scholarly journals Impact of SARS-COV-2 Pandemic on Kidney Cancer Management

Kidney Cancer ◽  
2021 ◽  
pp. 1-14
Author(s):  
Melissa Bersanelli ◽  
Camillo Porta
Keyword(s):  
Survival Rates ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Cost Benefit ◽  
Original Data ◽  
Immune Checkpoint Blockade ◽  
Retrospective Case ◽  
Renal Masses ◽  
Term Survival ◽  
Cancer Management

Background: The SARS-CoV-2 pandemic still has a huge impact on the management of many chronic diseases such as cancer. Few data are presently available reagarding how the management of renal cell carcinoma (RCC) has changed due to this unprecedented situation. Objective: To discuss the challenges and issues of the diagnosis and treatment of RCC in the COVID-19 era, and to provide recommendations based on the collected literature and our personal experience. Methods: Systematic review of the available Literature regarding the management of RCC during the SARS-CoV-2 pandemic. Results: Our review showed a prevalence of narrative publications, raising the issue of the real relevance of the evidence retrieved. Indeed, the only original data about RCC and COVID-19 found were a small retrospective case series and two surveys, providing either patients’ or physicians’ viewpoints. Conclusions: The expected delayed diagnosis of RCC could lead to an increase of advanced/metastatic cases; thus, proper therapeutic choices for patients with small renal masses should be carefully evaluated case by case, in order to avoid negative effects on long-term survival rates. The controversial interaction between immune checkpoint blockade and COVID-19 pathogenesis is more hypothetical than evidence-based, and thus immunotherapy should not be denied, whenever appropriate. To avoid treatments which won’t have an impact on patients’ survival, a honest and accurate evaluation of the cost/benefit ratio of each treatment option should be always performed. Finally, SARS-CoV-2 swab positivity should not prevent the continuation of ongoing active treatments in asymptomatic cases, or or after symptoms’ resolution.

scholarly journals A review of malignant pleural mesothelioma in a large North East UK pleural centre

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Declan C. Murphy ◽  
Alexander Mount ◽  
Fiona Starkie ◽  
Leah Taylor ◽  
Avinash Aujayeb
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Survival Rates ◽  
Case Series ◽  
Pleural Mesothelioma ◽  
Retrospective Case ◽  
Pleural Thickening ◽  
North East ◽  
Total Cohort ◽  
Anti Cancer ◽  
One Year

AbstractObjectivesThe National Mesothelioma Audit 2020 showed Northumbria to have low rates of histopathological confirmation, treatment and one-year survival rates for malignant pleural mesothelioma (MPM). We hypothesized that an internal analysis over a 10-year period provides valuable insights into presentation, diagnosis, treatment and outcomes.MethodsA single-centre retrospective case series of all confirmed MPM patients between 1 January 2009 and 31 December 2019 was performed. Demographics, clinical, radiological and histopathological characteristics and outcomes were collected. Statistical analysis was performed using SPSS V26.0.ResultsA total of 247 patients had MPM. About 86% were male, mean age 75.7 years. Dyspnoea (77.4%) and chest pain (38.5%) were commonest symptoms. 64.9 and 71.4% had pleural thickening and effusion, respectively. About 86.8% had at least one attempt to obtain a tissue biopsy, but histopathological confirmation in only 108 (43.7%). About 66.3% with PS 0 and 1 (62.7% of total cohort) had at least one anti-cancer therapy. Death within 12 months was associated with disease progression within 6 months (p≤0.001). Chemotherapy (p≤0.001) and epithelioid histological subtype (p=0.01) were protective.ConclusionsThis study confirms known epidemiology of MPM, demonstrates variability in practices and highlights how some NMA recommendations are not met. This provides the incentive for a regional mesothelioma multi-disciplinary meeting.

Case series of ventriculopleural shunts in adults: a single-center experience

2016 ◽  
Vol 126 (6) ◽  
pp. 2010-2016 ◽  
Author(s):  
Claudia Craven ◽  
Hasan Asif ◽  
Amna Farrukh ◽  
Flavia Somavilla ◽  
Ahmed K. Toma ◽  
...  
Keyword(s):  
Survival Rates ◽  
Case Series ◽  
Mantel Test ◽  
Single Center ◽  
Retrospective Case ◽  
Distal Catheter ◽  
Single Center Experience ◽  
Kaplan Meier ◽  
Shunt Survival ◽  
Ventriculopleural Shunt

OBJECTIVEThe peritoneal cavity is widely used as the destination of choice for cerebrospinal fluid shunts. Various alternative sites have been used, particularly in the presence of certain contraindications. The pleural cavity has been used; however, a paucity of evidence details ventriculopleural (VPL) shunt survival, complication, and revision rates in adults. The aim of this study was to present a single center's experience with VPL shunts, identifying complication, revision, and survival rates.METHODSA single-center, retrospective case series analysis was conducted for VPL shunt insertions and revisions over a period of 5 years. Demographic as well as clinical data were collected. Ventriculopleural shunt survival was assessed using Kaplan-Meier curves and the log rank (Cox-Mantel) test.RESULTSTwenty-two VPL shunts were inserted in 19 patients. Median survival of the VPL shunts was 14 months. Pathological indication for the VPL shunt did not significantly affect survival. A total of 10 complications was observed: 2 infections, 2 cases of overdrainage, 2 obstructions, 1 distal catheter retraction, 2 symptomatic pleural effusions, and 1 asymptomatic pleural effusion.CONCLUSIONSVentriculopleural shunting is a safe and viable second-line procedure for cases in which ventriculoperitoneal shunts are unsuitable. While VPL shunts have a high revision rate, their complication rate is comparable to that of VP shunts. Ventriculopleural shunt survival can be improved by careful patient selection and the implementation of a combination of valves with antisiphon devices.

Preoperative PD1 checkpoint blockade and receptor activator of NFkB ligand (RANKL) inhibition in non-small cell lung cancer (NSCLC) (POPCORN).

2019 ◽  
Vol 37 (8_suppl) ◽  
pp. TPS129-TPS129
Author(s):  
Elizabeth Stephanie Ahern ◽  
Annette Cubitt ◽  
Emma Ballard ◽  
Michele W.L. Teng ◽  
William C. Dougall ◽  
...  
Keyword(s):  
Mechanism Of Action ◽  
Peripheral Blood ◽  
Case Series ◽  
Response Rates ◽  
Immune Checkpoint Blockade ◽  
Pathologic Response ◽  
Checkpoint Blockade ◽  
R0 Resection ◽  
Retrospective Case ◽  
Receptor Activator

TPS129 Background: Preclinical studies indicate Receptor Activator of NF-κB Ligand (RANKL) blockade improves anti-tumor efficacy of immune checkpoint blockade (ICB). Clinical trials combining denosumab (anti-RANKL mAb) with ICB are underway in various cancers although the hypothesized mechanism of action of such combinations remains incomplete. RANKL and its receptor, RANK, are frequently expressed in NSCLC (tumor and immune cells). Denosumab demonstrated survival advantage over bisphosphonate in metastatic NSCLC (mNSCLC) to bone; a recent retrospective case series suggests a relationship between concurrent ICB and denosumab duration and survival in mNSCLC. Neoadjuvant nivolumab recently showed encouraging pathologic response rates in resectable NSCLC; neoadjuvant trials lend themselves to translational research. Methods: POPCORN is a multicenter phase 1b/2 study to determine the mechanism of action, activity and safety of neoadjuvant nivolumab plus denosumab versus nivolumab alone. 30 patients with resectable stage 1A (tumor > 2cm) – 3A NSCLC will be randomized 1:1 to two arms (Table). Exclusion criteria include uncontrolled autoimmune disease, steroid contraindications, and unhealed dental disease. Tumor tissue at baseline, surgery and relapse, and peripheral blood at various timepoints (including on-therapy) will be collected. The primary endpoint is to define pharmacodynamic correlates of the two arms through investigations including T-cell receptor clonality, RNA/transcription profile changes (tumor and peripheral blood), and expression of tumor/immune markers of interest via multiplex immunohistochemistry, compared between groups. Secondary endpoints include pathologic response rates, toxicity, R0 resection, and PFS/OS (exploratory). Statistical analysis will be primarily descriptive on the intention-to-treat population. The trial is sponsored by Metro North Hospital and Health Service (Queensland, Australia) with funding from AMGEN, Inc. Clinical trial information: ACTRN12618001121257. [Table: see text]

scholarly journals Feline and Canine Cutaneous Lymphocytosis: Reactive Process or Indolent Neoplastic Disease?

2022 ◽  
Vol 9 (1) ◽  
pp. 26
Author(s):  
Francesco Albanese ◽  
Francesca Abramo ◽  
Michele Marino ◽  
Maria Massaro ◽  
Laura Marconato ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Clinical Signs ◽  
Case Series ◽  
Response To Treatment ◽  
Neoplastic Disease ◽  
Retrospective Case ◽  
Term Survival ◽  
Dermal Infiltrate

Cutaneous lymphocytosis (CL) is an uncommon and controversial lymphoproliferative disorder described in dogs and cats. CL is generally characterized by a heterogeneous clinical presentation and histological features that may overlap with epitheliotropic lymphoma. Therefore, its neoplastic or reactive nature is still debated. Here, we describe clinicopathological, immunohistochemical, and clonality features of a retrospective case series of 19 cats and 10 dogs with lesions histologically compatible with CL. In both species, alopecia, erythema, and scales were the most frequent clinical signs. Histologically, a dermal infiltrate of small to medium-sized lymphocytes, occasionally extending to the subcutis, was always identified. Conversely, when present, epitheliotropism was generally mild. In cats, the infiltrate was consistently CD3+; in dogs, a mixture of CD3+ and CD20+ lymphocytes was observed only in 4 cases. The infiltrate was polyclonal in all cats, while BCR and TCR clonal rearrangements were identified in dogs. Overall, cats had a long-term survival (median overall survival = 1080 days) regardless of the treatment received, while dogs showed a shorter and variable clinical course, with no evident associations with clinicopathological features. In conclusion, our results support a reactive nature of the disease in cats, associated with prolonged survival; despite a similar histological picture, canine CL is associated with a more heterogeneous lymphocytic infiltrate, clonality results, and response to treatment, implying a more challenging discrimination between CL and CEL in this species. A complete diagnostic workup and detailed follow-up information on a higher number of cases is warrant for dogs.

scholarly journals Resection of oesophageal and oesophagogastric junction cancer liver metastases — a summary of current evidence

2021 ◽  
Author(s):  
Andreas R. R. Weiss ◽  
Noel E. Donlon ◽  
Hans J. Schlitt ◽  
Christina Hackl
Keyword(s):  
Liver Metastases ◽  
Performance Status ◽  
Survival Rates ◽  
Neoadjuvant Treatment ◽  
Case Series ◽  
Current Evidence ◽  
Cochrane Library ◽  
Term Survival ◽  
Treatment Protocols ◽  
Oesophagogastric Junction

Abstract  Purpose Metastatic oesophageal cancer is commonly considered as a palliative situation with a poor prognosis. However, there is increasing evidence that well-selected patients with a limited number of liver metastases (ECLM) may benefit from a multimodal approach including surgery. Methods A systematic review of the current literature for randomized trials, retrospective studies, and case series with patients undergoing hepatectomies for oesophageal and oesophagogastric junction cancer liver metastases was conducted up to the 31st of August 2021 using the MEDLINE (PubMed) and Cochrane Library databases. Results A total of 661 articles were identified. After removal of duplicates, 483 articles were screened, of which 11 met the inclusion criteria. The available literature suggests that ECLM resection in patients with liver oligometastatic disease may lead to improved survival and even long-term survival in some cases. The response to concomitant chemotherapy and liver resection seems to be of significance. Furthermore, a long disease-free interval in metachronous disease, low number of liver metastases, young age, and good overall performance status have been described as potential predictive markers of outcome for the resection of liver metastases. Conclusion Surgery may be offered to carefully selected patients to potentially improve survival rates compared to palliative treatment approaches. Studies with standardized patient selection criteria and treatment protocols are required to further define the role for surgery in ECLM. In this context, particular consideration should be given to neoadjuvant treatment concepts including immunotherapies in stage IVB oesophageal and oesophagogastric junction cancer.

scholarly journals Cervical tuberculous lymphadenitis: diagnosis and demographics, a five-year case series in the UK

2018 ◽  
Vol 100 (5) ◽  
pp. 392-396 ◽  
Author(s):  
D Moualed ◽  
M Robinson ◽  
A Qureishi ◽  
P Gurr
Keyword(s):  
Fine Needle Aspiration ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Open Biopsy ◽  
Retrospective Case ◽  
Full Data ◽  
Fine Needle ◽  
The Uk

Introduction Cervical tuberculous lymphadenitis is a low-volume condition in the UK with a potential for delayed diagnosis. This study describes typical demographic and clinical features of patients diagnosed with cervical tuberculous lymphadenitis in a UK population. The utility of cytological, histological and microbiological investigations is reviewed with comparison between fine-needle aspiration and open biopsy. This information can facilitate recognition of new cases and guide initial management. Methods Patients diagnosed with cervical tuberculous lymphadenitis between January 2009 and December 2013 at two district general hospitals were identified from local infectious disease databases. Retrospective case-note review was undertaken to collect demographic and diagnostic data and associated complications. Results Full data were available for 51 patients aged 19–70 years (mean 32.4 years) with mean follow-up of 370 days; 49/51 patients were immigrants to the UK with a wide geographic spread in the countries of origin and time since arrival; 42/51 had no significant comorbidities, although two patients had coexistent HIV infection. The clinical presentation was most frequently without constitutional symptoms (39/51) and often with no history of tuberculosis contact. Posterior triangle neck nodes were most commonly involved (26/51). Conclusion The ‘typical’ patient with cervical tuberculous lymphadenitis in our region is a young healthy individual who came to the UK from a high-risk country several years earlier. Diagnosis by fine-needle aspiration is as effective as open biopsy if fluid/pus is aspirated. Open biopsy is potentially associated with complications but does not appear to increase chronic wound discharge rates in our series.

Outcomes of penetrating keratoplasty in congenital hereditary endothelial dystrophy

2017 ◽  
Vol 102 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Hamed AlArrayedh ◽  
Louis Collum ◽  
Conor C Murphy
Keyword(s):  
Graft Survival ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Survival Rates ◽  
Case Series ◽  
Retrospective Case ◽  
Corneal Transplants ◽  
The Mean ◽  
Congenital Hereditary Endothelial Dystrophy

Background/aimTo report the outcome of penetrating keratoplasty (PKP) in Irish patients with congenital hereditary endothelial dystrophy (CHED).MethodsA retrospective case series review of patients with CHED who underwent PKP was conducted. The outcomes of PKP in 14 patients with CHED at the Royal Victoria Eye and Ear Hospital in Dublin from 1978 to 2013 were described following case note review. The main outcome measures were best-corrected visual acuity (BCVA) and graft survival.ResultsThirty-three corneal transplants were performed, which included 32 PKPs and one Descemet’s stripping endothelial keratoplasty. Twenty-four eyes underwent primary corneal grafts and nine eyes had regrafts. The graft survival rates at final follow-up were 37.5% and 33% in the primary graft and regraft groups, respectively. Preoperative BCVA was 20/200 or worse in all patients. At the final postoperative visit, the BCVA was 20/80 or better in four eyes following primary PKP, 20/160 in one eye following regrafting and was 20/200 or worse in all other eyes. The mean time to graft failure was 16 months (range 0–37 months). The mean follow-up time was 101 months (range 12–252 months). Fifty per cent of the patients continue to attend for follow-up.ConclusionsThis study has demonstrated a poor outcome from PKP for CHED in this Irish cohort. This arises from a combination of dense amblyopia and a high risk of graft failure in the long term.

Dedifferentiated Chondrosarcoma in the Dog and Cat: A Case Series and Review of the Literature

2018 ◽  
Vol 54 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Arathi Vinayak ◽  
Deanna R. Worley ◽  
Stephen J. Withrow ◽  
Dustin S. Adams ◽  
Barbara E. Powers
Keyword(s):  
Medical Records ◽  
Treatment Options ◽  
Case Series ◽  
Low Grade ◽  
Survival Times ◽  
Dedifferentiated Chondrosarcoma ◽  
Retrospective Case ◽  
Diagnostic Laboratory ◽  
Term Survival ◽  
Colorado State University

ABSTRACT This retrospective case series describes seven dogs and one cat diagnosed with dedifferentiated chondrosarcoma, an uncommon, aggressive variant of chondrosarcoma. The purpose of the study is to describe clinical, imaging, and histopathological findings of this tumor. Medical records and the diagnostic laboratory database at Colorado State University from 2000 to 2015 were reviewed and complete medical records were available for the eight animals in this report. Similar to what has been reported in people, poor long-term survival and high metastatic rate, particularly to the lungs, was observed in our case series. A bimorphic pattern on imaging (radiographs, computed tomography, and MRI) consisting of mineralized and nonmineralized areas was seen mirroring the high-grade sarcomatous component adjacent to a low-grade chondroid component seen histopathologically. A review of the human literature including suspected etiology, imaging findings, histopathology, and survival times with various treatment options is presented. This article describes the first reported cases of dedifferentiated chondrosarcoma in the veterinary literature. Early accurate recognition could lead to treatment plans tailored to this variant.

scholarly journals Restoration of 1325 teeth with partial-coverage crowns manufactured from high noble metal alloys: a retrospective case series 18.8 years after prosthetic delivery

2021 ◽  
Author(s):  
Philipp Rehm ◽  
Hermann Derks ◽  
Wilfried Lesaar ◽  
Benedikt Christopher Spies ◽  
Florian Beuer ◽  
...  
Keyword(s):  
Noble Metal ◽  
Therapeutic Option ◽  
Case Series ◽  
Metal Alloys ◽  
Success Rates ◽  
Retrospective Case ◽  
Term Survival ◽  
Partial Coverage ◽  
Observation Period ◽  
Noble Metal Alloys

Abstract Objectives To evaluate long-term survival and success rates of conventionally cemented partial-coverage crowns (PCCs) manufactured from high noble metal alloys (hn). Material and methods Restoration-, periodontal- and tooth-related criteria on patients, restored with a single or multiple conventionally cemented hnPCCs in a private dental office were collected from existing patient records. With regard to semi-annual follow-ups, data of the most recent clinical evaluations were considered. Kaplan–Meier and log-rank tests were used for statistical analyses. Level of significance was set at p ≤ .05. Results Between 09/1983 and 09/2009, 1325 hnPCCs were conventionally cemented on 1325 teeth in 266 patients (mean age: 44.5 ± 10.7 years). Due to various reasons, 81 hnPCCs showed complications, documenting a success rate of 93.9% after a mean observation period of 18.8 ± 5.7 years. Of these, additional 14 restorations were counted as survival, resulting in a survival rate of 94.9%. Most frequent complications were periodontal issues (n = 29, 35.8%). Significantly higher success rates were documented for hnPCCs of patients aged between 37 and 51 years (p = .012). Conclusion Partial-coverage crowns from high noble metal alloys showed excellent survival and success rates after a mean observation period of 18.8 ± 5.7 years. Higher patient age was one of the risk factors. Clinical Relevance According to the results of this study, hnPCCs still represent an excellent therapeutic option—even in modern dentistry.

scholarly journals Pathomechanisms and therapeutic opportunities in radiation-induced heart disease: from bench to bedside

2021 ◽  
Author(s):  
Márta Sárközy ◽  
Zoltán Varga ◽  
Renáta Gáspár ◽  
Gergő Szűcs ◽  
Mónika G. Kovács ◽  
...  
Keyword(s):  
Heart Disease ◽  
Survival Rates ◽  
Therapeutic Interventions ◽  
Term Survival ◽  
Normal Tissues ◽  
Cancer Management ◽  
Radiation Induced ◽  
Underlying Mechanisms ◽  
Oncology Practice ◽  
Molecular Pathomechanisms

AbstractCancer management has undergone significant improvements, which led to increased long-term survival rates among cancer patients. Radiotherapy (RT) has an important role in the treatment of thoracic tumors, including breast, lung, and esophageal cancer, or Hodgkin's lymphoma. RT aims to kill tumor cells; however, it may have deleterious side effects on the surrounding normal tissues. The syndrome of unwanted cardiovascular adverse effects of thoracic RT is termed radiation-induced heart disease (RIHD), and the risk of developing RIHD is a critical concern in current oncology practice. Premature ischemic heart disease, cardiomyopathy, heart failure, valve abnormalities, and electrical conduct defects are common forms of RIHD. The underlying mechanisms of RIHD are still not entirely clear, and specific therapeutic interventions are missing. In this review, we focus on the molecular pathomechanisms of acute and chronic RIHD and propose preventive measures and possible pharmacological strategies to minimize the burden of RIHD.

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