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1.
Anticancer Res ; 40(1): 491-499, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892604

RESUMO

This article is a narrative review of recent epidemiological findings regarding ultraviolet-B (UVB) dose or exposure, serum 25-hydroxyvitamin D [25(OH)D] concentrations, vitamin D supplementation, and genetic variations in 25(OH)D concentration for incidence, survival, and mortality rates of overall and breast, colorectal, and prostate cancer. According to ecological studies, solar UVB doses are inversely correlated with incidence/mortality rates for about 20 cancer types. Observational studies support a role of higher 25(OH)D concentrations in reducing risk of breast and colorectal cancer incidence and mortality rates but, for prostate cancer, in increasing incidence rates while reducing mortality rates. Mendelian randomization studies offer little support for vitamin D in reducing cancer risk. Their primary limitation is that they only investigate small variations in genetically predicted 25(OH)D concentration near the population mean value. The secondary analyses from the VITAL clinical trial indicated significant reductions from 2000 IU/d of vitamin D3 supplementation in all-cancer incidence and mortality rates for selected subgroups. Thus, Hill's criteria for causality in a biological system are now largely satisfied for supporting the claim that vitamin D reduces the risk of cancer incidence and death.


Assuntos
Neoplasias/epidemiologia , Vitamina D/metabolismo , Suplementos Nutricionais , Humanos , Neoplasias/sangue , Neoplasias/mortalidade , Estudos Observacionais como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Vitamina D/sangue
2.
Wien Med Wochenschr ; 169(15-16): 387-393, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31728785

RESUMO

The original English version of the palliative performance scale (PPS) has been used for two decades to describe the functional status of palliative patients. Based on clinical parameters PPS helps to estimate the survival time of palliative patients: the higher the functional status the longer the survival. This is interesting for patients, their family caregivers and health care professionals in order to plan for care. Until now there has not been published an official German version of the PPS.The functional status via a German version of the PPS of 394 patients of a palliative consulting team and their survival times were analyzed. Kaplan-Meier-curves were drawn and tested for differences. The hypothesis was tested if functional status using the German version of the PPS and survival are correlated. In this population differences in survival could clearly be shown for any category of PPS.This German version of the PPS is a useful and possible tool to estimate survival time of palliative patients using just clinical information.


Assuntos
Neoplasias , Cuidados Paliativos , Sobreviventes de Câncer/estatística & dados numéricos , Cuidadores , Humanos , Neoplasias/mortalidade , Cuidados Paliativos/estatística & dados numéricos , Prognóstico , Análise de Sobrevida
3.
J Surg Oncol ; 120(8): 1327-1334, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31680251

RESUMO

BACKGROUND: Despite the popularity of the U.S. News and World Report (USNWR) hospital rankings among the general public, the relationship between hospital rankings and actual patient outcomes for major cancers remains poorly investigated. METHODS: Medicare Inpatient Standard Analytic Files were queried from 2013-2015 to assess the relationship of postoperative outcomes and Medicare expenditures among patients undergoing surgery for colorectal, lung, esophageal, pancreatic, and liver cancer at hospitals ranked in the top-50 USNWR vs hospitals ranked below 50. RESULTS: Among 94 599 patients, 13 217 vs 81 382 patients underwent surgery at a top-50 hospital versus a non-top 50 ranked hospital. Other than among patients who underwent colorectal surgery, the odds of postoperative complications were lower at top ranked vs non-top ranked hospitals (colorectal: OR, 1.46, 95% CI, 1.28-1.65; lung: OR, 0.73, 95% CI, 0.61-0.87; esophagus: OR, 0.70, 95% CI, 0.52-0.94; pancreas: OR, 0.81, 95% CI, 0.70-0.94; liver: OR, 0.85, 95% CI, 0.69-1.04). Moreover, the odds of 90-day mortality were lower at top ranked hospitals vs non-top ranked hospitals (colorectal: OR, 0.59, 95% CI, 0.48-74; lung: OR, 0.66, 95% CI, 0.53-0.82; esophagus: OR, 0.56, 95% CI, 0.40-0.80; pancreas: OR, 0.51, 95% CI, 0.40-0.65; liver: OR, 0.61, 95% CI, 0.44-0.84). Outcomes were comparable among hospitals within the top-50 rank. CONCLUSION: Mortality rates were lower at hospitals in the top-50 USNWR versus non-top ranked, yet hospitals within the top-50 USNWR rankings had comparable outcomes.


Assuntos
Hospitais/estatística & dados numéricos , Neoplasias/mortalidade , Neoplasias/cirurgia , Idoso , Idoso de 80 Anos ou mais , Falha da Terapia de Resgate/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Readmissão do Paciente/estatística & dados numéricos , Publicações Periódicas como Assunto , Complicações Pós-Operatórias/epidemiologia , Estados Unidos/epidemiologia
4.
BMJ ; 367: l5584, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619383

RESUMO

OBJECTIVE: To investigate the association between weight changes across adulthood and mortality. DESIGN: Prospective cohort study. SETTING: US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014. PARTICIPANTS: 36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline). MAIN OUTCOME MEASURES: All cause and cause specific mortality from baseline until 31 December 2015. RESULTS: During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality. CONCLUSIONS: Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.


Assuntos
Doenças Cardiovasculares , Causas de Morte , Mortalidade Prematura/tendências , Mortalidade/tendências , Neoplasias , Ganho de Peso , Perda de Peso , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/mortalidade , Inquéritos Nutricionais , Obesidade/diagnóstico , Obesidade/mortalidade , Estudos Prospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Razão Cintura-Estatura
5.
Medicine (Baltimore) ; 98(39): e17180, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574824

RESUMO

BACKGROUND: ATPase family, AAA+ domain containing 2 (ATAD2) is also known as AAA+ nuclear coregulator cancer-associated protein or PRO2000. ATAD2 has been reported as a prognostic factor in different cancer types, but the association between ATAD2 high expression and survival is still unclear. Thereby, this meta-analysis was performed to evaluate the prognostic value of ATAD2 high expression in human cancers. METHODS: All of the studies included were retrieved from PubMed, EMBASE, and Cochrane Library electronic databases. The clinical outcomes were evaluated by calculating hazard ratio (HR) with their 95% confidence interval (CI). RESULTS: Thirteen studies including 2689 patients were eligible for this analysis. The pooled results showed that ATAD2 over-expression was significantly associated with shorter overall survival (OS) (HR = 2.32, 95% CI = 1.77-3.02), as well as shorter recurrence-free survival (RFS), disease-free survival (DFS), and disease-specific survival (DSS) (HR = 1.83, 95% CI = 1.51-2.23) among human cancers. Subgroup analyses for OS were implemented in terms of region, tumor type, and sample size and the results were coincident with overall pooled results. Begg funnel plot and Egger test showed the presence of publication bias for OS. Sensitivity analysis indicated that both results were not affected for removing any study. CONCLUSION: ATAD2 would be likely to act as a prognostic biomarker for the patients of different cancer types and provide a guide on clinical treatment. Prospective clinical studies are needed to support these findings.


Assuntos
ATPases Associadas a Diversas Atividades Celulares/análise , Adenosina Trifosfatases/análise , Proteínas de Ligação a DNA/análise , Neoplasias/enzimologia , Neoplasias/mortalidade , Intervalo Livre de Doença , Humanos , Prognóstico , Modelos de Riscos Proporcionais
6.
Medicine (Baltimore) ; 98(40): e17346, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577729

RESUMO

BACKGROUND: Kinesin family member C1 (KIFC1), a C-type kinesin motor protein, plays important roles in centrosome assembly and intracellular transport. Numerous studies have focused on the prognostic value of KIFC1 in malignant tumors and the relationship between KIFC1 expression and clinicopathological traits of cancer patients, but the studies remain controversial. And no meta-analysis has yet shown the association between KIFC1 and various cancers. METHODS: Systematic retrieval was carried out within several databases, including PubMed, Embase, Web of Science, Wanfang and China National Knowledge Infrastructure (CNKI). In addition, hazard ratios (HR) and relative risks (RR) with 95% confidence intervals (CIs) were calculated to examine the risk or hazard correlation by Stata SE15.1. RESULTS: Eleven studies with the overall 2424 participants were included in this research. High KIFC1 expression was remarkably correlated with worse OS (HR = 1.33, 95% CI = 1.07-1.60) and poorer relapse-free survival (HR = 2.28, 95% CI = 1.75-2.80). In subgroup analysis, high KIFC1 expression was a negative predictor for OS in patients with ovarian cancer (P < .001), breast cancer (P < .001), hepatocellular carcinoma (P < .001), and non-small cell lung cancer (P < .001), but not for esophageal squamous cell carcinoma (P = .246). Moreover, high levels of KIFC1 were related with positive lymph node metastasis (RR = 1.23, 95% CI = 1.01-1.50, P = .041) and advanced tumor node metastasis (TNM) stage (RR = 1.55, 95% CI = 1.27-1.89, P < .001). CONCLUSIONS: KIFC1 overexpression indicates poor prognosis and more serious clinicopathological characteristics in kinds of malignancies. Thus, we conclude that KIFC1 could be a target for clinical diagnosis and treatment of various cancers.


Assuntos
Cinesina/biossíntese , Neoplasias/mortalidade , Neoplasias/patologia , Biomarcadores Tumorais , Humanos , Metástase Linfática , Prognóstico , Análise de Sobrevida
7.
Medicine (Baltimore) ; 98(40): e17439, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577764

RESUMO

BACKGROUND: Speckle-type POZ protein (SPOP) has recently been reported as a prognostic tumor biomarker. However, the predictive value of SPOP remains controversial in human cancers. The current meta-analysis was performed to obtain a comprehensive evaluation of the relationship between SPOP expression and prognosis of cancer patients. METHODS: Embase, Pubmed, Web of Science, and Chinese Biomedical Literature database were systematically searched up to January 2, 2019. The pooled hazard ratios (HRs) and/or pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to quantitatively assess the relationship of SPOP expression with prognosis and lymph node metastasis (LNM). RESULTS: A total of 9 studies with 928 patients were included in this meta-analysis. The results showed that low SPOP expression was significantly related to poor overall survival (high/low: HR = 0.55; 95% CI: 0.38-0.79, P = .001), especially for digestive system cancers (high/low: HR = 0.46; 95% CI: 0.27-0.78, P = .003). However, SPOP expression did not affect progression-free survival in cancer patients (high/low: HR = 2.07; 95% CI: 0.16-26.70, P = .578). Additionally, the association between SPOP overexpression and LNM was positive in patients with clear cell renal cell carcinoma (ccRCC) (OR = 5.26; 95% CI: 1.66-16.68, P = .005) but negative in cancer patients without ccRCC (OR = 0.36; 95% CI: 0.21-0.62, P < .001). CONCLUSION: Decreased SPOP expression could predict poor prognosis of cancer patients, suggesting that SPOP protein may be a useful prognostic biomarker in cancer patients.


Assuntos
Metástase Linfática/diagnóstico , Neoplasias/diagnóstico , Neoplasias/metabolismo , Proteínas Nucleares/metabolismo , Proteínas Repressoras/metabolismo , Humanos , Neoplasias/mortalidade , Valor Preditivo dos Testes , Prognóstico
9.
Medicine (Baltimore) ; 98(43): e17432, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651846

RESUMO

BACKGROUND: Several studies have explored the prognostic value of stanniocalcin 2 (STC2) in various cancers, but obtained inconsistent results. Therefore, this meta-analysis was performed to determine the prognostic and clinicopathologic significance of STC2 in various cancers. METHODS: Eligible studies were identified by searching the online databases PubMed, Embase, Web of Science, and the China National Knowledge Infrastructure up to March 2019. Hazard ratios (HRs) with 95% confidence intervals (CIs) and were calculated to clarify the correlation between STC2 expression and prognosis of different cancers. Odds ratios (ORs) with 95% CI were selected to appraise the correlation between STC2 with clinicopathologic characteristics of patients with cancer. RESULTS: A total of 16 eligible studies with 4074 patients with cancer were included in our meta-analysis. The results showed that high STC2 expression can predict poor overall survival (OS) for cancer (HR = 1.48, 95% CI: 1.15-1.90, P = .002). Subgroup analysis found that high STC2 expression was associated with worse OS in Asian (HR = 1.85, 95% CI: 1.35-2.55), the reported directly from articles group (HR = 1.39, 95% CI: 1.05-1.84), survival curves group (HR = 1.93, 95% CI: 1.36-2.74), and gastric cancer (HR = 1.43, 95% CI: 1.04-1.95). Furthermore, high STC2 expression was significantly related to advanced T stage (OR = 1.83, 95% CI: 1.17-2.86, P = .008), lymph node metastasis (OR = 2.29, 95% CI: 1.51-3.45, P < .001), lymphatic invasion (OR = 2.15, 95% CI: 1.53-3.02, P < .001), venous invasion (OR = 1.97, 95% CI: 1.30-2.99, P = .001), and more advanced clinical stage (OR = 2.36, 95% CI: 1.74-3.19, P < .001) CONCLUSION:: Elevated expression of STC2 suggested a poor prognosis in patients with cancer and may serve as a new tumor marker to monitor cancer development and progression.


Assuntos
Glicoproteínas/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Neoplasias/sangue , Neoplasias/mortalidade , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/genética , Biomarcadores Tumorais/sangue , Feminino , Humanos , Metástase Linfática/genética , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/genética , Estadiamento de Neoplasias , Neoplasias/patologia , Razão de Chances , Valor Preditivo dos Testes , Prognóstico , Modelos de Riscos Proporcionais , Neoplasias Gástricas/sangue , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia
10.
Br J Anaesth ; 123(5): 655-663, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31558315

RESUMO

BACKGROUND: The Korean National Health Insurance Service (NHIS) was developed to provide population data for medical research. The aim of this study was to estimate trends in prescription opioid use in South Korea, and to determine the association between chronic opioid use and 5-yr mortality in cancer and non-cancer patients. METHODS: A population-based cohort study was conducted amongst the South Korean adult population using data from the NHIS. Those prescribed a continuous supply of opioids for ≥90 days were defined as chronic opioid users. Multivariable Cox regression analysis was used to assess the association between chronic opioid use and 5-yr mortality. RESULTS: The proportion of chronic weak opioid users increased from 1.03% in 2002 to 9.62% in 2015. The proportion of chronic strong opioid users increased from 0.04% in 2002 to 0.24% in 2015. In the 2010 cohort (n=822 214), compared with non-users, chronic weak opioid users had a significantly lower 5-yr mortality (hazard ratio [HR]: 0.93; 95% confidence interval [CI]: 0.89-0.96; P<0.001), and chronic strong opioid users had a significantly higher 5-yr mortality (HR: 1.45; 95% CI: 1.28-1.63; P<0.001). Similar results were observed in non-cancer patients, but chronic weak opioid users were not significantly associated with 5-yr mortality in cancer patients (P=0.063). CONCLUSIONS: In South Korea, chronic opioid use has increased since 2002. Chronic strong opioid use was associated with a higher 5-yr mortality, and chronic weak opioid use was associated with a slightly lower 5-yr mortality. However, the findings regarding chronic weak opioid users should be interpreted carefully because there might be residual confounders in this study. Further study is needed to confirm these retrospective findings.


Assuntos
Analgésicos Opioides/administração & dosagem , Dor Crônica/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor Crônica/mortalidade , Estudos de Coortes , Relação Dose-Resposta a Droga , Esquema de Medicação , Prescrições de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Neoplasias/mortalidade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores Socioeconômicos
11.
Tumour Biol ; 41(9): 1010428319873749, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31496424

RESUMO

Differentiation therapy is directed to the self-renewing cancer stem cells, as well as their progeny transit amplifying cells, to force them to mature to terminal differentiation. Differentiation therapy is effective in treatment of neuroblastomas and myeloid leukemias. Checkpoint inhibition therapy removes blocks to cancer reactive T-killer cells and allows them to react to malignant cells and limit the growth of cancer. The percentage of patients with a given cancer that responds to either therapy is less than hoped for, and the duration of response is variable. Multiplying the response rate (percentage of patients responding to therapy) by the duration of response may be used to derive a survival score for patients treated with differentiation therapy or checkpoint inhibition. By this criterion, differentiation therapy gives better survival scores than checkpoint inhibition. Yet, checkpoint inhibition is considered a great success, mostly because it may be applied to many different types of cancer, and differentiation therapy is considered relatively ineffective because it is limited to a few specific cancers. On the other hand, the cost of checkpoint inhibition treatment is 10-20 times more per patient than that of differentiation therapy. Hopefully, future combined treatments and advances in both approaches will increase the effectiveness of these cancer treatments.


Assuntos
Antineoplásicos/uso terapêutico , Sobreviventes de Câncer/estatística & dados numéricos , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Neoplasias/mortalidade , Células-Tronco Neoplásicas/efeitos dos fármacos , Linfócitos T/efeitos dos fármacos , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/patologia , Prognóstico , Taxa de Sobrevida
12.
Medicine (Baltimore) ; 98(37): e17019, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517821

RESUMO

The role of cytokines in the systemic inflammatory response (SIR) is now well established. This is in keeping with the role of the SIR in tumorigenesis, malignant spread, and the development of cachexia. However, the relationship between performance status/systemic inflammation frameworks and cytokine profiles is not clear. The aim of the present study was to examine the relationship between the Eastern cooperative oncology group performance status/modified Glasgow prognostic score (ECOG-PS/mGPS) and cooperative oncology group performance status/neutrophil platelet score (ECOG-PS/NPS) frameworks and their cytokine profile in patients with advanced cancer.This was a retrospective interrogation of data already collected as part of a recent clinical trial (NCT00676936). The relationship between the independent variables (ECOG-PS/mGPS and ECOG-PS/NPS frameworks), and dependent variables (cytokine levels) was examined using independent Mann-Whitney U and Kruskal Wallis tests where appropriate.Of the 40 patients included in final analysis the majority had evidence of an SIR assessed by mGPS (78%) or NPS (53%). All patients died on follow-up and the median survival was 91 days (4-933 days). With increasing ECOG-PS there was a higher median value of Interleukin 6 (IL-6, P = .016) and C-reactive protein (CRP, P < .01) and lower albumin (P < .01) and poorer survival (P < .001). With increasing mGPS there was a higher median value of IL-6 (P = .016), Macrophage migration inhibitory factor (MIF, P = .010), erythrocyte sedimentation rate (ESR, P < .01) and poorer survival (P < .01). With increasing NPS there was a higher median value of TGF-ß (P < .001) and C-reactive protein (P = .020) and poor survival (P = .001). When those patients with an ECOG-PS 0/1 and mGPS0 were compared with those patients with an ECOG-PS 2 and mGPS2 there was a higher median value of IL-6 (P = .017) and poorer survival (P < .001). When those patients with an ECOG-PS 0/1 and NPS0 were compared with those patients with an ECOG-PS 2 and NPS1/2 there was a higher median value of IL-6 (P = .002), TGF-ß (P < .001) and poorer survival (P < .01).In patients with advanced cancer IL-6 was associated with the ECOG-PS/mGPS and ECOG-PS/NPS frameworks and survival in patients with advanced cancer. Therefore, the present work provides supporting evidence that agents targeting IL-6 are worthy of further exploration.


Assuntos
Citocinas/imunologia , Inflamação/imunologia , Neoplasias/imunologia , Idoso , Biomarcadores/metabolismo , Feminino , Seguimentos , Humanos , Inflamação/diagnóstico , Inflamação/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/mortalidade , Neoplasias/terapia , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise de Sobrevida
13.
Anticancer Res ; 39(9): 4597-4602, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519556

RESUMO

Our previous review of the literature assessed the existing knowledge (until 2000) about the possible link between angiotensin-converting enzyme inhibitors (ACEIs) and factors influencing the development of malignancies. We reviewed the literature for reports of statistical associations (or lack thereof) between ACEi treatment and incidence of specific cancers (e.g. breast, gastrointestinal, and skin). We concluded then that results from the epidemiological studies are conflicting, even taking the different methodology and endpoints into consideration, and thus inconclusive. Further investigation is needed beyond the observation period of most of these studies, and additional experimental studies are needed also to study the mechanisms by which agents blocking the renin-angiotensin system may obtain their inhibitory effect on tumor growth and metastasis. The present review elaborates further with more recent evidence from numerous human clinical studies from the past two decades (including large epidemiological studies, and long-term prospective and retrospective studies) on a protective association between ACEi treatment and the prognosis of patients with specific cancer types, malignancy characteristics or stage. Moreover, treatment with ACEI/angiotensin receptor blockers represents an adjuvant therapy with synergistic effects to chemotherapy and may improve patient outcomes (i.e. progression-free survival, and prolonged overall survival) in different types of cancers.


Assuntos
Neoplasias/metabolismo , Neoplasias/mortalidade , Sistema Renina-Angiotensina/efeitos dos fármacos , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Animais , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Estudos Clínicos como Assunto , Modelos Animais de Doenças , Progressão da Doença , Humanos , Estadiamento de Neoplasias , Neoplasias/diagnóstico , Neoplasias/etiologia , Prognóstico , Resultado do Tratamento
14.
Anticancer Res ; 39(9): 4687-4698, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519568

RESUMO

BACKGROUND/AIM: Propagermanium (PG) inhibits the CCL2/CCR2 axis, and has been shown to function as an immune modulator. This study investigated its anti-tumor mechanism in patients with refractory cancers. MATERIALS AND METHODS: Five healthy volunteers and 23 patients with refractory oral (n=8) or gastric (n=15) cancer received PG (30 mg/day). We performed flow cytometry (FCM) of peripheral blood mononuclear cells and in vitro killing assays. RESULTS: FCM revealed that CD16+/CD56Dim NK cells (i.e., mature, cytolytic subset) increased, and the apoptosis induction rate of cancer cells increased after PG administration. Among gastric cancer patients, median OS was 172.0 days. Two patients showed complete remission of lung or liver metastasis. Survival of patients with oral cancer also tended to be prolonged. CONCLUSION: PG induces NK cell maturation, and may potentiate anti-tumor activity.


Assuntos
Antineoplásicos/farmacologia , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/imunologia , Células Matadoras Naturais/efeitos dos fármacos , Células Matadoras Naturais/imunologia , Neoplasias/imunologia , Neoplasias/mortalidade , Compostos Organometálicos/farmacologia , Linhagem Celular Tumoral , Resistencia a Medicamentos Antineoplásicos , Humanos , Estimativa de Kaplan-Meier , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Subpopulações de Linfócitos/imunologia , Subpopulações de Linfócitos/metabolismo , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Tomografia Computadorizada por Raios X
15.
Adv Gerontol ; 32(3): 301-310, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31512414

RESUMO

Every year more than 600 000 (617 177 in 2017 year) of new cases of malignant neoplasms (cancer) and more than 290 000 (290 622 in 2017 year) of death are registered in Russia. Cancer is on the second place among all causes of death (15,9% - 2017 year) followed cardiovascular morbidity (48,8% - 2017 year), while in a number of economically developed countries the cancer treatment has reached a new level. About 20-25% of the population of Russia suffer from this disease. Malignant neoplasms are common noncommunicable diseases strongly associated with the age structure of the population. More than 70% (72,5%) of the diseased and about 80% (79,07%) of those who died in Russia were registered at pensionable age. Census data for the period since 1960 until now has shown, that the proportion of persons of retirement age has doubled, what certainly influenced the morbidity rate and number of deaths from malignant neoplasms. The population-based cancer registries, established in 1990s of XX century, contributed to improving the reliability of summarized data from the country's oncological service. It had become possible to conduct in-depth epidemiological studies of the malignant tumors prevalence. The dynamics of age-specific rates of mortality in Russia from cancer is overlooked in this paper, taking into account sex, age and leading localization of tumors. The specificity of the dynamics of the structure of oncopathology for men and women of different age groups is presented as well. The established patterns of the reduce mortality in Russia in standardized indices over a long period demonstrate the real success of the anti-cancer means.


Assuntos
Neoplasias , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Mortalidade , Neoplasias/epidemiologia , Neoplasias/mortalidade , Reprodutibilidade dos Testes , Federação Russa/epidemiologia
16.
Artigo em Japonês | MEDLINE | ID: mdl-31534066

RESUMO

OBJECTIVES: The purpose of this study was to confirm the association of the status of implementation of nonsmoking at eating and drinking establishments with the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses, and mortality rate using prefectural data. METHODS: The prefectural rate of eating and drinking establishments implementing nonsmoking (hereafter, nonsmoking rate) was calculated using the data from "Tabelog®". The variables of interest were the prevalence of persons with subjective symptoms, the prevalence of persons with diseases under treatment, medical expenses (total, hospitalization and nonhospitalization expenses), and the mortality rates of malignant neoplasms (lung cancer, stomach cancer, and colon cancer), heart disease, acute myocardial infarction, cerebrovascular disease, cerebral infarction, and pneumonia in each prefecture. The partial correlation coefficient was estimated between the nonsmoking rate and the variable of interest using the smoking rate by prefectural as the control variable. RESULTS: The nonsmoking rate showed a significantly negative correlation with the medical expenses. When eating and drinking establishments were divided into "restaurant", "café", and "bar", the nonsmoking rate also indicated a significantly negative correlation with the medical expenses in any category. It was negatively related to the mortality rates of cerebrovascular disease, cerebral infarction, and pneumonia. The negative correlation was stronger in females than in males. CONCLUSIONS: These results suggest that the implementation of nonsmoking at eating and drinking establishments may reduce the mortality rates of diseases, such as cerebrovascular disease, cerebral infarction, and pneumonia, and medical expenses. Thus, it is important to implement nonsmoking at eating and drinking establishments in line with the Revised Health Promotion Act.


Assuntos
Transtornos Cerebrovasculares/mortalidade , Gastos em Saúde/estatística & dados numéricos , Promoção da Saúde/estatística & dados numéricos , Cardiopatias/mortalidade , Neoplasias/mortalidade , não Fumantes/estatística & dados numéricos , Restaurantes/estatística & dados numéricos , Prevenção do Hábito de Fumar/estatística & dados numéricos , Humanos , Japão/epidemiologia , Infarto do Miocárdio/mortalidade , Pneumonia/mortalidade , Prevalência
18.
Crit Rev Oncol Hematol ; 142: 153-163, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31404827

RESUMO

BACKGROUND: Outcomes for children diagnosed with cancer have improved dramatically over the past 20 years. However, although 40% of pediatric cancer patients require at least one intensive care admission throughout their disease course, PICU outcomes and resource utilization by this population have not been rigorously studied in this specific group. METHODS: Using a systematic strategy, we searched Medline, Embase, and CINAHL databases for articles describing PICU mortality of pediatric cancer patients admitted to PICU. Two investigators independently applied eligibility criteria, assessed data quality, and extracted data. We pooled PICU mortality estimates using random-effects models and examined mortality trends over time using meta-regression models. RESULTS: Out of 1218 identified manuscripts, 31 studies were included covering 16,853 PICU admissions with the majority being retrospective in nature. Overall pooled weighted mortality was 27.8% (95% confidence interval (CI), 23.7-31.9%). Mortality decreased slightly over time when post-operative patients were excluded. The use of mechanical ventilation (odds ratio (OR): 18.49 [95% CI 13.79-24.78], p < 0.001), inotropic support (OR: 14.05 [95% CI 9.16-21.57], p < 0.001), or continuous renal replacement therapy (OR: 3.24 [95% CI 1.31-8.04], p = 0.01) was significantly associated with PICU mortality. CONCLUSIONS: PICU mortality rates of pediatric cancer patients are far higher when compared to current mortality rates of the general PICU population. PICU mortality has remained relatively unchanged over the past decades, a slight decrease was only seen when post-operative patients were excluded. This compared infavorably with the improved mortality seen in adults with cancer admitted to ICU, where research-led improvements have led to the paradigm of unlimited, aggressive ICU management without any limitations on resuscitations status, for a time-limited trial.


Assuntos
Mortalidade Hospitalar , Hospitalização , Unidades de Terapia Intensiva Pediátrica , Neoplasias/mortalidade , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
19.
BMJ ; 366: l4673, 2019 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-31405892

RESUMO

OBJECTIVE: To investigate whether vitamin D supplementation is associated with lower mortality in adults. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase, and the Cochrane Central Register from their inception to 26 December 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing vitamin D supplementation with a placebo or no treatment for mortality were included. Independent data extraction was conducted and study quality assessed. A meta-analysis was carried out by using fixed effects and random effects models to calculate risk ratio of death in the group receiving vitamin D supplementation and the control group. MAIN OUTCOME MEASURES: All cause mortality. RESULTS: 52 trials with a total of 75 454 participants were identified. Vitamin D supplementation was not associated with all cause mortality (risk ratio 0.98, 95% confidence interval 0.95 to 1.02, I2=0%), cardiovascular mortality (0.98, 0.88 to 1.08, 0%), or non-cancer, non-cardiovascular mortality (1.05, 0.93 to 1.18, 0%). Vitamin D supplementation statistically significantly reduced the risk of cancer death (0.84, 0.74 to 0.95, 0%). In subgroup analyses, all cause mortality was significantly lower in trials with vitamin D3 supplementation than in trials with vitamin D2 supplementation (P for interaction=0.04); neither vitamin D3 nor vitamin D2 was associated with a statistically significant reduction in all cause mortality. CONCLUSIONS: Vitamin D supplementation alone was not associated with all cause mortality in adults compared with placebo or no treatment. Vitamin D supplementation reduced the risk of cancer death by 16%. Additional large clinical studies are needed to determine whether vitamin D3 supplementation is associated with lower all cause mortality. STUDY REGISTRATION: PROSPERO registration number CRD42018117823.


Assuntos
Suplementos Nutricionais , Mortalidade , Vitamina D/administração & dosagem , Colecalciferol/administração & dosagem , Ergocalciferóis/administração & dosagem , Humanos , Neoplasias/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
BMC Public Health ; 19(1): 1065, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391013

RESUMO

BACKGROUND: Cancer outcomes vary widely among different countries. However, comparisons of cost-effectiveness and cost-efficiency of different systems are complex because the incidences of different cancers vary across countries and their chances of cure also differ substantially. We aim to propose a new standardized method for global comparison and to explore its relationship with economic indicators. METHODS: Cancer statistics from all 184 countries and 27 cancers listed in GLOBOCAN 2012 were analyzed. The complement of age-standardized mortality/incidence ratio [1 - (ASM/ASI)] was taken as the proxy relative survival (RS). Accounting for various country-specific cancer patterns, the cancer site-standardized proxy RS (proxy SS-RS) of individual countries were calculated by weighting the proportion of specific cancer sites as compared with the global pattern of incidence. Economic indicators of different countries listed by the World Bank were correlated with corresponding proxy SS-RS. RESULTS: Substantial variation in site-specific survival and new case distribution supported the use of proxy SS-RS, which ranged from 0.124 to 0.622 (median 0.359). The median total health expenditure per capita (HEpc) increased from US$44 for countries with proxy SS-RS < 0.25, to US$4643 for countries with proxy SS-RS ≥0.55. Results from logarithmic regression model showed exponential increase in total HEpc for better outcome. The expenditure varied widely among different strata, with the widest difference observed among countries with SS-RS ≥0.55 (total HEpc US$1412-$9361). CONCLUSIONS: Similar to age-standardization, cancer site-standardization adjusted for variation in pattern of cancer incidence provides the best available and feasible strategies for comparing cancer survivals across countries globally. Furthermore, cancer outcome correlated significantly with economic indicators and the amount of HEpc escalated exponentially. Our findings call for more in-depth studies applying cancer-site standardization to provide essential data for sharing of experience and urgent actions by policy makers to develop comprehensive and financially sustainable cancer plan for greater equity.


Assuntos
Saúde Global/estatística & dados numéricos , Neoplasias/epidemiologia , Gastos em Saúde/estatística & dados numéricos , Humanos , Incidência , Neoplasias/economia , Neoplasias/mortalidade , Taxa de Sobrevida
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