Antipsychotic treatment, prolactin, and breast tumorigenesis

Background: Over the last decades prolactin (PRL) has gained attention for its possible role in breast tumorigenesis. As all antipsychotics (although differences with respect to PRL elevation are large) have the propensity to induce hyperprolactinemia (HPRL), questions have arisen concerning the influence of PRL-elevating antipsychotic medications on breast cancer risk. Subjects and methods: A literature search (until January 2016), using the MEDLINE database, was conducted for Englishlanguage published clinical studies to identify and synthesize data of the current state of knowledge concerning the relationship between HPRL, breast cancer risk (factors) and antipsychotic medication. Results: Results of human prospective studies evaluating the relationship between pre-diagnostic circulating PRL levels and breast cancer risk are limited, equivocal and only correlational. Associations between higher circulating PRL levels and other breast cancer risk factors than nulliparity and hormone therapies mostly have been negative for both pre-and postmenopausal women. Until today, no causal link between (chronic) administration of antipsychotics and breast tumorigenesis in humans has been demonstrated. Finally, several reports describe mechanisms of cancer protection with the PRL hormone as well as with antipsychotic medication. Conclusion: The role of PRL in breast carcinogenesis therefore remains unclear, unconfirmed, yet controversial. Antipsychotics should not be withhold for breast cancer prevention reasons to patients in need of this sometimes life-saving medication, even if classical breast cancer risk factors are present

ANTIPSYCHOTIC TREATMENT, PROLACTIN, AND BREAST TUMORIGENESIS

Background: Over the last decades prolactin (PRL) has gained attention for its possible role in breast tumorigenesis. As all antipsychotics (although differences with respect to PRL elevation are large) have the propensity to induce hyperprolactinemia (HPRL), questions have arisen concerning the influence of PRL-elevating antipsychotic medications on breast cancer risk. Subjects and methods: A literature search (until January 2016), using the MEDLINE database, was conducted for Englishlanguage published clinical studies to identify and synthesize data of the current state of knowledge concerning the relationship between HPRL, breast cancer risk (factors) and antipsychotic medication. Results: Results of human prospective studies evaluating the relationship between pre-diagnostic circulating PRL levels and breast cancer risk are limited, equivocal and only correlational. Associations between higher circulating PRL levels and other breast cancer risk factors than nulliparity and hormone therapies mostly have been negative for both pre-and postmenopausal women. Until today, no causal link between (chronic) administration of antipsychotics and breast tumorigenesis in humans has been demonstrated. Finally, several reports describe mechanisms of cancer protection with the PRL hormone as well as with antipsychotic medication. Conclusion: The role of PRL in breast carcinogenesis therefore remains unclear, unconfirmed, yet controversial. Antipsychotics should not be withhold for breast cancer prevention reasons to patients in need of this sometimes life-saving medication, even if classical breast cancer risk factors are present

Postoperative complications in individuals aged 70 and over undergoing elective surgery for colorectal cancer

This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC)..status: publishe

The impact of frailty on postoperative outcomes in individuals aged 65 and over undergoing elective surgery for colorectal cancer: A systematic review

Colorectal cancer surgery is frequently performed in the older population. Many older persons have less physiological reserves and are thus more susceptible to adverse postoperative outcomes. Therefore, it seems important to distinguish the fit patients from the more vulnerable or frail. The aim of this review is to examine the evidence regarding the impact of frailty on postoperative outcomes in older patients undergoing surgery for colorectal cancer. A systematic literature search of Medline Ovid was performed focusing on studies that examined the impact of frailty on postoperative outcomes after colorectal surgery in older people aged ≥65years. The methodological quality of the studies was evaluated using the MINORS quality assessment. Five articles, involving four studies and 486 participants in total, were included. Regardless of varying definitions of frailty and postoperative outcomes, the frail patients had less favourable outcomes in all of the studies. Compared to the non-frail group, the frail group had a higher risk of developing moderate to severe postoperative complications, had longer hospital stays, higher readmission rates, and decreased long-term survival rates. The results of this systematic review suggest the importance of assessing frailty in older persons scheduled for colorectal surgery because frailty is associated with a greater risk of postoperative adverse outcomes. We conclude that, although there is no consensus on the definition of frailty, assessing frailty in colorectal oncology seems important to determine operative risks and benefits and to guide perioperative management.publisher: Elsevier articletitle: The impact of frailty on postoperative outcomes in individuals aged 65 and over undergoing elective surgery for colorectal cancer: A systematic review journaltitle: Journal of Geriatric Oncology articlelink: http://dx.doi.org/10.1016/j.jgo.2016.06.001 content_type: article copyright: © 2016 Elsevier Ltd. All rights reserved.status: publishe

Value of geriatric screening and assessment in predicting postoperative complications in patients older than 70 years undergoing surgery for colorectal cancer

This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC).status: publishe

Geriatric Assessment and Functional Decline in Older Patients with Lung Cancer

Older patients with lung cancer are a heterogeneous population making treatment decisions complex. This study aims to evaluate the value of geriatric assessment (GA) as well as the evolution of functional status (FS) in older patients with lung cancer, and to identify predictors associated with functional decline and overall survival (OS).status: publishe

The prognostic value of 3 commonly measured blood parameters and geriatric assessment to predict overall survival in addition to clinical information in older patients with cancer

BACKGROUND: The current study was performed to evaluate the prognostic value of laboratory parameters and geriatric assessment (GA) in addition to a baseline model with clinical information regarding overall survival (OS) in patients with cancer. METHODS: GA was systematically performed in patients aged ≥70 years. The baseline model consisted of age, tumor type, and stage of disease. The incremental prognostic values of the GA as a whole (10-item GA) and laboratory parameters were assessed separately and combined. The parameters included hemoglobin (Hb), albumin, C-reactive protein (CRP), and the Glasgow Prognostic Score (GPS). Analyses were conducted with continuous and dichotomized variables. Cox models were compared based on Akaike information criterion (ΔAIC) and their discriminatory ability was assessed using the concordance probability estimate (CPE). RESULTS: A total of 328 patients were considered for this analysis. The baseline model had a CPE of 0.725. The addition of CRP, albumin, and Hb combined resulted in the best performing model (ΔAIC: 40.12 and CPE: 0.757) among the laboratory parameters. However, the 10-item GA improved the baseline model even more (ΔAIC: 46.03 and CPE: 0.769). Similar results were observed in the analysis with dichotomous variables. The addition of the 3 laboratory parameters (CRP, albumin, and Hb) improved the CPE by 1.4% compared with the baseline model already extended with the 10-item GA. The CPE increase (1.7%) was the highest with the GPS in the analysis with dichotomous variables. CONCLUSIONS: GA appears to add slightly more prognostic information than laboratory parameters in addition to clinical information. The laboratory parameters have an additional prognostic value beyond clinical and geriatric information.status: publishe

The added value of geriatric screening and assessment for predicting overall survival in older patients with cancer

BACKGROUND: The aim of this study was to determine and compare the added prognostic value of screening tools, geriatric assessment (GA) components, and GA summaries to clinical information for overall survival (OS) in older patients with cancer. METHODS: A screening and a 10-item GA were systematically performed in patients ≥70 years old with cancer. Cox regression analyses were conducted to evaluate the added prognostic value for OS of screening tools, GA, and GA summaries to clinical information (age, stage, and tumor type) in 2 cohorts (A and B). Cox models were compared on the basis of the Akaike information criterion and the concordance probability estimate. The 2 cohorts for the analyses were similar but independent. RESULTS: A complete case analysis was available for 763 patients (median age, 76 years) in cohort A and for 402 patients (median age, 77 years) in cohort B. In both cohorts, most individual GA components were independent prognostic factors for OS. Nutritional status (assessed with the Mini Nutritional Assessment Short Form) and functional status (assessed with the Instrumental Activities of Daily Living) consistently displayed a strong capacity to predict OS. Less consistent results were found for screening tools. GA summaries performed the best in comparison with the screening tools and the individual GA components. CONCLUSIONS: Most individual GA components, especially nutritional status and functional status, are prognostic factors for OS in older patients with cancer. GA summaries provide more prognostic information than individual GA components but only moderately improve the prognostic baseline model with clinical information.status: publishe

Oral versus intramuscular high-oral medroxyprogesterone acetate (HD-MPA) in advanced breast cancer. A randomized study of the Belgian Society of Medical Oncology

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

A Case of Severe Acute Cardiac Failure on Sunitinib After Left-Sided Thoracal Radiation Therapy

publisher: Elsevier articletitle: A Case of Severe Acute Cardiac Failure on Sunitinib After Left-Sided Thoracal Radiation Therapy journaltitle: Clinical Genitourinary Cancer articlelink: http://dx.doi.org/10.1016/j.clgc.2016.05.015 content_type: article copyright: © 2016 Elsevier Inc. All rights reserved.status: publishe