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1.
Zhonghua Zhong Liu Za Zhi ; 42(3): 222-227, 2020 Mar 23.
Artículo en Chino | MEDLINE | ID: mdl-32252201

RESUMEN

Objective: To analyze the risk factors related to lung cancer in participants with low-dose computed tomography (LDCT) screening, to provide data support for identifying high-risk groups of lung cancer and to improve the effectiveness of LDCT lung cancer screening. Methods: A total of 5 366 asymptomatic subjects (2 762 males and 2 604 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The result of LDCT and the risk factors of participants were analyzed. The LDCT positive results were defined as solid or part-solid nodules≥5 mm and non-solid nodule≥8 mm. A total of 12 factors were included and multivariate logistic regression was used to analyze the risk factors associated with lung cancer in the study. Results: Of the 5 366 asymptomatic subjects, 389 were positive and 4 977 were negative for LDCT screening. Among them, 26 of 389 positive cases were confirmed as lung cancers pathologically, and the detection rate of stage I lung cancer was 92.3% (24/26). Multivariate logistic regression showed that age, smoking, low level of education were the relevant risk factors for lung cancer and positive nodules. A stratified analysis of age showed that no risk factors were detected in the 40-49 years old group, while age, smoking, low level of education (primary school and below) were recognized as risk factors in the ≥50 years old group. No statistically significant risk factor was detected between the lung cancer group and the positive nodules group. Conclusions: Age, smoking, and low level of education (primary school and below) are related risk factors for lung cancer and positive nodules. People aged 50 years or older, smoking, and low level of education may be a high risk group for lung cancer. LDCT can effectively detect early lung cancer.


Asunto(s)
Detección Precoz del Cáncer/métodos , Neoplasias Pulmonares/diagnóstico por imagen , Tamizaje Masivo , Tomografía Computarizada por Rayos X/métodos , Adulto , China/epidemiología , Femenino , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Factores de Riesgo , Sensibilidad y Especificidad , Fumar/efectos adversos
2.
Medicine (Baltimore) ; 99(14): e19565, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32243374

RESUMEN

Findings on the association between cotton dust exposure and lung cancer risk in epidemiologic studies have been inconsistent. Therefore, we conducted a meta-analysis of data from observational studies to quantify this association.PubMed, EMBASE, and the Cochrane library databases were searched for observational studies with data on cotton dust exposure and lung cancer risk. Studies that reported adjusted relative risks (RRs) with 95% confidence intervals (CIs) of lung cancer associated with cotton dust exposure were included. Subgroup analyses were conducted according to key characteristics.Fifteen studies involving a total of 73,812 individuals were included in the meta-analysis. Combining estimates from all the 15 observational studies, cotton dust exposure was associated with a decreased risk of lung cancer (combined RR, 0.78; 95% CI, 0.66-0.91; P = .002). Pooled estimates of multivariate RRs by gender were 0.71 (95% CI, 0.58-0.88; P = .001) among males, based on 7 studies, and 0.77 (95% CI, 0.67-0.89; P < .001) among females, based on 9 studies. Further analyses examining the influence of a single study on the results by omitting a study at each turn yielded a range of RR from 0.74 to 0.82.Our meta-analysis indicates that cotton dust exposure is associated with a decreased risk of lung cancer.


Asunto(s)
Fibra de Algodón/análisis , Polvo/análisis , Neoplasias Pulmonares/epidemiología , Exposición Profesional/análisis , Industria Textil , Factores de Edad , Humanos , Estudios Observacionales como Asunto , Factores de Riesgo , Factores Sexuales
3.
Cent Eur J Public Health ; 28(1): 59-64, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32228819

RESUMEN

OBJECTIVE: The aim of the study was to analyze indicators on lung cancer (C33-C34, ICD-10) in Split-Dalmatia County in the period 2003-2012. METHODS: Data on lung cancer occurrence for the period 2003-2012 were obtained from the Croatian National Cancer Registry, while mortality data were obtained from electronic database of the Teaching Public Health Institute of Split-Dalmatia County. Croatian census 2011 and population estimates of the Central Bureau of Statistics of the Republic of Croatia were used to calculate the indicators. Results are presented as absolute numbers, shares (%), specific rates per 100,000 population, age-standardized rate (standard European population). RESULTS: There were 2,804 registered patients with lung cancer in the period 2003-2012 in Split-Dalmatia County - 2,179 men (77.71%) and 625 women (22.29%); 2,737 people died from lung cancer in the same period - 2,117 men (77.35%) and 620 women (22.65%). Specific rates of incidence and mortality rates were four times higher among men than among women. From 2003 to 2012, the rate of incidence among men showed a significant decrease, while among women there were no significant changes of incidence and mortality. CONCLUSIONS: According to the indicators of incidence and mortality of lung cancer in Split-Dalmatia County, this malignant neoplasm should occupy a high place within County public health priorities measures of prevention programme, targeting risk factors responsible for their formation.


Asunto(s)
Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/mortalidad , Croacia/epidemiología , Bases de Datos Factuales , Femenino , Humanos , Incidencia , Masculino , Sistema de Registros
4.
Anticancer Res ; 40(4): 2065-2072, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32234898

RESUMEN

BACKGROUND/AIM: The aim of this multi-center retrospective study was to investigate the results of stereotactic body radiotherapy (SBRT) for pulmonary oligometastases from esophageal cancer. PATIENTS AND METHODS: Oligometastases from the esophagus were identified from a dataset of a Japanese survey. The Kaplan-Meier method and Cox regression were applied to perform analyses. RESULTS: A total of 114 patients with 132 pulmonary oligometastases were collected. The 3-year local control rate, freedom from further metastasis (FFFM) rate and overall survival (OS) rate were 70.2%, 25.3% and 37.5%, respectively. Performance status (PS) (PS 1 vs. PS 0, p<0.01), disease-free interval (p=0.03) and history of local therapy for metastasis (p=0.01) had significant relationships with FFFM and only PS was an independent prognostic factor for OS (PS 1 vs. PS 0, p=0.02; PS 2-3 vs. PS 0, p=0.04). CONCLUSION: SBRT for pulmonary oligometastases from esophageal cancer provided good local control and survival.


Asunto(s)
Neoplasias Esofágicas/radioterapia , Neoplasias Pulmonares/radioterapia , Radiocirugia , Adulto , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Neoplasias Esofágicas/epidemiología , Neoplasias Esofágicas/patología , Femenino , Humanos , Estimación de Kaplan-Meier , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Modelos de Riesgos Proporcionales
5.
J Surg Oncol ; 121(6): 927-935, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32124433

RESUMEN

BACKGROUND: The objective of the current study was to define and compare rates of textbook outcomes (TO) among patients undergoing colorectal, lung, esophagus, liver, and pancreatic surgery for cancer at U.S. News & World Report (USNWR) ranked hospitals. METHODS: Medicare Inpatient Standard Analytic Files 2013-2015 were utilized to examine the relationship of TO and USNWR hospital ratings following surgery for colorectal, lung, esophageal, pancreatic, and liver cancer. TO was defined as no postoperative surgical complications, no prolonged length of hospital stay, no readmission within 90 days after discharge, and no postoperative mortality within 90 days after surgery. RESULTS: Among the 35,352 Medicare patients included in the cohort, 16,820 (47.6%) underwent surgery at honor roll hospitals, whereas 18 532 (52.4%) underwent surgery at non-honor roll hospitals. The overall proportion of patients who achieved TO was 50.1%. In examining the clinical outcomes of patients who underwent surgery, there was no difference in the odds of achieving TO at honor roll vs non-honor roll hospitals (colorectal: odds ratio [OR], 0.87; 95% confidence interval [CI], 0.69-1.10; lung: OR, 1.07; 95% CI, 0.87-1.32; esophagus: OR, 1.44; 95% CI, 0.72-2.89; liver: OR, 1.27; 95% CI, 0.87-1.84; pancreas: OR, 1.04; 95% CI, 0.67-1.62). CONCLUSION AND RELEVANCE: Patients undergoing surgery for lung, esophageal, liver, pancreatic, and colorectal cancer had comparable rates of TO at honor roll vs non-honor roll hospitals. No linear association was observed between hospital position in the rank and postoperative outcomes such as TO indicating that patients should not overly focus on the exact position within USNWR ranked hospitals. These data highlight to patients and physicians that up to one-half of patients undergoing surgery for cancer should anticipate at least one adverse outcome.


Asunto(s)
Neoplasias del Sistema Digestivo/cirugía , Hospitales/normas , Neoplasias Pulmonares/cirugía , Oncología Quirúrgica/normas , Anciano , Neoplasias del Sistema Digestivo/epidemiología , Femenino , Humanos , Neoplasias Pulmonares/epidemiología , Masculino , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Oncología Quirúrgica/métodos , Oncología Quirúrgica/estadística & datos numéricos , Resultado del Tratamiento , Estados Unidos/epidemiología
6.
Medicine (Baltimore) ; 99(11): e19533, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176106

RESUMEN

We investigated the prognosis of patients with dry pleural dissemination (DPD) of non-small cell lung cancer (NSCLC) and the risk factors of developing to malignant pleural effusion (MPE).We retrospectively reviewed 104 patients with NSCLC and DPD, confirmed surgically from 1996 to 2016. Incidence rate and risk factors of MPE were analyzed statistically. The prognosis of NSCLC patients with MPE was evaluated using the Kaplan-Meier method.The most common histologic type was adenocarcinoma in 95 (91.3%) patients. The median follow-up duration was 65.5 months and the median survival time was 37.7 months. MPE developed in 51 (49%) patients, and the median effusion-free interval was 41.9 months. The median survival time of the patients with and without MPE was not different (41.3 vs 31.7 months, P = .16). No predictive factors for the development of MPE were identified. Fifteen (14.4%) patients underwent invasive procedures for the management of MPE.Almost half of all patients with NSCLC and DPD experienced MPE, and 14.4% patients developed symptomatic MPE requiring invasive procedures. MPE in DPD did not affect the survival in NSCLC patients.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/epidemiología , Neoplasias Pulmonares/epidemiología , Derrame Pleural Maligno/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/etiología , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Femenino , Humanos , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Derrame Pleural Maligno/etiología , Derrame Pleural Maligno/mortalidad , Pronóstico , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Análisis de Supervivencia
8.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(2): 120-125, 2020 Feb 12.
Artículo en Chino | MEDLINE | ID: mdl-32062881

RESUMEN

Objective: To study the prevalence of c-ros oncogene 1 fusion in lung adenocarcinoma and to evaluate its relationship with clinical characteristics. Methods: We retrospectively analyzed epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ROS1) fusion in 1 482 patients with adenocarcinoma from March 2014 to January 2017 in the first affiliated hospital of Zhejiang University. Furthermore, ROS1 fusion positive patients diagnosed between February 2017 and December 2017 were also included in ROS1 positive group. The data of age, sex, smoking history, TNM stage and chest computed tomography were collected by Electronic Medical Record (EMR). The clinical data were compared by the chi-squared test or Mann-Whitney test. Results: Of these 1 482 patients,54 cases were diagnosed with ROS1 rearrangement, including 19 males and 35 females, while 73 cases were diagnosed with ALK rearrangement, including 28 males and 45 females, and 679 cases diagnosed with EGFR mutation including 293 males and 386 females. And there were 676 patients without driven genes mutation. The mean age in ROS1 fusion group (54±12) was lower than EGFR mutation group (60±11, z=-3.982, P<0.001) and WT group (62±10, z=-4.944, P<0.001). Female proportion in ROS1 fusion group (64.8%, 35/54) was higher than WT group (28.4%, 192/676, χ(2)=30.94, P<0.001). Non-smoker percentages in ROS1 fusion group (72.2%, 39/54) was significantly higher than WT group (38.0%,257/676, χ(2)=24.27, P<0.001). ROS1 fusion group was similar to ALK fusion group in sex, age and smoking history, and there were no significant difference in TNM stage among these groups. On chest CT, adenocarcinomas with ROS1 fusion were found to be more peripheral in location (71.4%, 20/28) and solid in density (75%, 21/28), usually with lobulated margins (75.0%, 21/28) and spiculated in contour (57.1%,16/28). Conclusion: In our study lung adenocarcinoma with c-ROS oncogene 1 fusion was a rare subtype lung cancer and was usually detected in young, never smoking, and female patients.


Asunto(s)
Adenocarcinoma del Pulmón/diagnóstico , Quinasa de Linfoma Anaplásico/genética , Receptores ErbB/genética , Neoplasias Pulmonares/diagnóstico , Proteínas Tirosina Quinasas/genética , Proteínas Proto-Oncogénicas/genética , Proteínas Tirosina Quinasas Receptoras/genética , Adenocarcinoma del Pulmón/epidemiología , Adenocarcinoma del Pulmón/genética , Adulto , Anciano , Quinasa de Linfoma Anaplásico/metabolismo , China/epidemiología , Femenino , Fusión Génica/genética , Genes erbB-1 , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/genética , Masculino , Persona de Mediana Edad , Mutación/genética , Proteínas de Fusión Oncogénica , Prevalencia , Proteínas Tirosina Quinasas/metabolismo , Proteínas Proto-Oncogénicas/metabolismo , Especies Reactivas de Oxígeno , Estudios Retrospectivos
9.
Bull Cancer ; 107(3): 308-321, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32035648

RESUMEN

INTRODUCTION: Health care utilization of people with lung cancer (LC) the last year of life, their causes of death and place of death and the associated expenditure have been poorly described together. Then we conducted an observational study. METHODS: People with LC covered by the French health Insurance general scheme (77% of the population) who died in 2015 were identified in the national health data system, together with their health care utilization and, in 95% of cases, their causes of death. RESULTS: A total of 22,899 individuals were included (mean age: 68 years, SD±11.4), 72% of whom died in short-stay hospitals (SSH), 4% in hospital-at-home, 8% in Rehab hospital, 2% in skilled nursing homes and 14% at home. One-half of these people had also a chronic respiratory tract disease and 18% another cancer. Hospital palliative care (HPC) was identified for 65% of people, but for only 9% prior to their end-of-life stay. During the last month of life, 49% of people had two or more SSH stays, 15% were admitted to an intensive care unit, 23% received a chemotherapy session (13% during the last 14 days). The main cause of death was cancer for 92% of individuals (LC for 82%) The mean expenditure during the last year of life was €43,329 per individual. DISCUSSION: This study indicates high rates of intensive care unit admissions and chemotherapy during the last month of life and a SSH hospital-centered management with intensive use of HPC mainly during the end-of-life stay.


Asunto(s)
Gastos en Salud , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Neoplasias Pulmonares/economía , Neoplasias Pulmonares/terapia , Anciano , Anciano de 80 o más Años , Causas de Muerte , Comorbilidad , Cuidados Críticos/economía , Cuidados Críticos/estadística & datos numéricos , Quimioterapia/economía , Quimioterapia/estadística & datos numéricos , Femenino , Francia/epidemiología , Mortalidad Hospitalaria , Humanos , Cobertura del Seguro/estadística & datos numéricos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Cuidados Paliativos/estadística & datos numéricos , Características de la Residencia , Cuidado Terminal/estadística & datos numéricos , Factores de Tiempo
10.
J Cancer Res Clin Oncol ; 146(5): 1299-1306, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32107626

RESUMEN

BACKGROUND: The aim of this study was to verify the predictors of recurrence and survival in lung adenocarcinoma patients with experiences of breast cancer therapies. METHODS: We retrospectively reviewed consecutive patients who were treated at our hospital for lung adenocarcinoma from 2004/01 to 2014/03. The patients were divided into groups of those with lung adenocarcinoma alone and those with lung and breast cancer. Kaplan-Meier plots and log-rank tests were used to estimate outcomes. RESULTS: 54 patients with lung adenocarcinoma and breast cancer were compared with 457 patients with single primary lung adenocarcinomas. After propensity score matching with control of age, operation type, smoking status and pathologic stage, tumor differentiation, recurrence rate and tumor size were significantly different between two groups. The significant predictors for recurrence included undergone chemotherapy (HR = 25, p < 0.001), moderate/poor differentiation (HR = 8.125, p = 0.012), tumor size ≧ 2 cm (HR = 15, p < 0.001), LVSI (HR = 13.67, p = 0.031) and GGO ratio < 50% (HR = 14.667, p = 0.014). The significant prognostic factors for survival were accepted chemotherapy (HR = 6.182, p = 0.021), LVSI (HR = 22, p = 0.012) and GGO ratio < 50% (HR = 9.143, p = 0.045). Kaplan-Meier analysis revealed that patients with lung adenocarcinoma and breast cancer had a better 5-year disease-free survival (p = 0.009), while the Her2-negative patients obtained a better overall survival (p = 0.038). CONCLUSIONS: In patients with breast cancer and lung adenocarcinoma, independent risk factors of recurrence were undergone chemotherapy, moderate/poor differentiation, tumor size ≧ 2 cm, LVSI and GGO ratio < 50%. Only undergone chemotherapy, LVSI and GGO ratio < 50% were significant poor predictors for survival. However, patients with metachronous lung adenocarcinoma and breast cancer had better disease-free survival and less tumor recurrence than patients with lung adenocarcinoma alone.


Asunto(s)
Adenocarcinoma del Pulmón/diagnóstico , Neoplasias de la Mama/diagnóstico , Neoplasias Pulmonares/diagnóstico , Recurrencia Local de Neoplasia/diagnóstico , Neoplasias Primarias Secundarias/diagnóstico , Adenocarcinoma del Pulmón/epidemiología , Adenocarcinoma del Pulmón/metabolismo , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/metabolismo , Femenino , Humanos , Estimación de Kaplan-Meier , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/metabolismo , Recurrencia Local de Neoplasia/epidemiología , Recurrencia Local de Neoplasia/metabolismo , Neoplasias Primarias Secundarias/epidemiología , Pronóstico , Puntaje de Propensión , Receptor ErbB-2/metabolismo , Sistema de Registros , Estudios Retrospectivos , Riesgo , Taiwán/epidemiología
11.
BMC Public Health ; 20(1): 210, 2020 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-32046683

RESUMEN

BACKGROUND: Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situations. METHODS: We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables affect interventions net benefit. RESULTS: A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention. CONCLUSIONS: This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.


Asunto(s)
Industria de la Construcción , Exposición Profesional/prevención & control , Salud Laboral/economía , Dióxido de Silicio/efectos adversos , Análisis Costo-Beneficio/métodos , Humanos , Neoplasias Pulmonares/economía , Neoplasias Pulmonares/epidemiología , Exposición Profesional/efectos adversos , Equipo de Protección Personal/economía , Probabilidad , Ventilación/economía
12.
PLoS One ; 15(2): e0229090, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32059049

RESUMEN

BACKGROUND: Smoking is widely recognized as one of the most prevalent and preventable causes of many cancer types. This study aimed to quantify the population attributable fraction (PAF) of the lung cancer burden for smoking in Mongolia. METHODS: Lung cancer incidence and lung cancer-related death data came from the population-based national registry covering the period 2007-2016. Smoking prevalence data came from the STEPwise approach (STEP) national survey. The lung cancer-related disease burden was calculated and expressed in Disability Adjusted Life Years (DALYs) lost by gender and by year. This was combined with current smoking and former smoking prevalence data, and relative risks (RR) of lung cancer-related deaths for current smokers and former smokers versus never smokers from region-specific cohort studies to estimate the PAF of lung cancer attributable to "ever-smoking" in Mongolia. RESULTS: Between 2007 and 2016, lung cancer accounted for the loss of over 63,000 DALYs in Mongolia. The PAF of lung cancer-related deaths attributable to current and former smoking combined was 58.1% (95% IR = 43.1%-72.2%) for men and 8.9% (95% IR = 4.1% -13.5%) for women. Smoking-attributable DALYs loss amounted to 2589 years (95% IR = 1907-3226) in 2016. CONCLUSIONS: A considerable health loss may be prevented with an effective anti-smoking policy. In Mongolia, more than one third of lung cancer-related DALY loss is attributable to active smoking, and thus is potentially preventable. Furthermore, a gender-specific tobacco control policy may be worthwhile because of the large gender difference in smoking exposure in Mongolia. Next to this, age specific policy, including a smoke-free generation policy for adolescents, with targeted education, and mass media campaigns is needed.


Asunto(s)
Costo de Enfermedad , Personas con Discapacidad/estadística & datos numéricos , Neoplasias Pulmonares/epidemiología , Fumar Tabaco/efectos adversos , Adolescente , Adulto , Anciano , Causas de Muerte , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Esperanza de Vida , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/prevención & control , Masculino , Persona de Mediana Edad , Mongolia/epidemiología , Prevalencia , Años de Vida Ajustados por Calidad de Vida , Sistema de Registros/estadística & datos numéricos , Medición de Riesgo , Factores Sexuales , Fumar Tabaco/epidemiología , Adulto Joven
14.
Arch. bronconeumol. (Ed. impr.) ; 56(1): 23-27, ene. 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-186462

RESUMEN

Introducción: El objetivo del estudio es evaluar las modificaciones del riesgo de mortalidad y morbilidad cardiorrespiratoria calculada mediante los modelos de riesgo Eurolung 1 y 2 en los últimos 20 años para identificar variaciones en la selección de los pacientes o en la práctica quirúrgica que hayan conducido a cambios en el riesgo de muerte y complicaciones tras resecciones anatómicas pulmonares. Método: Análisis retrospectivo de una serie de 2435 casos consecutivos sometidos a resección pulmonar anatómica. La población fue dividida en tres períodos de tiempo: 1994-2006 (976 casos), 2007-2015 (945 casos) y 2016-2017 (420 casos). Se aplicaron los modelos Eurolung 1 y 2 a la serie y se calculó la probabilidad individual de efectos adversos. Se comparó dicha probabilidad media, así como la prevalencia o las medias de cada una de las variables que constituyen los modelos en cada período y se representó gráficamente la evolución del riesgo. Resultados: Se observó un descenso progresivo de ambos efectos adversos a lo largo del tiempo. La prevalencia de las variables binarias, excepto enfermedad coronaria, fue mayor en el último período. El porcentaje de neumonectomías y de resecciones ampliadas descendió en los dos últimos períodos y el número de casos abordados por VATS se incrementó considerablemente en 2016-2017. Conclusiones: El descenso del número de neumonectomías y el incremento de la tasa de procedimientos mínimamente invasivos se consideran las variables más relacionadas con la disminución del riesgo. Otros cambios en las características clínicas de los pacientes no parecen haber influido en los resultados


Introduction: The aim of this study is to evaluate changes in the risk of cardiorespiratory mortality and morbidity calculated by Eurolung risk models 1 and 2 in the last 20 years, and to identify variations in patient selection or surgical practice that might have altered the risk of death and complications after anatomical lung resections. Method: This was a retrospective analysis of a series of 2,435 consecutive patients who underwent anatomical lung resection. The population was divided into three time periods: 1994-2006 (976 cases), 2007-2015 (945 cases), and 2016-2017 (420 cases). Eurolung models 1 and 2 were applied to the series, and the individual probability of adverse effects was calculated. We compared this mean probability, and the prevalence or means of each of the variables included in the models in each period and plotted the evolution of the risk. Results: A progressive decrease was observed in both adverse effects over time. The prevalence of the binary variables, except for coronary heart disease, was higher in the last period. The percentage of pneumonectomies and extended resections fell in the last two periods and the number of cases treated with VATS increased substantially in 2016-2017. Conclusions: The decline in the number of pneumonectomies and the increase in the rate of minimally invasive procedures appear to be the variables most closely associated with decreased risk. Other changes in the clinical characteristics of the patients do not seem to have influenced the outcomes


Asunto(s)
Humanos , Gestión de Riesgos , Medición de Riesgo/métodos , Neoplasias Pulmonares/epidemiología , Neumonectomía/métodos , Complicaciones Posoperatorias/etiología , Factores de Riesgo , Indicadores de Morbimortalidad , Estudios Retrospectivos , Paro Cardíaco/terapia , Complicaciones Posoperatorias/mortalidad
15.
N Z Med J ; 133(1508): 43-64, 2020 01 17.
Artículo en Inglés | MEDLINE | ID: mdl-31945042

RESUMEN

Maori are more likely than non-Maori to get cancer, and once they have cancer they are less likely to survive it. One frequently proposed explanation for this survival disparity is differences between these groups in terms of stage at diagnosis-whereby Maori may be less likely to be diagnosed at an earlier stage, when treatment is more feasible and outcomes are better for the patient. However, this simple explanation ignores the true complexity of the issue of stage at diagnosis as a driver of survival disparities, and makes critical assumptions about the quality of available staging data. In this manuscript we draw on New Zealand Cancer Registry and available clinical audit data to explore this issue in detail. We found that Maori are less likely than European/Other patients to have localised disease and more likely to have advanced disease for several commonly diagnosed cancers; however, we also found that this was not the case for several key cancers, including lung and liver cancer. There is evidence that Maori have more advanced disease at diagnosis for each of the cancers for which we currently have a national screening programme, reinforcing the importance of achieving equity in access to these programmes. Missing stage information on our national registry undermines our ability to both a) monitor progress towards achieving early diagnosis, and b) examine and monitor the role of stage at diagnosis as a driver of survival disparities for several important cancers for Maori, including lung, liver and stomach cancers.


Asunto(s)
Neoplasias Hepáticas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias/diagnóstico , Neoplasias/etnología , Detección Precoz del Cáncer/métodos , Grupos Étnicos , Femenino , Disparidades en Atención de Salud , Humanos , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/etnología , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/etnología , Masculino , Tamizaje Masivo/métodos , Estadificación de Neoplasias/estadística & datos numéricos , Neoplasias/epidemiología , Neoplasias/patología , Nueva Zelanda/etnología , Grupo de Ascendencia Oceánica/etnología , Sistema de Registros , Análisis de Supervivencia
16.
N Engl J Med ; 382(6): 503-513, 2020 02 06.
Artículo en Inglés | MEDLINE | ID: mdl-31995683

RESUMEN

BACKGROUND: There are limited data from randomized trials regarding whether volume-based, low-dose computed tomographic (CT) screening can reduce lung-cancer mortality among male former and current smokers. METHODS: A total of 13,195 men (primary analysis) and 2594 women (subgroup analyses) between the ages of 50 and 74 were randomly assigned to undergo CT screening at T0 (baseline), year 1, year 3, and year 5.5 or no screening. We obtained data on cancer diagnosis and the date and cause of death through linkages with national registries in the Netherlands and Belgium, and a review committee confirmed lung cancer as the cause of death when possible. A minimum follow-up of 10 years until December 31, 2015, was completed for all participants. RESULTS: Among men, the average adherence to CT screening was 90.0%. On average, 9.2% of the screened participants underwent at least one additional CT scan (initially indeterminate). The overall referral rate for suspicious nodules was 2.1%. At 10 years of follow-up, the incidence of lung cancer was 5.58 cases per 1000 person-years in the screening group and 4.91 cases per 1000 person-years in the control group; lung-cancer mortality was 2.50 deaths per 1000 person-years and 3.30 deaths per 1000 person-years, respectively. The cumulative rate ratio for death from lung cancer at 10 years was 0.76 (95% confidence interval [CI], 0.61 to 0.94; P = 0.01) in the screening group as compared with the control group, similar to the values at years 8 and 9. Among women, the rate ratio was 0.67 (95% CI, 0.38 to 1.14) at 10 years of follow-up, with values of 0.41 to 0.52 in years 7 through 9. CONCLUSIONS: In this trial involving high-risk persons, lung-cancer mortality was significantly lower among those who underwent volume CT screening than among those who underwent no screening. There were low rates of follow-up procedures for results suggestive of lung cancer. (Funded by the Netherlands Organization of Health Research and Development and others; NELSON Netherlands Trial Register number, NL580.).


Asunto(s)
Tomografía Computarizada de Haz Cónico , Detección Precoz del Cáncer/métodos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/mortalidad , Anciano , Bélgica/epidemiología , Reacciones Falso Positivas , Femenino , Humanos , Incidencia , Neoplasias Pulmonares/epidemiología , Masculino , Uso Excesivo de los Servicios de Salud , Persona de Mediana Edad , Países Bajos/epidemiología , Sistema de Registros , Factores Sexuales , Fumar/epidemiología
17.
Cancer Causes Control ; 31(2): 153-159, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31894492

RESUMEN

PURPOSE: Survival benefits could be potentially improved by adding cardiorespiratory fitness (CRF) to lung cancer screening. The current pilot study aimed to assess the association between CRF and adverse outcomes in current male smokers who are meeting the American Cancer Society (ACS) criteria for lung cancer screening. METHODS: A total of 260 men with a baseline CRF assessment (treadmill exercise test) who are met the ACS lung cancer screening criteria ("current smokers aged 55-74 years with ≥ 30 pack/years smoking history") were prospectively studied. Cox proportional hazard models were analyzed for all-cause and cancer mortality, total and lung cancer incidence. RESULTS: Mean age was 63.3 ± 5.4 years, smoking history 50.4 ± 26.7 pack/years, and CRF was 7.8 ± 3.2 metabolic equivalents (METs). During a mean of 10.2 ± 6.1 years follow-up, 80 participants developed any type of cancer, 19 were diagnosed with lung cancer and 66 died (cancer, n = 39, other causes, n = 27). In multivariable models, only CRF was associated with all-cause and cancer mortality. Each 1-MET higher CRF was associated with a 10% reduced risk for all-cause mortality [0.9, 95% CI (0.83 to 0.98), p = 0.017] and cancer mortality [0.9, 95% CI (0.8 to 0.99), p = 0.048]. CRF was not associated with total cancer incidence (p = 0.59) or lung cancer incidence (p = 0.96). CONCLUSION: Higher CRF is independently associated with lower risk of all-cause and cancer mortality in current male smokers who meet the ACS criteria for lung cancer screening. Screening for CRF and achieving higher CRF levels could potentially reduce mortality and serve as complementary preventive strategy in heavy smokers.


Asunto(s)
Capacidad Cardiovascular , Detección Precoz del Cáncer , Neoplasias Pulmonares/diagnóstico , Fumadores , Anciano , American Cancer Society , Prueba de Esfuerzo , Humanos , Incidencia , Neoplasias Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Proyectos Piloto , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Conducta de Reducción del Riesgo , Fumar/epidemiología
18.
Gene ; 731: 144357, 2020 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-31935503

RESUMEN

BACKGROUND: Genome-wide association studies (GWAS) have identified 5p15.33 as a susceptible locus for lung cancer. However, for non-small cell lung cancer (NSCLC), low-frequency risk variants in this region have not been systematically studied. We intended to explore the associations between low-frequency variants on 5p15.33 and NSCLC using a next-generation sequencing based approach in this study. METHODS: We have acquisited the variation spectrum of 400 NSCLC patients on 5p15.33 by sequencing the targeted region before. Candidate variants were primarily selected by restricting the minor allele frequency (MAF 1-5%) and then by comparing their frequency in 400 NSCLC patients with 1008 East Asians from The genome Aggregation Database (gnomAD). The associations between candidate variants and NSCLC were discovered and replicated in two case-control sets: discovery stage with 960 cases and 916 controls, and replication stage with 1596 cases and 1614 controls in total. RESULTS: Five low-frequency variants were selected as our candidates and subsequent association analyses showed that 2 polymorphisms were significantly associated with risk of NSCLC, including rs33963617 (OR = 0.63, 95% CI: 0.53-0.76, P = 3.80 × 10-7) in TERT and rs77518573 (OR = 0.73, 95% CI: 0.63-0.84, P = 2.00 × 10-5) in upstream of CLPTM1L. When stratified by histologic subtype, a significant association was only investigated in adenocarcinoma for rs77518573. We also observed an obvious cumulative effect of the two significant variants. CONCLUSIONS: We newly identified two NSCLC related variants on chromosome 5p15.33. Both TERT-rs33963617 and CLPTM1L-rs77518573 conferred reduced risk for NSCLC in Chinese Han population.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/genética , Neoplasias Pulmonares/genética , Proteínas de la Membrana/genética , Proteínas de Neoplasias/genética , Polimorfismo de Nucleótido Simple , Telomerasa/genética , Anciano , Grupo de Ascendencia Continental Asiática/genética , Carcinoma de Pulmón de Células no Pequeñas/epidemiología , Estudios de Casos y Controles , China/epidemiología , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Humanos , Neoplasias Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo
19.
J Surg Res ; 246: 325-334, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-30737098

RESUMEN

BACKGROUND: Mutant KRAS tumors are purported to metastasize differently than wild-type KRAS tumors. The biological heterogeneity of tumors from different parts of the colon are also reported to affect metastasis. This study aims to characterize the metastatic profile by evaluating these factors in unison. METHODS: Retrospective analysis of 899 patients with metastatic colorectal cancers treated from January 2010 to December 2014 was conducted. KRAS mutation status and primary tumors location were correlated with single-site metastasis (liver, lung, and peritoneum) and dual-site metastases (liver-peritoneum, liver-lung, and lung-peritoneum). Patients without KRAS analyses were excluded. RESULTS: Right-sided tumors had highest frequency of peritoneal metastasis as compared to left-sided or rectal tumors (34.7% versus 15.8% versus 8.8%, P = 0.00) regardless of KRAS status (32.6% versus 38.5%, P = 0.62). Left-sided tumors with wild-type KRAS had greater proportion of liver metastasis (78.6% versus 53.5%, P = 0.00), whereas those with mutant KRAS had greater proportion of lung metastasis (23.3% versus 8.7%, P = 0.02). Rectal tumors with wild-type KRAS tend to spread to the liver (81.4% versus 48.0%, P = 0.00) and not to the peritoneum (2.3% versus 20.0%, P = 0.01). In dual-site metastases, left-sided tumors with wild-type KRAS had more liver-peritoneal metastases (75.0% versus 29.4%, P = 0.00), whereas mutant KRAS had greater lung-liver metastases (64.7% versus 20.8%, P = 0.01). Rectal tumors had the predilection for lung-liver metastases as compared to right-sided and left-sided tumors (92.3% versus 40.0% versus 39.0%, P = 0.00) regardless of KRAS status (100% versus 75%, P = 0.12). CONCLUSIONS: Our results may streamline surveillance programs based on primary tumor location and KRAS mutational status.


Asunto(s)
Neoplasias Colorrectales/patología , Neoplasias Hepáticas/epidemiología , Neoplasias Pulmonares/epidemiología , Neoplasias Peritoneales/epidemiología , Proteínas Proto-Oncogénicas p21(ras)/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Neoplasias Colorrectales/genética , Femenino , Humanos , Incidencia , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/secundario , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/secundario , Masculino , Persona de Mediana Edad , Mutación , Neoplasias Peritoneales/genética , Neoplasias Peritoneales/secundario , Estudios Retrospectivos , Adulto Joven
20.
Int J Cancer ; 146(5): 1261-1267, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-31125113

RESUMEN

Free thiol groups of intra and extracellular molecules are considered to be antioxidative and to protect cells from damage caused by free radicals. However, the associations of serum total thiol levels (TTL) with the incidences of the four most frequent cancer sites have not yet been investigated in a large population-based, prospective study. TTL was measured in case-cohort design in a sample from the population-based, Norwegian Tromsø 3 study (cancer cases: n = 941; random subcohort: n = 1,000) and was repeatedly measured at Tromsø 5. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated by weighted multivariable-adjusted Cox regression with time-dependent modeling of TTL for incident lung, colorectal, breast and prostate cancer. High serum TTL were associated with a reduced risk of all four major cancers. The associations with lung (top vs. bottom tertile: HR, 0.64; 95% CI, 0.41, 0.99) and breast cancer (top vs. bottom tertile: HR, 0.64; 95% CI, 0.42, 0.96) were statistically significant, whereas associations with colorectal (top vs. bottom tertile: HR, 0.79; 95% CI, 0.54, 1.16) and prostate cancer (top vs. bottom tertile: HR, 0.79; 95% CI, 0.53, 1.17) were not statistically significant but pointed in the same protective direction. These findings from a large, prospective Norwegian cohort study suggest a preventive role of thiols against the development of the four most frequent cancers. Whereas associations with breast and lung cancer could be shown with statistical significance, larger studies are needed to corroborate potential associations of TTL with colorectal and prostate cancer.


Asunto(s)
Neoplasias/sangre , Compuestos de Sulfhidrilo/sangre , Adulto , Anciano , Neoplasias de la Mama/sangre , Neoplasias de la Mama/epidemiología , Estudios de Cohortes , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/epidemiología , Femenino , Humanos , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/epidemiología , Masculino , Persona de Mediana Edad , Neoplasias/epidemiología , Noruega/epidemiología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/epidemiología , Riesgo , Adulto Joven
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