Oncology Section Research Articles

Prevalence and Risk Factors of Low Anterior Resection Syndrome in Epithelial Ovarian Cancer Surgery.

BackgroundIn this study, we aimed to determine the prevalence and risk factors of low anterior resection syndrome (LARS) in epithelial ovarian cancer (EOC) surgery.MethodologyA descriptive cross-sectional study was conducted at the Gynecologic Oncology Section of the Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan. Using non-probability consecutive sampling technique, all patients who underwent cytoreductive surgery involving low anterior resection for EOC between January 2016 and January 2021 were included. Patients were assessed for LARS symptoms using the LARS score, along with its risk factors. Descriptive statistics, that is, continuous variables were expressed as the median and interquartile range, while categorical variables were expressed as frequencies and percentages. The LARS score was categorized according to a two-tier model with “no or minor LARS” and “major LARS.” Univariate analyses were performed by the chi-square tests providing odds ratios and 95% confidence intervals to identify risk factors for major LARS.ResultsOverall, 95% of cases had LARS scores that fell in “no or minor LARS,” while only 5% of cases had “major LARS.” Univariate analyses relieved no statistically significant association between the occurrence of major LARS and any of the risk factors.ConclusionsThe prevalence of LARS was 5%, and no risk factors were associated with major LARS in our study population.

171 Developing & Centralising a Nurse-Led Local Anaesthetic (La) Transperineal (Tp) Biopsy Service During Covid: A Success Story

IntroductionDuring the first COVID-19 wave, the BAUS Section of Oncology issued guidance to minimise risks of sepsis and general anaesthesia at prostate biopsy. Consequently, and as a result of diminished diagnostics capacity on Trust acute sites, we implemented a centralised network-wide nurse-led LA TP biopsy service on a COVID-secure “green” site and abandoned trans-rectal biopsies. We evaluated the impact of this service improvement on patient waiting times before and after national lockdown in March 2020.MethodClassic Quality Improvement (QI) methodology was used with continuous data collection and waiting list management by clinical staff with standard admin support. Balancing measurements were collected. Run charts were used to confirm whether a change led to a real and sustainable improvement.ResultsThe number of days waiting, from time of request to date of biopsy, is presented in the following run chart. The mean waiting time for those pre lockdown was 145 days (SD 57) whereas post lockdown was 23 days (SD 20). This identified that there was a significant difference between the average waiting time pre and post lockdown (U = 55.5, p = <0.001) There were also reductions in waiting time when subcategorised into planned Active Surveillance cases, target cases and delayed cases.ConclusionsCentralising the TP biopsy service and converting to a nurse led LA service has led to reductions in waiting lists and was safely expedited and resilient even in the COVID-19 pandemic. Allowing a second advanced TP practitioner to be fully trained, during COVID. The service was highly valued by patients and staff.

Attitudes and trends in the use of radiolucent spinal implants: A survey of the North American Spine Society section of spinal oncology

BackgroundIn spinal oncology, titanium implants pose several challenges including artifact on advanced imaging and therapeutic radiation perturbation. To mitigate these effects, there has been increased interest in radiolucent carbon fiber (CF) and CF-reinforced polyetheretherketone (CFR-PEEK) implants as an alternative for spinal reconstruction. This study surveyed the members of the North American Spine Society (NASS) section of Spinal Oncology to query their perspectives regarding the clinical utility, current practice patterns, and recommended future directions of radiolucent spinal implants. MethodsIn February 2021, an anonymous survey was administered to the physicians of the NASS section of Spinal Oncology. Participation in the survey was optional. The survey contained 38 items including demographic questions as well as multiple-choice, yes/no questions, Likert rating scales, and short free-text responses pertaining to the “clinical concept”, “efficacy”, “problems/complications”, “practice pattern”, and “future directions” of radiolucent spinal implants. ResultsFifteen responses were received (71.4% response rate). Six of the participants (40%) were neurosurgeons, eight (53.3%) were orthopedic surgeons, and one was a spinal radiation oncologist. Overall, there were mixed opinions among the specialists. While several believed that radiolucent spinal implants provide substantial benefits for the detection of disease recurrence and radiation therapy options, others remained less convinced. Ongoing concerns included high costs, low availability, limited cervical and percutaneous options, and suboptimal screw and rod designs. As such, participants estimated that they currently utilize these implants for 27.3% of anterior and 14.7% of all posterior reconstructions after tumor resection. ConclusionA survey of the NASS section of Spinal Oncology found a lack of consensus with regards to the imaging and radiation benefits, and several ongoing concerns about currently available options. Therefore, routine utilization of these implants for anterior and posterior spinal reconstructions remains low. Future investigations are warranted to practically validate these devices’ theoretical risks and benefits.

Editorial introductions.

Editorial introductions.

32P Can circulating immune checkpoints and KIT exon 11 mutations be prognostic factors in metastatic gastrointestinal stromal tumors?

32P Can circulating immune checkpoints and KIT exon 11 mutations be prognostic factors in metastatic gastrointestinal stromal tumors?

Cardiac metastasis of triple-negative breast cancer mimicking myxoma: A case report.

IntroductionMetastatic heart tumors are rare, occurring in 1.5–20% of cancer patient autopsies. Lymphoma, melanoma, leukemia, and carcinomas of the lung, esophagus, and breast are the most prevalent causes of these metastases, although they can originate from any malignant tumor. Here we report a case of triple-negative breast cancer with cardiac metastasis mimicking myxoma.Presentation of caseA 39-year-old woman presented at the emergency department with shortness of breath. Vital signs were hypotension and tachypnea. There were coarse crackles at the bases of both lungs. Electrocardiography results showed a normal sinus rhythm. Chest X-ray revealed cardiomegaly with signs of pulmonary edema. Echocardiography revealed a large left atrial (LA) mass protruding to the mitral valve and attached to the interatrial septum during diastole. The patient was diagnosed with cardiogenic shock, acute kidney injury, elevated liver enzymes, and an LA mass. Surgical excision through median sternotomy was planned. Intraoperatively, an LA mass was found. The histopathology evaluation showed an LA mass with invasive ductal carcinoma of metastatic breast tumors. Immunohistochemistry (IHC) confirmed the diagnosis of triple-negative breast cancer that had metastasized to the heart. Postoperative echocardiography confirmed complete excision of the tumor.DiscussionBreast cancer that has metastasized to the heart is uncommon. This patient was referred to the surgical oncology section for the treatment of triple-negative breast cancer with cardiac metastasis.ConclusionA heart mass should be suspected of having metastasized if the patient has a history of malignancy, even if it occurred several years earlier.

Quality Analysis of YouTube Videos Presenting Shoulder Exercises after Breast Cancer Surgery

Background: The prolonged immobilization suggested after breast cancer (BC) surgery causes morbidity. Patients search the Internet, especially social networks, for recommended exercises. Objective: The aim of this observational study was to assess the quality of YouTube videos, accessible for any patient, about exercises after BC surgery. Methods: A systematic search was performed on YouTube. One hundred and fifty videos were selected and analyzed. Two statistical analyses were conducted based on machine-learning techniques. Videos were classified as “Relevant” and “Non-Relevant” using principal component analysis models. Popularity was evaluated by Video Power Index (VPI), informational quality and accuracy were measured using the DISCERN Scale and Global Quality Scale (GQS). Scoring criteria for exercises were established according to the exercises recommended by the Oncology Section of the American Physical Therapy Association (APTA). Interobserver agreement and individual correlations were statistically examined. Results: DISCERN scored a mean of 50.97 (standard deviation [SD] 19.19). HONcode scored 78.30 (11.02) and GQS scored 3.49 (0.74). Average number of views was 53,963 (SD 67,376), mean duration was 9:42 min (9:15), mean days online was 2,158 (922), mean view ratio was 27.14 (30.24), mean likes was 245 (320.5), mean dislikes was 13.4 (14.2), and mean VPI was 93.48 (5.42). Conclusion: The quality of YouTube videos of recommended exercises post-BC surgery is high and can be a translational activity to improve patients’ behavior. Health institutions and NGOs, with higher popularity levels than academic institutions, should consider this information when implementing new policies focused on video quality which can contribute to adaptive behavior in patients.

Importance of sickle cell trait counseling for adolescents and young adults.

Pediatric Blood & CancerVolume 68, Issue 12 e29300 COMMENTARY Importance of sickle cell trait counseling for adolescents and young adults Seethal A. Jacob, Corresponding Author seejacob@iu.edu orcid.org/0000-0003-2906-6102 Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University, Indianapolis, Indiana, USA Correspondence Seethal A. Jacob, Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, 410 W. 10th St., Suite 2000A, Indianapolis, IN 46202, USA. Email: seejacob@iu.eduSearch for more papers by this authorEmily Riehm Meier, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USASearch for more papers by this author Seethal A. Jacob, Corresponding Author seejacob@iu.edu orcid.org/0000-0003-2906-6102 Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, Indianapolis, Indiana, USA Center for Pediatric and Adolescent Comparative Effectiveness Research, Indiana University, Indianapolis, Indiana, USA Correspondence Seethal A. Jacob, Section of Pediatric Hematology Oncology, Department of Pediatrics, Indiana University, 410 W. 10th St., Suite 2000A, Indianapolis, IN 46202, USA. Email: seejacob@iu.eduSearch for more papers by this authorEmily Riehm Meier, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USASearch for more papers by this author First published: 16 August 2021 https://doi.org/10.1002/pbc.29300 Funding information: National Heart, Lung, And Blood Institute of the National Institutes of Health, Grant Number: K23HL143162. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume68, Issue12December 2021e29300 RelatedInformation

Editorial Comment.

No AccessJournal of UrologyAdult Urology1 Aug 2021Editorial CommentThis article comments on the following:Active Surveillance for Risk Stratification of All Small Renal Masses Lacking Predefined Clinical Criteria for Intervention Arnav Srivastava, and Eric A. Singer Arnav SrivastavaArnav Srivastava Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, Belle Mead, New Jersey More articles by this author , and Eric A. SingerEric A. Singer Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, Belle Mead, New Jersey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001714.02AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Comment." The Journal of Urology, 206(2), pp. 238–239

Oral cavity complications in oncological and hemato-oncological patients.

Oral cavity injuries are very significant complications in the treatment of oncological and hemato-oncological patients. Preventive and curative interventions and patient education reduce the risk of complications and their consequences. A working group of authors from professional groups prepared recommendations for care. A basic summary of recommended interventions to prevent and treat oral cavity injuries in daily practice, defined on the basis of expert societies guidelines, trials, literature data and proven practice and on the consensus opinions of the authors group members. Preventive measures and patient education are essential in the approach to dealing with oral injuries in chemotherapy, radiotherapy, risky targeted treatment and osteonecrosis of the jaw. Local care products are an important element of care, in case of infections, their antimicrobial action is essential, in case of graft-versus-host disease or in connection with targeted oncological therapy, corticoids are used. The recommended procedures contribute to the reduction of the development, severity and consequences of oral complications in oncological and hemato-oncological patients.

Capmatinib (Tabrecta™)

Capmatinib (Tabrecta™)

Editorial introductions.

Editorial introductions.

Evaluating the Risk Factors and Induced Cardiotoxicity in Breast Cancer Patients

Background: Breast cancer (BC) is one of the most common cancers among women. The survival of the BC patients is based on new treatment protocols. Cardiotoxicity is the most common side effect in these patients. Methods: This was a descriptive study in which we selected our patients randomly among the BC patients and used questionnaires for data completion.66 BC patients whose disease were confirmed according to the histology and laboratory data taken to the oncology section of Ahvaz Golestan hospital between 2017 - 2018. Risk factors, history of the patients, and the function of the heart were evaluated 6 and 12 months after chemotherapy through echocardiography. Result: Six months after chemotherapy, the follow-up patients in 6 indicated five significant risk factor included Age (P &lt; 0.03), history of heart disease (P &lt; 0.02), blood pressure (P &lt; 0.00), diabetes (P &lt; 0.00), and cholesterol (P &lt; 0.04), which confirm the dysregulation function of heart and indication of cardiotoxicity. In 12 months follow- up, the result indicated that only the history of heart disease was significantly correlated with cardiotoxicity (P &lt; 0.01). Conclusion: Finally, the detection of risk factors in BC can introduce a prognostic factor when cardiotoxicity occurs simultaneously with the conduction of chemotherapy.

Medical rehabilitation&#x0D; of cancer patients:&#x0D; A literature review

Relevance: Today, the restorative treatment of patients&#x0D; with malignant neoplasms remains a relevant issue. This section of oncology is the most laborious and requires an integrated approach. The concept of Quality of Life (QoL) increasingly appears in clinical trials, along with survival.&#x0D; The purpose was to review the literature on various aspects of medical rehabilitation of cancer patients.&#x0D; Results: The selected sources analysis suggests the necessity of an integrated approach to the restorative treatment of cancer patients because the changes in these&#x0D; patients’ life status are often pronounced. These changes&#x0D; might involve the patient’s physical condition and its various functional indicators; psycho-emotional state, with&#x0D; the relationship between predictive perception, QoL and&#x0D; the patient’s mood; and the social status, which is decisive&#x0D; for the patient’s reintegration in society. Such a multilateral&#x0D; approach will cover all aspects of patients’ life activity and&#x0D; address the main focus of cancer patients’ medical rehabilitation – their QoL improvement.&#x0D; Conclusion: Implementation of an integrated medical&#x0D; rehabilitation program for cancer patients will promote a&#x0D; maximum possible restoration of these patients’ life conditions and facilitate their physical and psycho-social adaptation after specialized treatment.

40 - anniversary (1980-2020) of the establishment of the Oncological Section of the Polish Society of Otorhinolaryngologists and Head and Neck Surgeons

The Oncology Section of the Polish Society of Otorhinolaryngologists Head and Neck Surgeons is one of the oldest sections of the PSOHNS, it was established by a resolution of the General Meeting of the PSOHNS in Poznań on 22nd September 1980 upon request of prof. Stanisław Iwankiewicz, who became its Chairman. On 12th December 1981, the 1st Conference of the Section was held in Wrocław, laryngeal cancer was the topic. During its 40th anniversary, the Oncology Section organized 3 conferences and 17 symposia, bringing pride to the entire Society, and promoted the latest scientific trends in the approach to head and neck cancer. With the development of basic sciences, genetic and molecular tests as well as new diagnostic and therapeutic methods, the topics of the meetings gradually expanded to include new sections and issues in ENT oncology.

Analysis of the OITE Oncology Section: An Updated Review of Years 2013 to 2019

The importance of the Orthopaedic In-Training Examination (OITE) is well documented. The purpose of this study is to provide an updated analysis of the oncology section compared to the review by Frassica et al. from 2002 to 2006, as a means to provide insight into more focused resident study. This study is a retrospective database review using published OITE exams from years 2013 to 2019. Methods were based off a previous review by Frassica et al. where oncology-related questions were analyzed for underlying diagnosis, benign versus malignant condition, imaging and histology provided, and genes/translocations tested. Questions were classified by category and taxonomy. Oncology-related questions per exam ranged from 19 (7%) to 23 (8.4%) of total questions, which is fewer than years 2002 to 2006. Twenty malignant and 27 benign entities were tested with malignant conditions tested at a higher rate of 1.3:1 versus benign. Eighteen combinations of imaging modalities were provided for analysis versus 11 from 2002 to 2006. With regard to taxonomy, the average number of questions per classification ranged from 2.4 to 5.4. The least common classification tested was treatment modality and the most commonly tested classification was treatment from diagnosis (taxonomy 3). Previously, tumor knowledge (taxonomy 1) was most tested with an average of 8.8 questions per exam. 12 questions were directly related to genes and translocations across all years. Oncology questions made up a smaller percentage of the OITE exam than previous years, although more conditions were tested using more imaging combinations, necessitating a wider range of knowledge. However, malignant conditions continue to be tested more commonly. There has been a shift toward Taxonomy 3 level questions, indicating a higher level of thought processing required from residents as opposed to recall. Additionally, genes and translocations became more commonly tested throughout the most recent analysis, indicating a focus for future years of study.

Mothers’ Attitudes toward the Use of Complementary and Alternative Medicine in Children with Cancer

Background: Children who have cancer suffer from a wide range of symptoms and side-effects of disease and treatment, and such conditions have harmful effects on the quality of life of a child and family. So, the families of such children turn to complementary and alternative medicine treatments for children with cancer. Objectives: Therefore, this study aimed at determining the mothers’ attitudes toward the use of complementary and alternative medicine in children with cancer. Methods: This cross-sectional research was conducted from January 2018 to January 2019 in the oncology section of Yazd Shahid Sadooghi Hospital in a nonrandom and convenience sampling method on 150 mothers of children with cancer. The instruments of data collection include demographic information questionnaires and a 6-part questionnaire to evaluate mothers’ performance. To investigate the face and content validity of the questionnaire, the opinions of 10 experts were considered, and to investigate the reliability of the questionnaire, the test-retest method was used, and the intraclass correlation coefficient (ICC) was reportedly 0.80. After completing the questionnaires, the collected data were analyzed, using SPSS 23 by utilizing descriptive statistics, including mean, standard deviation (SD), frequency, and percent. Results: Overall, 83.34% of mothers mentioned praying as a way of complementary and alternative medicine, 67.34% used complementary and alternative medicine to increase child recovery chance, 74% reported general child recovery, 20% reported the occurrence of side-effects following the use of complementary and alternative medicine, 67.33% introduced their friends as their information source, 33.6% avoided informing the physician regarding the use of complementary and alternative medicine, and 76% maintained that due to the objection of physicians, they avoided informing him/her. Conclusions: The use of complementary and alternative medicine is common among mothers but due to the occurrence of side-effects, using invalid information sources and hiding it from a physician, the oncologists must provide a suitable opportunity for asking and answering to guide mothers for correct performance in the use of complementary and alternative medicine.

1723P Organizational challenges and oncological activity volumes during the SARS-CoV-2 epidemic peak in Verona, Italy

On February 23rd the first case of SARS-CoV-2 infection was diagnosed at the University Hospital Trust of Verona, Italy. On March 13th, the Oncology Section was converted into a 22 inpatient beds COVID unit and we had to reshape our organization and personnel to face the SARS-CoV-2 epidemic, while maintaining our oncological activity.

1701P Oncological patients’ perception of infection risks and level of acceptance of protective measures during SARS-CoV-2 pandemic

The health emergency caused by the SarS-Cov-2 pandemic has a strong impact on oncological patients’ (pts) life. The purpose of this study is to explore the emotional impact and pts’ perception experienced who accessed to our Oncology section at University Hospital and Trust of Verona (Italy) regarding these rules.

Acute Toxicity and Local Response using Three Fractions of High Dose Rate (HDR) Brachytherapy for Curative Treatment of Carcinoma Cervix.

Descriptive study. Radiation Oncology Section, Department of Oncology, The Aga Khan University Hospital, Karachi, Pakistan from January 2008 till December 2015. Protocol was formulated for carcinoma cervix to complete treatment in 7 weeks. Patients were treated with chemotherapy and pelvic EBRT to a total dose of 45 Gy/25 fractions, followed by three intracavitary HDR brachytherapy fractions of 8 Gy each. Vaginal toxicity and local clinical response was assessed at the end of treatment, at 4 and 8 weeks. A total of 57 patients were treated with HDR brachytherapy and 49 patients were evaluated for assessment of toxicity and response. According to FIGO staging system, two had stage IB2, one had IIA, thirty-six had IIB, seven had IIIB, one had IVA disease and two had IVB with para aortic nodes. Concurrent gemcitabine and cisplatin were given to 26 (46%); whereas, 28 (49%) received concurrent cisplatin alone. Grade III acute vaginal mucosal toxicity was seen in 52 and Grade IV acute vaginal mucosal toxicity was observed in 08 patients. At completion of treatment, 40 patients had complete clinical response, at 4 weeks follow-up, complete regression of disease was found in 3 more and at 8 weeks none had clinical residual disease. This regimen of HDR brachytherapy treatments is feasible, efficacious, and well-tolerated for carcinoma cervix in a setup with cost constraints. Long term toxicity and disease control remains to be reported with longer follow-up. Key Words: Carcinoma cervix, High dose rate brachytherapy, Acute toxicity, Local response, External beam radiation therapy, Intracavitary brachytherapy.