Survival Among Patients With High-Risk Gastrointestinal Cancers During the COVID-19 Pandemic

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(3), P. e240160 - e240160

Published: March 5, 2024

Importance Prior reports demonstrated that patients with cancer experienced worse outcomes from pandemic-related stressors and COVID-19 infection. Patients certain malignant neoplasms, such as high-risk gastrointestinal (HRGI) cancers, may have been particularly affected. Objective To evaluate disruptions in care among HRGI cancers during the pandemic, assessing for signs of long-term changes populations survival. Design, Setting, Participants This retrospective cohort study used data National Cancer Database to identify (esophageal, gastric, primary liver, or pancreatic) diagnosed between January 1, 2018, December 31, 2020. Data were analyzed August 23 September 4, 2023. Main Outcome Measures Trends monthly new cases proportions by stage 2020 compared prior 2 years. Kaplan-Meier curves Cox regression assess 1-year mortality 2018 2019. Proportional trends multivariable logistic 30-day 90-day Results Of 156 937 included this study, 54 994 (35.0%) aged 60 69 years 100 050 (63.8%) men. There was a substantial decrease newly March May 2020, which returned prepandemic levels July For stage, there proportional diagnosis I (−3.9%) II (−2.3%) disease, an increase IV disease (7.1%) early months pandemic. Despite slight survival rates (50.7% 2019 vs 47.4% 2020), remained unchanged (all P > .05). After adjusting confounders, not associated increased (hazard ratio, 0.99; 95% CI, 0.97-1.01). The (2.1% 2.0% 2019, 2.1% 2020) (4.3% 4.4% 4.6% operative also similar. Conclusions Relevance In period underdiagnosis observed pandemic; however, no change mortality. These results demonstrate risks gaps tremendous efforts community ensure quality delivery Future research should investigate all types additional follow-up are accrued.

Language: Английский

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The effect of the pandemic on colorectal cancer in the United States: An increased disease burden

Surgical Oncology Insight, Journal Year: 2024, Volume and Issue: 1(1), P. 100014 - 100014

Published: Feb. 9, 2024

BackgroundThe COVID-19 pandemic posed an unprecedented global threat to healthcare systems, causing delays in colorectal cancer (CRC) diagnoses. This study aims assess the impact of on presentation stages U.S.MethodsData from national database (2015-2020) were analyzed, categorizing patients into pre-COVID (2015-2019) and COVID (2020) groups for evaluation.ResultsIn group, with colon had a notably higher prevalence Clinical stage IV disease at diagnosis, accompanied by increased incidence metastatic (Clinical C, 12.9% vs. 4.5%, p < 0.001). Similar trends observed rectal 2.2% 0.8%, Black patients, those specific insurance status (Medicaid or not insured private insurance), cohort significantly associated worse clinical both multivariable analysis.ConclusionThe has led notable surge advanced-stage diagnoses, ongoing repercussions anticipated. Colorectal surgeons should devise strategies address this issue establish preparedness measures future crises.

Language: Английский

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Oncologic outcomes and survival of modern surgical approaches for gastric gastrointestinal stromal tumor (GIST)

Surgical Endoscopy, Journal Year: 2024, Volume and Issue: 38(11), P. 6854 - 6864

Published: Aug. 23, 2024

Studies have demonstrated comparable outcomes between laparoscopic and open resection of gastrointestinal stromal tumor (GIST). We sought to compare among robotic, laparoscopic, gastric GIST in the era expanding minimally invasive surgery.

Language: Английский

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Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle‐Invasive Bladder Cancer in the United States

Cancer Medicine, Journal Year: 2025, Volume and Issue: 14(4)

Published: Feb. 1, 2025

ABSTRACT Purpose To characterize trends and patterns in treatment characteristics perioperative outcomes of patients with urothelial muscle‐invasive bladder cancer (MIBC). Materials Methods We utilized the National Cancer Database to assess modalities (radical cystectomy [RC] or without neoadjuvant/adjuvant treatments, trimodal bladder‐sparing [trimodal treatment], others) among MIBC diagnosed between 2004 2017. also assessed short‐term post‐surgery outcomes, including 30‐day 90‐day mortality, readmissions. Results Among 83,259 patients, those who received RC, treatment, transurethral resection tumor (TURBT) plus chemotherapy were 34,715 (41.7%), 7,372 (8.9%), 6,171 (7.4%), respectively. A substantial proportion (29,314; 35.2%) other TURBT‐only. From through 2017, guideline‐recommended whether RC (from 36.4% 42.8%) 7.9% 10.2%), increased. there was a increase neoadjuvant (NAC) utilization, from 7.8% 29.4%. Conversely, utilization treatments decreased 62.3% 32.7%. There significant decrease (2.8%–1.8%) (7.1%–5.3%) mortality rates recipients. Conclusion shift for MIBC, increased NAC. may indicate improved although unmet need NAC requires further investigation.

Language: Английский

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Temporal trends in cross-country inequalities of early-onset pancreatic cancer: a comprehensive analysis for the global burden of disease study 2021

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: April 28, 2025

By 2040, pancreatic cancer is expected to become the second leading cause of cancer-related deaths in U.S., with early-onset (EOPC) cases rising among adolescents and young adults. This study uses global burden disease (GBD) 2021 dataset examine global, regional, national EOPC trends predicts through 2050. The analysis covers from 1990 2021, focusing on age-standardized prevalence rate (ASPR), incidence (ASIR), mortality (ASMR), disability-adjusted life years (ASDR). Annual percentage change (APC) average annual (AAPC) were calculated via joinpoint regression. Clustering frontier based sociodemographic index (SDI) assessed link between development levels health outcomes. We used WHO-recommended equity methods quantify disparities applied a Bayesian age-period-cohort (BAPC) model project trends. In rose 42,254, 73% increase 1990, while reached 26,996, up 57%. Although ASIR, ASMR, ASDR declined, ASPR (EAPC = 0.1). Central Eastern Europe had highest burden, fastest growth Australasia 2.78) Western Sub-Saharan Africa 2.25). Males about double females, though female increased. widening gap low- high-SDI regions especially concerning. While currently affects countries most, there clear trend over time showing gradual shift towards low-SDI countries. 2050, ASPR, are projected stabilize, increasing until 2036, then decreasing. High-SDI bear disproportionately high significant diagnostic management challenges, particularly Europe. Rising highlights need identify differences risk factors across develop targeted prevention control strategies.

Language: Английский

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Alterations in Cancer Treatment During the First Year of the COVID-19 Pandemic in the US

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(10), P. e2340148 - e2340148

Published: Oct. 30, 2023

Importance The COVID-19 pandemic created challenges to the evaluation and treatment of cancer, abrupt resource diversion toward patients with put cancer on hold for many patients. Previous reports have shown substantial declines in screening diagnoses 2020; however, extent which delivery care was altered remains unclear. Objective To assess alterations US during first year pandemic. Design, Setting, Participants This retrospective cohort study used data from National Cancer Database (NCDB) older than 18 years newly diagnosed January 1, 2018, December 31, 2020. Main Outcomes Measures main outcomes were accessibility (time treatment, travel distance, multi-institutional care), availability (proportional changes between years), utilization (reductions by modality, hospital type) 2020 compared 2018 2019. Autoregressive models forecasted expected findings based observations prior years. Results Of 1 229 654 identified NCDB 2020, 074 225 treated representing a 16.8% reduction what expected. Patients predominately female (53.8%), median age 66 (IQR, 57-74 similar demographics Median time diagnosis 26 days 0-36 days) distance 11.1 miles 5.0-25.3 miles), In fewer traveled longer distances (20.2% traveling &amp;gt;35 miles). proportions chemotherapy (32.0%), radiation (29.5%), surgery (57.1%) those Overall, 146 805 underwent surgery, 80 480 received radiation, 68 014 chemotherapy. Academic hospitals experienced greatest decrease approximately 484 (−19.0%) per 99 (−12.6%) at community 110 (−12.8%) integrated networks. Conclusions Relevance found that among access remained intact; reductions varied across modalities greater academic networks values. These results suggest resilience service lines frame economic losses

Language: Английский

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Dose and fractionation regimen for brachytherapy boost in cervical cancer in the US

Gynecologic Oncology, Journal Year: 2023, Volume and Issue: 180, P. 55 - 62

Published: Dec. 5, 2023

Language: Английский

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Unveiling the Hidden Consequences: Initial Impact of COVID-19 on Colorectal Cancer Operation

Journal of the American College of Surgeons, Journal Year: 2024, Volume and Issue: 239(2), P. 85 - 97

Published: March 25, 2024

Language: Английский

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Fragmentation of care in breast cancer: greater than the sum of its parts

Breast Cancer Research and Treatment, Journal Year: 2024, Volume and Issue: 208(3), P. 511 - 521

Published: Aug. 3, 2024

Abstract Introduction Fragmentation of care (FC, the receipt at > 1 institution) has been shown to negatively impact cancer outcomes. Given multimodal nature breast treatment, we sought identify factors associated with FC and its effects on survival patients. Methods A retrospective analysis was performed surgically treated, stage I–III patients in 2004–2020 National Cancer Database, excluding neoadjuvant therapy recipients. Patients were stratified into two groups: or non-FC care. Treatment delay defined as definitive surgery 60 days after diagnosis. Multivariable logistic regression predictive FC, compared using Kaplan–Meier multivariable Cox proportional hazards methods. Results Of 531,644 identified, 340,297 (64.0%) received FC. After adjustment, (OR 1.27, 95% CI 1.25–1.29) independently treatment delay. Factors included Hispanic ethnicity 1.04, CI: 1.01–1.07), comprehensive community programs 1.06, 1.03–1.08) integrated network 1.55, 1.51–1.59), AJCC II 1.05–1.07) III tumors 1.02–1.10), HR + /HER2 1.05, 1.02–1.07). increased risk mortality (HR 1.23, 1.20–1.26), whereas 0.87, 0.86–0.88) showed benefit. Conclusions While impacts patients, our findings suggest could be a marker for multispecialty that may mitigate some these effects.

Language: Английский

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Cyclization of acyl thiosemicarbazides led to new Helicobacter pylori α‐carbonic anhydrase inhibitors

Archiv der Pharmazie, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 29, 2024

The eradication of Helicobacter pylori, the etiologic agent gastric ulcer and adenocarcinoma, is a big concern in clinics due to increasing drug resistance phenomena limited number efficacious treatment options. exploitation H. pylori carbonic anhydrases (HpCAs) as promising pharmacological targets has been validated by antibacterial activity previously reported CA inhibitors role these enzymes bacterium survival mucosa. development new HpCA seems be on way filling existing antibiotics gap. Due recent evidence ability coumarin scaffold inhibit microbial α-CAs, large library derivatives developed means pH-regulated cyclization reaction coumarin-bearing acyl thiosemicarbazide intermediates. obtained 1,3,4-thiadiazoles (10-18a,b) 1,2,4-triazole-3-thiones (19-26a,b) were found strongly selectively HpαCA computational studies fundamental gaining an understanding interaction networks governing enzyme-inhibitor complex. Antibacterial evaluations ATCC 43504 highlighted some compounds that maintained potency resistant clinical isolate. Also, their combinations with metronidazole decreased both minimal inhibitory concentration bactericidal values antibiotic, no synergistic effect.

Language: Английский

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