Treatment with immune checkpoint inhibitors (ICI) has demonstrated clinical benefit for a wide range of cancer types. Because only a subset of patients experience clinical benefit, there is a strong ...need for biomarkers that are easily accessible across diverse practice settings. Here, in a retrospective cohort study of 1714 patients with 16 different cancer types treated with ICI, we show that higher neutrophil-to-lymphocyte ratio (NLR) is significantly associated with poorer overall and progression-free survival, and lower rates of response and clinical benefit, after ICI therapy across multiple cancer types. Combining NLR with tumor mutational burden (TMB), the probability of benefit from ICI is significantly higher (OR = 3.22; 95% CI, 2.26-4.58; P < 0.001) in the NLR low/TMB high group compared to the NLR high/TMB low group. NLR is a suitable candidate for a cost-effective and widely accessible biomarker, and can be combined with TMB for additional predictive capacity.
Re: Pragmatism and professionalism Roche, C D
Annals of the Royal College of Surgeons of England,
11/2022, Letnik:
104, Številka:
9
Journal Article
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The absence of a data availability statement and the fact that the raw data is not loaded into a permanent data repository such as the Open Science Framework (OSF) or Zenodo (CERN, Geneva, ...Switzerland) with a permanent DOI link is, to me, also a yellow flag for both articles. ...Bischoff's 2017 article includes this as 25 pages of supplementary material which was uploaded with their original submission and peer reviewed. ...the victims may be seriously inconvenienced in all this, for example one hears of editors forwarding victim's complaints verbatim to their accused plagiariser (who might be the corresponding author but also might hold a position of power over the person making the complaint)!
Letter to Editor Re Hardie et al Roche, C D
Annals of the Royal College of Surgeons of England,
09/2022, Letnik:
104, Številka:
8
Journal Article
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Cutting edge selection: learning from high reliability organisations for virtual recruitment in surgery during the COVID-19 pandemic. ...we should take the notion behind this statement even further: ...whatever is put on the scoring matrices for National Selection determines exactly what potential candidates do (ie how they shape themselves, often from as early as the first year at medical school). For another pertinent example, consider the effects, rippling throughout the profession, of having a ‘leadership’ station in core surgical applications rather than a ‘teamworking’ station. ...we move away from box-ticking, scoring matrices and matching algorithms we will continue to recruit/reward the opposite of teamworkers. Cutting edge selection: learning from high reliability organisations for virtual recruitment in surgery during the COVID-19 pandemic.
Since October 2013, French Polynesia has experienced the largest documented outbreak of Zika virus (ZIKAV) infection. To prevent transmission of ZIKAV by blood transfusion, specific nucleic acid ...testing of blood donors was implemented. From November 2013 to February 2014: 42 (3%) of 1,505 blood donors, although asymptomatic at the time of blood donation, were found positive for ZIKAV by PCR. Our results serve to alert blood safety authorities about the risk of post-transfusion Zika fever.
Most ovarian cancers originate in the fimbriated end of the fallopian tube. This has led to the hypothesis that surgical resection of the fallopian tubes at the time of gynecologic and nongynecologic ...surgical procedures-referred to as an opportunistic salpingectomy-may prevent the development of epithelial ovarian cancer for women at an average risk of developing the disease.
To compile a comprehensive, state-of-the-science review examining the current landscape of performing bilateral salpingectomy for ovarian cancer prevention.
A systematic review of the literature was performed on March 4, 2022, to identify studies examining salpingectomy for ovarian cancer prevention. This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 statement. Four databases were selected: PubMed via the National Library of Medicine's PubMed.gov, Embase via Elsevier's Embase.com, Cochrane Central Register of Controlled Trials (CENTRAL) via Wiley's Cochrane Library, and Northern Light Life Sciences Conference Abstracts via Ovid. A total of 20 gray literature sources, including 1 database, 2 registers, 1 repository, 1 index, 1 archive, 1 preprint server, 1 agency, and 12 organizations, were also searched.
The initial search produced 1089 results; a total of 158 publications were included in the final review. Salpingectomy has been associated with ovarian cancer risk reduction of approximately 80%. Studies have demonstrated that salpingectomy was safe, cost-effective, and was not associated with an earlier age of menopause onset. With widespread implementation, salpingectomy has the potential to reduce ovarian cancer mortality in the US by an estimated 15%. Both physician and patient awareness regarding the adnexa as the origin for most ovarian cancers, as well as the existence of salpingectomy and its potential benefits in reducing ovarian cancer risk, has increased during the past decade. Raising awareness and developing effective implementation strategies are essential.
The results of this systematic review suggest that bilateral salpingectomy for ovarian cancer prevention was safe and feasible and has the potential to be a cost-effective and cost-saving strategy across the population. Prospective studies to demonstrate long-term survival outcomes and feasibility in nongynecologic surgical procedures are warranted.
La sécurité transfusionnelle concerne toutes les étapes depuis la prescription des examens immuno-hématologiques jusqu’à la réalisation de l’acte transfusionnel. Dans sa décision du 5 novembre ...2006 relative aux bonnes pratiques transfusionnelles, l’Afssaps recommande de transfuser les patients pendant les heures ouvrables de l’établissement et de limiter les transfusions la nuit aux seules urgences vitales. Une enquête rétrospective menée au sein de notre établissement a permis d’évaluer la proportion des transfusions réalisées en horaires de garde. L’objectif de cette évaluation des pratiques professionnelles est d’analyser les raisons conduisant à réaliser des transfusions à des horaires tardifs et d’en évaluer la pertinence.
Blood transfusion safety covers all stages from prescription of immuno-haematological examinations until the completion of the transfusion. According to the 05/11/2006 Afssaps’ decision on good transfusion practices, transfusions should not be given at night unless the patient is actively bleeding or has some other urgent clinical need. A retrospective study was used to assess the proportion of transfusions at night. Through this professional practice evaluation, we analyze the reasons leading to perform transfusions at late hours, in order to reduce errors and improve safety for patients.
Abstract Objective To assess the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease (RD) at primary cytoreduction in advanced ovarian cancer. Methods A ...prospective, non-randomized, multicenter trial of patients who underwent primary debulking for stage III–IV epithelial ovarian cancer previously identified 9 criteria associated with suboptimal (> 1 cm residual) cytoreduction. This is a secondary post-hoc analysis looking at the ability to predict any RD. Four clinical and 18 radiologic criteria were assessed, and a multivariate model predictive of RD was developed. Results From 7/2001–12/2012, 350 patients met eligibility criteria. The complete gross resection rate was 33%. On multivariate analysis, 3 clinical and 8 radiologic criteria were significantly associated with the presence of any RD: age ≥ 60 years (OR = 1.5); CA-125 ≥ 600 U/mL (OR = 1.3); ASA 3–4 (OR = 1.6); lesions in the root of the superior mesenteric artery (OR = 4.1), splenic hilum/ligaments (OR = 1.4), lesser sac > 1 cm (OR = 2.2), gastrohepatic ligament/porta hepatis (OR = 1.4), gallbladder fossa/intersegmental fissure (OR = 2); suprarenal retroperitoneal lymph nodes (OR = 1.3); small bowel adhesions/thickening (OR = 1.1); and moderate-severe ascites (OR = 2.2). All ORs were significant with p < 0.01. A ‘predictive score’ was assigned to each criterion based on its multivariate OR, and the rate of having any RD for patients who had a total score of 0–2, 3–5, 6–8, and ≥ 9 was 45%, 68%, 87%, and 96%, respectively. Conclusions We identified 11 criteria associated with RD, and developed a predictive model in which the rate of having any RD was directly proportional to a predictive score. This model may be helpful in treatment planning.
Le centre de transfusion sanguine des armées assure l’ensemble des étapes de la chaîne transfusionnelle pour permettre le soutien transfusionnel des forces armées. Considérant la forte exposition de ...la population militaire au paludisme, la stratégie de dépistage de ce risque se doit d’être la plus efficiente possible. L’objectif principal de notre étude est d’évaluer notre stratégie de dépistage reposant uniquement sur la sérologie par rapport à une stratégie en deux étapes faisant intervenir un examen de confirmation, en termes de nombre de donneurs indument écartés et de coût au laboratoire. L’objectif secondaire est de décrire la population de donneurs séropositifs pour le paludisme. Nous avons réalisé une étude prospective reposant sur la réalisation systématique d’un examen d’immunofluorescence en cas de sérologie positive et le recueil des données démographiques sur notre logiciel médico-technique. Nous avons pu mettre en évidence une forte représentation des donneurs nés en zone d’endémie parmi les sérologies confirmées en immunofluorescence et estimer le nombre de donneurs abusivement éconduit du don du sang pour une durée de trois ans. Cependant, compte-tenu de nos estimations, le passage à une stratégie en deux étapes ne permettrait de réaliser qu’un faible gain en volume de collecte.
The French Military Blood Institute is responsible for the entire blood supply chain in the French Armed Forces. Considering, the high exposition rate of military to malaria risk, blood donation screening of plasmodium infection must be as efficient as possible. The main aim of our study was to assess our malaria testing strategy based on a single Elisa test compared with a two-step strategy implying immunofluorescence testing as confirmation test. The second goal was to describe characteristic of malaria Elisa positive donors. We conducted a prospective study: every malaria Elisa positive test was implemented by immunofluorescence testing and demographical data were recorded as usual by our medical software. We showed a significant risk of malaria ELISA positive tests among donor born in endemic area and we estimate the number of abusively 3-year rejected donors. However, based on our estimations, the two-step strategy is not relevant since the number of additionally collected blood products will be low.
To compare oncologic and perioperative outcomes in patients who underwent minimally invasive surgery (MIS) compared to laparotomy for newly diagnosed early-stage cervical carcinoma.
We ...retrospectively identified patients who underwent radical hysterectomy for stage IA1 with lymphovascular invasion (LVI), IA2, or IB1 cervical carcinoma at our institution from 1/2007–12/2017. Clinicopathologic characteristics and surgical and oncologic survival outcomes were compared using appropriate statistical testing. Multivariable Cox regression analysis was used to control for potential confounders.
We identified 196 evaluable cases—117 MIS (106 robotic 90.6%) and 79 laparotomy cases. Cohorts had similar age, BMI, substage, histologic subtype, clinical and pathologic tumor size, positive margins, and presence of LVI. The MIS group had more cases with no residual tumor in the hysterectomy (24.8% vs. 10.1%, P = 0.01). The laparotomy group had more cases with positive nodes (29.1% vs. 17.1%, P = 0.046) and more patients who received adjuvant therapy (53.2% vs. 33.3%, P = 0.006). Median follow-up was ~4 years. Five-year disease-free survival (DFS) rates were 87.0% in the MIS group and 86.6% in the laparotomy group (P = 0.92); 5-year disease-specific survival (DSS) rates were 96.5% and 93.9%, respectively (P = 0.93); and 5-year overall survival (OS) rates were 96.5% and 87.4%, respectively (P = 0.15). MIS was not associated with DFS, DSS, or OS on multivariable regression analysis. The rate of postoperative complications was significantly lower in the MIS cohort (11.1% vs. 20.3%; P = 0.04).
MIS radical hysterectomy for cervical carcinoma did not confer worse oncologic outcomes in our single-center and concurrent series of patients with early-stage cervical carcinoma.
•Minimally invasive surgery (MIS) is an appropriate option in early-stage cervical carcinoma.•MIS confers similar survival outcomes compared with laparotomy for the management of early-stage cervical carcinoma.•MIS is associated with fewer postoperative complications compared with laparotomy in the management of these patients.
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