Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

The biocultural evolution in the Osmore valley. Morphological dental traits in pre-inca populations

The Osmore (Moquegua) Valley, in the South Central Andes, has an extremely varied history of human occupation that goes back at least 12,000 years (Rice, 1989). The discovery, over the past decades, of a considerable number of Chinchorro, Tiwanaku, and Chiribaya mummies has triggered an extensive investigation of the cultural and genetic changes that took place in the valley in pre-Inca times (Blom, 2005; Blom et al., 1998; Lozada, 1998; Moraga et al., 2005; Sutter, 1997, 2000, 2005; Sutter and Mertz, 2004). These studies resulted in the formulation of different hypotheses that were aimed at accounting for the diversity and diffusion of the material culture throughout the region (Rostworowsky, 1977; Browman, 1980, 1984; Dillehay and Nuñez, 1988; Sutter, 2000). The most widely accepted hypothesis is the spread of ethnically diverse colonists from the Tiwanaku Empire, which occupied many areas of the Upper Osmore Valley, establishing permanent settlements like Chen Chen and Omo (Goldstein, 2013; Sutter and Sarrat, 2010). Archaeological evidence seems to indicate that the culturally and ethnically diverse Tiwanaku colonists had established relationships with the valley’s indigenous populations (Goldstein, 2013). Conversely, the fewer Wari outposts in the valley, such as Cerro Baul (Nash and Williams, 2005; Williams, 2001), seem not to have instituted cultural relationships with their neighboring communities

Queyrat's erythroplasia of the prepuce: a case-report.

Abstract A case of Queyrat's erythroplasia of the prepuce is reported. The Authors emphasize the precancerous role of the lesion because of its high frequency of malignant transformation. Local excision appears to be the only adequate form of treatment. PMID: 4082852 [PubMed - indexed for MEDLINE

Leiomyosarcoma of the prostate in adults.

Abstract Three cases of prostatic leiomyosarcoma and a brief review of the literature are presented. The authors emphasize the differences in clinical features, management and prognosis between the sarcomas occurring in childhood and the rarest leiomyosarcoma of elderly patients. PMID: 4083781 [PubMed - indexed for MEDLINE