A multicenter, retrospective archive study of radiological and clinical features of ALK-positive non-small cell lung cancer patients and crizotinib efficacy.

To evaluate radiological and clinical features in metastatic anaplastic lymphoma kinase+ non-small cell lung cancer patients and crizotinib efficacy in different lines. This national, non-interventional, multicenter, retrospective archive screening study evaluated demographic, clinical, and radiological imaging features, and treatment approaches in patients treated between 2013-2017. Totally 367 patients (54.8% males, median age at diagnosis 54 years) were included. Of them, 45.4% were smokers, and 8.7% had a family history of lung cancer. On radiological findings, 55.9% of the tumors were located peripherally, 7.7% of the patients had cavitary lesions, and 42.9% presented with pleural effusion. Pleural effusion was higher in nonsmokers than in smokers (37.3% vs. 25.3%, P = .018). About 47.4% of cases developed distant metastases during treatment, most frequently to the brain (26.2%). Chemotherapy was the first line treatment in 55.0%. Objective response rate was 61.9% (complete response: 7.6%; partial response: 54.2%). The highest complete and partial response rates were observed in patients who received crizotinib as the 2nd line treatment. The median progression-free survival was 14 months (standard error: 1.4, 95% confidence interval: 11.2-16.8 months). Crizotinib treatment lines yielded similar progression-free survival (P = .078). The most frequent treatment-related adverse event was fatigue (14.7%). Adrenal gland metastasis was significantly higher in males and smokers, and pleural involvement and effusion were significantly higher in nonsmokers-a novel finding that has not been reported previously. The radiological and histological characteristics were consistent with the literature data, but several differences in clinical characteristics might be related to population characteristics.

Can Systemic Immune-Inflammation Index Create a New Perspective for the IMDC Scoring System in Patients with Metastatic Renal Cell Carcinoma?

INTRODUCTION: The aim of the study was to evaluate impact of the systemic immune-inflammation index (SII) on prognosis and survival within the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score groups. METHODS: The records of 187 patients with metastatic renal cell carcinoma (RCC) were reviewed retrospectively. The SII was calculated as follows: SII = Neutrophil × Platelet/Lymphocyte. The patients were categorized into 2 groups based on a median SII of 730 (×109 per 1 L) as SII low (<730) and SII high (≥730). The Kaplan-Meier method was used for survival analysis and a Cox regression model was utilized to determine independent predictors of survival. RESULTS: The median age was 61 years (range: 34-86 years). Kaplan-Meier tests revealed significant differences in survival between the SII-low and SII-high levels (27.0 vs. 12.0 months, respectively, p < 0.001). The Cox regression model revealed that SII was an independent prognostic factor. The implementation of the log-rank test in the IMDC groups according to the SII level provided the distinction of survival in the favorable group (SII low 49.0 months vs. SII high 11.0 months, p < 0.001), in the intermediate group (SII low 26.0 vs. SII high 15.0 months, p = 0.007), and in the poor group (SII low 19.0 vs. SII high 6.0 months, p = 0.019). CONCLUSION: The SII was an independent prognostic factor and provided significant differences in survival for the favorable, intermediate, and poor IMDC groups. Thus, the SII added to the IMDC score may be clinically beneficial in predicting survival.

The Prognostic Effect of Metastatic Lymph Node Ratio in Operated Gastric Cancer Patients.

OBJECTIVE: To assess the prognostic importance of metastatic lymph node ratio (MLNR) in operated gastric cancer patients. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Health Sciences University, Yildirim Beyazit Diskapi Training and Research Hospital, Department of General Surgery, Ankara, Turkey, between January 2014 and March 2019. METHODOLOGY: Initially, record of a total of 171 patients, operated for gastric cancer, were retrieved. Inclusion criteria involved having gastric adenocarcinoma, undergoing curative-intent surgery, absence of neoadjuvant chemotherapy, dissection of ≥15 lymph nodes, negative surgical margins, and no mortality within the first 30 days after surgery. Thirty patients were excluded for various reasons. Thus, clinicopathological features and prognostic factors including MLNR on overall and disease-free survival (DFS) were evaluated for the remaining 141 patients. RESULTS: The median age of the 141 patients was 63 years (IQR: 54 - 72 years). The median MLNR was 0.18 (IQR: 0 - 0.47). The cut-off value with highest sensitivity and specificity was determined as 0.25 (area under the curve (AUC); 0.724, CI 95%; 0.639-0.808, p <0.001) in ROC curve analysis. Multivariable Cox regression analysis showed MLNR and perineural invasion (PNI) as independent prognostic factors. Patients with MLNR >0.25 had a 2.39-fold higher risk of disease progression, and 3.76-fold higher risk of shorter survival. CONCLUSION: The study contributed to the literature that MLNR is practical and useful as an independent prognostic factor predicting survival even better than tumor/node/metastasis (TNM) staging system.  Key Words: Gastric cancer, Metastatic lymph node ratio, Prognostic factor, Surgery.

Worse patient-physician relationship is associated with more fear of cancer recurrence (Deimos Study): A study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG).

OBJECTIVE: Fear of cancer recurrence (FCR) is an important psychological trauma associated with reduction in the quality of life, disruptions in the level of adjustment, emotional distress and anxiety. The purpose of the study was to evaluate the impact of patient-physician relationship on FCR. METHODS: The study was designed as a multicentre survey study. The cancer survivors, who were under remission, were evaluated with structured questionnaires. Patient-physician relationship (PPR) scale in which higher scores indicate better relationship and FCR inventory was used. RESULTS: Between January and April 2019, 1,580 patients were evaluated. The median age was 57.0 (19-88), and 66% were female. There was high level of FCR scores in 51% of participants. There was a negative correlation between PPR and FCR scores (r = -.134, p < .001). In multivariate analysis, young age, female gender, history of metastasectomy and worse PPR were associated with high levels of FCR. CONCLUSION: It is the first data showing the adverse impact of worse PPR on FCR. The strategies to improve the PPR should be practised. In addition, the cancer survivors, who are under the risk of FCR, should be evaluated and managed.

Response to Trastuzumab Treatment and Number of Cycles in Her2-Positive Metastatic Gastric Cancer Survival.

ABSTRACT  Objective: To evaluate the effects of trastuzumab on overall survival (OS) and progression-free survival (PFS) in patients with HER2-positive metastatic gastric cancer. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, from January 2012 to December 2019. METHODOLOGY: Medical records of 33 HER2-positive metastatic gastric cancer patients who had received trastuzumab combined with chemotherapy at least 6 cycles and/or followed by maintenance as the first-line treatment were examined. Kaplan-Meier method was used for survival analysis. Log-Rank test was used to compare survival times. The prognostic factors were determined by Cox regression analysis. RESULTS:  The median OS was 15.97 months, and the median PFS was 11.11 months. The median OS and PFS were significantly higher in those who demonstrated partial or complete response to trastuzumab combination treatment, and those who received more than 10 cycles of trastuzumab. A Cox regression analysis revealed that the risk of death was 3.18 times higher in patients with stable disease and 0.44 times lower in patients who received more than 10 cycles of trastuzumab as maintenance. CONCLUSION:  The OS time was prolonged when the partial and complete response was obtained with chemotherapy combined with trastuzumab, as well as OS and PFS times were improved with the increasing number of trastuzumab cycles. Thus, it is concluded that the response better than stable disease of trastuzumab treatment and an increased number of cycles predicts improved survival efficiently in patients with HER2-positive metastatic gastric cancer.  Key Words: Metastatic gastric cancer, Trastuzumab, Prognosis, Response, Efficiency.

Effect of Aromatherapy Massage on Chemotherapy-Induced Peripheral Neuropathic Pain and Fatigue in Patients Receiving Oxaliplatin: An Open Label Quasi-Randomized Controlled Pilot Study.

BACKGROUND: Patients receiving oxaliplatin may experience peripheral neuropathic pain and fatigue. Aromatherapy massage, a nonpharmacological method, may help to control these symptoms. OBJECTIVE: The aim of this open-label, parallel-group, quasi-randomized controlled pilot study was to investigate the effect of aromatherapy massage on chemotherapy-induced peripheral neuropathic pain and fatigue in patients receiving oxaliplatin. METHODS: Stratified randomization was used to allocate 46 patients to 2 groups: intervention (n = 22) and control (n = 24). Between week 1 and week 6, participants in the intervention group (IG) received aromatherapy massage 3 times a week. There was no intervention in weeks 7 and 8. The control group (CG) received routine care. Neuropathic pain was identified using the Douleur Neuropathique 4 Questions; severity of painful paresthesia was assessed with the numerical rating scale; fatigue severity was identified with the Piper Fatigue Scale. RESULTS: At week 6, the rate of neuropathic pain was significantly lower in the IG, when compared with the CG. The severity of painful paresthesia based on numerical rating scale in the IG was significantly lower than that in the CG at weeks 2, 4, and 6. At week 8, fatigue severity in the IG was significantly lower when compared with CG (P < .05). CONCLUSION: Aromatherapy massage may be useful in the management of chemotherapy-induced peripheral neuropathic pain and fatigue. IMPLICATIONS FOR PRACTICE: This pilot study suggests that aromatherapy massage may be useful to relieve neuropathic pain and fatigue. However, there is a need for further clinical trials to validate the results of this study.

Gastric Medullary Carcinoma: A Rare Case Report.

A case of 64-year-old female patient with early stage gastric medullary carcinoma has been presented, along with a review of the literature.