BCRL is a common complication for breast cancer patients after surgery. It can be fairly diagnosed only 1 month post-operation and the cumulative incidence of BCRL seems to be increasing over time, especially in the first year after surgery. ALND, radiotherapy, MRM, the number of positive axillary lymph nodes and BMI were found to be independent risk factors in the development of BCRL in this study.

This systematic analysis aimed to investigate the value of microRNA-21 (miR-21) in colorectal cancer for multiple purposes, including diagnosis and prognosis, as well as its predictive power in combination biomarkers. Fifty-seven eligible studies were included in our meta-analysis, including 25 studies for diagnostic meta-analysis and 32 for prognostic meta-analysis. For the diagnostic meta-analysis of miR-21 alone, the overall pooled results for sensitivity, specificity, and area under the curve (AUC) were 0.64 (95% CI: 0.53-0.74), 0.85 (0.79-0.90), and 0.85 (0.81-0.87), respectively. Circulating samples presented corresponding values of 0.72 (0.63-0.79), 0.84 (0.78-0.89), and 0.86 (0.83-0.89), respectively. For the diagnostic meta-analysis of miR-21-related combination biomarkers, the above three parameters were 0.79 (0.69-0.86), 0.79 (0.68-0.87), and 0.86 (0.83-0.89), respectively. Notably, subgroup analysis suggested that miRNA combination markers in circulation exhibited high predictive power, with sensitivity of 0.85 (0.70-0.93), specificity of 0.86 (0.77-0.92), and AUC of 0.92 (0.89-0.94). For the prognostic meta-analysis, patients with higher expression of miR-21 had significant shorter disease-free survival [DFS; pooled hazard ratio (HR): 1.60; 95% CI: 1.20-2.15] and overall survival (OS; 1.54; 1.27-1.86). The combined HR in tissues for DFS and OS were 1.76 (1.31-2.36) and 1.58 (1.30-1.93), respectively. Our comprehensive systematic review revealed that circulating miR-21 may be suitable as a diagnostic biomarker, while tissue miR-21 could be a prognostic marker for colorectal cancer. In addition, miRNA combination biomarkers may provide a new approach for clinical application.

Asian Pac J Cancer Prev, 15 (16), 6535-6541 IntroductionBreast cancer related lymphedema (BCRL)is a chronic and common complication caused by abnormal accumulation of protein-rich fluid in the interstitial space secondary to inadequate lymphatic drainage, which manifests unilateral or bilateral upper extremity swelling in the clinical. (Cheville et al., 2003). Lymphedema and its related symptoms (pain, heaviness, tightness, and decreased range of motion) seriously affect recreational and social relationships (Hayes et al., 2012). Patients with BCRL have a lower quality of life, a higher level of anxiety or depression (Pyszel et al., 2006;Heiney et al., 2007).Due to differences in study designs, measurement methods and criterias , length of follow-up, lymphedema definitions and timing of lymphedema measurement since diagnosis and treatment, previous studies have shown about 20% of breast cancer survivors will develop lymphedema. (sakorafas et al., 2006) In recent years, many studies have established risk factors of BCRL, but conclusions are not consistent, which even contradict each other from some studies. The study systematically reviews the risk factors for BCRL with meta-analysis method to increase the credibility of the conclusions for the purpose of providing scientific evidence for early prevention of lymphedema in clinical work. Materials and Methods Literature SearchWe searched comprehensively clinical studies which were published in PubMed, Ovid, EMbase, the Cochrane Library from January 1, 1996 to December 30, 2012. The MeSH headings and keywords in this search used included "breast cancer", "upper extremity", "lymphedema" and "risk factors" Relevant articles were identified and their references were checked for additional studies.The search strategy used: ( ("Breast Neoplasms" (Mesh) AND "Upper Extremity" (Mesh)) AND ("Lymphedema" (Mesh) OR "Edema" (Mesh)) AND ("1996/01/01" (PDAT) : "2012/12/31" (PDAT)) Inclusion and Exclusion CriteriaInclusion criteria: studies of female patients with unilateral breast cancer; the primary studies of risk factors for BCRL published abroad.Exclusion criteria: studies of patients with bilateral breast cancer, primary lymphoedema, or metastatic disease (n=258); review, meta-analyses, editorial, comment , and case reports (n=121); studies that did not either inform OR and 95%CI or provide adequate information to calculate the OR and its variance (n=39); non-English-language studies (n=8).

ObjectiveThe outbreak of COVID-19 pandemic has greatly impacted on radiotherapy (RT) strategy for breast cancer patients, which might lead to increased distressing psychological symptoms. We performed a multi-center cross-section survey to investigate prevalence of fear of cancer recurrence (FCR) and predictors for FCR in patients referred to RT during pandemic.Methods542 patients were consecutively enrolled from three regions in China including Yangtze Delta River Region, Guangdong and Shanxi province. Patients’ characteristics were collected using an information sheet, Fear of progression questionnaire-short form, Hospital Anxiety/Depression Scale and EORTC QLQ-C30. The hierarchical multiple regression models were performed.Results488 patients with complete data were eligible. The RT strategy was affected in 265 (54.3%) patients, including 143 with delayed RT initiation, 66 believing to have delayed RT initiation but actually not, 24 with RT interruptions, 19 shifting to local hospitals for RT and the remaining 13 influenced on both RT schedule and hospital level. The model explained 59.7% of observed variances in FCR (p<0.001) and showed that influence of RT strategy had significantly impacted on FCR (△R2 = 0.01, △F=2.966, p=0.019). Hospitals in Shanxi province (β=-0.117, p=0.001), emotional function (β=-0.19, p<0.001), social function (β=-0.111, p=0.006), anxiety (β=0.434, p<0.001) and RT interruption (β=0.071, p=0.035) were independent predictors.ConclusionsRT strategy for breast cancer patients was greatly influenced during pandemic. RT interruption is an independent predictor for high FCR. Our findings emphasize the necessity to ensure continuum of RT, and efforts should be taken to alleviate FCR through psychological interventions.