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European Urology Nov 2022International variations in the rates of kidney cancer (KC) are considerable. An understanding of the risk factors for KC development is necessary to generate... (Review)
Review
CONTEXT
International variations in the rates of kidney cancer (KC) are considerable. An understanding of the risk factors for KC development is necessary to generate opportunities to reduce its incidence through prevention and surveillance.
OBJECTIVE
To retrieve and summarize global incidence and mortality rates of KC and risk factors associated with its development, and to describe known familial syndromes and genetic alterations that represent biologic risk factors.
EVIDENCE ACQUISITION
A systematic review was conducted via Medline (PubMed) and Scopus to include meta-analyses, reviews, and original studies regarding renal cell carcinoma, epidemiology, and risk factors.
EVIDENCE SYNTHESIS
Our narrative review provides a detailed analysis of KC incidence and mortality, with significant variations across time, geography, and sex. In particular, while KC incidence has continued to increase, mortality models have leveled off. Among the many risk factors, hypertension, obesity, and smoking are the most well established. The emergence of new genetic data coupled with observational data allows for integrated management and surveillance strategies for KC care.
CONCLUSIONS
KC incidence and mortality rates vary significantly by geography, sex, and age. Associations of the development of KC with modifiable and fixed risk factors such as obesity, hypertension, smoking, and chronic kidney disease (CKD)/end-stage kidney disease (ESKD) are well described. Recent advances in the genetic characterization of these cancers have led to a better understanding of the germline and somatic mutations that predispose patients to KC development, with potential for identification of therapeutic targets that may improve outcomes for these at-risk patients.
PATIENT SUMMARY
We reviewed evidence on the occurrence of kidney cancer (KC) around the world. Currently, the main avoidable causes are smoking, obesity, and high blood pressure. Although other risk factors also contribute, prevention and treatment of these three factors provide the best opportunities to reduce the risk of developing KC at present.
Topics: Biological Products; Carcinoma, Renal Cell; Humans; Hypertension; Kidney Neoplasms; Obesity
PubMed: 36100483
DOI: 10.1016/j.eururo.2022.08.019 -
Theranostics 2023Metabolic reprogramming is one of the most important hallmarks of malignant tumors. Specifically, lipid metabolic reprogramming has marked impacts on cancer progression... (Review)
Review
Metabolic reprogramming is one of the most important hallmarks of malignant tumors. Specifically, lipid metabolic reprogramming has marked impacts on cancer progression and therapeutic response by remodeling the tumor microenvironment (TME). In the past few decades, immunotherapy has revolutionized the treatment landscape for advanced cancers. Lipid metabolic reprogramming plays pivotal role in regulating the immune microenvironment and response to cancer immunotherapy. Here, we systematically reviewed the characteristics, mechanism, and role of lipid metabolic reprogramming in tumor and immune cells in the TME, appraised the effects of various cell death modes (specifically ferroptosis) on lipid metabolism, and summarized the antitumor therapies targeting lipid metabolism. Overall, lipid metabolic reprogramming has profound effects on cancer immunotherapy by regulating the immune microenvironment; therefore, targeting lipid metabolic reprogramming may lead to the development of innovative clinical applications including sensitizing immunotherapy.
Topics: Humans; Tumor Microenvironment; Lipid Metabolism; Immunotherapy; Cell Death; Lipids; Neoplasms
PubMed: 37064872
DOI: 10.7150/thno.82920 -
Critical Reviews in Oncology/hematology Aug 2022Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive... (Review)
Review
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
Topics: Adult; Anxiety; Caregivers; Health Services Needs and Demand; Humans; Needs Assessment; Neoplasms; Social Support; Surveys and Questionnaires
PubMed: 35662585
DOI: 10.1016/j.critrevonc.2022.103728 -
Journal of Clinical Oncology : Official... Feb 2020To provide updated recommendations about prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer.
PURPOSE
To provide updated recommendations about prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer.
METHODS
PubMed and the Cochrane Library were searched for randomized controlled trials (RCTs) and meta-analyses of RCTs published from August 1, 2014, through December 4, 2018. ASCO convened an Expert Panel to review the evidence and revise previous recommendations as needed.
RESULTS
The systematic review included 35 publications on VTE prophylaxis and treatment and 18 publications on VTE risk assessment. Two RCTs of direct oral anticoagulants (DOACs) for the treatment of VTE in patients with cancer reported that edoxaban and rivaroxaban are effective but are linked with a higher risk of bleeding compared with low-molecular-weight heparin (LMWH) in patients with GI and potentially genitourinary cancers. Two additional RCTs reported on DOACs for thromboprophylaxis in ambulatory patients with cancer at increased risk of VTE.
RECOMMENDATIONS
Changes to previous recommendations: Clinicians may offer thromboprophylaxis with apixaban, rivaroxaban, or LMWH to selected high-risk outpatients with cancer; rivaroxaban and edoxaban have been added as options for VTE treatment; patients with brain metastases are now addressed in the VTE treatment section; and the recommendation regarding long-term postoperative LMWH has been expanded. Re-affirmed recommendations: Most hospitalized patients with cancer and an acute medical condition require thromboprophylaxis throughout hospitalization. Thromboprophylaxis is not routinely recommended for all outpatients with cancer. Patients undergoing major cancer surgery should receive prophylaxis starting before surgery and continuing for at least 7 to 10 days. Patients with cancer should be periodically assessed for VTE risk, and oncology professionals should provide patient education about the signs and symptoms of VTE.Additional information is available at www.asco.org/supportive-care-guidelines.
Topics: Anticoagulants; Humans; Meta-Analysis as Topic; Neoplasms; Randomized Controlled Trials as Topic; Venous Thromboembolism
PubMed: 31381464
DOI: 10.1200/JCO.19.01461 -
Thyroid : Official Journal of the... Mar 2021Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Since the guidelines for the management of ATC by the American Thyroid Association...
Anaplastic thyroid cancer (ATC) is a rare but highly lethal form of thyroid cancer. Since the guidelines for the management of ATC by the American Thyroid Association were first published in 2012, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, and researchers on published evidence relating to the diagnosis and management of ATC. The specific clinical questions and topics addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of the Task Force members (authors of the guideline). Relevant literature was reviewed, including serial PubMed searches supplemented with additional articles. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. The guidelines include the diagnosis, initial evaluation, establishment of treatment goals, approaches to locoregional disease (surgery, radiotherapy, targeted/systemic therapy, supportive care during active therapy), approaches to advanced/metastatic disease, palliative care options, surveillance and long-term monitoring, and ethical issues, including end of life. The guidelines include 31 recommendations and 16 good practice statements. We have developed evidence-based recommendations to inform clinical decision-making in the management of ATC. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with ATC.
Topics: Consensus; Evidence-Based Medicine; Humans; Medical Oncology; Prognosis; Thyroid Carcinoma, Anaplastic; Thyroid Neoplasms
PubMed: 33728999
DOI: 10.1089/thy.2020.0944 -
Nutrients Jan 2022Cancer survival continues to improve in high-income countries, partly explained by advances in screening and treatment. Previous studies have mainly examined the... (Meta-Analysis)
Meta-Analysis
Cancer survival continues to improve in high-income countries, partly explained by advances in screening and treatment. Previous studies have mainly examined the relationship between individual dietary components and cancer prognosis in tumours with good therapeutic response (breast, colon and prostate cancers). The aim of this review is to assess qualitatively (and quantitatively where appropriate) the associations of dietary patterns and cancer prognosis from published prospective cohort studies, as well as the effect of diet interventions by means of randomised controlled trials (RCT). A systematic search was conducted in PubMed, and a total of 35 prospective cohort studies and 14 RCT published between 2011 and 2021 were selected. Better overall diet quality was associated with improved survival among breast and colorectal cancer survivors; adherence to the Mediterranean diet was associated to lower risk of mortality in colorectal and prostate cancer survivors. A meta-analysis using a random-effects model showed that higher versus lower diet quality was associated with a 23% reduction in overall mortality in breast cancer survivors. There was evidence that dietary interventions, generally combined with physical activity, improved overall quality of life, though most studies were in breast cancer survivors. Further cohort and intervention studies in other cancers are needed to make more specific recommendations.
Topics: Breast Neoplasms; Cancer Survivors; Colorectal Neoplasms; Diet; Diet, Mediterranean; Feeding Behavior; Female; Guideline Adherence; Humans; Male; Neoplasms; Nutrition Policy; Prognosis; Prospective Studies; Prostatic Neoplasms; Randomized Controlled Trials as Topic
PubMed: 35057525
DOI: 10.3390/nu14020348 -
Artificial Intelligence in Medicine May 2023Cervical cancer is one of the most common cancers in women with an incidence of around 6.5 % of all the cancer in women worldwide. Early detection and adequate... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Cervical cancer is one of the most common cancers in women with an incidence of around 6.5 % of all the cancer in women worldwide. Early detection and adequate treatment according to staging improve the patient's life expectancy. Outcome prediction models might aid treatment decisions, but a systematic review on prediction models for cervical cancer patients is not available.
DESIGN
We performed a systematic review for prediction models in cervical cancer following PRISMA guidelines. Key features that were used for model training and validation, the endpoints were extracted from the article and data were analyzed. Selected articles were grouped based on prediction endpoints i.e. Group1: Overall survival, Group2: progression-free survival; Group3: recurrence or distant metastasis; Group4: treatment response; Group5: toxicity or quality of life. We developed a scoring system to evaluate the manuscript. As per our criteria, studies were divided into four groups based on scores obtained in our scoring system, the Most significant study (Score > 60 %); Significant study (60 % > Score > 50 %); Moderately Significant study (50 % > Score > 40 %); least significant study (score < 40 %). A meta-analysis was performed for all the groups separately.
RESULTS
The first line of search selected 1358 articles and finally 39 articles were selected as eligible for inclusion in the review. As per our assessment criteria, 16, 13 and 10 studies were found to be the most significant, significant and moderately significant respectively. The intra-group pooled correlation coefficient for Group1, Group2, Group3, Group4, and Group5 were 0.76 [0.72, 0.79], 0.80 [0.73, 0.86], 0.87 [0.83, 0.90], 0.85 [0.77, 0.90], 0.88 [0.85, 0.90] respectively. All the models were found to be good (prediction accuracy [c-index/AUC/R] >0.7) in endpoint prediction.
CONCLUSIONS
Prediction models of cervical cancer toxicity, local or distant recurrence and survival prediction show promising results with reasonable prediction accuracy [c-index/AUC/R > 0.7]. These models should also be validated on external data and evaluated in prospective clinical studies.
Topics: Humans; Female; Uterine Cervical Neoplasms; Prospective Studies; Quality of Life; Prognosis
PubMed: 37100501
DOI: 10.1016/j.artmed.2023.102549 -
Complementary Therapies in Medicine Aug 2022Despite advances in the diagnosis and treatment of cancer, patients still suffer from the various physical and psychological complications of cancer. The aim of this... (Review)
Review
OBJECTIVE
Despite advances in the diagnosis and treatment of cancer, patients still suffer from the various physical and psychological complications of cancer. The aim of this research was to integrate and synthesize relevant scientific evidence about the effect of lavender on cancer complications.
METHODS
A systematic review of the international literature was undertaken. The search process encompassed four databases of PubMed [including MEDLINE], Web of Science, Scopus, and Cochrane library without time and language limits. All types of interventional studies examining the effects of lavender on cancer complications were included in data analysis and research synthesis. Relevant data were obtained from eligible studies after quality appraisal using appropriate methodological tools. Given that meta-analysis could not performed, the review findings were synthesized narratively.
RESULTS
Thirteen studies were included in this review with a total of 838 patients. Nine studies used a randomized controlled trial design and the majority of them were conducted on patients with multiple types of cancer. Lavender was often used as inhalation aromatherapy. In the majority of the included studies, lavender was significantly effective in the reduction of anxiety and pain, and improved sleep quality and vital signs.
CONCLUSIONS
This review provides scientific evidence regarding the effectiveness of lavender in mitigating cancer complications. Healthcare providers are suggested to use lavender in patient care along with other healthcare interventions to relieve cancer complications.
Topics: Anxiety; Anxiety Disorders; Aromatherapy; Humans; Lavandula; Neoplasms; Oils, Volatile; Pain; Plant Oils; Randomized Controlled Trials as Topic
PubMed: 35462027
DOI: 10.1016/j.ctim.2022.102836 -
Supportive Care in Cancer : Official... Jun 2022To provide evidence-based recommendations on the management of malignant bowel obstruction (MBO) for patients with advanced cancer.
PURPOSE
To provide evidence-based recommendations on the management of malignant bowel obstruction (MBO) for patients with advanced cancer.
METHODS
The Multinational Association for Supportive Care in Cancer (MASCC) MBO study group conducted a systematic review of databases (inception to March 2021) to identify studies about patients with advanced cancer and MBO that reported on the following outcomes: symptom management, bowel obstruction resolution, prognosis, overall survival, and quality of life. The review was restricted to studies published in English, but no restrictions were placed on publication year, country, and study type. As per the MASCC Guidelines Policy, the findings were synthesized to determine the levels of evidence to support each MBO intervention and, ultimately, the graded recommendations and suggestions.
RESULTS
The systematic review identified 17,656 published studies and 397 selected for the guidelines. The MASCC study group developed a total of 25 evidence-based suggestions and recommendations about the management of MBO-related nausea and vomiting, bowel movements, pain, inflammation, bowel decompression, and nutrition. Expert consensus-based guidance about advanced care planning and psychosocial support is also provided.
CONCLUSION
This MASCC Guideline provides comprehensive, evidence-based recommendations about MBO management for patients with advanced cancer.
Topics: Humans; Intestinal Obstruction; Nausea; Neoplasms; Palliative Care; Quality of Life
PubMed: 35274188
DOI: 10.1007/s00520-022-06889-8 -
Supportive Care in Cancer : Official... Dec 2021Nausea and vomiting are a common clinical symptom in the advanced cancer patient. Pharmacologic management is important. Evidence for drug choices and guidelines are...
BACKGROUND
Nausea and vomiting are a common clinical symptom in the advanced cancer patient. Pharmacologic management is important. Evidence for drug choices and guidelines are needed to help clinicians manage nausea and vomiting in this population METHODS: Evidence from a systematic review published in 2010, initial MASCC guidelines developed from a systematic review of literature to 2015, and a new systematic review of randomized trials published between 2015 and February 2, 2021, was combined to establish a new guideline.
RESULTS
A search of the literature between 2015 and February 2, 2021, revealed 257 abstracts of which there was one systematic review and 4 randomized trials which were used to modify the guideline. The new guideline is as follows: First Line: Metoclopramide (II) multiple small RCTs including a placebo-controlled trial, haloperidol (II) multiple non-placebo-controlled RCTs, high consensus. Second line: Methotrimeprazine (II) 1 well-powered non-placebo-controlled RCT, olanzapine (II) 1 placebo-controlled pilot RCT, high consensus. Third line: Tropisetron (II) large unblinded lower quality non-placebo-controlled RCT, levosulpiride (II) 1 blinded non-placebo-controlled pilot RCT, high consensus.
DISCUSSION
Haloperidol, metoclopramide, methotrimeprazine, olanzapine tropisetron, and levosulpiride have been antiemetics used in randomized trials with antiemetic activity demonstrated. There are only three placebo-controlled randomized trials we could find in our literature review. Placebo responses varied significantly between two randomized trials. More randomized placebo-controlled trials with either metoclopramide or haloperidol rescue are needed to clarify antiemetic choices in advanced cancer.
CONCLUSION
First-line antiemetics for nausea and vomiting in advanced cancer are metoclopramide and haloperidol, and second-line medications are methotrimeprazine and olanzapine.
Topics: Antiemetics; Humans; Metoclopramide; Nausea; Neoplasms; Vomiting
PubMed: 34398289
DOI: 10.1007/s00520-021-06437-w