slides
- •Pre-operative CT has a low sensitivity in detecting tumor dissemination patterns
- •Sensitivities at key operability-determining sites did not exceed 63%
- •Specificity and Sensitivity were particularly low in detecting lymph-node involvement
Saturday, September 03, 2016
Changes in oncological outcomes after radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma
Blogger's Note: not specific to genetics (Lynch syndrome)
abstract:
Changes in oncological outcomes after radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma treated in the last two decades: a retrospective analysis based on a multicenter collaborative study
Methods A retrospective review was conducted of 1180 urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy in multicenter collaborative institutions between 1996 and 2015.
...Multivariate analysis with adjustment for possible confounding factors revealed no significant differences in disease-specific survival, overall survival or intravesical recurrence-free survival among the four groups.
Conclusions Despite
advances in diagnostic instruments, surgery and systemic chemotherapy,
the clinical outcome of urinary tract urothelial
carcinoma after radical surgery has not
significantly improved over the last two decades, and further research
is therefore
required.
Correlation of pre-operative CT findings with surgical & histological tumor dissemination patterns at cytoreduction for primary advanced/relapsed epithelial ovarian cancer
abstract:
Correlation of pre-operative CT findings with surgical & histological tumor dissemination patterns at cytoreduction for primary advanced and relapsed epithelial ovarian cancer: A retrospective evaluation
Highlights
Abstract
Objectives
Computed tomography (CT) is an essential part of preoperative planning prior to cytoreductive surgery for primary and relapsed epithelial ovarian cancer (EOC). Our aim is to correlate pre-operative CT results with intraoperative surgical and histopathological findings at debulking surgery.Methods
We performed a systematic comparison of intraoperative tumor dissemination patterns and surgical resections with preoperative CT assessments of infiltrative disease at key resection sites, in women who underwent multivisceral debulking surgery due to EOC between January 2013 and December 2014 at a tertiary referral center. The key sites were defined as follows: diaphragmatic involvement(DI), splenic disease (SI), large (LBI) and small (SBI) bowel involvement, rectal involvement (RI), porta hepatis involvement (PHI), mesenteric disease (MI) and lymph node involvement (LNI).Results
A total of 155 patients, mostly with FIGO stage IIIC disease (65%) were evaluated (primary = 105, relapsed = 50). Total macroscopic cytoreduction rates were: 89%. Pre-operative CT findings displayed high specificity across all tumor sites apart from the retroperitoneal lymph node status, with a specificity of 65%.The ability however of the CT to accurately identify sites affected by invasive disease was relatively low with the following sensitivities as relating to final histology:
32% (DI), 26% (SI), 46% (LBI), 44% (SBI), 39% (RI), 57% (PHI), 31% (MI), 63% (LNI).
Conclusion
Pre-operative CT imaging shows high specificity but low sensitivity in detecting tumor involvement at key sites in ovarian cancer surgery. CT findings alone should not be used for surgical decision making.Ovarian Cancer and Us (blog) - how were you reading the blog?
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Friday, September 02, 2016
FDA toughens stand on antibacterial soap labelling (thyroid/environment...)
FDA
'Antibacterial ingredients may do more harm than good over the long term,' says FDA medical doctor
There is no scientific evidence that antibacterial washes are more effective at preventing the spread of germs than plain soap and water.
The FDA issued what is called its final rule on safety and effectiveness of the soaps, saying it applies to products containing one or more of 19 specific active ingredients, including the most commonly used ingredients — triclosan and triclocarban.
The two chemicals are similar in structure and function. The FDA says some short-term animal studies have shown that exposure to high doses of triclosan is associated with a decrease in the levels of some thyroid hormones....
....In 2012, a Canadian government study found that triclosan in waste water can interfere with the growth and reproduction of plants and animals in lakes and streams.
The finding led to Health Canada and Environment Canada to propose that industry voluntarily cut the amount of triclosan it uses, particularly in personal-care products that tend to get rinsed away into lakes and rivers....
How Does Caregiver Well-Being Relate to Perceived Quality of Care in Patients With Cancer?
open access
How Does Caregiver Well-Being Relate to Perceived Quality of Care in Patients With Cancer? Exploring Associations and Pathways
Outcomes of Concurrent Breast and Gynecologic Risk Reduction Surgery
abstract
BACKGROUND:
Women considering risk reduction surgery after a diagnosis of breast/ovarian cancer and/or inherited cancer gene mutation face difficult decisions. The safety of combined breast and gynecologic surgery has not been well studied; therefore, we evaluated the outcomes for patients who have undergone coordinated multispecialty surgery.METHODS:
We conducted a retrospective review of patients undergoing simultaneous breast and gynecologic surgery for newly or previously diagnosed breast cancer and/or an inherited cancer gene mutation during the same anesthetic at a single institution from 1999 to 2013.RESULTS:
Seventy-three patients with a mean age of 50 years (range 27-88) were identified. Most patients had newly diagnosed breast cancer or ductal carcinoma in situ (62 %) and 28 patients (38 %) had an identified BRCA mutation. Almost all gynecologic procedures were for risk reduction or benign gynecologic conditions (97 %). Mastectomy was performed in 39 patients (53 %), the majority of whom (79 %) underwent immediate reconstruction. The most common gynecologic procedure involved bilateral salpingo-oophorectomy, which was performed alone in 18 patients (25 %) and combined with hysterectomy in 40 patients (55 %). A total of 32 patients (44 %) developed postoperative complications, most of which were minor and did not require surgical intervention or hospitalization. Two of the 19 patients who underwent implant reconstruction (11 %; 3 % of the entire cohort) had major infectious complications requiring explantation.CONCLUSION:
Combined breast and gynecologic procedures for a breast cancer diagnosis and/or risk reduction in patients can be accomplished with acceptable morbidity. Concurrent operations, including reconstruction, can be offered to patients without negatively impacting their outcome.Thursday, September 01, 2016
Barack Obama declared September National OvarianCancer Awareness Month
Today BarackObama declared September is National OvarianCancer Awareness Month. Thank you! Read the proclamation:
OMIM Entry - # 120435 - LYNCH SYNDROME (ovarian cancer section/BRCA compare/see comment)
Blogger's Note: also search blog for survival in Lynch syndrome women - Japanese/Finnish women
OMIM Entry
Grindedal et al. (2010) performed a retrospective survival study of 144 women with ovarian cancer due to MMR mutations. Fifty-one (35.4%) had a mutation in MLH1, 78 (54.2%) had a mutation in MSH2, and 15 (10.4%) had a mutation in MSH6. The mean age of onset was 44.7 years, compared to 51.2 years in carriers of BRCA1 (113705) mutations with ovarian cancer and 57.5 in carriers of BRCA2 (600185) mutations with ovarian cancer (Risch et al., 2001). Most (81.5%) women with MMR mutations were diagnosed at stage 1 or 2. Twenty-nine (20.1%) of 144 woman with MMR-related ovarian cancer died of their ovarian cancer. The 5-, 10-, 20- and 30-year survival specific for deaths due to ovarian cancers were 82.7%, 80.6%, 78.0% and 71.5%, respectively. About 50% of the women developed another cancer in the HNPCC/Lynch syndrome tumor spectrum. The 5-, 10-, 20-, and 30-year survival specific for deaths due to HNPCC/Lynch syndrome-associated cancers were 79.2%, 75.7%, 68.4% and 47.3%, respectively. Overall, the survival rate for women with ovarian cancer due to MMR mutations was better than that of women with ovarian cancer due to BRCA1/2 mutations, which is less than 40% at 10 years. The lifetime risk of ovarian cancer in MMR mutation carriers was about 10% and the risk of dying from ovarian cancer was 20%, yielding an overall risk of dying from ovarian cancer of about 2% in MMR mutation carriers. Grindedal et al. (2010) suggested that mutations in the MMR and BRCA1/2 genes may predispose to biologically different types of tumors.26. Grindedal, E. M., Renkonen-Sinisalo, L., Vasen, H., Evans, G., Sala, P., Blanco, I., Gronwald, J., Apold, J., Eccles, D. M., Sanchez, A. A., Sampson, J., Jarvinen, H. J., Bertario, L., Crawford, G. C., Stormorken, A. T., Maehle, L., Moller, P. Survival in women with MMR mutations and ovarian cancer: a multicentre study in Lynch syndrome kindreds. J. Med. Genet. 47: 99-102, 2010. [PubMed: 19635727, related citations] [Full Text]
The Rivkin Center: Apply for a Research Grant (2 programs: Pilot Study/Scientific Scholar)
Apply
Pilot Study Program
This grant competition is open from September 1 to December 1, 2016. All applicants must first register by November 18, 2016. All applications must be received by 5pm Pacific Time on December 1, 2016 to be eligible.Scientific Scholar Award
This grant competition is open from September 1 to December 1, 2016. All applicants must first register by November 18, 2016. All applications must be received by 5pm Pacific Time on December 1, 2016 to be eligible.CDC - Inside Knowledge Campaign - share your story (cervical, ovarian, uterine, vaginal, or vulvar cancer)
CDC - Inside Knowledge Campaign
The Inside Knowledge campaign raises awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. Inside Knowledge encourages women to pay attention to their bodies, so they can recognize any warning signs and seek medical care.
Your Story
If you’re a cervical, ovarian, uterine, vaginal, or vulvar cancer survivor, please consider sharing your story. Send a note to CDC-INFO and we’ll get in touch with you. See other survivor stories.
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