Imaging-Based Prevalence of Oligometastatic Disease: A Single-Center Cross-Sectional Study.

PURPOSE: Oligometastatic disease refers to a distinct state in patients with cancer characterized by a low metastatic burden, with diagnosis being informed by a limited number of distant metastases in radiologic imaging. However, oligometastasis remains poorly understood in terms of its biology and prevalence in the metastatic cascade. In the absence of clinically viable molecular biomarkers, this study examined the prevalence of oligometastasis using oncological imaging. METHODS AND MATERIALS: This study is based on all consecutive [fluorine-18]-fluorodeoxyglucose (FDG)- and [gallium-68]-prostate specific membrane antigen (PSMA)-positron emission tomography (PET) scans conducted at our cancer center between January and December 2020. We identified and analyzed all PET scans from patients with a maximum of 5 distant metastases from a solid malignancy and also reviewed concurrent cranial magnetic resonance imaging (cMRI) imaging in all candidate patients. Data on the number and sites of metastases were extracted from the imaging reports and verified on imaging studies in case of uncertainties. RESULTS: In total, 7000 PET scans were analyzed, of which 1155 were performed in unique metastatic patients, and 637 patients showed extracranial oligometastatic disease (55%). Concurrent cMRI scans were available for 20% (130/637) of extracranial oligometastatic patients, 36 of which proved to be polymetastatic after combined PET and cMRI analysis. Prevalence of oligometastatic disease was influenced by primary tumor histology and was most frequent in pancreatic, liver and gallbladder cancers (59%), but was least frequent in cancer of unknown primary (26%). In 72% of oligometastatic cases, only 1 or 2 metastases were detected. Bone/soft tissue metastases were the most common sites of distant metastasis (41%). About 75% of patients had metachronous oligometastatic disease. CONCLUSIONS: Our analysis suggests that about half of patients with metastatic cancer are characterized by a limited tumor burden detectable on PET and cMRI imaging. This finding warrants intensified research efforts to better understand the biology of oligometastatic disease and to optimize multidisciplinary treatment strategies.

Toward Data-Driven Radiation Oncology Using Standardized Terminology as a Starting Point: Cross-sectional Study.

BACKGROUND: The inability to seamlessly exchange information across radiation therapy ecosystems is a limiting factor in the pursuit of data-driven clinical practice. The implementation of semantic interoperability is a prerequisite for achieving the full capacity of the latest developments in personalized and precision medicine, such as mathematical modeling, advanced algorithmic information processing, and artificial intelligence approaches. OBJECTIVE: This study aims to evaluate the state of terminology resources (TRs) dedicated to radiation oncology as a prerequisite for an oncology semantic ecosystem. The goal of this cross-sectional analysis is to quantify the state of the art in radiation therapy specific terminology. METHODS: The Unified Medical Language System (UMLS) was searched for the following terms: radio oncology, radiation oncology, radiation therapy, and radiotherapy. We extracted 6509 unique concepts for further analysis. We conducted a quantitative analysis of available source vocabularies (SVs) and analyzed all UMLS SVs according to the route source, number, author, location of authors, license type, the lexical density of TR, and semantic types. Descriptive data are presented as numbers and percentages. RESULTS: The concepts were distributed across 35 SVs. The median number of unique concepts per SV was 5 (range 1-5479), with 14% (5/35) of SVs containing 94.59% (6157/6509) of the concepts. The SVs were created by 29 authors, predominantly legal entities registered in the United States (25/35, 71%), followed by international organizations (6/35, 17%), legal entities registered in Australia (2/35, 6%), and the Netherlands and the United Kingdom with 3% (1/35) of authors each. Of the total 35 SVs, 16 (46%) did not have any restrictions on use, whereas for 19 (54%) of SVs, some level of restriction was required. Overall, 57% (20/35) of SVs were updated within the last 5 years. All concepts found within radiation therapy SVs were labeled with one of the 29 semantic types represented within UMLS. After removing the stop words, the total number of words for all SVs together was 56,219, with a median of 25 unique words per SV (range 3-50,682). The total number of unique words in all SVs was 1048, with a median of 19 unique words per vocabulary (range 3-406). The lexical density for all concepts within all SVs was 0 (0.02 rounded to 2 decimals). Median lexical density per unique SV was 0.7 (range 0.0-1.0). There were no dedicated radiation therapy SVs. CONCLUSIONS: We did not identify any dedicated TRs for radiation oncology. Current terminologies are not sufficient to cover the need of modern radiation oncology practice and research. To achieve a sufficient level of interoperability, of the creation of a new, standardized, universally accepted TR dedicated to modern radiation therapy is required.

Breast cancer care in northern Ethiopia - cross-sectional analysis.

BACKGROUND: In Ethiopia, the incidence of new cases of breast cancer is currently increasing resulting to high rates of morbidity and mortality. Breast cancer is by far the most common cancer accounting for more than one out of three cancer cases in women and one out of every five in the general population. The study was conducted in University of Gondar Hospital cancer center, located in the North-West Ethiopia; to evaluate the clino-pathologic characteristics of breast cancer and care provided for patients. METHODS: All biopsy proven breast cancer patients treated between 2016 and 2017, were identified and information regarding histology, stage, therapeutic procedure and follow up was retrospectively collected from their individual medical records and descriptive analysis was done. RESULTS: Among 82 patients treated, 67 (82%) were women and 15 (18%) were men. The median age at the time of diagnosis was 45 years (25-82 years). Operation was performed for 56 (68%) patients. The predominant histology was ductal carcinoma in 61 patients (74%), followed by breast carcinoma of No Special Type (NST) in 17 (21%). The late presentation of the patients and the advanced stage at the time of presentation was observed in most of the patients. Chemotherapy was administered in 79 (96%) patients. Radiotherapy was not available in the hospital. CONCLUSION: Breast cancer incidence is rising and becoming a major public health problem in Northern Ethiopia. Breast cancer care in northern-Ethiopia is limited in terms of both pathology, imaging and the offered treatment modalities, which need to be improved.