Effectiveness of Multi-Prognostic Index in older patients with advanced malignancies treated with immunotherapy

Publication date: Available online 28 October 2019Source: Journal of Geriatric OncologyAuthor(s): Andrea Sbrana, Rachele Antognoli, Giuseppe Pasqualetti, Giuseppe Linsalata, Chukwma Okoye, Valeria Calsolaro, Federico Paolieri, Francesco Bloise, Sergio Ricci, Andrea Antonuzzo, Fabio MonzaniAbstractBackgroundOlder adults with cancer are less likely to be offered treatment for cost-benefit concern. The Multi-Prognostic Index (MPI) has been validated in various clinical settings for survival estimation. We aimed to evaluate MPI as a screening tool for older adults with cancer eligible to receive immunotherapy.Patients and MethodsOlder adults with advanced or metastatic cancer, admitted to the Oncology Day Hospital of the University Hospital of Pisa from January 2017 to May 2018, eligible to receive immunotherapy were prospectively enrolled. In addition to routine oncological evaluation, each patient received a comprehensive geriatric assessment with MPI calculation. Overall survival (Cox-adjusted curve) was stratified by tertiles of MPI score. Drug toxicity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (Version 4.03: June 14, 2010).ResultsSeventy-nine patients [26.6% women, mean age (±SD) 74.0 ± 6.1 years] were enrolled with the following diagnosis: melanoma (51.9%), non-small cell lung cancer (25.3%), renal cell cancer (12.7%), urothelial cancer (8.9%) and Merkel cell carcinoma (1.2%). Median follow-up ...
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research

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ConclusionsWomen whose treatment did not conform to NCCN guidelines were not associated with worse outcomes.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
This study reviewed the applicability of laparoscopy in this challenging setting.MethodsRetrospective analysis of patients who underwent trans-abdominal re-operative rectal surgery from 2010-2019 was performed.ResultsSeventy-eight patients [35 females (45%); BMI 25kg/m2) were included. Reasons for reoperation were recurrent cancer in 18 (43%) patients and anastomotic failure in 57 (73%). Twenty-two (28%) had laparoscopic surgery and 4 had attempted laparoscopy converted to laparotomy. A higher success rate was noted for laparoscopy with prior laparoscopic surgery. Benefits of laparoscopy included significant reduction in l...
Source: The American Journal of Surgery - Category: Surgery Source Type: research
CONCLUSION: Primary Signet ring cell carcinoma of the prostate is a rare and aggressive histological variant of adenocarcinomas of the prostate. Treatment is the same as classical adenocarcinoma with an emphasis on aggressive multimodal treatment. PMID: 31797810 [PubMed - in process]
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
Authors: Yalcin S, Kaya E, Ebiloglu T, Akay S, Zor M, Sarıkaya S, Yilmaz S, Bedir S Abstract OBJECTIVES: In this research, we designed a cognitive fusion(CF) prostate biopsy(PB) (CFPB) technique by examining the multiparametric MRI of prostate (MP_MRI-P) images in a smart-phone near the trans-rectal ultrasound (TRUS) device, and examined the results. METHODS: Between January 2011 and January 2017, a total of 344 men who had PB enrolled in this study. Group 1 had a minimum of a 12-core standard TRUS PB (TRUSPB). Group 2 had CFPB while examining the MP_ MRI-P images in a smartphone near the TRUS device. A minimu...
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
Authors: Murray NP, Aedo S, Fuentealba C, Salazar A, Reyes E, Lopez MA, Minzer S Abstract INTRODUCTION: Minimal residual disease (MRD) is that which persists after curative treatment for prostate cancer. It has the potential to grow and cause metastasis. The detection of circulating prostate cells (CPCs) and bone marrow micro-metastasis could represent different sub-types of MRD. OBJECTIVE: To determine biochemical failure free survival and time to failure, the presence of circulating prostate cells and bone marrow micro-metastasis in men treated for low risk prostate cancer. HYPOTHESIS: The presence of MRD...
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
CONCLUSION: Video-endoscopic inguinal lymphadenectomy contributes to less morbidity with a lower- rate of cutaneous complications and less severity. Furthermore, VEIL gives lower hospital stay without changing in initial oncologic outcomes. Although we need longer series to stablish the oncologic long-term results. PMID: 31797801 [PubMed - in process]
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
CONCLUSION: Remote ischemic preconditioning did not modify irisin or troponin I expression, independent of the time of collection. PMID: 31799981 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
Three medical stories that we didn't cover, explained.Medscape
Source: Medscape General Surgery Headlines - Category: Surgery Tags: Internal Medicine Article Source Type: news
Today's open access research on tryptophan and its role in age-related immune dysfunction is particularly interesting in the context of ongoing research into the changes that take place in gut microbiota with age. Other recent work has examined the way in which tryptophan production by gut microbes declines precipitously with age, as this is one of a number of compounds produced by bacteria, such as butyrate, indole, and proprionate, that are influential on long term health. It is a slow process, but researchers are uncovering the specific mechanisms linking age-related changes in gut microbe populations with declining hea...
Source: Fight Aging! - Category: Research Authors: Tags: Medicine, Biotech, Research Source Type: blogs
Conclusion. BIVP led to a significant decrease in SSI rates following spine tumor surgery. Administration of BIVP is not time consuming and decreased SSI rates. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
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