Background

Most of breast cancer patients survive for a long-term period. The existing assessment of survivors’ prognosis has had some limitations in breast cancer because it is based on an evaluation at the time of diagnosis. Conditional survival reflects change over time after diagnosis and treatment of cancer. Conditional disease-free survival (CDFS) and conditional overall survival (COS) can provide more accurate prognosis to breast cancer patients. In this study, we aimed to determine 5-years CDFS and COS according to disease-free period after diagnosis and treatment of breast cancer in Korea.

Methods

We retrospectively reviewed clinical data of 5664 patients aged 16 to 86 who underwent curative surgery for breast cancer between January 2000 and December 2008 at Samsung Medical Center, a single tertiary hospital in Korea. The CDFS and COS rates were based on cumulative DFS and OS estimates up to 15 years using the Kaplan-Meier method.

Results

At baseline, each 5-years DFS and OS were 88.0% and 93.8%. For patients who kept disease free status from 1 to 9 years after surgery, the 5-years CDFS rates were calculated as 88.7%, 90.7%, 91.6%, 91.1%, 91.5%, 91.0%, 89.5%, 86.1% and 86.1%, respectively. The 5-year COS rates of the patients who had survived from 1 to 9 years after surgical treatment were calculated as 92.6%, 92.1%, 91.2%, 91.0%, 89.4%, 85.6%, 80.7%, 75.3%, and 73.0%, respectively.

Conclusions

Our study showed that 5-years CDFS and COS for most patients who have breast cancer in Korea seemed to be good prognosis for a long time. However, cancer recurrence tended to occur after a long period postoperatively. Further study is required to identify risk factors associated with recurrence after several years in Korean breast cancer patients.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Obesity is a risk factor for several cancer. In Korea, prevalence of obesity has increased and incidence of several cancers of gastrointestinal (GI) tract, such as colon cancer and rectal cancer have increased. The aim of this study was to evaluate the association between obesity prevalence and cancer incidence of gastrointestinal tract in Korea adults.

Methods

The data were collected from the webpage of Statistic Korea, where the incidence of GI tract cancer between 2001 and 2016 was obtained from National Cancer Center, and the prevalence of obesity between 2001 and 2016 was obtained from National Health and Nutrition Examination Survey. The obesity was defined as BMI ≥25 kg/m² among adults ≥30 years old. The association between obesity and cancer of GI tract was calculated by using linear regression analysis.

Results

In men, prevalence of obesity was significantly associated with esophageal cancer (β: 0.176, P = 0.001), colon cancer (β: 2.034, P = 0.013), rectal cancer (β: 1.305, P = 0.035), gallbladder cancer and other biliary tract cancer (β: 0.712, P < 0.0001), and pancreatic cancer (β: 0.717, P < 0.0001). But, gastric cancer (β: 1.396, P = 0.076) and liver cancer (β: 0.122, P = 0.496) were not associated with obesity prevalence (Table) In women, incidence of GI tract cancer was not associated with obesity prevalence.Table:

159P Linear regression between obesity and GI cancer in men adults

Conclusions

In Korean adults, incidence of some GI tract cancer seems to be associated with obesity prevalence.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

The emetogenic classification of antineoplastic agents has provided a framework for defining antiemetic treatment recommendations in international guidelines. The most widely used classification schema identified four emetic risk levels. However, information on the emetogenicity of each chemotherapeutic regimen is insufficient. We previously reported that the emetic risk of pemetrexed was higher than that of taxans. Risk factors for chemotherapy-induced nausea and vomiting (CINV) were also assessed in patients with lung cancer receiving carboplatin plus pemetrexed (CBDCA+PTX) or carboplatin plus paclitaxel (CBDCA+PEM), and the CINV incidence was compared between these two regimens.

Methods

Data were pooled from two prospective studies, and propensity score matching was used to compare the CINV incidence between CBDCA+PTX and CBDCA+PEM groups. Risk factors for CINV were identified using logistic regression models. The pattern of CINV occurrence was evaluated by 7-day patient diary for recording CINV after the commencement of chemotherapy.

Results

Among 240 evaluable patients, the CINV incidence was higher in the CBDCA+PEM group than in the CBDCA+PTX group at the delayed phase (nausea: 51.1% vs. 36.2%, P = 0.040; vomiting: 23.4% vs. 14.9%, P = 0.138). The pattern of delayed CINV occurrence peaked on days 5 and 4 for CBDCA+PEM and CBDCA+PTX regimens, respectively. Logistic regression analysis identified younger age, female sex, no alcohol consumption, two antiemetics, and CBDCA+PEM regimen as independent risk factors associated with delayed nausea, and female sex and two antiemetics for delayed vomiting.

Conclusions

The emetic risk of CDBCA+PEM regimen was higher than that of CBDCA+PTX regimen. More aggressive antiemetic prophylaxis such as quadruple therapy, including olanzapine, may be considered in patients receiving CDBCA+PEM regimen.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Hepatocellular carcinoma [HCC] is the third leading cause of death from cancer worldwide. In Egypt, HCC accounts for about 4.7% of chronic liver disease. To date, no controlled studies have evaluated the Sorafenib efficacy in comparison to no treatment in HCC patients whose etiology of HCV genotype 4 (The most prevalent hepatitis C virus genotype in Egypt).

Methods

A multicenter prospective controlled interventional study. 110 Patients were evaluated for overall survival [OS], Progression-free survival [PFS], safety and quality of life [QOL] using FACT Hepatobiliary Symptom Index [FHSI-8] questionnaire. NCT02971696.

Results

Out of 110 patients enrolled, only 55 completed the trial; sorafenib [n = 35], no-treatment control group [n = 20]. The one year OS was 0.0% versus 75.5% [p = 0.008] in control and sorafenib respectively. Median PFS was 5 months versus 12 months in control group and sorafenib respectively [p = 0.008]. Sorafenib group HR for developing progression was 2.35; [95% [CI], 1.19 to 4.62; P = 0.014]. QOL scores [FHSI-8] was significantly different between the 2 groups [F = 4.455, p = 0.047]. Most observed side effects of sorafenib were; Diarrhea [n = 15] and hand-foot syndrome [n = 12].

Conclusions

Sorafenib treatment showed a better outcome OS, PFS and QOL as compared to no-treatment in Egyptian patients with advanced Hepatocellular Carcinoma.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer death among males and females. There is evidence that diet habit may influence lung cancer risk. To determine the association between fish intake and dietary polyunsaturated fatty acids (PUFA) and incidence of lung cancer, we identified all available studies to clarify the dose-response relationship between fish and PUFA and lung cancer risk, evaluated the potential effects of frequent fish and PUFA intake on lung cancer mortality, and studied the ability of their supplementations during chemotherapy in patients with lung cancer.

Methods

We systematically reviewed and meta-analyzed the published studies in MEDLINE, EMBASE databases, Cochrane Library database (Cochrane central register of controlled trials) and ClinicalTrials, supplemented with manual screening. Large-scale prospective cohort study and randomized control trials quantifying the associations of fish and PUFA consumption with risk of lung cancer were included. Two investigators dependently assessed studies for inclusion and extracted data on methods, interventions, outcomes and study quality. Relative risk (RR) with 95% confidence interval (CI) was calculated.

Results

13 population-based prospective cohort studies involving 1,785,000 participants and 2 randomized control trials were included. Our study demonstrated that dietary PUFA significant reduced risk of lung cancer for men (RR 0.99, 95%CI 0.98 to 1.00) and USA population (RR 0.99, 95%CI 0.98 to 1.00). Dose-response analysis indicated that a 5g/day increment of dietary PUFA was associated with 5% lower risk of lung cancer (RR 0.95, 95%CI 0.91 to 0.99). In addition, PUFA supplementation is significant improved overall survival in patients with lung cancer (RR 1.98, 95%CI 1.09 to 3.59).

Conclusions

Our study showed an inverse association between dietary PUFA and risk of lung cancer in males and among USA population. Although smoking cessation is the single biggest factor associated with lung cancer risk reduction, this study adds to a growing body of evidence that diet may have a role in modestly reducing lung cancer risk.

Editorial acknowledgement

This work was supported by program for the National Natural Science Foundation of China (grant number 81700025), the Medical and Health Science and Technology Project of Zhejiang (grant number 2018245859), the Medical Science and Technology Plan Projects of Ningbo (grant number 2016A03), the Science Foundation of Zhejiang (grant number LY15H010002) and the Beijing Medical Health Foundation (grant number YWJKJJHKYJJ-HX32).

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

Background

Cardiotoxicity is a well-recognized adverse outcome following adjuvant breast cancer treatment including anthracyclines, trastuzumab, and chest radiation. Its prevention remains an important challenge in clinical practice. We aimed to determine the effectiveness of prophylactic cardioprotective agents in preventing treatment-related cardiotoxicity in women with breast cancer.

Methods

A systematic review of published literature was conducted by searching PubMed, EMBASE and EBSCO host databases. Studies where prophylactic intervention was given to breast cancer patients without a prior history of heart disease were included. The outcomes of interest were preservation of left ventricular ejection fraction (LVEF), or development of cardiac events. Mean differences (MD) in LVEF, and relative risks (RR) of cardiac events, were evaluated using random-effects models.

Results

Thirteen randomized controlled trials (RCTs), which used prophylactic beta-blockers, dexrazoxane, angiotensin receptor blockers, angiotensin converting enzyme (ACE) inhibitors or other pharmacologic agents were included. Overall, the use of prophylactic cardioprotective agents resulted in a statistically significant smaller LVEF decline compared to use of placebo (MD = 2.42%, 95% confidence interval (CI): 0.59%-4.24%). While there were 52 cardiac events in the intervention arm (n = 405) compared to 79 in the control arm (n = 396), use of prophylactic cardioprotective agents did not significantly protect against incident cardiac events (RR = 0.63, 95%CI: 0.33-1.22).

Conclusions

In breast cancer patients without a history of heart disease, use of cardioprotective agents appear to confer only a very marginal protection against LVEF decline, falling below the ideal 10% cardioprotection. However, given the sample number of RCTs in this area, more studies are needed to substantiate the effectiveness of prophylactic cardioprotective agents in prevention of cardiotoxicity in women with breast cancer.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.