Mathewsmalloy1995
More T1N0M0 renal cell carcinoma (RCC) is detected and the prognosis has improved, but, the current focus on non-RCC-related mortality is superficial. We investigated cause-specific mortality and its temporal patterns after an RCC diagnosis.
In the Surveillance, Epidemiology, and End Results-18 database, patients with T1N0M0 RCC treated with partial nephrectomy (PN) or radical nephrectomy (RN) during 2000-15 were identified. Standardized mortality ratios (SMRs) for cause of death were calculated. Risk predictors for each cause-specific mortality were investigated using the Fine and Gray sub-distribution model.
In all, 68,612 eligible patients were pooled. A total of 14,047 (20.5%) patients had died (cardiovascular disease [CVD], 28.3%; other non-cancer-related diseases, 20.3%; RCC, 18.7%; other cancer types, 16.3%; non-disease events, 16.1%) during follow-up. Heart disease, diabetes mellitus, and cerebrovascular disease were the primary causes of non-RCC-related mortality within 1 year after the diagnosegarded for the better holistic management of survivors of local RCC. Targeted prevention strategies for non-RCC-related death could lead to significant reductions in mortality for RCC survivors.
RCC-specific mortality is a common challenge for the prognosis. Importantly, a large proportion and higher SMRs of other non-RCC-related diseases (especially CVD) should not be disregarded for the better holistic management of survivors of local RCC. Targeted prevention strategies for non-RCC-related death could lead to significant reductions in mortality for RCC survivors.
To propose a synthesis method of pseudo-CT (CT
) images based on an improved 3D cycle generative adversarial network (CycleGAN) to solve the limitations of cone-beam CT (CBCT), which cannot be directly applied to the correction of radiotherapy plans.
The improved U-Net with residual connection and attention gates was used as the generator, and the discriminator was a full convolutional neural network (FCN). The imaging quality of pseudo-CT images is improved by adding a 3D gradient loss function. Fivefold cross-validation was performed to validate our model. Each pseudo CT generated is compared against the real CT image (ground truth CT, CT
) of the same patient based on mean absolute error (MAE) and structural similarity index (SSIM). The dice similarity coefficient (DSC) coefficient was used to evaluate the segmentation results of pseudo CT and real CT. 3D CycleGAN performance was compared to 2D CycleGAN based on normalized mutual information (NMI) and peak signal-to-noise ratio (PSNR) metrics betweenave more accurate electronic density and anatomical structure.
Little is known regarding the outcomes of systemic treatments in BAP1-altered malignant pleural mesothelioma (MPM).
Forty five patients with MPM [group A eight MPM patients with BAP1 inactivating mutation/copy number loss (FoundationOne
CDx/TEMPUSxT), selected from the electronic databases of four Israeli cancer centers (ICC); group B 37 consecutive (years 2016-2018) MPM patients selected from the electronic databases of two ICC-of those six patients without a BAP1 alteration (group B1) and 31 patients not tested for BAP1 (group B2)] were analyzed for ORR, PFS (mRECIST), and OS with 1
-line platinum/pemetrexed+/-antiangiogenic drug (CT, n-28), immune check-point inhibitors (ICPi, n-16) and poly (ADP-ribose) polymerase inhibitors (PARPi, n-4). OS since diagnosis (OSDx) was assessed.
There were no differences in ORR or mPFS with CT between the groups ORR-50%
. 47%
. 50%
. 47% (p>0.9), mPFS-9.1mo (95% CI, 1.2-16.1)
. 9.2mo (95% CI, 2.9-13.3)
. 7.2mo (95%CI, 2.3-NR)
. 10.9mo (95%CI, 2.9-20bserved with PARPi.Background Selecting proper postoperative adjuvant therapy is of great importance for prolonging overall survival (OS) of patients with biliary tract cancer (BTC). OS is commonly affected by high rate of postoperative recurrence and metastasis. Purpose The present study aimed to identify the optimal adjuvant therapy for BTC patients. Method A comprehensive search was carried out on Pubmed, Web of science, and Embase databases to acquire articles regarding BTC therapy approaches. Subsequently, the hazard ratio (HR) and its 95% confidence intervals (CIs) were applied to evaluate the efficacy of different adjuvant therapy regimens. The GemTc (GemTc.0.8-2) and R (R.3.6.0) software were employed to perform statistical analyses. Result Data from 22 articles, including 14,646 patients, were quantitatively analyzed. The results showed that in terms of 5-year OS, gemcitabine (GEM) was considered as the optimal adjuvant therapy for BTC compared with chemoradiotherapy (CRT; HR = 0.59; 95% CI = 0.34-0.97), observation (OB; HR = 0.49; 95% CI = 0.33-0.73), and radiotherapy (RT; HR = 0.40; 95% CI = 0.22-0.71). Additionally, 5-fluorouracil (5-FU) exhibited improved efficacy compared with RT (HR = 0.52; 95% CI = 0.29-0.91) and OB (HR = 0.63; 95% CI = 0.43-0.92). When the efficacy of 5-FU was compared with that of GEM, the results showed that 5-FU (HR = 1.29) was more effective than GEM. Furthermore, CRT and RT prolonged positive resection margin (R+)-OS (HR = 0.69; 95% CI = 0.49-1.00) and positive lymph node-(N+)-OS (HR = 0.22; 95% CI = 0.074-0.66) in BTC patients. In terms of median recurrence-free survival (RFS) and 1-year OS, the differences were not statistically significant among different therapeutic interventions. Conclusion The present study suggested that GEM could be used as a first-line adjuvant therapy for resected BTC patients. Additionally, CRT could be the optimal treatment approach for R+ and N+ patients.
By virtue of largely disparate clinical outcomes of prostate cancer (PCA), there is a pressing need to search for useful biomarkers for PCA prognosis. Cell-free DNA (cfDNA) is a promising biomarker for detecting, monitoring, and predicting survival of prostate cancer (PCA). However, the utility of total cfDNA quantitation in PCA in clinical setting remains elusive. Here, we performed a thorough meta-analysis to assess the prognostic value of cfDNA concentration for patients with PCA. In addition, we tested the possibility of the combination of PSA and cfDNA test results to improve the prediction power in PCA prognosis.
More than six databases, including PubMed, Web of Science, Medline, PMC, EMBASE and the Cochrane Library were searched. Results yielded all eligible articles from the date of inception to June 30, 2020. AZD0156 Continuous, diagnostic, and prognostic variables in cfDNA in PCA were included in the meta-analysis by STATA.
A total of 23 articles were enrolled in our meta-analysis 69.6% (16/23) were related to diagnosis, and 56.