Mortality determinants in colorectal cancer patients at different grades: a prospective, cohort study in Iran.

BACKGROUND Colorectal cancer (CRC) is an important cause of mortality and morbidity in many communities worldwide. This population based study was conducted to assess determinants of colorectal mortality in Iranian patients. MATERIALS AND METHODS A cohort of 1,127 cases of confirmed colorectal cancer registered in a population based registry covering 10 referral hospital in Tehran, Iran, were followed for five years. Information about tumor characteristics, smoking status and family history were collected at base line and survival status were followed every six months by contacting patient or next of kin (if patients died during the follow-up). The cause of death for each case was validated by verbal autopsy and referring to patient medical records at the time of death. The data were analyzed by Stata software using univariate and multivariate analysis (Cox regression). In building the model a p value of less than 5% was considered as significant. RESULTS The age at diagnosis was 53.5±14 years. Sixty one percent were male. Colorectal mortality among the patients was 96.9 person-years among men and 83 person-years among women. Seventy five percent of patients lived for 2.72 years, 50% for 5.83, and 25% for 13 years after the diagnosis of colorectal cancer. The age at diagnosis was significantly different between men and women (p<0.03). Higher tumor grade predicted higher death rate; the adjusted hazard ratios were 1.79 (95%CI, 0.88-3.61), 2.16 (95%CI, 1.07-4.37), and 3.1 (95%CI, 1.51-6.34) for grades II, III, and IV respectively when they were compared with grade I as reference. Ethnicity, marital status, family history of cancer, and smoking were related to survival with different degrees of magnitude. CONCLUSIONS Among many factors related to survival among the colorectal patients, tumor grade and smoking showed the highest magnitudes of association

Incidence rate of thyroid cancer in Iranian population, trend analysis from 2003 to 2009

Background and aims: Thyroid cancer is the most common endocrine malignant and papillary cancer and three times more prevalent in women than men. The aim of this study was to evaluate the incidence rate and trend of thyroid cancer in Iranian population. Methods: National incidence was rated by Iran National Cancer Registry data derived from Iran’s annual national cancer registration reported from 2003 to 2009. The crude rate and age standardized rate were used to express the incidence of thyroid cancer. Results: The results indicated that, the incidence of thyroid cancer increased from 2003 to 2009. The age standardized rate for women and men increased from 2.02 and 0.82 to 4.2 and 1.36 per 100,000, respectively. Conclusion: This study indicated remarkable increasing trends in thyroid cancer incidence. So, attention to high risk groups and public programs is necessary to reduce the incidence of this cancer in future

Effect of metabolic syndrome and its components on survival in colorectal cancer: a prospective study.

INTRODUCTION Metabolic syndrome (MetS) may affect prognosis of the patients diagnosed with colorectal cancer (CRC). OBJECTIVES This study was aimed to design a model and to examine the prognostic effect of MetS on survival time in the patients with CRC. PATIENTS AND METHODS Data were collected from 1127 cases of CRC from Cancer Registry Center of the Research Institute of Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran. In this cohort study, patients were divided into two groups based on the presence of MetS. We tested the prognostic value of MetS in the patients by Cox proportional hazard modeling. RESULTS Mean ± standard deviation of the patients' age at diagnosis in MetS group and non-MetS group was 56 ± 13 years old and 53 ± 15 years old respectively. Tumor stage as an independent variable affected CRC survival. The mean survival time of the MetS and non-MetS groups was 23 and 27 months respectively. Independent variables like tumor stage (hazard ratio [HR], 1.76; 95% CI, 0.29-0.90) and educational level (HR, 0.50; 95% CI, 0.23-0.97) had significant effect on CRC survival and MetS (HR, 0.95; 95% CI, 0.52-1.5), tumor size (HR, 1.390; 95% CI, 1.237-1.560), family history, age, gender, and smoking had non-significant effect on CRC survival. CONCLUSION MetS could be a prognostic factor for survival in the patients with CRC. The results suggested that effect of MetS was not significant

Canon Journal of Medicine: Developing Editorial Policies and Recommence of Publication

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Biological and Clinical Relevance of Long Non-Coding RNA PCAT-1 in Cancer, A Systematic Review and Meta-Analysis

Long non-coding RNA (lncRNA) prostate cancer associated transcript 1 (PCAT-1) has been identified as a potential biomarker for the diagnosis and prognosis of various cancers. We performed this systematic review and meta-analysis to evaluate the role of dysregulation as well as the biological and clinical significance of lnc-PCAT-1 for predicting the malignancy status in several cancers. Two independent reviewers conducted an extensive search in electronic databases of Medline, Embase, Scopus, Web of Science and PubMed until the December of 2017. Five articles investigating the clinical significance of lncRNA PCAT-1, including 996 patients, were analyzed. Our results revealed that the increased PCAT-1 expression was related to overall survival (OS) (HR = 1.9, 95%CI: 1.13-3.18, P=0.015). Also, pooled results of the diagnostic data analysis demonstrated that PCAT-1 has a sensitivity of 0.59 and specificity of 0.66 for cancer diagnosis. Moreover, pooled area under curve was 0.62 (95% CI: 0.58–0.69). This meta-analysis revealed that lncRNA PCAT-1 could be served as a potential diagnostic and prognostic biomarker in various solid tumors

Application of a non-parametric non-mixture cure rate model for analyzing the survival of patients with colorectal cancer in Iran

OBJECTIVES Colorectal cancer (CRC) patients are considered to have been cured when the mortality rate of individuals with the disease returns to the same level as expected in the general population. This study aimed to assess the impact of various risk factors on the cure fraction of CRC patients using a real dataset of Iranian CRC patients with a non-mixture non-parametric cure model. METHODS This study was conducted on the medical records of 512 patients who were definitively diagnosed with CRC at Taleghani Hospital, Tehran, Iran from 2001 to 2007. A non-mixture non-parametric cure rate model was applied to the data after using stepwise selection to identify the risk factors of CRC. RESULTS For non-cured cases, the mean survival time was 1,243.83 days (95% confidence interval [CI], 1,174.65 to 1,313.00) and the median survival time was 1,493.00 days (95% CI, 1,398.67 to 1,587.33). The 1- and 3-year survival rates were 92.9% (95% CI, 91.0 to 95.0) and 73.4% (95% CI, 68.0 to 79.0), respectively. Pathologic stage T1 of the primary tumor (estimate=0.58; p=0.013), a poorly differentiated tumor (estimate=1.17; p<0.001), a body mass index (BMI) between 18.6 and 24.9 kg/m2 (estimate=−0.60; p=0.04), and a BMI between 25.0 and 29.9 kg/m2 (estimate=−1.43; p<0.001) had significant impacts on the cure fraction of CRC in the multivariate analysis. The proportion of cured patients was 64.1% (95% CI, 56.7 to 72.4). CONCLUSIONS This study found that the pathologic stage of the primary tumor, tumor grade, and BMI were potential risk factors that had an impact on the cure fraction. A non-mixture non-parametric cure rate model provides a flexible framework for accurately determining the impact of risk factors on the long-term survival of patients with CRC

The Effect of Abdominal Touch on Nutritional Tolerance in Premature Infants: A Randomized Controlled Clinical Trail

Background The most common cause of death during neonatal period is prematurity. Nutritional tolerance is very important in this period. If during this period the problems of feeding the preterm infant are not resolved, chronic disorder occurs in normal growth. Materials and Methods In this randomized controlledclinical trial we selected 60 preterm infants in the neonatal intensive care unit of Motahhari Hospital in Urmia, Iran, and randomly assigned to control and intervention groups. The infants were touched using Field technique by olive oil in two steps in the morning and evening, with a time of 15 minutes by first researcher. Nutritional tolerance was evaluated using the "Daily Observation Chart" and by gavage milk volume, abdominal circumference, the frequency of defecations and gastric residual volume. The data were collected during 4 consecutive days and the results were compared on the fourth day, with the first day. Data were analyzed using SPSS software version 17.0. Results According to the results, the abdominal circumference after touch was less in the intervention group (1.77±1.38) compared to the control group (1.43±1.22) (

Effect of the rehabilitation program on the fatigue of patients with coronary artery diseases

Background: This study aimed to evaluate the changes in fatigue of patients with coronary artery diseases after the rehabilitation intervention based on demographic and clinical variables. Methods: This study was a single-arm clinical trial with a pre and post-intervention design. The statistical population of the study included patients with coronary artery diseases who underwent coronary artery bypass surgery or percutaneous coronary interventions, 4-6 weeks after discharge, referred to Khorramabad Cardiac Rehabilitation Center. They were selected by a purposeful sampling method. The data were collected through demographic and clinical information questionnaires and Piper Fatigue Measurement Questionnaire. Education on risk factors at home (weeks 4 and 8) was presented in the area of rehabilitation, the data were analyzed with descriptive and analytical statistics in SPSS software. Results: Most of the patients were male (54.4%), married (87%), and in the age group of 47-58 years (50%). Their mean age was 54.63 ± 8.87 years, and the mean duration of heart disease in the subjects (by months) was 33.24 ± 50.84. Comparing the mean changes in fatigue after the intervention based on some influencing demographic variables of the patients, including age, gender, type of treatment, and the duration of the disease showed no significant difference (p&gt;0.05). Conclusion: The implementation of a home cardiac rehabilitation program by nurses, as a low-cost, accessible, and feasible intervention, can be considered an effective step in reducing the fatigue of patients with coronary artery disease and should be considered by managers

Machine learning-based classifiers to predict metastasis in colorectal cancer patients

BackgroundThe increasing prevalence of colorectal cancer (CRC) in Iran over the past three decades has made it a key public health burden. This study aimed to predict metastasis in CRC patients using machine learning (ML) approaches in terms of demographic and clinical factors.MethodsThis study focuses on 1,127 CRC patients who underwent appropriate treatments at Taleghani Hospital, a tertiary care facility. The patients were divided into training and test datasets in an 80:20 ratio. Various ML methods, including Naive Bayes (NB), random rorest (RF), support vector machine (SVM), neural network (NN), decision tree (DT), and logistic regression (LR), were used for predicting metastasis in CRC patients. Model performance was evaluated using 5-fold cross-validation, reporting sensitivity, specificity, the area under the curve (AUC), and other indexes.ResultsAmong the 1,127 patients, 183 (16%) had experienced metastasis. In the predictionof metastasis, both the NN and RF algorithms had the highest AUC, while SVM ranked third in both the original and balanced datasets. The NN and RF algorithms achieved the highest AUC (100%), sensitivity (100% and 100%, respectively), and accuracy (99.2% and 99.3%, respectively) on the balanced dataset, followed by the SVM with an AUC of 98.8%, a sensitivity of 97.5%, and an accuracy of 97%. Moreover, lower false negative rate (FNR), false positive rate (FPR), and higher negative predictive value (NPV) can be confirmed by these two methods. The results also showed that all methods exhibited good performance in the test datasets, and the balanced dataset improved the performance of most ML methods. The most important variables for predicting metastasis were the tumor stage, the number of involved lymph nodes, and the treatment type. In a separate analysis of patients with tumor stages I–III, it was identified that tumor grade, tumor size, and tumor stage are the most important features.ConclusionThis study indicated that NN and RF were the best among ML-based approaches for predicting metastasis in CRC patients. Both the tumor stage and the number of involved lymph nodes were considered the most important features