Survival Rate Of Cancer Patients Research Articles

Amino acids and their roles in tumor immunotherapy of breast cancer.

Breast cancer is the most commonly diagnosed cancer among women. The primary treatment options include surgery, radiotherapy, chemotherapy, targeted therapy and hormone therapy. The effectiveness of breast cancer therapy varies depending on the stage and aggressiveness of the cancer, as well as individual factors. Advances in early detection and improved treatments have significantly increased survival rates for breast cancer patients. Nevertheless, specific subtypes of breast cancer, particularly triple-negative breast cancer, still lack effective treatment strategies. Thus, novel and effective therapeutic targets for breast cancer need to be explored. As substrates of protein synthesis, amino acids are important sources of energy and nutrition, only secondly to glucose. The rich supply of amino acids enables the tumor to maintain its proliferative competence through participation in energy generation, nucleoside synthesis and maintenance of cellular redox balance. Amino acids also play an important role in immune-suppressive microenvironment formation. Thus, the biological effects of amino acids may change unexpectedly in tumor-specific or oncogene-dependent manners. In recent years, there has been significant progress in the study of amino acid metabolism, particularly in their potential application as therapeutic targets in breast cancer. In this review, we provide an update on amino acid metabolism and discuss the therapeutic implications of amino acids in breast cancer.

Safety of Vaginal Estrogen Therapy for Genitourinary Syndrome of Menopause in Women With a History of Breast Cancer

(Abstracted from Obstet Gynecol 2023;142:660–668) The current 5-year survival rate for female breast cancer patients has risen to 90%, but several breast cancer systemic treatments such as radiotherapy, chemotherapy, and endocrine therapy can all worsen hypoestrogenic states. Genitourinary syndrome of menopause (GSM) can result from lack of circulating estrogen, which can possibly lead to conditions such as sexual dysfunction.

Abstract A129: Association of concordance with guidelines of the National Comprehensive Cancer Network and overall survival in Puerto Rican women with endometrial cancer

Abstract Background: Endometrial cancer represents a significant burden in Puerto Rico, as it is one of the most common cancers among women. Although it has a favorable prognosis when diagnosed early, it remains the fifth leading cause of cancer-related deaths among women living in Puerto Rico. This highlights the need to address healthcare disparities and improve the quality of the healthcare system. Treatment guidelines are designed to assist healthcare professionals in offering the best possible care to patients by providing evidence-based suggestions. Implementing standardized practices is crucial to enhancing healthcare quality outcomes. Our objective was to assess the concordance of National Comprehensive Cancer Network (NCCN) guidelines for endometrial cancer treatment and its association with overall survival. Methods: Data on endometrial cancer patients aged 18 years and older diagnosed between 2009 and 2015 was obtained from the Puerto Rico Central Cancer Registry, linked to the Puerto Rico Health Insurance Administration database (n=2,114). The association between clinical aspects, health system, and socioeconomic factors with receipt of guideline-concordant treatment was evaluated using logistic regression. Overall survival (OS) was calculated using the Kaplan-Meier method. Univariate and multivariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between guideline-concordant treatment and OS. Results: In our cohort, 53.9% of patients received guideline-concordant treatment. Patients receiving treatment at a Commission on Cancer (CoC)-accredited facility are twice as likely to receive guideline-concordant treatment than non-accredited facilities (95% CI: 1.71-2.98). Individuals who received an assessment from a gynecologist oncologist are 90.0% more likely to receive treatment based on NCCN guidelines than those who did not (95% CI: 1.56-2.32). Private insured patients are 28.0% more likely to receive guideline-concordant treatment than Medicaid patients (95% CI: 1.02-1.61). In Cox regression models, guideline-concordant treatment was associated with a lower mortality risk compared to women who did not receive guideline-concordant treatment (95% CI: 0.59- 0.89). Conclusion: Receiving guideline-concordant treatment is a strong predictor of improved survival rates in endometrial cancer patients. Additionally, patients treated at CoC-accredited hospitals and by gynecologic oncologists tend to receive higher-quality care. Given that guidelines based on effective treatment standards have been demonstrated to enhance cancer patient outcomes, we must encourage and support factors contributing to their increased adoption. By doing so, we can strive to improve the prognosis and overall well-being of individuals affected by endometrial cancer in Puerto Rico. Citation Format: Yisel Pagan-Santana, Karen J. Ortiz-Ortiz, Maira Castañeda-Avila, Ruth Rios-Motta. Association of concordance with guidelines of the National Comprehensive Cancer Network and overall survival in Puerto Rican women with endometrial cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A129.

Abstract LB_C03: Protein translation inhibition enforces histone deacetylase inhibitor activity resulting in synergistic pancreatic cancer cell death

Abstract Management of pancreatic cancer presents significant challenges due to late-stage diagnosis, aggressive tumor biology, and limited efficacy of existing treatment options. Gemcitabine and FOLFIRINOX (folinic acid, 5-FU, irinotecan hydrochloride, oxaliplatin) are standard treatments for advanced pancreatic cancer. Despite these therapies the overall 5-year survival rate for pancreatic cancer patients is at 12%, largely due to drug resistance. Thus, there is a critical need to explore new therapeutic strategies. Our study explores a small molecule combination that induces epigenetic reprogramming as a potential novel therapeutic strategy for pancreatic cancer. We have identified marked sensitivity of pancreatic cancer cells to the combination of a novel inhibitor of RNA helicase eIF4A, DMPatA (MZ735), and a histone deacetylase (HDAC) inhibitor, romidepsin. A short-term, low dose romidepsin treatment, when combined with MZ735, triggers persistent global histone acetylation, transcriptional upregulation, replication inhibition, and augmented DNA damage. This combined effect induces a synergistic anti-proliferative response in pancreatic cancer cells. We have identified a tolerable protocol for this combination regimen in animals, demonstrating its efficacy against tumor growth in a MIA PaCa-2 xenograft mouse model of pancreatic cancer. Treatment with the combination resulted in inhibition and then complete suppression of tumor growth in animals for 39 days. Our in vitro studies aimed at understanding the mechanism of this combination treatment showed that at low doses of romidepsin monotherapy, histone acetylation rapidly faded, while robust acetylation persisted to 18 and 24 hours with the combination. Additionally, R-loop accumulation was observed using confocal microscopy and DRIP-qPCR, along with a reduction in replication fork speed, which might account for the identified DNA damage and genome instability. The combination treatment significantly reduces acetyl-CoA and c-MYC protein levels and disrupts glycolysis and oxidative phosphorylation. We show that a structurally different HDAC inhibitor exhibits the same synergistic effects when co-administered with MZ735, confirming a unique method of eliciting synthetic lethality in PDAC cells. In conclusion, this combination shows significant antitumor activity in both in vitro and in vivo models of pancreatic cancer and warrant translation to the clinic. Citation Format: Maryam Safari, Luigi Scotto, Agnes Basseville, Thomas Litman, Haoran Xue, Luba Petrukhin, Ping Zhou, Christopher Damoci, Minhzhao Zhu, Kenneth Hull, Kenneth P Olive, Antonio T Fojo, Daniel Romo, Susan E Bates. Protein translation inhibition enforces histone deacetylase inhibitor activity resulting in synergistic pancreatic cancer cell death [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr LB_C03.

Weight maintenance and gain were significantly associated with lower risk of all-cause and cancer-related mortality in Korean adults who were newly diagnosed with cancer based on the Korean NHIS-HEALS cohort.

The burden of malignant neoplasms is increasing worldwide. Healthy lifestyles such as maintaining a healthy body weight are important to improve survival rate in cancer patients. This study was aimed to test the hypothesis that weight change affects mortality in patients newly diagnosed with cancer. This study was retrospectively designed based on the National Health Insurance Service-National Health Screening Cohort. A total of 1856 subjects aged at least 40 years who received a national health checkup within 6 months before cancer diagnosis was included. Study subjects were classified into 3 categories based on weight change before and after cancer diagnosis: weight loss, maintenance, and gain. Cox proportional hazards regression models were adopted to examine the association between weight change and mortality after adjusting for confounders. Compared to those experiencing weight loss, the adjusted hazards ratios (HRs) (95% confidence intervals [CIs]) for those experiencing weight maintenance were 0.327 (0.189-0.568) for all-cause mortality and 0.431 (0.215-0.867) for cancer-related mortality. The adjusted HRs (95% CIs) for those experiencing weight gain were 0.149 (0.044-0.505) for all-cause mortality and 0.289 (0.080-1.045) for cancer-related mortality. After stratifying according to baseline body mass index (BMI), weight maintenance and gain were negatively associated with all-cause mortality (0.286 [0.138-0.592] for weight maintenance and 0.119 [0.027-0.533] for weight gain) among those with a BMI < 25 kg/m2. Weight maintenance and gain reduced the risk of all-cause mortality in patients newly diagnosed with any cancer. In addition, weight maintenance was significantly related to cancer-related mortality.

Role of CCNB1, CENPF, and neutrophils in lung cancer diagnosis and prognosis.

This study aimed to investigate CCNB1, CENPF, and Neutrophils as diagnostic predictors of lung cancer and to explore their association with clinical prognosis. Clinical data were obtained for a total of 52 patients. In addition, we downloaded 555 lung cancer-related samples from the cancer genome atlas (TCGA) database. Differentially expressed genes were further screened. Immune cell infiltration and survival analysis were performed. Immunohistochemistry was used to confirm gene expression. Peripheral blood analysis showed that neutrophil percentages were significantly reduced in patients with lung cancer. The least absolute shrinkage and selection operator and multivariate regression analysis revealed that CCNB1 and CENPF were lung cancer risk factors. Both CCNB1 and CENPF are overexpressed in lung cancer. The clinical diagnostic model constructed using CCNB1, CENPF, and neutrophils had a C-index of 0.994. This model area under the curve (AUC) and internal validation C-index values were 0.994 and 0.993, respectively. The elevated expression of CCNB1 and CENPF showed that the survival rate of lung cancer patients was reduced. CCNB1 and CENPF expression was positively correlated with the clinical stage of lung cancer. Further studies confirmed that CCNB1 and CENPF are overexpressed in lung cancer tissues. The clinically constructed model with high accuracy based on CCNB1, CENPF, and neutrophils demonstrated that these are crucial indicators for lung cancer diagnosis. High expression of CCNB1 and CENPF indicates a poor prognosis in patients with lung cancer.

Incidence and Survival of Testicular Cancers in a Province in Northern Italy and Their Association with Second Tumors.

This study investigated the incidence, mortality, and 5-year survival rates of testicular cancers diagnosed in a northern Italian province, which were eventually associated with previous or subsequent extratesticular neoplasms. Cases from 1996 to 2020 were examined by age and histotype (seminoma vs. non-seminoma). The standardized incidence rate was calculated using the European population, and the annual percent change (APC) was reported. The five-year relative survival was estimated using the Pohar Perme method. The association with the second neoplasm was also evaluated. In our study, 385 patients with testicular cancer were included, most of whom were aged between 30 and 40 years. The non-seminoma and seminoma groups accounted for 44% and 18% of younger adults, respectively. The incidence rate increased during the study period (APC 1.6*); however, it increased in seminomas (APC 2.3*) but not in non-seminomas (APC -0.1). Conversely, the mortality rate remained constantly low either overall or in each of the two groups. The overall 5-year survival rate of testicular cancer patients was 95% (99% and 88% for seminomas and non-seminomas, respectively). Primary extratesticular tumors were documented in 37 cases, 18 after and 19 before the testicular cancer diagnosis. Our study confirms that the increased incidence and excellent survival rate are the prerogative of seminomas.

Chitinase 3-like-1 Expression in the Microenvironment Is Associated with Neutrophil Infiltration in Bladder Cancer.

Bladder cancer is a common cancer with well-established therapeutic strategies. However, recurrence occurs in 50% of patients with non-muscle-invasive bladder cancer, and 20% of patients progress to muscle-invasive bladder cancer. The 5-year survival rate for muscle-invasive bladder cancer patients is disappointingly low, ranging from 36% to 48%. A molecular marker of interest is chitinase 3-like-1 (CHI3L1), which is elevated in various cancers, including bladder cancer. In addition to its role in cancer cells, CHI3L1 also has regulatory abilities in immune cells. Neutrophil infiltration has been shown to positively correlate with overall survival, progression-free survival, and relapse-free survival in bladder cancer patients. However, the relationship between CHI3L1 and neutrophils remain poorly understood. Therefore, this study investigated the relationship between CHI3L1 level and protumor neutrophil infiltration in bladder cancer. We analyzed the GSE128959 dataset and the data of a bladder cancer cohort undergoing chemotherapy. We observed higher expression of CHI3L1 in bladder cancer patients with invasive or chemotherapy-resistance. Our results revealed a positive correlation between CHI3L1 expression and protumor neutrophil infiltration. Elevated CHI3L1 expression was associated with genes which were related to the recruitment and infiltration of neutrophils. Consequently, CHI3L1 may serve as a novel evaluation factor for the degree of neutrophil infiltration in advanced bladder cancer in those scheduled for chemotherapy.

Establishment and assessment of a nomogram for predicting prognosis in bone-metastatic prostate cancer.

For the purposes of patients' consultation, condition assessments, and guidance for clinicians' choices, we developed a prognostic predictive model to evaluate the 1-, 3-, and 5-year overall survival (OS) rates of bone-metastatic prostate cancer (PCa) patients. We gathered data from 5522 patients with bone metastatic PCa registered in the Surveillance, Epidemiology, and End Results (SEER) database to develop a nomogram. A total of 359 bone metastatic PCas were collected from 2 hospitals to validate the nomogram and assess its discriminatory ability. In addition, we plotted the actual survival against the predicted risk to assess the calibration accuracy. Moreover, we designed a web calculator to quickly obtain accurate survival probability outcomes. Univariate and multivariate Cox hazard regression analyses suggested that age, marital status, prostate-specific antigen (PSA) level, Gleason score, clinical T stage, N stage, surgery, and chemotherapy were closely associated with OS rates. The calibration charts of the training and validation groups showed a high accuracy and reliability. The decision curve analysis (DCA) suggested a favorable clinical net benefit. Based on demography and clinical pathology, we developed a reliable nomogram to help clinicians more accurately predict the 1-, 3-, and 5-year OS rates of patients with bone metastatic PCa to guide evaluation and treatment.

MORBIDITY OF PROSTATE CANCER AND FEATURES OF MEDICAL CARE FOR MEN IN THE SUBARCTIC REGION OF NORTH-WEST RUSSIA

Relevance: The need for epidemiological studies of prostate cancer is due to the fact that this type of oncology occupies one of the leading positions among other malignant tumors. Over the past ten years, there has been an increase in the incidence of prostate cancer by almost half. The aim of the study is to identify the features of the prevalence of prostate cancer and its consequences among residents of the Arkhangelsk region, as well as problems in the system of prevention, early diagnosis, medical care and rehabilitation of patients. Materials and methods: The information materials of the Unified State Interdepartmental Information and Statistical System of the Federal State Statistics Service were used. A retrospective analysis of the incidence and mortality of prostate cancer from 2012 to 2021 in the Arkhangelsk region was carried out. To assess the general and annual trend, its degree of reliability, a trend line was constructed and the value of the approximation coefficient R2 was calculated, which in all cases turned out to be acceptable. The results of the study: During the studied period of time, an increase in the incidence of prostate cancer was noted among men of the Arkhangelsk region and the Russian Federation. At the same time, the last decade has been marked by an increase in mortality from prostate cancer. In the diagnosis of prostate cancer in the early stages, the effective organization of the health care system is of great importance. Among them, special attention is paid to regional projects "Fight against oncological diseases". Conclusion. At the regional level, the organization of centers for the supply of specialized (oncological) medical care on the basis of medical organizations has made a great contribution to the early diagnosis of malignant neoplasms of the prostate gland. Such successes had a positive impact on the mortality and survival rates of cancer patients.

Prevalence and predictors of survival among patients with prostate cancer attending Nyeri County and referral hospital, Kenya: a review of records 2017-2022

Background: Prostate cancer is a significant health concern globally. The incidence rate of prostate cancer (PCa) has continued to rise in Kenya. This study aimed to investigate the prevalence of prostate cancer in patients attending Nyeri County and referral hospital in Kenya, identify predictors of survival, and assess the impact of treatment modalities on survival outcomes. Methods: A retrospective observational design was employed, analyzing data from 252 patient records documented between 2017 and 2022. Demographic characteristics, clinical features, treatment modalities, and survival outcomes were extracted and analyzed. Results: The prevalence of prostate cancer among the study population was found to be 10.84%. The majority of patients diagnosed with prostate cancer were aged 70 years or older, with none below 40 years. Most patients were residents of Nyeri County, and some came from neighboring counties in central Kenya. The overall survival rate for prostate cancer patients was 64.29%, indicating that 35.71% of patients died during the study period. Advanced age, comorbidities, and late-stage diagnosis were associated with lower survival rates. Multivariate analysis revealed that prostate cancer cases with hypertension were 2.91 times more likely to die compared to those without comorbidities (p=0.01, CI: 1.285051-6.597691). Conclusions: The study highlights a significant prevalence of prostate cancer in the region and emphasizes the need for enhanced management strategies. Early detection programs, tailored treatment approaches considering comorbidities, and improved access to healthcare services are recommended to enhance survival rates and overall management of prostate cancer in this population.

Preservation of Fertility in Cancer Patients: A Narrative Review.

The survival rates for cancer patients have been steadily improving in recent years due to the improved efficacy of contemporary oncological care, including radiotherapy and chemotherapy. Modern technology makes it feasible to maintain fertility in cancer patients, and this practice needs to be included in oncological care. In many instances, it is impossible to avoid the harm that cancer treatments can cause to a patient's fertility; hence, research in fertility preservation techniques is being conducted to allow cancer patients to have future children biologically related to them. The development of fertility preservation approaches has grown in importance in the field of research over the past few years to increase patient's quality of life and survival. Oncologists must be aware of circumstances in which cancer patients' fertility will be impacted by their therapy and the avenues open for procedures like cryopreservation of the gametes or embryos. When cancer therapy is scheduled, all patients should receive prompt and thorough information on the fertility-related side effects of treatment and the prospects for fertility preservation. The article analyzes the literature, enlisting the factors that contribute to cancer and their effects on fertility, followed by a list of available and newly developed strategies for maintaining fertility in patients. The efficiency of the various fertility preservation techniques following cancer therapy is also discussed.

Dietary intervention and physical exercise in prevention and treatment of pharmacological cardiotoxicity during cancer

One of the main priorities in the cardiovascular care of cancer patients is to reduce morbidity and mortality and improve the quality of life of cancer survivors through interdisciplinary efforts. The survival rate in cancer patients has improved dramatically over the last few decades. Even in the midst of achievements and advances, survivors may be more likely to die from long-term cardiovascular disease secondary not only to the potential toxicity of cancer therapy but also to cancer biology. In this context, cardio-oncology has been highlighted as a promising field of medicine, obtaining, through studies in this area, relevant information and promising results. Among the initial data, researchers have highlighted the importance of dietary interventions represented by a healthy diet and correct supplementation, and the practice of physical exercises by cancer survivors, with the aim not only of preventing, but also of treating cardiotoxicity and its consequences in the long term.

Does the ypTNM-stage adequately predict long-term survival rates in gastric cancer patients receiving neoadjuvant chemotherapy followed by radical resection?

Background Following neoadjuvant chemotherapy (NAC) for resectable gastric cancer, the prognostic adequacy of the UICC staging system needs to be investigated. In particular to explore whether the ypTNM curves for radically resected gastric cancer patients receiving NAC follow the stage-matched survival curves of radically resected chemo-naïve patients (pTNM). Further, to disclose any interaction between the TNM-response mode to NAC and stage-specific survival rates, i.e., whether survival for a particular pathological disease stage was dependent on whether this was reached through a downstaging or as stable disease following NAC. Material and methods Retrospective study on radically resected patients ≤ 75 years of age with gastric adenocarcinoma stages I-III diagnosed during 2001–2016. The patients constitute two population-based cohorts; the SURG-group with n = 121 patients treated before 2007 when NAC was introduced, and the NAC-group with n = 126 patients diagnosed since early 2007, receiving NAC and subsequent radical resection. Results Long-term survival rates were similar when specific ypTNM-stages were compared to their corresponding pTNM chemo-naïve counterparts. The dichotomised N0 vs. N + had a substantial impact on the long-term survival rates in both groups, however, no discrepancy in long-term survival rates between pN0 vs. ypN0, and pN + vs. ypN + was found. The pathological stage determined long-term survival rates irrespective of the baseline disease stage, as no interaction between the response mode and stage-specific survival rates was found. Conclusions Survival curves for specific ypTNM-stages following NAC did not differ from the corresponding survival curves of their chemo-naïve pTNM counterparts. The interpretation is that NAC affected the gastric cancer, lymph nodes, and micrometastases, in such a way that the final ypTNM-stage provided similar prognostic information as the chemo-naïve pTNM-stages. Survival rates were contingent on the final ypTNM-stages alone, and not influenced by the response mode to reach that particular disease stage, or predetermined by the original clinical TNM-stage.

The state of cancer care in Russia: breast cancer. Epidemiology and survival of patients. The impact of the SARS-CoV-2-beta-coronavirus epidemic (clinical and population study)

Background. Breast cancer is the main cause of morbidity and mortality of the female population among economically developed countries, including in Russia. Despite the continued increase in morbidity, mortality is decreasing, which is confirmed by a decrease in the index of accuracy (the ratio of the number of deaths to the sick). Calculations of survival at the population level (the most important criterion for evaluating the activities of the oncological service) in Russia are carried out only on the basis of databases of the population cancer registry of the North-Western Federal District. The accumulated 1.5 million primary cases of malignant tumors allowed for the in-depth development of data on rare tumor localities, including breast cancer among the male population.Aim. To study the impact of the coronavirus pandemic on the dynamics of the process of detection, mortality and survival of breast cancer patients in Russia and in the North-Western Federal District of the Russian Federation.Materials and methods. The material of the study is the reference books of the P. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia, and the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, and the database of the population cancer registry of the North-Western Federal District, clinical materials of the surgical department of breast tumors of theN.N. Petrov National Medical Research Oncology Center. More than 110 thousand primary cases of breast cancer were selected. Data processing was carried out by standard methods of oncology statistics recommended by the International Association of Cancer Registries (Eurocare program).Results. A significant impact of the coronavirus pandemic on the primary registration of breast cancer in Russia from 2019 to 2020 has been established, with some weakening of its impact in the subsequent period. The pandemic has had a significant impact on the quality of primary registration of patients. The value of the index of accuracy has been set back five years, but there is a sign of its improvement in 2021. The positive dynamics of one-year and five-year survival of patients with breast cancer is shown. The quality of registration of patients with breast cancer by detailed localization and histological structures of breast cancer was investigated. A significant decrease in the mortality of patients was noted when studying the patterns of dynamics in annual mortality over three follow-up periods.Conclusion. A steady increase in the incidence of breast cancer among women has been established, and the negative impact of the coronavirus pandemic has been noted. The mortality rate of the Russian population from breast cancer continues to decrease. The localization and histological structure of the incidence of breast cancer in women remains unchanged. The one-year and five-year survival rate of breast cancer patients continues to grow.

Current status of fertility preservation in a Spanish tertiary public hospital: multidisciplinary approach and experience in over 1500 patients.

Currently, 15% of gynaecological and 9% of haematological malignancies are diagnosed before the age of 40. The increased survival rates of cancer patients who are candidates for gonadotoxic treatments, the delay in childbearing to older ages, and the optimization of in vitro fertilisation techniques have all contributed to an increased interest in fertility preservation (FP) treatments. This study reviews the experience of the Fertility Preservation Programme (FPP) of a tertiary public hospital with a multidisciplinary approach. This retrospective study included all the available (FP) treatments, performed in patients of childbearing age between 2006 and 2022. 1556 patients were referred to the FPP: 332 oocyte vitrification cycles, 115 ovarian cortex cryopreservation with 11 orthotopic autotransplantations, 175 gonadotropin-releasing hormone (GnRH) agonist treatments, 109 fertility-sparing treatments for gynaecological cancer, and 576 sperm cryopreservation were performed. Malignancy was the main indication for FP (the main indications being breast cancer in women and haematological malignancies in men), although non-oncological pathologies, such as endometriosis and autoimmune diseases, have increased in recent years. Currently, the most widely used FP technique is oocyte vitrification, the increase of which has been associated with a decrease in the use of cortex CP and GnRH agonists. The increase in FP treatment reflects the implementation of reproductive counselling in oncology programmes. A multidisciplinary approach in a tertiary public hospital allows individualised FP treatment for each patient. In recent years, there has been a change in trend with the introduction of new indications for FP and a change in techniques due to their optimisation.

High expression of RAB7A is associated with poor prognosis of gastric cancer by promoting tumor invasion

To explore the expression level of Ras-related protein 7A (RAB7A) in gastric cancer and its prognostic implications. Based on data from public databases and a cohort of 104 patients undergoing radical gastrectomy for gastric cancer in our hospital, we analyzed RAB7A expression level in gastric cancer and adjacent tissues and its association with clinicopathological parameters and prognosis of the patients. Bioinformatic analysis was performed to predict the pathways of RAB7A to affect gastric cancer invasion. In gastric cancer MGC803 cells with lentivirus-mediated interference or overexpression of RAB7A, the changes in extracellular matrix (ECM) degradation and cell migration and invasion were analyzed using immunoblotting, wound healing assay and Transwell experiments. The data from public cancer databases and clinical samples showed a significantly higher expression of RAB7A in gastric cancer tissues than in normal or adjacent tissues (P<0.01) with a close correlation with a poorer patient survival (P<0.01) and a positive correlation with serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels (P<0.001). Univariate and multivariate Cox regression analyses suggested that a high RAB7A expression was an independent risk factor affecting the 5-year survival rate of gastric cancer patients (HR: 2.882; 95% CI: 1.459-5.693). ROC curve analysis showed that at the cut-off value of 2.625, RAB7A expression level had a sensitivity of 84.62% and a specificity of 71.15% for predicting postoperative 5-year mortality of the patients. Bioinformatic analysis suggested that RAB7A was involved in ECM degradation and activation of PI3K/AKT signaling in gastric cancer. MGC803 cells with RAB7A overexpression showed activation of the PI3K/AKT signaling pathway (P<0.01) with enhanced expressions of MMP-2 and MMP-9 (P<0.01) and cell migration and invasion capacities (P<0.01). RAB7A is highly expressed in gastric cancer tissues and affects the patients' prognosis possibly by activating the PI3K/AKT signaling pathway and enhancing ECM degradation to promote tumor invasion.

Prevalence and Epidemiological Profile of Cervical Cancer Patients Attending Nyeri County and Referral Hospital, Kenya: a Review of Records

Objective: This study aimed to establish the prevalence and epidemiological characterization of cervical cancer patients registered in Nyeri County and Referral Hospital, Kenya. Methods and analysis: This was a retrospective observational design that involved the systematic collection and analysis of data from 2328 patient records. Relevant variables, including demographic characteristics, clinical features, treatment modalities and survival outcomes, were extracted and analyzed. Descriptive statistics were used to determine the prevalence of cervical cancer, while Chi-square test was performed to assess the association between various factors and survival outcomes. Multivariate analysis was conducted to control for confounding variables and determine the independent effects of predictors. Ethical clearance was obtained and ethical principles maintained. Results: Records of 2328 cancer patients were analyzed, out of which 120 were cervical cancer. Majority of cervical cancer patients were aged 50-59 years with majority residing in Nyeri County. The prevalence of cervical cancer was 5.16%. The overall survival rate for cervical cancer patients was 58.33%. Advanced age and late-stage diagnosis were factors associated with lower survival rates. Conclusion: The study revealed a prevalence of 5.16% of cervical cancer among patients attending Nyeri County and Referral Hospital in Kenya from the year 2017 to 2022 with an overall survival rate of 58.33%. Age and latestage diagnosis were found to be influential factors in survival outcomes. Therefore, improving early detection and initiation of early treatment for all cervical cancer patients is required in order to improve survival status.

Real world data of recurrent and survival rates of penile cancer patients in Songklanagarind hospital: Tumor stage as a predictor for disease-free survival.

This study investigated disease-free survival and oncological outcomes in penile cancer patients treated surgically at a high-volume center and identified the prognostic factors for disease-free survival. A retrospective analysis was conducted on primary penile cancer patients diagnosed and treated at Songklanagarind Hospital, Thailand, between January 2001 and December 2021. Disease-free survival (DFS) was assessed using Kaplan-Meier survival curves, and Cox proportional hazard models were used for multivariate analysis. The study included 188 patients with primary penile cancer. The majority (98.4%) were uncircumcised. Tumor staging revealed 40.6% with T1 tumors, 72.9% with well-differentiated tumors, and 23.5% diagnosed at stage IIIA. The recurrence rate was 19.1%, with a mean time to recurrence of 25.9 months. Disease-free survival rates at 1, 3, and 5 years were 81.1%, 70.9%, and 70.9%, respectively. Median overall survival was 16.43 months, with survival rates at 1, 3, and 5 years at 67.7%, 42.7%, and 35.4%, respectively. Cox proportional hazard models showed significant associations between disease-free survival and a higher T stage, a high level of CRP (>15 mg/L), delayed onset of symptoms, primary lesion location, groin node metastasis, lymphovascular invasion, and pelvic lymph node metastases. However, multivariate analysis revealed that a higher primary tumor stage (T) was the only independent prognostic factor for disease-free survival. This study presents one of the largest cohorts investigating disease-free survival outcomes in penile cancer treatment at a single institution over a prolonged period. A higher pathologic T stage is a significant prognostic factor for disease-free survival. Further large-scale prospective studies are needed for validation.

Factors Affecting Survival of Patients with Cervical Cancer.

Cervical cancer is the fourth leading cause of cancer-related death among women worldwide. We aimed to identify the factors affecting the survival rate of cervical cancer patients, as these factors are vital for preventing the progression and effective treatment of cancer. In this retrospective cohort study, 254 patients with cervical cancer who were registered in The Kerman Population-Based Cancer Registry (KPBCR) between 2012 and 2022 and whose status was known to be alive or dead were enrolled. Since the proportional hazard assumption was not established for the type of treatment, the extended Cox model was used to determine the variables influencing the survival of the patients. The mean survival time of the patients was 91.28 ± 3.02 months. The results of fitting the extended Cox model showed that the risk of death increases by 1.02 per year of age at diagnosis (HR=1.02; 95% CI: 1.00, 1.04). Moreover, for a one-unit increase in body mass index (BMI), the risk of death increased by 0.93 (HR=0.93; 95% CI: 0.88, 0.98). The risk of death in patients with disease stages III&IV was 3.08 times that of patients with disease stages I&II (HR=3.08; 95% CI: 1.05, 9.03). The risk of death in patients receiving at least one of the radiotherapy and chemotherapy treatments after 18 months was 7.11 times that of patients undergoing surgery (HR=7.11; 95% CI: 1.69, 29.91). The age of diagnosis, BMI, disease stage, and type of treatment significantly affect the survival of patients. Thus, raising women's awareness of periodical examinations and early diagnosis can reduce the risk of death and prevent cervical cancer progression.