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Objective: Depression is the most common psychiatric disorder affecting patients on hemodialysis (HD) and has been associated with impaired Quality of Life (QoL). This study aimed to investigate the prevalence of depression and the relationship between depression, QoL, and demographic factors in HD patients. Methods: Short form 36 (SF–36) and Beck's depression inventory (BDI) were employed to assess the relationship between depression, QoL and demographics in 50 hemodialysis patients. The relationship between scores of BDI and SF–36, and annual biochemical and demographic data were then evaluated. Results: Mean age of the patients was 56.4 ±16.4 years and the mean HD duration was 57.11 ±39.09 months. The incidence of depression (BDI>14) was 36%. Age, hemoglobin, ferritin, body mass index (BMI), and Kt/V values were observed to be significantly correlated with the QoL scores (p

Purpose: Tumor invasion of the external anal sphincteric muscle in patients with lower rectal cancer is one of the most important contraindications for the intersphincteric resection technique, which is the most common sphincter-sparing method in lower rectal cancer surgery. The main purpose of this article is showed that in lower rectum patients with external anal sphincter invasion, the tumoral lower rectal segment can be excised together with the invaded proximal segment of the external anal sphincter muscle system using the transsphincteric rectal resection surgeries performed with combined abdominal and perineal access, and it is highlighted that they can be considered as sphincter-sparing surgical procedures in these cases.Methods: This study includes the retrospective evaluation of 4 male and 1 female patient with advanced lower rectal adenocarcinoma detected external anal sphincteric invasion on their preoperative MRI results who underwent proximal segmental sphincteric excision and sphincter-sparing rectal resection operations in transsphincteric plan after neoadjuvant chemoradiotherapy.Results: In the postoperative follow-up of patients; Perineal fistula developed in 3 patients. Anastomotic stenosis developed in 2 patients, one of whom developed a perineal fistula. No external sphincteric invasion was detected in the postoperative histopathological evaluation of 1 patient. In the anal sphincteric pressure measurements made in the postoperative period, partial decreases were observed in the resting and maximal squeezing anal pressures of the patients. In the clinical follow-up of the patients whose ileostomy was closed, it was determined that sufficient continence was achieved. One patient died at postoperative 8th month following systemic metastases occurring at postoperative 5th month.Conclusion: Invased proximal sphincteric segment can be resected by using transsphinteric rectal resection techniques in advanced lower rectal cancer cases.

Additional file 2. Table of themes, subthemes, and corresponding supplementary quotes from study participants.

Background Breast cancer is prevalent and has high cure rates. The resultant increase in numbers of breast cancer survivors (BCS) may overwhelm the current oncology workforce in years to come. We postulate that primary care physicians (PCPs) could play an expanded role in comanaging survivors, provided they are given the appropriate tools and training to do so. Objective To explore the perspectives of PCPs towards managing BCS in a community-based shared-care programme with oncologists. Methods Eleven focus groups and six in-depth interviews were conducted with seventy PCPs recruited by purposive sampling. All sessions were audio-recorded, transcribed verbatim and coded by three independent investigators. Thematic data analysis was performed and the coding process facilitated by NVivo 12. Results Majority of PCPs reported currently limited roles in managing acute and non-cancer issues, optimizing comorbidities and preventive care. PCPs aspired to expand their role to include cancer surveillance, risk assessment and addressing unmet psychosocial needs. PCPs preferred to harmonize cancer survivorship management of their primary care patients who are also BCS, with defined role distinct from oncologists. Training to understand the care protocol, enhancement of communication skills, confidence and trust were deemed necessary. PCPs proposed selection criteria of BCS and adequacy of their medical information; increased consultation time; contact details and timely access to oncologists (if needed) in the shared-care programme. Conclusions PCPs were willing to share the care of BCS with oncologists but recommended role definition, training, clinical protocol, resources and access to oncologist’s consultation to optimize the programme implementation.

The occurrence of neurotrophic tyrosine receptor kinase (NTRK) gene fusions in a wide range of tumor types presents an attractive opportunity for using a tropomyosin receptor kinase (TRK) inhibitor as cancer therapy. Recent clinical studies have demonstrated highly efficacious outcomes associated with the use of TRK inhibitors, such as larotrectinib and entrectinib in NTRK fusion-bearing cancers, in both adult and pediatric populations. While NTRK gene fusions are commonly found in some uncommon adult and pediatric malignancies, they are also found, albeit rarely, in a wide range of more common malignancies. The potential value of testing for NTRK gene fusions in practically all advanced malignancies is underpinned by the remarkable therapeutic outcomes that TRK inhibitors offer. This requirement presents practical and financial challenges in real-world oncological practice. Furthermore, different testing platforms exist to detect NTRK gene fusions, each with its advantages and disadvantages. It is, therefore, imperative to develop strategies for NTRK gene fusion testing in an attempt to optimize the use of limited tissue specimen and financial resources, and to minimize the turnaround time. A multidisciplinary task force of Singapore medical experts in both public and private sectors was convened in late 2020 to propose testing algorithms for adult colorectal tumors, sarcomas, non-small cell lung cancer, and pediatric cancers, with particular adaptation to the Singapore oncological practice. The recommendations presented here highlight the heterogeneity of NTRK-fusion positive cancers, and emphasize the need to customize the testing methods to each tumor type to optimize the workflow.

Additional file 2: Supplemental Table S1. Clinical and demographic characteristics of patients receiving chemotherapy.

Additional file 1: Supplemental Figure S1. Maintenance rituximab therapy and OS outcomes. (a) Maintenance rituximab in patients

In this work, we demonstrate the optical trapping of 1,2-dichlorobenzene, chloroform and toluene microdroplets in water. The trapping was done by using near infrared laser with wavelength 915 nm. Power spectrum for the microdroplets at 6.3 MW/cm2 laser power were analysed to obtain the corner frequency. It was found that 1,2-dichlorobenzene had the highest corner frequency at 6.3 MW/cm2 among the three organic solvents. The difference in corner frequency of the organic solvents microdroplets could be associated with their indices of refraction.

This study aims to identify recurrent genetic alterations in relapsed or refractory (RR) natural-killer/T-cell lymphoma (NKTL) patients who have achieved complete response (CR) with programmed cell death 1 (PD-1) blockade therapy. Seven of the eleven patients treated with pembrolizumab achieved CR while the remaining four had progressive disease (PD). Using whole genome sequencing (WGS), we found recurrent clonal structural rearrangements (SR) of the PD-L1 gene in four of the seven (57%) CR patients’ pretreated tumors. These PD-L1 SRs consist of inter-chromosomal translocations, tandem duplication and micro-inversion that disrupted the suppressive function of PD-L1 3’UTR. Interestingly, recurrent JAK3-activating (p.A573V) mutations were also validated in two CR patients’ tumors that did not harbor the PD-L1 SR. Importantly, these mutations were absent in the four PD cases. With immunohistochemistry (IHC), PD-L1 positivity could not discriminate patients who archived CR (range: 6%-100%) from patients who had PD (range: 35%-90%). PD-1 blockade with pembrolizumab is a potent strategy for RR NKTL patients and genomic screening could potentially accompany PD-L1 IHC positivity to better select patients for anti-PD-1 therapy.

Calibration of axial quadrant photodetector (QPD) signal to the trapped bead position in an optical tweezer is important to measure the quantitative mechanical parameter in axial (laser propagation) direction. An alternative calibration based on the Stuck Bead Method (SBM) was proposed in this study. 3 µm polystyrene beads were stuck at the surface of glass coverslip and moved axially around the laser focus. QPD was used to obtain the position dependent intensity profile at three different laser powers (19.8 mW, 34.1 mW, 48.5 mW). The QPD signal-to-distance calibration value was consistent at 26 mV/µm for the used bead at the three laser powers. It was found that the calibration values are independent of laser powers and limited by the resolution of distance adjustment.

e19553Background: DLBCL has a 40% relapse rate in the rituximab era. Patients who relapse within a year do poorly even with salvage treatment. We aim to compare the clinical features and outcomes o...

11049 Background: Recent studies suggest that markers of systemic inflammation such as blood neutrophil-to-lymphocyte ratio (NLR) may be prognostic for various cancers, though its clinical utility has not been widely accepted. This study aims to investigate its clinical relevance in patients (pts) with soft tissue sarcoma (STS). Methods: Five hundred and twenty-nine pts with localized STS who had available pre-operative blood counts at the time of diagnosis were retrospectively examined. An optimal cutoff for high NLR ( > 2.5) in predicting overall survival (OS) and relapse-free survival (RFS) in pts who underwent curative surgery (n = 473) was determined using receiver operating curve analyses. Cutoffs for platelet-lymphocyte ratios (PLR, > 180) and lymphocyte-monocyte ratios (LMR, < 3.6) were similarly obtained. Survival analysis was performed using the Kaplan-Meier method and multivariate Cox proportional models. Median follow-up was 40 months. Results: A high NLR was present in 311 (58.8%) pts, which was significantly associated with tumor grade ( p< 0.0001), depth ( p= 0.003) and size > 5 cm ( p= 0.0242), but not with age at diagnosis, sex or ethnicity. High NLR was associated with both worse OS (HR 1.78; 95%CI 1.28-2.47; p= 0.0005) and RFS (HR 1.54; 95%CI 1.17-2.03; p= 0.0019), as were age at diagnosis, tumor grade, size, PLR and LMR. In multivariate models adjusted for clinicopathological predictors of survival, only NLR, in addition to tumor grade and size, were independently associated with worse OS (HR 1.52; 95%CI 1.09-2.11; p= 0.0131) and RFS (HR 1.42; 95%CI 1.08-1.85; p= 0.0114). Analysis of survival according to American Joint Committee on Cancer (AJCC) stages subdivided as NLR-high and NLR-low revealed a significant worse prognosis for NLR-high subgroups ( p< 0.0001), with a 2.2-fold and 1.5-fold higher risk of death within stages II (HR 2.20; 95%CI 1.20-4.01; p= 0.0103) and III (HR 1.55; 95%CI 1.01-2.37; p= 0.0459), respectively. Conclusions: High NLR is an independent marker of poor prognosis among pts with localized STS. Inclusion of NLR as a classifier into the AJCC staging of STS may improve estimation of survival.

e19076Background: Patients with lymphoma experience fevers due to infections (with or without bacteremia), malignant fever or as a complication of cancer treatment. This study was designed to evalu...