- Identification and assessment of frailty in older patients with chronic myeloid leukemia and myelofibrosis, and indications for tyrosine kinase inhibitor treatment. [Review]
- AHAnn Hematol 2018 Feb 22
- The incidence of cancer, including myeloproliferative neoplasms (MPNs), is projected to increase significantly due to the growing proportion of people aged > 65 years. These older individuals are a h...
The incidence of cancer, including myeloproliferative neoplasms (MPNs), is projected to increase significantly due to the growing proportion of people aged > 65 years. These older individuals are a heterogeneous population in terms of fitness, comorbidity, and psychological reserve. Therefore, age per se does not always provide an accurate indication of condition in patients with cancer. Frailty has been proposed as an alternative measure of vulnerability that might better indicate which patients can tolerate standard cancer treatment and those who may benefit from treatment adjustment. A number of methods can be used to assess frailty in older patients with hematological malignancies, including the Cardiovascular Health Study Frailty Screening Measure, the FRAIL (Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight) questionnaire, the Clinical Frailty Scale (CFS), and the Gérontopôle Frailty Screening Tool. In addition to physical frailty, comorbidity and quality of life should also be included in the assessment. Prior to the introduction of tyrosine kinase inhibitors (TKIs), age was considered a marker of poor prognosis in patients with MPNs. In contrast, data show that age is not necessarily a contraindication for TKI use. In CML, the efficacy of TKIs has been shown to be independent of age. The JAK1/2 inhibitor ruxolitinib also seems to be effective across a range of patient ages. Available data suggest that chronological age itself should not necessarily be a contraindication for many new therapies in patients with MPNs, and that frailty does provide a better measure of vulnerability. There is a need for specific methods to assess frailty in patients with MPNs, particularly the context of effective new treatment options, such as TKIs and ruxolitinib.
- Metastatic cardiac tumors: from clinical presentation through diagnosis to treatment. [Journal Article]
- BCBMC Cancer 2018 Feb 20; 18(1):202
- CONCLUSIONS: Metastatic cardiac tumors are extremely rare. As new diagnostic technologies and improved survival of oncological patients may increase the incidence of metastatic cardiac tumors in the future, awareness to their existence and knowledge of their presentation are key factors in their timely recognition.
- Clinicopathological indicators of survival among patients with pulmonary carcinoid tumor. [Journal Article]
- AOActa Oncol 2018 Feb 20; :1-8
- CONCLUSIONS: We conclude that PCs are uncommon tumors. When resected, the long-term survival is in general favorable. In this consecutive, single-institution cohort of patients, presence of metastatic disease, tumor size, histological subtype and Ki-67 index were associated with shorter disease-specific survival. As TC and AC have different clinical behaviors, the correct tumor classification at the time of diagnosis is a necessity.
- Primary neoplasms of the small bowel at CT: a pictorial essay for the clinician. [Journal Article]
- EREur Rev Med Pharmacol Sci 2018; 22(3):598-608
- CONCLUSIONS: Multidetector-CT, performed after distension of the small bowel with oral contrast material and intravenous injection of iodinated contrast material, is a useful method for the diagnosis and staging of small bowel neoplasms.
- A Rare Case of Multiple Myxoma Involving Both Mitral Valve Leaflets. [Journal Article]
- ATAnn Thorac Cardiovasc Surg 2018 Feb 20
- Mitral valve myxoma is a very rare entity. Multiple myxomas with extensive involvement of the anterior and posterior leaflets of the mitral valve are exceedingly rare. We report a 58-year-old man who...
Mitral valve myxoma is a very rare entity. Multiple myxomas with extensive involvement of the anterior and posterior leaflets of the mitral valve are exceedingly rare. We report a 58-year-old man who was admitted as sudden syncope. Thoracic echocardiography showed several masses adherent to the anterior and posterior leaflets and the mitral annulus with obvious mobility. Intraoperative probing revealed multiple tumors attached to the mitral annulus, valve leaflets, and tendinous cords. Mechanical mitral valve replacement was performed. Histopathological examination confirmed all tumors to be myxomas.
- A Giant Cardiac Cavernous Hemangioma Involving the Left Atrial Roof in an Elderly Woman. [Journal Article]
- ATAnn Thorac Cardiovasc Surg 2018 Feb 16
- Cardiac tumors are relatively rare, with primary hemangiomas being a particularly rare benign neoplasm. Herein, we report a case of a symptomatic cardiac tumor detected via echocardiography in an 82-...
Cardiac tumors are relatively rare, with primary hemangiomas being a particularly rare benign neoplasm. Herein, we report a case of a symptomatic cardiac tumor detected via echocardiography in an 82-year-old woman. Although we performed advanced imaging examinations for her heart, we could not diagnose the tumor before surgery. Eventually, a tumor involving the left atrial roof was detected, and it was completely resected to relieve her symptoms and establish a precise diagnosis. Histopathological examination indicated a cardiac cavernous hemangioma. The patient exhibited an uneventful recovery without any complications.
- The Failing Heart Stimulates Tumor Growth by Circulating Factors. [Journal Article]
- CircCirculation 2018 Feb 19
- Background -Heart failure (HF) survival has improved and nowadays many patients with HF die from non-cardiac causes, including cancer. Our aim was to investigate whether a causal...
Background -Heart failure (HF) survival has improved and nowadays many patients with HF die from non-cardiac causes, including cancer. Our aim was to investigate whether a causal relationship exists between HF and the development of cancer. Methods -HF was induced by inflicting large anterior myocardial infarction (MI) in APCmin mice, which are prone to develop precancerous intestinal tumors, and tumor growth was measured. In addition, to rule out hemodynamic impairment, a heterotopic heart transplantation model was employed, where an infarcted or sham-operated heart was transplanted into a recipient mouse, while the native heart was left in situ. After 6 weeks, tumor number, volume, and proliferation were quantified. Candidate secreted proteins were selected because they were previously associated both with (colon) tumor growth and with myocardial production in post-MI proteomic studies. Myocardial gene expression levels of these selected candidates were analyzed, as well as their proliferative effects on HT-29 (colon cancer) cells. We validated these candidates by measuring them in plasma of healthy subjects and HF patients. Finally, we associated the relation between cardiac specific and inflammatory biomarkers and new-onset cancer in a large prospective general population cohort. Results -The presence of failing hearts, both native and heterotopically transplanted, resulted in significantly increased intestinal tumor load of 2.4fold in APCmin mice (all P<0.0001). The severity of left ventricular (LV) dysfunction and fibrotic scar strongly correlated with tumor growth (P=0.002 and P=0.016, respectively). We identified several proteins (including serpinA3 and A1, fibronectin, ceruloplasmin, and PON1) that were elevated in human patients with chronic HF (N=101) compared to healthy subjects (N=180, P<0.001). Functionally, serpinA3 resulted in marked proliferation effects in human colon cancer (HT-29) cells, associated with Akt-S6 phosphorylation. Finally, elevated cardiac and inflammation biomarkers in apparently healthy humans (N=8319), were predictive for new-onset cancer (N=1124), independent from risk factors for cancer (age, smoking status and body mass index). Conclusions -We demonstrate that the presence of HF is associated with enhanced tumor growth and this is independent from hemodynamic impairment and could be due cardiac excreted factors. A diagnosis of HF may therefore be considered a risk factor for incident cancer.
- Cardiac Metastasis from Clivus Chordoma: A Case Report. [Journal Article]
- WNWorld Neurosurg 2018 Feb 14
- CONCLUSIONS: This case illustrates the metastatic potential of clivus chordoma and the heart can be a site of metastasis.
- Examining the Incidence and Presentation of Melanoma in the Cardiothoracic Transplant Population. [Journal Article]
- JDJAMA Dermatol 2018 Feb 16
- CONCLUSIONS: Representing one of the largest reported studies of patients with CTT developing MM, our findings suggest that the CTT population experiences an incidence of MM similar to that of other solid organ transplant recipients and with a median of 2.5 years from transplant to melanoma diagnosis. While the small scale of our study prevents far-reaching conclusions, further study is warranted to better understand the incidence, timing, and clinical ramifications of melanomagenesis in the CTT population.
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- Resection of Intrathoracic Paraganglioma With and Without Cardiopulmonary Bypass. [Journal Article]
- ATAnn Thorac Surg 2018 Feb 13
- CONCLUSIONS: In this series, 73% of intrathoracic PGLs were functional and involved noradrenergic, mixed noradrenergic and dopaminergic, or pure dopaminergic secretion. Cardiac and pericardial paraganglioma resection may require cardiopulmonary bypass. Although intraoperative bleeding in most complex cases may be uncontrollable, as for 1 of our patients, those who survived hospital discharge had favorable long-term outcomes.