Recurrence-Free Survival Prediction for Anal Squamous Cell Carcinoma Chemoradiotherapy using Planning CT-based Radiomics Model

Objectives: Approximately 30% of non-metastatic anal squamous cell carcinoma (ASCC) patients will experience recurrence after chemoradiotherapy (CRT), and currently available clinical variables are poor predictors of treatment response. We aimed to develop a model leveraging information extracted from radiation pretreatment planning CT to predict recurrence-free survival (RFS) in ASCC patients after CRT. Methods: Radiomics features were extracted from planning CT images of 96 ASCC patients. Following pre-feature selection, the optimal feature set was selected via step-forward feature selection with a multivariate Cox proportional hazard model. The RFS prediction was generated from a radiomics-clinical combined model based on an optimal feature set with five repeats of five-fold cross validation. The risk stratification ability of the proposed model was evaluated with Kaplan-Meier analysis. Results: Shape- and texture-based radiomics features significantly predicted RFS. Compared to a clinical-only model, radiomics-clinical combined model achieves better performance in the testing cohort with higher C-index (0.80 vs 0.73) and AUC (0.84 vs 0.79 for 1-year RFS, 0.84 vs 0.78 for 2-year RFS, and 0.86 vs 0.83 for 3-year RFS), leading to distinctive high- and low-risk of recurrence groups (p<0.001). Conclusions: A treatment planning CT based radiomics and clinical combined model had improved prognostic performance in predicting RFS for ASCC patients treated with CRT as compared to a model using clinical features only

Prostate cancer incidence across stage, NCCN risk groups, and age before and after USPSTF Grade D recommendations against prostateâ specific antigen screening in 2012

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153721/1/cncr32604.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153721/2/cncr32604_am.pd

Conservative management of lowâ risk prostate cancer among young versus older men in the United States: Trends and outcomes from a novel national database

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151903/1/cncr32332.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151903/2/cncr32332_am.pd

The burden of respiratory infections among older adults in long-term care:a systematic review

BACKGROUND: Respiratory infections among older adults in long-term care facilities (LTCFs) are a major global concern, yet a rigorous systematic synthesis of the literature on the burden of respiratory infections in the LTCF setting is lacking. To address the critical need for evidence regarding the global burden of respiratory infections in LTCFs, we assessed the burden of respiratory infections in LTCFs through a systematic review of the published literature. METHODS: We identified articles published between April 1964 and March 2019 through searches of PubMed (MEDLINE), EMBASE, and the Cochrane Library. Experimental and observational studies published in English that included adults aged ≥60 residing in LTCFs who were unvaccinated (to identify the natural infection burden), and that reported measures of occurrence for influenza, respiratory syncytial virus (RSV), or pneumonia were included. Disagreements about article inclusion were discussed and articles were included based on consensus. Data on study design, population, and findings were extracted from each article. Findings were synthesized qualitatively. RESULTS: A total of 1451 articles were screened for eligibility, 345 were selected for full-text review, and 26 were included. Study population mean ages ranged from 70.8 to 90.1 years. Three (12%) studies reported influenza estimates, 7 (27%) RSV, and 16 (62%) pneumonia. Eighteen (69%) studies reported incidence estimates, 7 (27%) prevalence estimates, and 1 (4%) both. Seven (27%) studies reported outbreaks. Respiratory infection incidence estimates ranged from 1.1 to 85.2% and prevalence estimates ranging from 1.4 to 55.8%. Influenza incidences ranged from 5.9 to 85.2%. RSV incidence proportions ranged from 1.1 to 13.5%. Pneumonia prevalence proportions ranged from 1.4 to 55.8% while incidence proportions ranged from 4.8 to 41.2%. CONCLUSIONS: The reported incidence and prevalence estimates of respiratory infections among older LTCF residents varied widely between published studies. The wide range of estimates offers little useful guidance for decision-making to decrease respiratory infection burden. Large, well-designed epidemiologic studies are therefore still necessary to credibly quantify the burden of respiratory infections among older adults in LTCFs, which will ultimately help inform future surveillance and intervention efforts

Psychological distress and cognition among long-term survivors of adolescent and young adult cancer in the USA

Patients diagnosed with cancer as adolescent and young adult (AYA) are at risk for a range of long-term psychosocial sequelae, which have been poorly studied. We sought to characterize the prevalence of cognitive dysfunction and psychological distress among long-term AYA cancer survivors. Using data from the National Health Interview Survey between 2010 and 2018, multivariable logistic regression analyses defined the association between AYA cancer diagnosis and cognitive dysfunction and psychological distress, as defined by the 6-item Kessler Psychological Distress Scale. Among AYA cancer survivors, the association between psychological distress and cognitive dysfunction was assessed via multivariable logistic regression. Among 230,675 participants, 2646 (1.1%) were AYA cancer survivors diagnosed > 10 years prior to survey administration. Prior AYA cancer diagnosis was associated with greater odds of cognitive dysfunction (AOR 1.61, 95% CI 1.41-1.82; 27.8% vs. 16.4%) and psychological distress (AOR 1.60, 95% CI 1.41-1.83; 26.6 vs. 15.3%) as compared to individuals without a cancer history. Among survey participants reporting a cancer diagnosis, greater psychological distress was associated with greater odds of cognitive dysfunction (AOR 12.31, 95% CI 7.51-20.18 for severe psychological distress) and cognitive dysfunction was associated with having psychological distress (AOR 4.97, 95% CI 3.66-6.73). Long-term survivors of AYA cancer have higher rates of cognitive dysfunction and psychological distress as compared to the general population. Additional services addressing psychosocial and neurocognitive issues should be integrated into standard AYA cancer survivorship care. Cancer survivors should be aware of self-reported high rates of long-term cognitive dysfunction and psychologic distress and actively seek out formal evaluation and services such as mental health counseling

Trends in Smoking and e-Cigarette Use Among US Patients With Cancer, 2014-2017

This cross-sectional study of data from the National Health Interview Survey analyzes the prevalence of e-cigarette use in US patients with cancer

Obesity and younger versus older onset colorectal cancer in the United States, 1998-2017

The etiology behind the increasing incidence of early onset colorectal cancer (EOCRC) are incompletely elucidated, but could be attributed in part to lifestyle factors. We assessed the association between obesity and colorectal cancer (CRC) in younger versus older adults in the National Health Institute Survey. Multivariable logistic regression defined adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs) for CRC including an age (< ≥50 years) *BMI (< ≥30.0 kg/m ) interaction term. Among 583,511 study participants with a total of 3,173 CRC cases, there was a significant age*BMI interaction term (P=0.02) such that for participants aged 18-49 years, BMI ≥30.0 kg/m was associated with diagnosis of CRC (34.1% 27.4%, AOR 1.39, 95% CI: 1.00-1.92) but not for participants aged ≥50 (29.6% 31.4%, AOR 0.93, 95% CI: 0.85-1.03). Obese BMI appears to be associated with diagnosis of EOCRC, thus weight control by early adulthood, among other healthy lifestyle behaviors, could serve as potential risk reduction strategies for CRC

Prevalence and Nondisclosure of Complementary and Alternative Medicine Use in Patients With Cancer and Cancer Survivors in the United States

This cross-sectional study analyzes the proportion of patients with cancer and cancer survivors who use complementary and alternative medicine (CAM) without disclosing this information to their physicians