Multivariate Curve Resolution Alternating Least Squares Analysis of In Vivo Skin Raman Spectra.

In recent years, Raman spectroscopy has been used to study biological tissues. However, the analysis of experimental Raman spectra is still challenging, since the Raman spectra of most biological tissue components overlap significantly and it is difficult to separate individual components. New methods of analysis are needed that would allow for the decomposition of Raman spectra into components and the evaluation of their contribution. The aim of our work is to study the possibilities of the multivariate curve resolution alternating least squares (MCR-ALS) method for the analysis of skin tissues in vivo. We investigated the Raman spectra of human skin recorded using a portable conventional Raman spectroscopy setup. The MCR-ALS analysis was performed for the Raman spectra of normal skin, keratosis, basal cell carcinoma, malignant melanoma, and pigmented nevus. We obtained spectral profiles corresponding to the contribution of the optical system and skin components: melanin, proteins, lipids, water, etc. The obtained results show that the multivariate curve resolution alternating least squares analysis can provide new information on the biochemical profiles of skin tissues. Such information may be used in medical diagnostics to analyze Raman spectra with a low signal-to-noise ratio, as well as in various fields of science and industry for preprocessing Raman spectra to remove parasitic components.

Combination of Optical Biopsy with Patient Data for Improvement of Skin Tumor Identification.

In this study, patient data were combined with Raman and autofluorescence spectral parameters for more accurate identification of skin tumors. The spectral and patient data of skin tumors were classified by projection on latent structures and discriminant analysis. The importance of patient risk factors was determined using statistical improvement of ROC AUCs when spectral parameters were combined with risk factors. Gender, age and tumor localization were found significant for classification of malignant versus benign neoplasms, resulting in improvement of ROC AUCs from 0.610 to 0.818 (p < 0.05). To distinguish melanoma versus pigmented skin tumors, the same factors significantly improved ROC AUCs from 0.709 to 0.810 (p < 0.05) when analyzed together according to the spectral data, but insignificantly (p > 0.05) when analyzed individually. For classification of melanoma versus seborrheic keratosis, no statistical improvement of ROC AUC was observed when the patient data were added to the spectral data. In all three classification models, additional risk factors such as occupational hazards, family history, sun exposure, size, and personal history did not statistically improve the ROC AUCs. In summary, combined analysis of spectral and patient data can be significant for certain diagnostic tasks: patient data demonstrated the distribution of skin tumor incidence in different demographic groups, whereas tumors within each group were distinguished using the spectral differences.

Patient blood management in oncology in the Russian Federation: Resolution to improve oncology care.

There is accumulating evidence that anemia and iron deficiency, thrombocytopenia, blood loss and coagulopathy are independent risk factors for adverse patient outcomes in oncology and other settings. Patient blood management (PBM) aims to address these factors by managing and preserving a patient's blood. PBM improves patient health, but also reduces resource utilization, including use of allogeneic blood components, which is another risk factor for adverse outcomes. Supported by the World Health Organization and endorsed in WHA63.12, PBM is recommended by an increasing number of health authorities and is about to become a new standard of care. In support of the Russian National Long-Term Oncology Strategy 2030 to improve quality of oncological care, and with support from the National Association of Specialists in PBM, the PBM Oncology Working Group of the Russian Federation was created. In July 2020, this Group met to discuss the rationale and need for PBM in Russian oncology care. The Group recommended to include PBM as an integral part of standard oncology treatment pathways and developed a national resolution as a call to action on this matter, which was adopted in August 2020. This article details the rationale behind the resolution, delineates the action required from facilitating stakeholders (government; healthcare providers; educational facilities; research entities/institutions; funders; patient representatives/advocates), and proposes a roadmap for implementation. The generation of local health-economic and outcome data and the development of educational programs will be important in the implementation of PBM to help alleviate the health, social and economic burden of cancer.

Single-Center Experience of Surgical Treatment of Primary Retroperitoneal Tumors.

This study is an evaluation of surgical treatment results of primary retroperitoneal tumors. In Samara Regional Clinical Oncology Dispensary, from 2008 to 2015, the treatment of 187 patients (53 men and 134 women) was conducted. One hundred fifteen patients got tumor removal within the healthy tissue (R0), and 61 patients went through complete resection of tumor with wide margins (R0). Complete resection of tumor with wide margins (R0) with preoperative tumor vessel embolization was performed in 11 patients. According to the histological examination, malignant retroperitoneal tumor was detected in 85 patients (48.4%); in most cases it was presented by various forms of sarcoma. A benign tumor was diagnosed in 71 patients (40.3%), fibrolipomas (17.1%), and neurofibromas (12.5%). The diagnosis of 20 patients needs subsequent clarification, as mesenchymal tumor (6.2%) and histiocytoma (5.1%) were diagnosed. Short-term results of surgical treatment for the group, where complete resection of tumor with wide margins was performed: intraoperative blood loss 410.91 + - 113.31(ml), operation time 185.15 + -32.49(min); postoperative complications 10 (16,4%); mortality 3 (4,9%); LOS 23,14 ± 6,31; for removal of the tumor within healthy tissues: intraoperative blood loss 281.33 + -110.94 (ml), operation time 58.33 + -27.14(min) postoperative complications 7 (6,08%); mortality 2 (1,74%); LOS 6,98 ± 4,83; (t = 279, p = 0,015). For patients who went through preoperative tumor feeding vessel embolization, intraoperative blood loss was 121.33 ± 27.94 (ml), time of operation 43.13 ± 16.11 (min), postoperative complication 1 (4.5%), mortality 0 (0%), and length of stay 12.72 ± 1.49. After the complete resection of tumor with wide margins, intraoperative blood loss, operation time, the number of postoperative complications, and postoperative LOS were significantly greater in comparison with the group of patients where the tumor was removed within healthy tissues. The method of preoperative embolization of the tumor feeding vessels can reduce intraoperative blood loss, the time of operation, and the number of postoperative complications.

The Results of the Combine Treatment of Patients with Liver Bilobar Metastases from Colorectal Cancer Using Radiofrequency Ablation.

Colorectal cancer (CRC) is the third most common cancer worldwide. The mortality from CRC remains very high. The main cause of such a high mortality is a disseminate process with the appearance of distant metastases. In this regard, the treatment of metastatic lesions is recognized as an important trend in modern oncology. The program of study included 176 patients with colorectal cancer after primary tumor removal with the malignant progression-multiple (more than 4) bilobar liver metastases. The research was organized in Samara Regional Oncology Centre from 2001 to 2014. By the treatment method, patients were divided into two groups. Main group got the combined (chemotherapy + radiofrequency ablation (RFA)) treatment (n = 98). In control group, only chemotherapy was applied (n = 78). One-, two-, and three-year OS were 73.5, 25.1, and 7.2% in the main group and 39.6, 6.3, and 2.1% in the control group. The RFA application allowed us to reach the index of 4-year survival 1.8% in the main group, while we received only 2.1 of 3-year survival in the control group. The OS median reached 18 months in the main group and 11 months in the control group. So, the OS curves in two comparing groups were significantly different according to statistics (log-rank test 3.77, р = 0.000). The application of RFA in combination with chemotherapy in the treatment of bilobar metastasis colorectal cancer allows to improve the performance of disease-free survival and overall survival significantly, compared with the group of patients who received only chemotherapy.