International Journal of Cancer Management
Year:2021 | Volume:14 | Issue:4|Papers Count:8

Background: Identifying Lynch syndrome (LS) in patients with colorectal cancer (CRC) and monitoring their relatives can increase the life expectancy of these patients. Objectives: The aim of this study was to analyze the cost-effectiveness of 5 molecular testing strategies to screen LS among patients with newly diagnosed CRC and to conduct preventive surveillance in their first-degree relatives. Methods: A decision tree model was designed to identify the number of LS mutations and the related costs in the CRC patients. Five strategies were modeled, i. e., Amsterdam II criteria, microsatellite instability (MSI) testing, immunohistochemistry (IHC), and next-generation sequencing (NGS). A Markov model was also used to estimate the long-term outcome of monitoring (including colonoscopy and taking aspirin) among relatives of those patients with CRC who carried LS. Results: All strategies were cost-effective compared with no testing condition. The 2 most cost-effective strategies were strategy 2 (IHC testing followed by NGS testing) and strategy 4 (MSI testing followed by NGS testing), with the ICER of 4, 604$ and 4, 748$ per quality-adjusted life year (QALY), respectively. Based on one-way sensitivity analysis of IHC sensitivity, the Cost of colonoscopy, MSI sensitivity, and the number of families who inherited LS had the most effect on the results. Conclusions: The findings suggested that from an Iranian health care system perspective, IHC testing followed byNGStesting could be regarded as the most cost-effective strategy compared to the other strategies. These results can be useful in offering to screen LS in newly diagnosed CRC patients.

Background: Invasive aspergillosis (IA) is the most prevalent invasive infection with high mortality among patients with leukemia. Early diagnosis of IA has been a challenging topic in this group of patients. Objectives: In this study, we evaluated the galactomannan levels of nasal lavage fluid (NALF) as a possible auxiliary method for IA diagnosis in patients with leukemia. Methods: In a prospective study, 32 adult patients with leukemia who were taking induction and/or consolidation chemotherapy with fever and neutropenia were included. In all patients, galactomannan (GM) levels of serum and NALF, and mycological examinations were evaluated before the first dose of antifungal therapy. Results: Fourteen (43. 7%) patients had NALF GM 0. 5; however, in 16 (50%) patients the level of serum GM was 0. 5. The elevated level of NALF GM had a significant association with the proven IA cases (P = 0. 048). The GM level of NALF with a cut-off value of 0. 45 (by receiver operating characteristic curve analysis) had 78% sensitivity and 64% specificity for the diagnosis of invasive aspergillosis (P = 0. 033). Conclusions: Due to its non-invasive nature, GMlevel of NALF may be contributory to be used as part of the diagnostic work-up of IA particularly in leukemic patients with thrombocytopenia which prohibits acquiring bronchoalveolar lavage.

Background: There is a global concern for the susceptibility of patients with cancer to the adverse effects of novel coronavirus disease (COVID-19). Nevertheless, there is a signal of potentially increased vulnerability of patients with cancer to more COVID-19-induced mortality, this notion needs to be further evaluated in various societies with different cancer epidemiology and practice. Objectives: To investigate the outcomes of cancer patients admitted due to COVID-19 and compare them with data of COVID-19 infected patients without a history of cancer. Methods: In this case-control study, the medical records of patients with cancer (Ca+ patients)whoinfected with COVID-19 were evaluated and compared with patients without a medical history of cancer (Ca-patients). Clinical data were collected from 19 February 2020 to 17 May 2020. The extracted data were classified into demographics, underlying medical conditions, clinical manifestations, imaging and laboratory findings, and clinical outcomes. Results: A total of 24 Ca+ patients were compared with 44 Ca-patients in terms of clinical manifestations and outcomes of COVID-19. The Ca-patients significantly developed more dry cough (75. 0% vs 29. 2%, P = 0. 01) and fever (72. 7% vs 45. 8%, P = 0. 02). Findings of the chest CT scan was comparable between groups, except for pleural effusion and lymphadenopathy that exclusively reported in Ca+ patients. (3% and 4%, respectively). At the end of observation, 13 (19. 1%) patients died from COVID-19. This rate was significantly higher in Ca+ patients (41. 7 vs 6. 8%, P = 001). Likewise, Ca+ patients experienced more mechanical ventilation (25. 0 vs 4. 7%, P = 0. 01). However, the rate of ICU admission was comparable between groups (P = 0. 29). Conclusions: The patients with cancer had a higher rate of mechanical ventilation and COVID-19-induced mortality.

Objectives: This study aimed at reporting a 10-years trend in epidemiology and morphology of colorectal cancer (CRC) in Tehran Metropolis, using the data of the National Cancer Registry. Methods: The main sources for data collection included pathology, clinical/paraclinical, as well as death registries. The quality assessment of data was performed based on standard protocols and international reference. Age-standardized incidence rates (ASR) per 100 000 were reported at province levels. Results: Totally, 16280 patients with CRC, who were diagnosed from 2006 to 2015 in Tehran Metropolis, were enrolled in the study; 56. 86% of cases were male. The ASRs of adenocarcinomaandothermorphology types were higher in males than females. The highest and lowest overall ASR (95% confidence interval (CI)) were reported in 2013 and 2006 with the value of 22. 46 (95% CI: 21. 58-23. 35) and 5. 55 (95% CI: 5. 04-6. 07) per 100 000 person-years, respectively. The average annual percentage change (AAPC) indicated that from 2006 to 2015, the overall ASR had a statistically upward trend with the value of 15. 0 (95% CI: 1. 80-30. 00) in total CRC patients. Besides, the AAPC of adenocarcinoma type in males and females was 15. 6 (95% CI: 1. 10-32. 20) and 12. 9 (95% CI: 0. 60-26. 60) over the study period, respectively, which showed a significant upward trend. The ASR was much higher in age 50 years old compared to age < 50 years old. Conclusions: The resultsshoweda growing trend in registry coverage in Tehran Province. Tehran is a high-risk area for the incidence of CRC. Cancer control programs need to be adjusted based on the status of cancer incidence in Tehran Province.

Background: As one of the most prevalent cancers in men, prostate cancer is a condition with multiple causes. Viral infections have been identified as one of the major sources of elevated incidence of prostate cancer. Objectives: The purpose of this research was to assess the association of the risk of prostate cancer and its aggressiveness with seropositivity of herpes simplex virus 2 (HSV-2) and/or human herpesvirus 8 (HHV-8). Methods: Totally, 103 men with prostate cancer as cases and 81 healthy individuals as controls were included in this case-control analysis and provided a serum sample. The specific IgG antibodies against HSV-2 and HHV-8 were screened by enzyme-linked immunosorbent assay (ELISA). To determine the association between HSV-2, HHV-8, prostate-specific antigen (PSA) level, and demographic variables with incidence of prostate cancer, univariate and multivariate logistic regression models were applied. Results: The results of the univariate logistic regression model showed a statistically significant association between HSV-2 and HHV-8 seropositivity, PSA level, age, and smoking with prostate cancer incidence (P  0. 20). The multivariate logistic regression model results after adjusting for the potential confounding variables showed a significant statistical association between the mean of PSA level [adjusted odds ratio (OR): 3. 44; 95% CI: 2. 15-5. 51; P < 0. 001) and incidence of prostate cancer. Moreover, the results of univariate and multivariate logistic regression model showed a significant statistical association between age [adjusted OR: 0. 88; 95% confidence interval (CI): 0. 81-0. 95; P = 0. 001] and HSV-2 and also significant statistical association was found between PSA (adjusted OR: 1. 02; 95% CI: 1. 005-1. 03; P = 0. 006) and HHV-8. Conclusions: Although the seroprevalence of HSV-2 and HHV-8 was higher in patients with prostate cancer than in the control group, it cannot be concluded that there is a significant association between the seropositivity of these viruses and prostate cancer incidence. However, the findings showed a significant statistical association between age and seropositivity of HSV-2 and also a significant statistical association between PSA levels and seropositivity of HHV-8.

Context: Increased survival of patients with cancer raises the need to pay attention to long-term side effects. Patients with brain metastasis experienced cognition failure after whole-brain radiotherapy. This review aimed at concluding the efficacy of Memantine in preserving cognitive function by reducing the brain toxicity of whole-brain radiotherapy for metastatic brain cancers. Evidence Acquisition: Published studies evaluating memantine protective effects during brain metastasis radiotherapy were searched for in scientific databases (e. g., Embase, PubMed, Cochrane database, Google Scholar, Scopus) using keywords including whole-brain radiotherapy and Memantine. Results: A total of 4 prospective clinical trials were included in the review. Effects of Memantine on cognition tests were evaluated in these trials. A significantly better Hopkins Verbal Learning Test-Revised (HVLT-R) delayed recognition at months 6 was achieved in RTOG 0614 and NRG CC001. Longer time to cognitive decline was found in the memantine arm of the RTOG trial and was statistically significant. Memantine effects were not statistically significant before 2 months. Conclusions: It seems reasonable to consider Memantine during radiation to prevent long-term cognitive failure in patients with brain metastasis due to the current results. Memantine improves cognition function during whole-brain radiotherapy (WBRT) without adding irreparable complications.

Introduction: Germ cell tumors account for 3. 5 % of pediatric tumors and yolk sac tumors are the most common pure malignant germ cell tumors in children. Testis and ovary are the most common sites of involvement in children older than 2 years. Case Presentation: A 20-month-old boy with a complaint of limping was described in this case report. Abdominal ultrasonography showed a 52  50 mm solid abdominal mass. Abdominal and pelvic computed tomography scans showed a left paraspinal heterogeneous mass. The tumor was extended into the spinal column with spinal cord compression. Four months later, at the end of chemotherapy, the tumor was completely resolved. Conclusions: Spinal cord compression is a rare presentation of yolk sac tumor (YST) and although this tumor is an uncommon malignancy, it can be cured completely.

Background: Attention to the electromagnetic exposure as a targeted tumor therapy has been recently increasing. Objectives: The aim of the current study was to investigate the effect of continuous and discontinuous electromagnetic fields on cell viability as well as phosphatase and tensin homolog (PTEN) and circular (circ)-RNA CDR1as genes expression in the normal and gastric cancer (GC) cell lines. Methods: After preparing gastric cancer cell lines (AGS) and normal cells (HU02 line), they were exposed to magnetic flux densities of 0. 25, 0. 5, 1, and 2 mT continuously and discontinuously (1h on/1h off) for 18 hours. The 3-(4, 5-dimethylthiazoyl-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay was used to evaluate cell viability. In addition, after designing the primers, the expression of the PTEN and circ-CDR1as genes was studied using the real-time polymerase chain reaction (real-time-PCR) technique. The results were analyzed using SPSS software version 25. Results: The exposed normal and tumor cells to discontinuous electromagnetic fields resulted in increasing of cell survival rate in both normal and tumor cells. In contrast, the exposure of continuous electromagnetic field showed no effect on the viability of the normal and tumor cells at intensities of 0. 25, 0. 5, and 1 mT. The electromagnetic field showed a significant effect on the expression of the circ-CDR1as gene and this effect depended on the intensity of the electromagnetic field used and the cell type. We have found that the activity of PTEN gene in the normal and tumor cells increased and decreased with increasing intensity of discontinuous electromagnetic field, respectively. Conclusions: In general, the effect of electromagnetic field on gastric cancer seems to depend on the kind of exposure as well as an extent of intensity and can be used for cancer therapeutic purposes. However, more research is needed on this subject.