Multicenter Database of Patients with Germ-Cell Tumors: A Latin American Cooperative Oncology Group Registry (LACOG 0515).

INTRODUCTION: Germ-cell tumors (GCTs) are the most common malignancy in young men. There is a paucity of data on GCTs in developing countries. LACOG 0515 study aimed to evaluate clinical characteristics and treatment outcomes in patients with GCTs from Brazilian cancer centers. MATERIALS AND METHODS: This is a retrospective cohort study evaluating male patients diagnosed with GCTs from 2000 to 2018 in 13 Brazilian hospitals. We described baseline characteristics, progression-free survival (PFS), and overall survival (OS). RESULTS: A total of 1232 patients were included, with a median age of 30 years. Histology was seminoma in 47.1% and non-seminoma GCT (NSGCT) in 52.9%. The primary tumor site was testis in 96.5%. At diagnosis, clinical stage I was present in 68.1% and 34.7% and clinical stages IS/II/III in 31.9% and 65.2% of patients with seminoma and NSCGT, respectively. Following orchiectomy, 55.2% of patients with clinical stage I were managed with surveillance. The 5-year disease-free survival rates among patients with stage I were 98.0% in seminoma and 92.3% in NSGCT, with 5-year OS of 99.6% and 97.6%, respectively. Among patients with advanced disease (IS, II, and III), the 5-year PFS were 88.7% in seminoma and 68.7% in NSGCT, with 5y-OS of 97.6% and 82.8%, respectively. CONCLUSION: This is the largest Brazilian cohort of GCTs. Our results show a high rate of adjuvant chemotherapy in patients with clinical stage I. Although our data demonstrate slightly inferior PFS compared with the International Germ Cell Cancer Collaborative Group and other contemporary series, the OS rates were similar.

ESR1 Mutations Are Not a Common Mechanism of Endocrine Resistance in Patients With Estrogen Receptor-Positive Breast Cancer Treated With Neoadjuvant Aromatase Inhibitor Therapy.

Introduction: Mutations in the ESR1 gene (ESR1m) are important mechanisms of resistance to endocrine therapy in estrogen receptor-positive (ER+) metastatic breast cancer and have been studied as a potential therapeutic target, as well as a predictive and prognostic biomarker. Nonetheless, the role of ESR1m as a possible mechanism of primary endocrine resistance, as well as whether it also occurs in tumors that are resistant to ET administered in early-stage disease as (neo)adjuvant, has not been adequately studied. In this study, we evaluated the prevalence of ESR1m in tumor samples from patients with ER+ breast cancer resistant to neoadjuvant aromatase inhibitor therapy. Methods: We followed a prospective cohort of patients with ER+ HER2- stages II and III breast cancer treated with neoadjuvant endocrine therapy (NET). Tumor samples from patients with a pattern of primary endocrine resistance [defined as a Preoperative Endocrine Prognostic Index (PEPI) score of ≥4] were identified and analyzed for the presence of ESR1m. Results: One hundred twenty-seven patients were included in the cohort, of which 100 (79%) had completed NET and underwent surgery. Among these patients, the PEPI score ranged from 0 to 3 in 70% (70/100), whereas 30% (30/100) had a PEPI score of 4 or more. Twenty-three of these patients were included in the analysis. ESR1 mutations were not identified in any of the 23 patients with early-stage ER+ breast cancer resistant to NET. Discussion: Growing evidence supports the notion that there are different mechanisms for primary and secondary endocrine resistance. Our study suggests that ESR1 mutations do not evolve rapidly and do not represent a common mechanism of primary endocrine resistance in the neoadjuvant setting. Therefore, ESR1m should be considered a mechanism of acquired endocrine resistance in the context of advanced disease. Further research should be conducted to identify factors associated with intrinsic resistance to ET.

Health-related quality of life before and during chemotherapy in patients with early-stage breast cancer.

OBJECTIVES: Identify the main changes in the health-related quality of life (HRQoL) of women diagnosed with breast cancer (BC) undergoing chemotherapy. METHODS: Prospective cohort study that included 33 women diagnosed with clinical stages I-III BC and who underwent adjuvant chemotherapy. HRQoL was assessed using the EORTC QLQ-C30 and EORTC QLQ-BR23 instruments 1 week before the start of chemotherapy and during the third month of chemotherapy. RESULTS: There was a decline in the HRQoL scores of patients during treatment. Therefore, chemotherapy alters the patient's perceptions of their HRQoL since there is a decrease in global health status/quality of life (QoL) and functional scales such as physical functioning, role functioning, emotional functioning, social functioning, body image, sexual function and sexual enjoyment. We also observed an increase in side effects related to the systemic therapy, fatigue, nausea and vomiting, insomnia, appetite loss and diarrhoea, despite a decrease in breast symptoms and arm symptoms. CONCLUSIONS: HRQoL was negatively affected during chemotherapy. Even though HRQoL assessment is a useful method for optimising patients' care, its implementation into clinical practice remains a challenge. Since side effects are very often underestimated, we consider that the evaluation of HRQoL parameters should be done for BC patients treated with chemotherapy.

Qualidade de Vida Relacionada à Saúde de Pacientes com Câncer de Mama: Revisão Integrativa da Literatura / Health-Related Quality of Life of Breast Cancer Patients: Integrative Literature Review / Calidad de Vida Relacionada con la Salud de Pacientes con Cáncer de Mama: Revisión Integradora de la Literatura

Introdução: O câncer de mama pode alterar a qualidade de vida relacionada à saúde das pacientes. Objetivo: Compreender o impacto da quimioterapia para câncer de mama na qualidade de vida relacionada à saúde de pacientes. Método: Trata-se de uma revisão integrativa da literatura, compreendendo artigos publicados entre 2007 e 2019, disponíveis nas bases de dados PubMed, LILACS e SciELO. Analisaram-se 25 artigos na íntegra. Resultados: Os questionários mais frequentemente utilizados nos estudos foram o European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) e o módulo complementar European Organization for Research and Treatment of Cancer Breast Cancer-specific Quality of Life Questionnaire (EORTC QLQ-BR23). Em relação às alterações da qualidade de vida, a saúde global diminui durante a quimioterapia, mas pode melhorar após o término do tratamento. O aumento dos sintomas é relatado em diversos estudos e prejudicou a qualidade de vida relacionada à saúde das pacientes. Entretanto, os sintomas diminuem após o término da quimioterapia, exceto para algumas escalas. As escalas de imagem corporal, função sexual e funcionamento físico pioram ao longo do tratamento. A qualidade de vida mental/psicológica tem oscilações durante o tratamento, assim como a escala sobre as relações sociais. Conclusão: A qualidade de vida relacionada à saúde de mulheres com câncer de mama é afetada negativamente pelo tratamento quimioterápico, expressando maior impacto nas escalas de sintomas.

Introduction: Breast cancer can change the health-related quality of life of patients. Objective: To understand the impact of chemotherapy for breast cancer on the health-related quality of life of patients. Method:Integrative review of the literature, comprising articles published between 2007 and 2019, available in PubMed, LILACS and SciELO databases. It were analyzed 25 articles. Results: The questionnaires most frequently used in the studies were the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and the European Organization for Research and Treatment of Cancer Breast Cancer-specific Quality of Life Questionnaire (EORTC QLQ-BR23) complementary module. In relation to changes in the quality of life, the global health diminishes during chemotherapy, but may improve after the end of the treatment. The increase of the symptoms is reported in several studies and have impaired the patients' health-related quality of life. However, symptoms decrease after chemotherapy ends, except in some scales. Body image, sexual function and physical functioning scales get worse throughout the treatment. Mental/psychological quality of life has oscillations during treatment, as does the scale on social relationships. Conclusion: The health-related quality of life of women with breast cancer is negatively affected by chemotherapy treatment, causing major impact in the scales of symptoms.

Introducción: El cáncer de mama puede alterar la calidad de vida relacionada con la salud de las pacientes. Objetivo: Comprender el impacto de la quimioterapia para el cáncer de mama en la calidad de vida relacionado con la salud de los pacientes. Método: Es una revisión integradora de la literatura, que comprende artículos publicados entre 2007 y 2019, disponibles en las bases de datos PubMed, LILACS y SciELO. Se analizaron 25 artículos en su totalidad. Resultados: Los cuestionarios más utilizados fueron European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) y European Organization for Research and Treatment of Cancer Breast Cancer-specific Quality of Life Questionnaire (EORTC QLQ-BR23). Con respecto a los cambios en la calidad de vida, la salud general disminuye durante la quimioterapia, pero puede mejorar después del final del tratamiento. El aumento de los síntomas se informa en varios estudios y afecta la calidad de vida relacionado con la salud de los pacientes. Sin embargo, los síntomas disminuyen después de que termina la quimioterapia, excepto en algunas escalas. Las escalas de imagen corporal, la función sexual y la función física empeoran a lo largo del tratamiento. La calidad de vida mental/psicológica tiene oscilaciones durante el tratamiento, al igual que la escala en las relaciones sociales. Conclusión: La calidad de vida relacionada con la salud de las mujeres con cáncer de mama se ve afectada negativamente por el tratamiento quimioterapéutico, que expresa un mayor impacto en las escalas de los síntomas.

QUALITY OF LIFE IN BREAST CANCER: THE BENEFITS OF PET OWNERSHIP AND PARTICIPATION IN LEISURE ACTIVITIES / Qualidade de vida em câncer de mama: os benefícios da posse de animais de estimação e participação em atividades de lazer

Objective: To evaluate the benefits in the perception of quality of life (QoL) of women with breast cancer related with pet ownership and experiencing leisure activities. Method: Cross-sectional study comparing QoL among patients, by applying the WHOQOL-Bref questionnaire. The participants were 272 women diagnosed with breast cancer. Results: The pet owners (n=162) had better average of QoL in perceptions of global QoL (72.45 vs. 67.16; p=0.01), and in environmental (67.52 vs. 64.23; p=0.04) and psychological domains (70.29 vs. 66.44; p=0.03) when compared to non-pet owners. Moreover, the patients who reported having leisure activities (n= 214) had better average in perceptions of global QoL (72.43 vs. 62.50; p<0.001), and physical health domain (63.28 vs. 50.92; p<0.001), environmental (68.22 vs. 58.67; p<0.001), psychological (71.01 vs. 60.34; p<0.001) and social relationships (74.73 vs. 65.09; p<0.001) when compared to those who do not have leisure activities. Conclusion: Women with breast cancer who are owners of pets and patients who perform leisure activities had better levels of QoL.

Objetivo: Avaliar os benefícios na percepção de qualidade de vida (QV) de mulheres portadoras de câncer de mama relacionado à posse de animais de estimação e da vivência de atividade de lazer. Métodos: Estudo transversal comparando a QV entre as pacientes, mediante a aplicação do Questionário WHOQOL-Bref. Participaram da pesquisa 272 mulheres diagnosticadas com câncer de mama. Resultados: As pacientes tutoras de animais de estimação (n=162) obtiveram melhores médias de QV na percepção de QV global (72,45 vs. 67,16; p=0,01) e nos domínios meio ambiente (67,52 vs. 64,23; p=0,04) e psicológico (70,29 vs. 66,44; p=0,03) quando comparadas as não tutoras de animais de estimação (n=110). Ainda, aquelas que afirmaram realizar atividade de lazer (n=214) obtiveram melhores médias de QV na percepção de QV global (72,43 vs. 62,50; p<0,001) e nos domínios físico (63,28 vs. 50,92; p<0,001), meio ambiente (68,22 vs. 58,67; p<0,001), psicológico (71,01 vs. 60,34; p<0,001) e relações sociais (74,73 vs. 65,09; p<0,001) quando comparadas aquelas que não realizavam tal atividade (n=58). Conclusão: Pacientes com câncer de mama tutoras de animais de estimação e pacientes que realizam atividades de lazer tem melhores níveis de QV.

Atividade física e seus benefícios na qualidade de vida de mulheres com câncer de mama: um estudo transversal em Caxias do Sul ­ RS / Physical activity and its benefits in quality of life of women with breast cancer: a cross sectional study in Caxias do Sul - RS

A qualidade de vida (QV) de mulheres com câncer de mama pode sofrer muitas alterações, dessa forma, é essencial encontrar fatores que auxiliem na melhora da QV desses indivíduos. O objetivo deste estudo é avaliar o impacto da atividade física na QV das pacientes com câncer de mama e verificar se os domínios da QV diferem em função da frequência de atividade física semanal. Trata-se de um estudo transversal, cuja população constituiu-se de 272 mulheres portadoras de câncer de mama. A QV foi avaliada por meio do questionário WHOQOL-Bref e as demais variáveis foram respondidas em questionário desenvolvido à parte. As mulheres que realizavam atividade física de forma regular obtiveram melhores pontuações significativas na QV nos domínios global (74,5 vs 67,8; p=0,001), físico (66,0 vs 57,3; p=0,001), meio ambiente (69,5 vs 64,1; p=0,001) e psicológico (72,4 vs 66,4; p=0,001). Em relação à frequência de atividade física por semana, as melhores médias de atividade física foram encontradas na faixa de realização de atividade três vezes na semana nos domínios global (79,5; p=0,01), físico (68,2; p=0,03) e meio ambiente (74,3; p=0,002). Dessa maneira, pode-se inferir que a realização de atividade física de forma regular é benéfica para a QV de mulheres com câncer de mama.

Quality of life (QoL) of women with breast cancer can have many changes; thus, it is essential to find factors that help in improving the QoL of these individuals. The main objective of this study is to evaluate the impact of physical activity on QoL of patients with breast cancer, and verify that the domains of QoL differ depending on physical activity weekly frequency. This paper consists of a transversal study, whose population consisted of 272 women with breast cancer. The QoL has been assessed by the WHOQOL-Bref questionnaire and other variables have been answered on a questionnaire developed apart. Women who perform physical activity regularly had better scores on the QoL in significant global domains (74.5 vs 67.8; p = 0.001), physical (66.0 vs 57.3; p = 0.001), environment (69.5 vs 64.1; p = 0.001) and psychological (72.4 vs 66.4; p = 0.001). Regarding the frequency of physical activity per week, the best averages of physical activity have been found in the range of performing activity of three times a week in the global domain (79.5; p = 0.03), physical domain (68.2; p = 0.03) and environment domain (74.3; p = 0.002). Thus, it can be concluded that physical activity on a regular basis is beneficial to QoL of women with breast cancer.