Previous History Of Cancer Research Articles

Effects of personal cancer history and genomic risk information on mothers' psychological adaptation to inherited breast/ovarian cancer syndrome.

This study aimed to understand long-term coping responses of mothers (N = 287) receiving genetic counseling and testing (GCT) for hereditary breast/ovarian cancer (HBOC) syndrome. Psychological characteristics, including cancer-specific distress (Impact of Events Scale-Revised, α = .85) and coping (Brief COPE, α = .93) were assessed via structured personal communication, along with epidemiologic items assessing personal and family history of cancer. Genetic risk was determined by BRCA1/2 carriage. A principal component analysis was conducted on the coping measure to reduce its summary score to active coping (α = .91) with nine approach-oriented strategies responsive to stress. A multivariable regression model examined the main and interacting effects of clinical and psychological characteristics on maternal coping. Personal cancer history (F = 4.99, df = 1, p = .026), BRCA test result (F = 22.20, df = 1, p < .001), and cancer-specific distress (F = 17.80, df = 1, p < .001) were associated with greater engagement in active coping strategies. When controlling for cancer-specific distress, the interaction between personal cancer history and genetic test results was significant, such that women previously unaffected by cancer who received positive BRCA results reported the greatest levels of active coping (F = 7.92, p < .001). These findings indicate that previous cancer history, genetic risk, and psychological distress independently and jointly impact how women adapt to the threat of cancer over time.

A Role for Germline Variants in Multiple Myeloma?

In Blood Cancer Discovery, Thibaud and colleagues report the incidence of pathogenic germline variants (PGV) in patients with multiple myeloma and that these PGVs are associated with DNA repair pathway genes, including BRCA1 and BRCA2. They find an association of patients with PGVs and previous family or personal history of cancer, and that these patients are diagnosed slightly earlier than those without PGVs. Patients with PGVs had a longer progression-free survival than those without PGVs when they received high-dose melphalan and autologous stem cell transplant, providing a therapeutic rationale for diagnostic germline testing in myeloma. See related article by Thibaud et al., p. 428.

Validation of the BOADICEA model for epithelial tubo-ovarian cancer risk prediction in UK Biobank

BackgroundThe clinical validity of the multifactorial BOADICEA model for epithelial tubo-ovarian cancer (EOC) risk prediction has not been assessed in a large sample size or over a longer term.MethodsWe evaluated the model discrimination and calibration in the UK Biobank cohort comprising 199,429 women (733 incident EOCs) of European ancestry without previous cancer history. We predicted 10-year EOC risk incorporating data on questionnaire-based risk factors (QRFs), family history, a 36-SNP polygenic risk score and pathogenic variants (PV) in six EOC susceptibility genes (BRCA1, BRCA2, RAD51C, RAD51D, BRIP1 and PALB2).ResultsDiscriminative ability was maximised under the multifactorial model that included all risk factors (AUC = 0.68, 95% CI: 0.66–0.70). This model was well calibrated in deciles of predicted risk with calibration slope=0.99 (95% CI: 0.98–1.01). Discriminative ability was similar in women younger or older than 60 years. The AUC was higher when analyses were restricted to PV carriers (0.76, 95% CI: 0.69–0.82). Using relative risk (RR) thresholds, the full model classified 97.7%, 1.7%, 0.4% and 0.2% women in the RR < 2.0, 2.0 ≤ RR < 2.9, 2.9 ≤ RR < 6.0 and RR ≥ 6.0 categories, respectively, identifying 9.1 of incident EOC among those with RR ≥ 2.0.DiscussionBOADICEA, implemented in CanRisk (www.canrisk.org), provides valid 10-year EOC risks and can facilitate clinical decision-making in EOC risk management.

Malignancies After Lung Transplantation.

Lung transplantation (LTx) is a well-known treatment for end-stage lung disease. This study aimed to report the incidence of cancer after LTx and long-term outcome among lung transplant recipients with a pretransplant diagnosis of cancer. Patients who underwent LTx between 1990-2016 were included in the study. Detection of cancer was obtained by cross-checking the study population with the Swedish Cancer Registry and the Cause-of-Death registry. A total of 614 patients were followed for a median of 5.1years. In all, 159 malignancies were diagnosed. The excess risk of cancer or standardized incidence ratio (SIR) following LTx was 5.6-fold compared to the general Swedish population. The most common malignancies were non-melanoma skin cancer (NMSC) (SIR 76.5 (95%CI 61.7-94.8); non-Hodgkin lymphoma (SIR 23.5, 95%CI 14.8-37.2); and lung cancer (SIR 8.89, 95%CI 5.67-13.9). There was no significant difference in overall survival between those with and without a history of cancer before LTx (p = 0.56). In total, 159 malignancies were identified after LTx, which was a 5.6-fold higher relative to the general population. A history of previous cancer yields similar survival in selected recipients, compared to those without cancer prior to LTx.

The risk for rectal cancer recurrence and overall mortality is not increased in men previously diagnosed with prostate cancer: a report from the Swedish colorectal cancer registry

IntroductionLimited data exists on oncological outcomes following rectal cancer surgery in men who have previously been diagnosed with prostate cancer (PC). This study aimed to assess overall mortality and rectal cancer recurrence in men previously diagnosed with PC who underwent bowel resection.MethodsData from the Swedish Colorectal Cancer Registry identified men who had rectal cancer surgery between 2000 and 2016, and the National Prostate Cancer Registry was used to identify those with a prior PC diagnosis. Cox regression analysis with propensity score matching was employed for data analysis. The primary outcome was overall mortality. Secondary outcome was recurrence for rectal cancer.ResultsOut of 13,299 men undergoing bowel resection for rectal cancer between 2000 and 2016, 1130 had a history of PC. Overall mortality did not significantly differ between men with and without a prior PC diagnosis. Cox regression analyses with propensity score matching revealed that men with previously diagnosed low- or intermediate-risk (HR, 0.79; 95% CI, 0.70–0.90) and high-risk PC (HR, 0.85; 95% CI, 0.74–0.98) had lower overall mortality after rectal cancer surgery compared with men without a PC. There was no significant difference in rectal cancer recurrence between men with a previous low or intermediate-risk PC (HR, 0.92; 95% CI, 0.74–1.14) or high-risk PC (HR, 0.73; 95% CI, 0.52–1.01) compared with those without PC history.ConclusionMen undergoing rectal cancer surgery with a previous diagnosis of prostate cancer do not experience an increased risk of rectal cancer recurrence or overall mortality compared with men without a previous history of prostate cancer.

Chest wall resection and reconstruction for primary chest wall sarcomas: Analysis of survival, predictors of outcome, and long-term functional status

ObjectivesWe aimed to analyze survival, predictors of outcome, and the long-term functional status of patients with a diagnosis of primary chest wall sarcoma who undergo chest wall resection and reconstruction. MethodsWe analyzed a prospectively maintained database, including all patients operated on between 2008 and 2021. The primary outcome measures were overall and disease-free survival and analyses were employed to determine the risk factors for poor survival and recurrence. ResultsOne hundred thirty-nine patients were included, 55% were men. The majority (96%) had an R0 resection and 75.1% had no postoperative complications up to 30 days postprocedure; median length of hospital stay was 7 days (range, 6-10 days). Median overall and disease-free survival was 58.8 and 53.6 months, respectively. For those alive, at long-term follow-up, 80% had a Medical Research Council dyspnea score of 0 and Karnofsky index >80%. Survival and mortality rates were better in chondrosarcomas compared with nonchondromatous sarcomas (P < .05). Previous history of radiotherapy, previous history of cancer, the type of sarcoma (Ewing's or soft tissue), the need for adjuvant treatment and tumor grade were significant predictors of mortality and recurrence on univariate testing. Extended resection, a higher number of ribs removed, and the incidence of postoperative complications were significantly associated with a worse postoperative Medical Research Council dyspnea score. ConclusionsCareful patient selection and multidisciplinary decision making is crucial. This leads to clear resection margins, good overall, and disease-free survival and good functional outcomes.

Knowledge, Attitudes and Practices to Sunscreen Use among Dermatology Patients at University Hospital Amman, Jordan: A Cross-Sectional Study

Background and Aims: Skin cancer is a significant public health concern globally. Jordan’s location and high exposure to UV radiation have led to an increase in the incidence rate of skin cancer. This study aimed to investigate the knowledge, attitudes, and practices of patients to sunscreen use in one of the major hospitals in Jordan, and identify demographic factors associated with regular sunscreen use. Methodology: An observational cross-sectional study was conducted at the dermatology clinic of Jordan University Hospital, Amman, Jordan, from February 2, 2023 to March 6, 2023. The study included 397 participants recruited from the clinic’s waiting area. A validated survey questionnaire was used to collect data on demographics, previous skin cancer history, sunscreen allergies, knowledge, attitudes, and practices related to sunscreen use. The data were analyzed using SPSS v. 26. Statistical significance was established at a p-value of &lt;0.05. Results: The majority of participants were female (67.0%) and aged 18–25 years (53.7%). Only 24.9% of participants reported using sunscreen regularly, while 34.0% reported never using it. Participants with higher education levels and income were more likely to use sunscreen regularly. The main sources of sunscreen recommendations were family and friends (48.1%), followed by dermatologists (32.7%). The most common reason for not using sunscreen was forgetfulness (40.1%). Conclusion: The study revealed that knowledge and practices related to sunscreen use among Jordanian dermatology patients are insufficient, and that there is a need for increased patient education regarding the importance of sunscreen use.

Inflammatory Bowel Disease and Colorectal Cancer.

Patients with inflammatory bowel diseases (IBDs), including both ulcerative colitis (UC) and Crohn's disease (CD), are at a higher risk of developing colorectal cancer (CRC). However, advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have led to a decrease in the incidence of CRC among IBD patients. Currently, the management of patients with IBD who have a history of or ongoing active malignancy is an unmet need. This involves balancing the risk of cancer recurrence/progression with the potential exacerbation of IBD if the medications are discontinued. The objective of this review is to provide an updated summary of the epidemiology, causes, risk factors, and surveillance approaches for CRC in individuals with IBD, and to offer practical guidance on managing IBD patients with history of previous or active cancer.

Association Between Bladder Cancer and Environmental Risk Factors in Guilan Province: A Case-Control Study

Background: Occupational settings expose workers to various substances linked to cancer risk, influenced by exposure intensity and duration. Considering the diverse work conditions across Iranian cities and the unexplored link between occupation and bladder cancer (BC) in Guilan Province, identifying high-risk occupations and industries is imperative for implementing preventive measures in the region. Objectives: To investigate the effect of people's occupations on bladder cancer in Guilan Province. Methods: The study encompassed 266 diagnosed BC patients in Guilan Province who received treatment at local healthcare centers, along with 191 control individuals aged 18 and over. Data for the cases were meticulously recorded in medical records at the Guilan Cancer Registry. The same checklists, including demographic characteristics, comorbidities, addiction status, water consumption habits, environmental exposures, current and previous occupation, previous history of cancer, and family history of cancer, were recorded for the controls. Odds ratios and their 95% confidence intervals were estimated using adjusted logistic regression (LR). Results: The study found that the odds ratio of bladder cancer (BC) was 2.80 (95% CI: 1.26 - 6.21) for the age group 60 - 70 years and 18.2 (95% CI: 7.31 - 45.6) for individuals above 70 years. Rural dwelling increased the risk by 5.06-fold, while well water consumption and regular opium use amplified it by 6.12-fold and 2.58-fold, respectively. Exposure to tar and carbon derivatives led to a 3.53-fold increase in risk, and exposure to combustion/greenhouse gases showed a 10.72-fold increase. Chemical-related occupations, tar, carbon derivatives, smoking, and opium consumption were significant risk factors. Conclusions: Occupations involving chemical substances such as greenhouse gases, tar, and carbon derivatives are associated with a higher risk of bladder cancer (BC). Furthermore, smoking, opium use, and well water consumption significantly elevate the risk of this cancer.

Long-term exposure to antihypertensive drugs and the risk of cancer occurrence: evidence from a large population-based study.

Available data on the association between antihypertensive drugs and cancer are characterized by a few years follow-up. Our aim has been to evaluate the association between long-term exposure to antihypertensive drugs and the risk of cancer occurrence. Using the healthcare utilization databases of the Lombardy region (Italy), individuals aged 40-85 years who had no previous history of cancer and were newly dispensed with at least one antihypertensive drug from the major drug classes between 2009 and 2011 were followed from the first drug dispensation to December 31, 2020. Data were analyzed according to the first drug used and the intention to treat principle, but also via an "as treated" approach, that is, by considering changes of and exposure to drugs during follow-up. The association between the duration of exposure to each drug class and the risk of cancer occurrence was evaluated using the adjusted Cox regression models. The study cohort included 338 910 new drug users (median age, 59 years; 49.5% males). During a median follow-up of 10.2 years, 36 556 cancers occurred. There was no consistent significant association between the risk of cancer occurrence and angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, or thiazides. A progressive, weak increase in cancer occurrence was associated with progressive exposure to calcium channel blockers and, limited to long-term exposure, to beta-blockers. A modest progressive increase in risk was observed also for thiazide-like and loop diuretics in the as treated, although not in the intention to treat approach. Long-term evaluation of exposure to antihypertensive drugs did not show consistent associations between thiazides, angiotensin-receptor blockers, or angiotensin-converting-enzyme inhibitors and the risk of cancer occurrence. A weak association was observed between cancer and the duration of exposure to calcium channel blockers and beta-blockers.

Awareness of skin cancer screening coverage in U.S. healthcare plans: Is there a need to better educate the public?

ObjectivesTo understand whether financial barriers or the lack of accessibility to dermatology services was a significant motivation for the public to seek free skin cancer screening. MethodsAn anonymous and voluntary survey was administered to participants of The Sun Bus free skin cancer screening program in 2023 at U.S. outdoor events in Colorado, Texas, Arizona, New Mexico, Iowa, Wyoming, Missouri, and Montana. 491 respondents answered questions on motivation, healthcare coverage, and demographics. Survey data was analyzed using Qualtrics’ crosstab IQ and statistical tests software. ResultsSkin screening found suspicious lesions in 45 % of 1300 participants with 18 % of respondents sharing a previous history of skin cancer. Concern for a lesion or Curiosity were the two top reasons for 60 % of respondents to seek free skin screening and remained the top reasons after data was stratified by gender, age, or income. Only 15 % of respondent were motivated by the cost of dermatology services or a long wait to see a dermatologist. A total of 38 % of people surveyed reported comprehensive plans covering skin screening while 46 % were unaware of the inclusion of screening in their healthcare plan. Notably, this unawareness increased up to 52 % among younger and less affluent respondents. Additionally, females were less likely than males to be aware of skin screening options in their healthcare plans. ConclusionsThis work highlights the significance of promoting public awareness of dermatology services covered by health insurance and the need for continued efforts in skin cancer education and screening programs.

Cervical metastasis of breast cancer: A case report and literature review.

Cervical metastasis of breast cancer is rare and its clinical manifestations are similar to those of primary cervical cancer. It is thus easy to misdiagnose, with diagnosis mainly depending on pathology and immunohistochemistry. There have been few studies on its treatment and there is thus no standard treatment plan. This is a 64-year-old female patient presented with a 2-month history of abnormal postmenopausal vaginal discharge, who had previous history of breast cancer. Based on the gynecological examination, imaging results, pathology, and immunohistochemical results, a diagnosis of metastatic carcinoma of the cervix and breast cancer was confirmed. She received computed tomography-guided 3-dimensional high-dose-rate brachytherapy in combination with chemotherapy. She achieved complete response locally. This case provides a new local treatment option for patients with inoperable localized cervical metastases. We hope that this report and the accompanying review help to enrich the literature pertaining to the treatment of rare cervical metastases, providing a foundation for the improved survival of affected patients.

Abbreviated Breast MRI Protocols in the Screening of High-Risk Females

Abstract Background Standard MRI breast more often than not, have lengthy protocols that make them much more expensive and time-consuming. And in spite its great potential for early detection of breast cancer in high-risk females, its wide application remains difficult, therefore the use of abbreviated MRI protocols in breast cancer screening is introduced. Results This study was done on high-risk women with a lifetime risk of over 20%. The majority of the examinations were performed on women with previous history of breast cancer (63.3%), while 36.7% had moderate to high family history. An abbreviated protocol was created form the sequences obtained from the full diagnostic protocol, which consisted of a pre-contrast T1, post-contrast T1, subtraction and MIP images. On MRI examination using the conventional protocol, 36% of the women in our study were diagnosed with breast mass lesions, of which 20% were malignant masses. Benign findings, whether mass or non-mass lesions constitutes of a total of 50.1%, and about 26.7% were normal. All the malignant lesions were identified on the abbreviated protocol by the designated reader after review of the clinical history. So, the cancer detection rate in our study using the abbreviated MRI protocols revealed a Kappa agreement test of 1.000, i.e., perfect agreement with the conventional protocols for the participant females. Conclusion The use of abbreviated MRI breast is feasible without compromising the cancer detection rate compared to a full protocol. It also achieved a significant reduction in scanning time, interpretation time, and total cost of the study, proving its efficacy and making it a more accessible first line of screening high-risk females.

Risk prediction model for gastric cancer within 5 years in healthy Korean adults.

Although endoscopy is commonly used for gastric cancer screening in South Korea, predictive models that integrate endoscopy results are scarce. We aimed to develop a 5-year gastric cancer risk prediction model using endoscopy results as a predictor. We developed a predictive model using the cohort data of the Kangbuk Samsung Health Study from 2011 to 2019. Among the 260,407 participants aged ≥20years who did not have any previous history of cancer, 435 cases of gastric cancer were observed. A Cox proportional hazard regression model was used to evaluate the predictors and calculate the 5-year risk of gastric cancer. Harrell's C-statistics and Nam-D'Agostino χ2 test were used to measure the quality of discrimination and calibration ability, respectively. We included age, sex, smoking status, alcohol consumption, family history of cancer, and previous results for endoscopy in the risk prediction model. This model showed sufficient discrimination ability [development cohort: C-Statistics: 0.800, 95% confidence interval (CI) 0.770-0.829; validation cohort: C-Statistics: 0.799, 95% CI 0.743-0.856]. It also performed well with effective calibration (development cohort: χ2=13.65, P=0.135; validation cohort: χ2=15.57, P=0.056). Our prediction model, including young adults, showed good discrimination and calibration. Furthermore, this model considered a fixed time interval of 5years to predict the risk of developing gastric cancer, considering endoscopic results. Thus, it could be clinically useful, especially for adults with endoscopic results.

Decompressive craniectomy in symptomatic intracerebral hemorrhage after ischemic stroke: a multicenter retrospective cohort study.

Symptomatic intracerebral hemorrhage (sICH) after stroke is a devastating neurological complication. Current guidelines support a "possible benefit" of decompressive craniectomy (DC) for large supratentorial sICH with significant mass effect. The authors conducted a retrospective study of 8 comprehensive stroke centers. They included all patients who sustained an sICH after acute ischemic stroke (AIS), as defined by the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST), from January 2016 to December 2020. They compared patients who underwent DC to those who were treated with standard medical treatment to measure functional outcome at 90 days, primarily as defined by the modified Rankin Scale (mRS) and secondarily by the Glasgow Outcome Scale-Extended (GOS-E). Eighty-five patients were identified, 26 of whom (30.5%) underwent DC. Patients who underwent DC were younger (58 years [DC] vs 76 years [no DC], p < 0.001). No patient with a previous history of cancer underwent DC (n = 14, p = 0.004). Twenty-five patients (96.2%) in the DC group underwent thrombectomy versus 54 (91.5%) in the non-DC group (p = 0.443). Patients who underwent DC had a longer ICU stay (median [IQR] 240 [38-408] hours vs 24 [5-96] hours in non-DC patients, p = 0.002). At 90 days, 3 patients (4.1%) had obtained an mRS score of 0-2 and 10 patients (11.7%) an mRS score of 0-3. Patients who had improved functional outcome were younger (mRS score, OR 1.06, 95% CI 1.01-1.10, p = 0.012). Patients with a history of cancer had worse 90-day mRS scores (OR 8.49, 95% CI 1.54-159, p = 0.046). The rate of in-hospital mortality or discharge to hospice was significantly higher in the non-DC cohort (10 [38.5%] patients in the DC cohort vs 38 [64.4%] in the non-DC cohort, p = 0.026). Ninety days later, patients who underwent DC were more likely to have improved outcome (mRS mean rank 30.0 vs 40.0, p = 0.027). In multivariable analysis, history of cancer (OR 12.2, 95% CI 1.26-118, p = 0.031) and older age (OR 1.07, 95% CI 1.02-1.13, p = 0.011) increased the odds of worse mRS outcomes while DC did not (OR 1.34, 95% CI 0.357-5.03, p = 0.665). DC after sICH did not improve functional outcome at 90 days according to multivariable analysis, although younger age and absence of previous cancer history were associated with improved outcomes.

Analysis of Risk Factors for Secondary Endometrial Cancer-Related Death: A SEER-Based Study.

The aim of this study was to analyze the survival of patients with endometrial cancer diagnosed after a prior cancer and identify risk factors of endometrial cancer death in this population. Totally 1371 women diagnosed with second primary endometrial cancer (SPEC) between 2004 and 2015 were identified using the SEER database. Clinicopathological characteristics were collected, and Fine and Gray regression model was employed to assess the impact of treatment for the first primary cancer (FPC) and SPEC on the mortality of endometrial cancer patients. After propensity score matching (PSM), patients diagnosed with single primary endometrial cancer and SPEC between 2004 and 2015 were included as the second cohort. Kaplan-Meier and Cox survival risk models were used to assess the influence of previous cancer history on survival. Patients previously diagnosed as lung cancer exhibited the lowest overall survival (OS). A diagnostic interval of ≥3 years was significantly associated with higher mortality from SPEC compared with that <3 years. Surgical treatment for SPEC was linked to a reduced risk of endometrial cancer-specific mortality (ECSM) and non-ECSM. Conversely, radiotherapy and chemotherapy were associated with an increased risk of ECSM. The 1-, 3-, and 5-year OS rates of patients with SPEC were significantly lower than those with single primary endometrial cancer whether before or after PSM. Univariate and multivariate analyses further demonstrated that endometrial cancer, either as FPC or SPEC, was independently associated with an increased risk for endometrial cancer-specific survival (ECSS) and OS. Chemotherapy and radiotherapy for SPEC can elevate the risk of ECSM. Whether as FPC or SPEC, endometrial cancer is demonstrated to be a significant independent risk factor for ECSS and OS.

The population-based effects of the FDA’s approval of durvalumab as consolidative therapy in patients with locally-advanced non-small cell lung cancer.

e20086 Background: In 2018, consolidative durvalumab (D) was FDA-approved in patients with locally advanced non-small cell lung cancer(NSCLC) because it increased PFS and was later found to increase overall survival (OS). This analysis will check the real-world effects of this agent prior to and after its approval. Methods: The SEER-17 database was queried from 2015-2020 and assessed for differences in OS/lung cancer specific survival (LCSS) and rates of second cancers (2C). Patients included were those with NSCLC who received chemotherapy and radiation with at least 7 months of follow-up. The population was split into two different groups, those diagnosed before and after D’s approval (2015-2017(BA) and 2018-2020(AA). Multi-variate analyses (MVA) were used to find prognostic factors which were used to adjust OS/LCSS rates for the BA and AA at 12, 24, and 30 months. Variables analyzed included patient characteristics, histopathology, and previous cancers (separated into alcohol, diet, smoking, virus and hormone related). Inverse propensity scores were weighted for OS factors to determine rates of second cancers. Results: Of 12,022 patients, 501 patients developed 2Cs. The OS was significantly better for AA group than the BA group ( p &lt; 0.001, HR = 0.79(0.74, 0.85) with rates at 12, 24, and 30 months of 0.86, 0.68, and 0.62%; and 0.83, 0.62, and 0.55%. Multivariate analyses for OS demonstrated similar prognostic factors in both year groups and were worse with advanced age, male sex, unmarried status, squamous histology, advanced stage and non-Hispanic white race. The LCSS was significantly better in AP than the BA group ( p &lt; 0.001, HR = 0.84 (0.7, 0.89) with rates at 12, 24, and 30 months of groups of 0.82,0.61, and 0.55%; and 0.80,0.56,and 0.48%. The prognostic factors for LCSS were the same in both group and included age, male sex, squamous histology, and advanced stage. The adjusted rates of 2C in 2018-2020 group were trending less than in 2015-2017 (HR = 0.80(0.63-1.03), p =0.07), largely driven by a reduction in smoking-related cancers (HR = 0.74(0.53-1.02, p= 0.07). The 2C rates at 12, 24, and 30 months were 1.0, 2.7, and 3.5% in the 2015-2017 and 0.9, 1.6, and 1.9% in 2018-2020 groups. MVA significant risk factors for 2Cs were age, history of previous cancer, male sex, and squamous histology in the BA group, but no factors were significant for 102 second cancers in the AA group. Conclusions: In the years after durvalumab's approval, there was a significant benefit in terms of overall survival and lung cancer specific survival, but prognostic factors remained similar. In addition to the OS/LCSS benefit, durvalumab's approval was associated with a strong trend for reducing the incidence of second cancers, especially in those with previous smoking related cancers.

Precision medicine for papillary thyroid carcinoma (PTC) variants: A machine learning approach to prognosis and treatment guidance.

e18072 Background: PTC is a common endocrine cancer with a good prognosis, but aggressive subtypes, such as Hürthle cell (HCC) and columnar cell variants (CCV), pose challenges due to their higher recurrence and metastasis rates. To provide personalized care, we applied machine learning to evaluate the treatment effectiveness and develop precise prognostic models for PTC variants. Methods: The Surveillance, Epidemiology, and End Results (SEER) database provided the data used for this study’s analysis (2000–2019). Patients who met any of the following criteria were excluded: diagnosis not confirmed by histology, previous history of cancer or with other concurrent malignancies, and unknown data. To identify prognostic variables, we conducted Cox regression analysis and constructed prognostic models using machine learning (ML) algorithms to predict the 5-year survival. Patient records were randomly divided into training (70 %) and validation (30 %) sets. A validation method incorporating the area under the curve (AUC) of the receiver operating characteristic curve was used to validate the accuracy and reliability of the ML models. Results: The study population comprised 3690 patients. Among them 3180 patients with CCV and 510 patients with HCC, respectively. Most patients (62.8%) were 45 years or older, with a median age of 52 years. A total of 56.9% of patients had a tumor size greater than 2 cm, with a median tumor size of 3.1 cm. The largest racial group was white, comprising 83.8% of the cases, and 11.8% of the cases were Asian. Most cases were regional (53.4%, n=1969), followed by localized (38.3%, n= 1413). Multivariate Cox regression analysis revealed that N1 negatively affected the survival of HCC patients. CCV has a favorable prognosis after surgery, radiotherapy, or total thyroidectomy. Poor prognosis in CCV is associated with black race, large tumor size, and T4 stage. Improved survival in the localized/regional stage and decreased survival with male sex, older age, distant metastasis, and advanced AJCC stage in both PTC subtypes. ML models revealed that the random forest classifier (RFC) and K-Nearest Neighbors (KNN) accurately predicted outcomes, followed by Logistic Regression (LR) models. The highest contributing factors were AJCC staging, tumor size, and T aspect of TNM staging. Conclusions: Our study offers a method for evaluating and treating patients with PTC variants. The machine learning model that we created serves as a useful and personalized resource to aid in clinical decision-making processes.[Table: see text]

Information and prevention needs among germline TP53(gTP53m)pathogenic variants carriers.

10551 Background: Li-Fraumeni syndrome (LFS) and more generally g TP53m situations increase the risk of many malignancies. A modifier role of several attributable factors has been recently suggested on LFS-carcinogenesis, including reproductive and lifestyle factors, obesity, physical activity (PA) and diet. However, among g TP53m carriers, prevention approaches have yet primarily focused on intensive cancer screening, with very little emphasis put on primary prevention measures. Methods: As part of the construction of a multicenter, national, multidisciplinary intervention delivering multimodal cancer prevention to g TP53m carriers, we designed a specific patient survey that aimed to analyze potential participants’ needs and wishes. The online questionnaire was sent to g TP53m adult carriers already followed in two national reference centers (n=120). Participants were asked to rate their personal perception of importance and need for each item from 0 to 100 (0=not interested, 100=very interested). The questionnaire contained no identifying data and was approved by the local ethics and data protection committee. Results: The response rate was 61%. 18% were aged &lt; 30, 71% between 30 and 60. g TP53m had been diagnosed in the past 10 years in 29% of patients, and 11% for &lt; 2 years. 58% had a personal history of cancer, and 18% were still receiving a treatment. The median perceived risk of new cancer was 79% for all, and 65% for those w/o a previous history of cancer. 19% did not feel comfortable to participate in information workshops with people they do not know. The median score of the main question on devoting a day to cancer risk information and primary and secondary prevention measures was 88 (95%CI 78 -96). The main desired topics (median score 69-92) were information on research programs, personal cancer risk, well-being measures, psychological aspects, and other cancer risk factors (diet, PA, etc). Wished supports were individual consultation for nutrition (score 81.5 (95%CI 59 -87.5), group workshop for risk factors (score 76 (95%CI 64 -86) and individual coaching for PA (score 76 (95%CI 71 -88.5). Demand for addictologist was low. Conclusions: This study could identify major unmet needs and very strong information-seeking behaviors among g TP53m carriers. It enables us to co-construct a coordinated multi-professional intervention focused on proactive shared cancer prevention. In a second phase, we will assess the effectiveness and feasibility of this new personalized cancer prevention intervention.

Laryngeal squamous cell carcinoma (LSCC) prognosis and machine learning insights.

e18058 Background: LSCC has seen a rise in cases and deaths over the past 30 years. Considering the evolving therapeutic options available in the treatment landscape, we evaluated treatment approaches and developed a machine learning (ML) model for patients with LSCC without distant metastasis. Methods: Data from 2000 to 2020 were obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results database with localized/regional stages only, including the glottis (GC), supraglottic (SuGC), and subglottic (SGC). Patients who were not diagnosed based on histology, previous history of cancer or other concurrent malignancies, or unknown data were excluded. T-tests and chi-square tests were used to compare variables, while the Kaplan-Meier estimator, log-rank tests, and Cox regression analysis identified prognostic factors for overall survival (OS) and cancer-specific survival (CSS). We constructed prognostic models using ML algorithms to predict the 5-year survival. Patient records were randomly divided into training (70 %) and validation (30 %) sets. A validation method incorporating the area under the curve (AUC) of the receiver operating characteristic curve was used to validate the accuracy and reliability of the ML models. Results: A total of 68,282 patients were included (43,434 with GC, 24,010 with SuGC, and 838 with SGC). Of the patients, 80.8% were males and 63.5% were over 60 years old and white (n=56,171). The tumors were &gt;2 cm in size (85.1%). The median patient age was 64 years, and the median tumor size was 3.2 cm. Of these patients, 36.5% underwent surgery with local tumor excision in 23.9 % and total laryngectomy in 5.7% of patients. White race, regional stage, large tumor size, and chemotherapy were poor prognostic factors for GC. Asian ethnicity, white race, and total laryngectomy were good prognostic factors for SuGC, whereas male sex and older age were poor prognostic factors. In terms of SCG "Surgery + adjuvant radiotherapy" was associated with better prognosis while regional and white race were associated with poor prognosis. Performance metrics for all ML algorithms are summarized in the Table. The factors that contributed the most to GC were the surgery type, stage, and age. Stage, surgery type, and race for SuGC and age, stage, and surgery type for SGC. Conclusions: ML models showed promising accuracy in predicting prognosis, highlighting the valuable contributions of factors such as surgery type, stage, age, and race. These findings offer insights into personalized treatment decisions and future research directions. [Table: see text]