These data pinpoint to diabetes mellitus (DM) as a possible prognostic factor for PFS in localized colorectal cancer and further cast doubt for the value of obesity as measured by body mass index (BMI) on local stage colorectal cancer prognosis.
BackgroundThe movement to improve patient-centred care, combined with the development of user-friendly technology has led to the spread of electronic patient portals (EPP). Little research has examined the effects of providing patients with access to their laboratory results on their healthcare and health behaviours.ObjectiveThe purpose of this study was to gain insight into the use of EPPs, understand why patients use EPPs to access their laboratory results and explore its impact on their health.MethodSemistructured interviews were conducted with 21 patients who used the laboratory results section of an EPP. Interviews were analysed using a grounded theory approach.ResultsParticipant interactions with their laboratory results varied based on their level of understanding of their results. Benefits of EPP-based access to test results included convenience, fewer appointments and decreased anxiety. Some participants described increased engagement in their healthcare and positive health changes. However, some were concerned about receiving alarming test results.ConclusionHealthcare providers using EPPs to provide patients with their test results should try to ensure their patients understand their test results. Patient comprehension of test results may be improved by having providers comment on the meaning of test results and by encouraging patients to use specific websites and search options within EPPs.
Aim To predict chemotherapy toxicity and hospitalisations in elderly patients using clinical and laboratory parameters. Methods Records of cancer patients 70 years old or older who received adjuvant chemotherapy or first‐line chemotherapy for a cancer in a single centre were reviewed. Factors associated with hospitalisations, grade 3–4 toxicities and dose reductions during treatment were evaluated. Results A total of 275 patients included in the study. Most patients (53.8%) were 70 to 75 years old. One hundred and five patients (38.2%) had a hospital admission during or within a month after their chemotherapy treatment. The only factor associated with admissions in the multivariate analysis was ECOG performance status (PS) >1 (p = .008, odds ratio 2.66, 95% CI: 1.28–5.53) and hypoalbuminaemia approached significance. Grade 3 and 4 toxicities were associated with a lower creatinine clearance in the multivariate analysis (p = .01, odds ratio 0.98, 95% CI: 0.97–1.0), and dose reductions were associated with metastatic stage (p = .03, odds ratio 1.88, 95% CI: 1.05–3.35). A combined index with all four parameters was associated with all three outcomes of interest. Conclusion ECOG PS, stage, albumin and creatinine clearance may be predictive of hospital admissions, grade 3–4 toxicities and dose reduction rates in cancer patients 70 years old and older receiving chemotherapy.
Background: Isolated tumor cells or small clusters of tumor cells observed in the vicinity of the main tumor mass in pathology sections, termed tumor budding, are common in cancers and have been associated with prognosis in some settings. This study examined the clinical associations and treatment efficacy implications of tumor budding in breast cancer patients receiving neo-adjuvant therapy. Methods: Breast cancer patients that received neo-adjuvant therapy before definitive surgical treatment in a single cancer center over a 7-year period were included, and their records were reviewed. Data extracted included patient demographics, tumor characteristics and pathologic response to treatment at surgery. The initial breast cancer biopsy before any therapy was reviewed by two pathologists, and a hot spot area was evaluated for tumor budding (defined as 1 to 5 cancer cells observed detached from the main tumor mass). Results: Seventy-five patients who received neo-adjuvant therapy (73 received chemotherapy and 2 received hormonal therapy) were included. Tumor budding was observed in two-thirds of the patients. There were no significant differences in patient (age and menopause status) and tumor (stage, histology and molecular sub-type equivalent) characteristics between the group that had tumor budding and the group that did not have tumor budding in the pre-treatment biopsy. Likewise, no statistically significant differences were observed in the frequency of complete or partial responses between the two groups. Conclusion: In this cohort of breast cancer patients receiving neo-adjuvant therapy, tumor budding was frequent, but it was not associated with tumor characteristics or pathologic responses to treatment. The value of tumor budding as a prognostic factor in the neo-adjuvant setting within the general breast cancer population could not be confirmed, but such a value in specific sub-groups deserves further investigation, given the pathophysiologic rationale and data from other settings.
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