and systemic infection in aging and immunosuppressed individuals, including patients with cancer.ObjectiveIn the present review, we focused on emergent evidence from cancer sufferers that have been contaminated with COVID-19 and cancer patients who were at higher risk of severe COVID-19, and indicates that anticancer treatment may either rise COVID-19 susceptibility or have a duple therapeutic impact on cancer as well as COVID-19; moreover, how SARS-CoV-2 infection impacts cancer cells. Also, to assess the global effect of the COVID-19 disease outbreak on cancer and its treatment.MethodsA literature survey was conducted using PubMed, Web of Science (WOS), Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and VIral Protein domain DataBase (VIP DB) between Dec 1, 2019 and Sep 23, 2021, for studies on anticancer treatments in patients with COVID-19. The characteristics of the patients, treatment types, mortality, and other additional outcomes were extracted and pooled for synthesis.ResultsThis disease has a huge effect on sufferers who have cancer(s). Sufferers of COVID-19 have a greater percentage of tumor diagnoses than the rest of the population. Likewise, cancer and highest proportion is lung cancer sufferers are more susceptible to COVID-19 constriction than the rest of the population.ConclusionSufferers who have both COVID-19 and tumor have a considerably elevated death risk than single COVID-19 positive patients overall. During the COVID-19 pandemic, there was a reduction in the screening of cancer and detection, and also deferral of routine therapies, which may contribute to an increase in cancer mortality there in future.

Iron Effects on Clostridioides difficile Toxin Production and Antimicrobial Susceptibilities.

Despite the benefits of red blood cell (RBC) transfusion therapy, it can render patients vulnerable to iron overload. The excess iron deposits in various body tissues cause severe complications and organ damage such as cardiotoxicity and mold infections. Clostridioides difficile infection (CDI) is the most common cause of nosocomial diarrhea among cancer patients and is associated with significant morbidity and mortality. Our study aims to determine the role of iron overload and the effects of iron chelators on CDI. Our results demonstrated that iron (Fe3+) stimulated the growth of C. difficile with increased colony formation units (CFU) in a dose-dependent manner. Exposure to excess iron also increased the gene expression levels of tcdA and tcdB. The production of C. difficile toxin A, necessary for the pathogenesis of C. difficile, was also elevated after iron treatment. In the presence of excess iron, C. difficile becomes less susceptible to metronidazole with significantly elevated minimum inhibitory concentration (MIC) but remains susceptible to vancomycin. Iron-stimulated colony formation and production of C. difficile toxins were effectively diminished by iron chelator deferoxamine co-treatment. Incorporating iron overload status as a potential factor in developing a risk prediction model of CDI and antibiotic treatment response may aid clinical practitioners in optimizing CDI management in oncology patients.

Systematic review: Nursing navigator for the oncology patients care and its management [Revisión Sistemática: Navegador de enfermería para el cuidado y manejo en pacientes oncólogicos

Objective: To analyze the development of scientific evidence on the use of the nurse navigator for the care and management of oncology patients. Materials and method: An integrative review was conducted in the databases PubMed, Science Direct Cochrane Library and Scielo of publications generated between 2011 and 2021, using the key descriptors "navigator", "nurse" "oncology" "cancer" and their respective synonyms in English and Spanish". Results: Scientific evidence highlights the need for the use of nurse navigators to promote educational actions for the management and health care of continuing and new oncology patients with the aim of sustaining self-care during the disease process. Conclusions: It is important to implement this platform in health services as a strategy of technological innovation in continuity of care, in order to avoid risk of complications in their health and to be addressed in a timely manner, to be referred to competent personnel as appropriate.

Impact of Wide Local Excision on Melanoma Patient Survival: A Population-Based Study.

IntroductionPromoting standardization and quality assurance (QA) in oncology on the strength of real-world data is essential to ensure better patient outcomes. Wide excision after primary tumor biopsy is a fundamental step in the therapeutic pathway for cutaneous malignant melanoma (CMM). The aim of this population-based cohort study is to assess adherence to wide local excision in a cohort of patients diagnosed with CMM and the impact of this recommended procedure on overall and disease-specific survival.Materials and MethodsThis retrospective cohort study concerns CMM patients diagnosed in the Veneto region (north-east Italy) in 2017, included in the high-resolution Veneto Cancer Registry, and followed up through linkage with the regional mortality registry up until February 29th, 2020. Using population-level real-world data, linking patient-level cancer registry data with administrative records of clinical procedures may shed light on the real-world treatment of CMM patients in accordance with current guidelines. After excluding TNM stage IV patients, a Cox regression analysis was performed to test whether the completion of a wide local excision was associated with a difference in melanoma-specific and overall survival, after adjusting for other covariates.ResultsNo wide excision after the initial biopsy was performed in 9.7% of cases in our cohort of 1,305 patients. After adjusting for other clinical prognostic characteristics, Cox regression revealed that failure to perform a wide local excision raised the hazard ratio of death in terms of overall survival (HR = 4.80, 95% CI: 2.05–11.22, p < 0.001) and melanoma-specific survival (HR = 2.84, 95% CI: 1.04–7.76, p = 0.042).ConclusionBy combining clinical and administrative data, this study on real-world clinical practice showed that almost one in ten CMM patients did not undergo wide local excision surgery. Monitoring how diagnostic-therapeutic protocols are actually implemented in the real world may contribute significantly to promoting quality improvements in the management of oncological patients.

Combinatorial Power of cfDNA, CTCs and EVs in Oncology.

Liquid biopsy is a promising technique for clinical management of oncological patients. The diversity of analytes circulating in the blood useable for liquid biopsy testing is enormous. Circulating tumor cells (CTCs), cell-free DNA (cfDNA) and extracellular vesicles (EVs), as well as blood cells and other soluble components in the plasma, were shown as liquid biopsy analytes. A few studies directly comparing two liquid biopsy analytes showed a benefit of one analyte over the other, while most authors concluded the benefit of the additional analyte. Only three years ago, the first studies to examine the value of a characterization of more than two liquid biopsy analytes from the same sample were conducted. We attempt to reflect on the recent development of multimodal liquid biopsy testing in this review. Although the analytes and clinical purposes of the published multimodal studies differed significantly, the additive value of the analytes was concluded in almost all projects. Thus, the blood components, as liquid biopsy reservoirs, are complementary rather than competitive, and orthogonal data sets were even shown to harbor synergistic effects. The unmistakable potential of multimodal liquid biopsy testing, however, is dampened by its clinical utility, which is yet to be proven, the lack of methodical standardization and insufficiently mature reimbursement, logistics and data handling.

Findings from precision oncology in the clinic: rare, novel variants are a significant contributor to scaling molecular diagnostics

BackgroundNext generation sequencing for oncology patient management is now routine in clinical pathology laboratories. Although wet lab, sequencing and pipeline tasks are largely automated, the analysis of variants for clinical reporting remains largely a manual task. The increasing volume of sequencing data and the limited availability of genetic experts to analyse and report on variants in the data is a key scalability limit for molecular diagnostics.MethodTo determine the impact and size of the issue, we examined the longitudinally compiled genetic variants from 48,036 cancer patients over a six year period in a large cancer hospital from ten targeted cancer panel tests in germline, solid tumour and haematology contexts using hybridization capture and amplicon assays. This testing generated 24,168,398 sequenced variants of which 23,255 (8214 unique) were clinically reported.ResultsOf the reported variants, 17,240 (74.1%) were identified in more than one assay which allowed curated variant data to be reused in later reports. The remainder, 6015 (25.9%) were not subsequently seen in later assays and did not provide any reuse benefit. The number of new variants requiring curation has significantly increased over time from 1.72 to 3.73 variants per sample (292 curated variants per month). Analysis of the 23,255 variants reported, showed 28.6% (n = 2356) were not present in common public variant resources and therefore required de novo curation. These in-house only variants were enriched for indels, tumour suppressor genes and from solid tumour assays.ConclusionThis analysis highlights the significant percentage of variants not present within common public variant resources and the level of non-recurrent variants that consequently require greater curation effort. Many of these variants are unique to a single patient and unlikely to appear in other patients reflecting the personalised nature of cancer genomics. This study depicts the real-world situation for pathology laboratories faced with curating increasing numbers of low-recurrence variants while needing to expedite the process of manual variant curation. In the absence of suitably accurate automated methods, new approaches are needed to scale oncology diagnostics for future genetic testing volumes.

405 The lockdown effect on gynaecological cancer surgeries during the COVID-19 Pandemic

Introduction: The impact of COVID-19 pandemic caused a disruption of the healthcare systems and led to significant delays in diagnosis and treatment of gynecological cancer patients. New algorithms that aim to sustain balance between management of oncological patients and the need to maintain a sufficient amount of resources were adapted. Methods: This retrospective study reviewed the patients with gynecological cancer operated in our hospital during the first lockdown period in Greece (between 13 March 2020 and 30 May 2020) and compared the results with the corresponding time period in 2019 before COVID-19 pandemic.

Ultraviolet radiation exposure and management of oncology patients in COVID-19: The skin cancer paradox

Ultraviolet radiation exposure and management of oncology patients in COVID-19: The skin cancer paradox

Investigating of the role of CT scan for cancer patients during the first wave of COVID-19 pandemic.

Amidst this current COVID-19 pandemic, we undertook this systematic review to determine the role of medical imaging, with a special emphasis on computed tomography (CT), on guiding the care and management of oncologic patients. Study selection focused on articles from 01/02/2020 to 04/23/2020. After removal of irrelevant articles, all systematic or non-systematic reviews, comments, correspondence, editorials, guidelines and meta-analysis and case reports with less than 5 patients were also excluded. Full-text articles of eligible publications were reviewed to select all imaging-based publications, and the existence or not of an oncologic population was reported for each publication. Two independent reviewers collected the following information: ( 1) General publication data; (2) Study design characteristics; (3) Demographic, clinical and pathological variables with percentage of cancer patients if available; (4) Imaging performances. The sensitivity and specificity of chest CT (C-CT) were pooled separately using a random-effects model. The positive predictive value (PPV) and negative predictive value (NPV) of C-CT as a test was estimated for a wide range of disease prevalence rates. A total of 106 publications were fully reviewed. Among them, 96 were identified to have extractable data for a two-by-two contingency table for CT performance. At the end, 53 studies (including 6 that used two different populations) were included in diagnosis accuracy analysis (N = 59). We identified 53 studies totaling 11,352 patients for whom the sensitivity (95CI) was 0.886 (0.880; 0.894), while specificity remained low: in 93% of cases (55/59), specificity was ≤ 0.5. Among all the 106 reviewed studies, only 7 studies included oncologic patients and were included in the final analysis for C-CT performances. The percentage of patients with cancer in these studies was 0.3% (34/11352 patients), lower than the global prevalence of cancer. Among all these studies, only 1 (0.9%, 1/106) reported performance specifically in a cohort of cancer patients, but it however only reported true positives. There is a concerning lack of COVID-19 studies involving oncologic patients, showing there is a real need for further investigation and evaluation of the performance of the different medical imaging modalities in this specific patient population.

Impacto de la primera ola de la pandemia de COVID-19 en la atención a pacientes oncológicos en un hospital terciario

BlackgroundThe COVID-19 pandemic has over-burdened the Spanish health service and, as a result, affected the treatment and management of oncological patients. The aim of this study is to make a descriptive analysis of the management of oncological patients and the functioning of the tumour committees in the University Hospital La Paz (Madrid) during the first wave of the pandemic. Materials and methodsA descriptive analysis was made, based on the results of a questionnaire given to all 18 adult tumour committees and 3 paediatric tumour committees in the University Hospital La Paz. Further information was obtained from all the hospital services involved in the diagnosis and treatment of oncological patients. ResultsDuring the first wave of the pandemic, there was a significant decrease in diagnostic tests. For many weeks, the majority of oncological surgical procedures were delayed or referred to other hospitals. Highly beneficial systemic and radiotherapeutic treatments were maintained and preoperative treatment was increased. The diagnosis and treatment of paediatric tumours was unaltered. Tumour committees were affected but each one adjusted in a different way. All the departments involved in the diagnosis and treatment of oncological patients made contingency plans to minimalize the effect on patients. ConclusionThis study shows how the management of oncological patients and the functioning of tumour committees was affected during the COVID-19 pandemic.

Narrative Medicine: A Digital Diary in the Management of Bone and Soft Tissue Sarcoma Patients. Preliminary Results of a Multidisciplinary Pilot Study.

Background. Guidelines for the implementation of narrative medicine in clinical practice exist; however, in Italy, no standard methodology is currently available for the management of oncological patients. Since 2017, at the “Regina Elena” National Cancer Institute, studies using “digital narrative diaries” (DNMLAB platform) have been carried out; this article focuses on a pilot, uncontrolled, real-life study aiming to evaluate the utility of DNM integrated with the care pathway of patients with bone and limb soft tissue sarcomas. Methods. Adult patients completed the diary during treatment or follow-up by writing their narrative guided by a set of narrative prompts. The endpoints were: (a) patients’ opinions about therapeutic alliance, awareness, and coping ability; (b) healthcare professionals’ (HCPs’) opinions about communication, therapeutic alliance, and information collection. Open- and closed-ended questions (Likert score: 1–5) were used to assess the items. Results. At the interim analysis of data from seven patients and five HCPs, DNM was shown to improve: (a) the expression of patients’ point of view, the perception of effective taking charge, disease awareness, and self-empowerment (score: 4.8/5); (b) patients’ communication, relationships, and illness knowledge (score: 4.6–4.8/5). Conclusions. The preliminary results supported the need to integrate patients’ narratives with clinical data and encourage further research.

Management of Surgical Oncology Patients During the COVID-19 Pandemic: Short-Term Results

Management of Surgical Oncology Patients During the COVID-19 Pandemic: Short-Term Results

Artificial Intellgence in the Era of Precision Oncological Imaging.

Rapid-paced development and adaptability of artificial intelligence algorithms have secured their almost ubiquitous presence in the field of oncological imaging. Artificial intelligence models have been created for a variety of tasks, including risk stratification, automated detection, and segmentation of lesions, characterization, grading and staging, prediction of prognosis, and treatment response. Soon, artificial intelligence could become an essential part of every step of oncological workup and patient management. Integration of neural networks and deep learning into radiological artificial intelligence algorithms allow for extrapolating imaging features otherwise inaccessible to human operators and pave the way to truly personalized management of oncological patients.Although a significant proportion of currently available artificial intelligence solutions belong to basic and translational cancer imaging research, their progressive transfer to clinical routine is imminent, contributing to the development of a personalized approach in oncology. We thereby review the main applications of artificial intelligence in oncological imaging, describe the example of their successful integration into research and clinical practice, and highlight the challenges and future perspectives that will shape the field of oncological radiology.