Search

Importance Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality.Objective To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality.Design, Setting, and Participants The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis.Exposures SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated.Main Outcomes and Measures The primary end point was all-cause mortality within the primary hospitalization.Results Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86).Conclusions and Relevance The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

Supplemental material, sj-docx-1-uro-10.1177_20514158211065949 for MRI-based nomogram for the prediction of prostate cancer diagnosis: A multi-centre validated patient���physician decision tool by Edwin M Chau, Beth Russell, Aida Santaolalla, Mieke Van Hemelrijck, Stuart McCracken, Toby Page, Sidath H Liyanage, Jonathan Aning, Vincent J Gnanapragasam and Peter Acher in Journal of Clinical Urology

Additional file 1: Table S1. Patient demographics of prostate, renal, urothelial, and testicular cancer groups. Table S2. Oncological characteristics of prostate, renal, urothelial, and testicular cancer groups.

Supplemental material, sj-docx-1-uro-10.1177_20514158211065949 for MRI-based nomogram for the prediction of prostate cancer diagnosis: A multi-centre validated patient���physician decision tool by Edwin M Chau, Beth Russell, Aida Santaolalla, Mieke Van Hemelrijck, Stuart McCracken, Toby Page, Sidath H Liyanage, Jonathan Aning, Vincent J Gnanapragasam and Peter Acher in Journal of Clinical Urology

Background Despite high contagiousness and rapid spread, SARS-CoV-2 has led to heterogeneous outcomes across affected nations. Within Europe, the United Kingdom (UK) is the most severely affected country, with a death toll in excess of 100.000 as of January 2021. We aimed to compare the national impact of COVID-19 on the risk of death in UK cancer patients versus those in continental Europe (EU). Methods We performed a retrospective analysis of the OnCovid study database, a European registry of cancer patients consecutively diagnosed with COVID-19 in 27 centres from February 27 to September 10, 2020. We analysed case fatality rates and risk of death at 30 days and 6 months stratified by region of origin (UK versus EU). We compared patient characteristics at baseline, including oncological and COVID-19 specific therapy across UK and EU cohorts and evaluated the association of these factors with the risk adverse outcome in multivariable Cox regression models. Findings Compared to EU (n=924), UK patients (n=468) were characterised by higher case fatality rates (40.38% versus 26.5%, p

Supplemental material, sj-pdf-1-inq-10.1177_00469580211030217 for Designing a Pragmatic Intervention to Help Improve the Bladder Cancer Patient Experience by Agustina Bessa, Cecilia Bosco, Fidelma Cahill, Beth Russell, Louis Fox, Charlotte Moss, Harriet Wylie, Anna Haire, Saran Green, Deborah Enting, Shamim Khan, Rajesh Nair, Ramesh Thurairaja, Kathryn Chatterton, Suzanne Amery, Nicola Peat, Sue Smith, Stuart Spear, Richard T Bryan, Leila Frodsham, Danny Burke, Jeannie Rigby, Lydia Makaroff, Phil Kelly, Melanie Costin, Christel Häggström and Mieke Van Hemelrijck in INQUIRY: The Journal of Health Care Organization, Provision, and Financing

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflamació; Mediadors d'inflamació Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflamación; Mediadores de la inflamación Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflammation; Inflammation mediators Background Patients with cancer are particularly susceptible to SARS-CoV-2 infection. The systemic inflammatory response is a pathogenic mechanism shared by cancer progression and COVID-19. We investigated systemic inflammation as a driver of severity and mortality from COVID-19, evaluating the prognostic role of commonly used inflammatory indices in SARS-CoV-2-infected patients with cancer accrued to the OnCovid study. Methods In a multicenter cohort of SARS-CoV-2-infected patients with cancer in Europe, we evaluated dynamic changes in neutrophil:lymphocyte ratio (NLR); platelet:lymphocyte ratio (PLR); Prognostic Nutritional Index (PNI), renamed the OnCovid Inflammatory Score (OIS); modified Glasgow Prognostic Score (mGPS); and Prognostic Index (PI) in relation to oncological and COVID-19 infection features, testing their prognostic potential in independent training (n=529) and validation (n=542) sets. Results We evaluated 1071 eligible patients, of which 625 (58.3%) were men, and 420 were patients with malignancy in advanced stage (39.2%), most commonly genitourinary (n=216, 20.2%). 844 (78.8%) had ≥1 comorbidity and 754 (70.4%) had ≥1 COVID-19 complication. NLR, OIS, and mGPS worsened at COVID-19 diagnosis compared with pre-COVID-19 measurement (p

Additional file 2. Study descriptives sorted by population characteristics.

Supplemental material, sj-pdf-1-inq-10.1177_00469580211030217 for Designing a Pragmatic Intervention to Help Improve the Bladder Cancer Patient Experience by Agustina Bessa, Cecilia Bosco, Fidelma Cahill, Beth Russell, Louis Fox, Charlotte Moss, Harriet Wylie, Anna Haire, Saran Green, Deborah Enting, Shamim Khan, Rajesh Nair, Ramesh Thurairaja, Kathryn Chatterton, Suzanne Amery, Nicola Peat, Sue Smith, Stuart Spear, Richard T Bryan, Leila Frodsham, Danny Burke, Jeannie Rigby, Lydia Makaroff, Phil Kelly, Melanie Costin, Christel Häggström and Mieke Van Hemelrijck in INQUIRY: The Journal of Health Care Organization, Provision, and Financing

Additional file 1. Search strategy.

List of conditions and medications included as exposures (DOCX 19 kb)

Supplemental material, sj-docx-1-tam-10.1177_17588359211042224 for Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective by Gehan Soosaipillai, Anjui Wu, Gino M Dettorre, Nikolaos Diamantis, John Chester, Charlotte Moss, Juan Aguilar-Company, Mark Bower, Christopher CT Sng, Ramon Salazar, Joan Brunet, Eleanor Jones, Ricard Mesia, Amanda Jackson, Uma Mukherjee, Ailsa Sita-Lumsden, Elia Seguí, Diego Ottaviani, Anna Carbó, Sarah Benafif, Rachel Würstlein, Carme Carmona, Neha Chopra, Claudia Andrea Cruz, Judith Swallow, Nadia Saoudi, Eudald Felip, Myria Galazi, Isabel Garcia-Fructuoso, Alvin J. X. Lee, Thomas Newsom-Davis, Yien Ning Sophia Wong, Anna Sureda, Clara Maluquer, Isabel Ruiz-Camps, Alba Cabirta, Aleix Prat, Angela Loizidou, Alessandra Gennari, Daniela Ferrante, Josep Tabernero, Beth Russell, Mieke Van Hemelrijck, Saoirse Dolly, Nicholas J Hulbert-Williams, David J Pinato in Therapeutic Advances in Medical Oncology

List of conditions and medications included as exposures (DOCX 19 kb)

Supplemental material, sj-docx-1-tam-10.1177_17588359211042224 for Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective by Gehan Soosaipillai, Anjui Wu, Gino M Dettorre, Nikolaos Diamantis, John Chester, Charlotte Moss, Juan Aguilar-Company, Mark Bower, Christopher CT Sng, Ramon Salazar, Joan Brunet, Eleanor Jones, Ricard Mesia, Amanda Jackson, Uma Mukherjee, Ailsa Sita-Lumsden, Elia Seguí, Diego Ottaviani, Anna Carbó, Sarah Benafif, Rachel Würstlein, Carme Carmona, Neha Chopra, Claudia Andrea Cruz, Judith Swallow, Nadia Saoudi, Eudald Felip, Myria Galazi, Isabel Garcia-Fructuoso, Alvin J. X. Lee, Thomas Newsom-Davis, Yien Ning Sophia Wong, Anna Sureda, Clara Maluquer, Isabel Ruiz-Camps, Alba Cabirta, Aleix Prat, Angela Loizidou, Alessandra Gennari, Daniela Ferrante, Josep Tabernero, Beth Russell, Mieke Van Hemelrijck, Saoirse Dolly, Nicholas J Hulbert-Williams, David J Pinato in Therapeutic Advances in Medical Oncology

Table S1. Adjusted Odds for association between AIMs exposure and PCa diagnosis in sensitivity analyses. Table S2. Adjusted Odds for association between AIMs exposure and PCa diagnosis in sensitivity analyses (DOCX 17 kb)

Table S1. Adjusted Odds for association between AIMs exposure and PCa diagnosis in sensitivity analyses. Table S2. Adjusted Odds for association between AIMs exposure and PCa diagnosis in sensitivity analyses (DOCX 17 kb)

Background Whether chronic inflammation increases prostate cancer risk remains unclear. This study investigated whether chronic inflammatory diseases (CID) or anti-inflammatory medication use (AIM) were associated with prostate cancer risk. Methods Fifty-five thousand nine hundred thirty-seven cases (all prostate cancer, 2007–2012) and 279,618 age-matched controls were selected from the Prostate Cancer Database Sweden. CIDs and AIMs was determined from national patient and drug registers. Associations were investigated using conditional logistic regression, including for disease/drug subtypes and exposure length/dose. Results Men with a history of any CID had slightly increased risk of any prostate cancer diagnosis (OR: 1.08; 95%CI: 1.04–1.12) but not ‘unfavourable’ (high-risk or advanced) prostate cancer. Generally, risk of prostate cancer was highest for shorter exposure times. However, a positive association was observed for asthma > 5 years before prostate cancer diagnosis (OR: 1.21; 95%CI: 1.05–1.40). Risk of prostate cancer was increased with prior use of any AIMs (OR: 1.26; 95%CI: 1.24–1.29). A positive trend with increasing cumulative dose was only observed for inhaled glucocorticoids (p

We investigated the association between metabolic syndrome (MetS) and its components and risk of prostate cancer (PCa) in a cohort of men enrolled in the UK Biobank. Our study cohort included 220 622 PCa‐free men with baseline measurements of triglycerides (TG), HDL‐cholesterol (HDL), glycated haemoglobin (HbA1c), blood pressure (BP), and waist circumference (WC). Multivariable Cox proportional hazards regression was used to analyse associations with PCa for: individual metabolic components (TG, HDL, HbA1c, BP, WC), combinations of two and three components, and MetS overall (three or more components). We conducted mediation analyses to examine potential hormonal and inflammatory pathways (total testosterone (TT), C‐reactive protein (CRP), insulin‐like growth factor 1 (IGF‐1)) through which MetS components may influence PCa risk. A total of 5409 men in the study developed PCa during a median follow‐up of 6.9 years. We found no significant association between MetS and PCa risk (Hazard Ratio (HR): 0.99, 95% Confidence Interval (CI): 0.92‐1.06). No associations were found with PCa risk and individual measurements of TG, HDL, BP or WC. However, an inverse association was observed with elevated HbA1c (≥42 mmol/mol) (HR: 0.89, 95%CI: 0.79‐0.98). Consistent inverse associations were observed between HbA1c and risk of PCa. Mediation analysis revealed TT, CRP and IGF‐1 as potential mediating factors for this association contributing 10.2%, 7.1% and 7.9% to the total effect, respectively. Overall MetS had no association with PCa risk. However, a consistent inverse association with PCa risk was found for HbA1c. This association may be explained in part through hormonal and inflammatory pathways.

Background: Despite high contagiousness and rapid spread, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to heterogeneous outcomes across affected nations. Within Europe (EU), the United Kingdom (UK) is the most severely affected country, with a death toll in excess of 100,000 as of January 2021. We aimed to compare the national impact of coronavirus disease 2019 (COVID-19) on the risk of death in UK patients with cancer versus those in continental EU. Methods: We performed a retrospective analysis of the OnCovid study database, a European registry of patients with cancer consecutively diagnosed with COVID-19 in 27 centres from 27th February to 10th September 2020. We analysed case fatality rates and risk of death at 30 days and 6 months stratified by region of origin (UK versus EU). We compared patient characteristics at baseline including oncological and COVID-19-specific therapy across UKand EU cohorts and evaluated the association of these factors with the risk of adverse out-comes in multivariable Cox regression models Findings: Compared with EU (n = 924), UK patients (n = 468) were characterised by higher case fatality rates (40.38% versus 26.5%, p < 0.0001) and higher risk of death at 30 days (haz-ard ratio [HR], 1.64 [95% confidence interval {CI}, 1.36-1.99]) and 6 months after COVID-19 diagnosis (47.64% versus 33.33%; p < 0.0001; HR, 1.59 [95% CI, 1.33-1.88]). UK patients were more often men, were of older age and have more comorbidities than EU counterparts (p < 0.01). Receipt of anticancer therapy was lower in UK than in EU patients (p < 0.001). Despite equal proportions of complicated COVID-19, rates of intensive care admission and use of mechanical ventilation, UK patients with cancer were less likely to receive anti-COVID-19 therapies including corticosteroids, antivirals and inter leukin-6 antagonists (p < 0.0001). Multivariable analyses adjusted for imbalanced prognostic factors confirmed the UK cohort to be characterised by worse risk of death at 30 days and 6 months, indepen-dent of the patient's age, gender, tumour stage and status; number of comorbidities; COVID-19 severity and receipt of anticancer and anti-COVID-19 therapy. Rates of permanent cessa-tion of anticancer therapy after COVID-19 were similar in the UK and EU cohorts. Interpretation: UK patients with cancer have been more severely impacted by the unfolding of the COVID-19 pandemic despite societal risk mitigation factors and rapid deferral of anti-cancer therapy. The increased frailty of UK patients with cancer highlights high-risk groups that should be prioritised for anti-SARS-CoV-2 vaccination. Continued evaluation of long-term outcomes is warranted. (C) 2021 Elsevier Ltd. All rights reserved.

Objectives To investigate the association between lower urinary-tract infections, their associated antibiotics and the subsequent risk of developing PCa. Subjects/Patients (or materials) and methods Using data from the Swedish PCBaSe 3.0, we performed a matched case-control study (8762 cases and 43806 controls). Conditional logistic regression analysis was used to assess the association between lower urinary-tract infections, related antibiotics and PCa, whilst adjusting for civil status, education, Charlson Comorbidity Index and time between lower urinary-tract infection and PCa diagnosis. Results It was found that lower urinary-tract infections did not affect PCa risk, however, having a lower urinary-tract infection or a first antibiotic prescription 6–12 months before PCa were both associated with an increased risk of PCa (OR: 1.50, 95% CI: 1.23–1.82 and 1.96, 1.71–2.25, respectively), as compared to men without lower urinary-tract infections. Compared to men with no prescriptions for antibiotics, men who were prescribed ≥10 antibiotics, were 15% less likely to develop PCa (OR: 0.85, 95% CI: 0.78–0.91). Conclusion PCa was not found to be associated with diagnosis of a urinary-tract infection or frequency, but was positively associated with short time since diagnoses of lower urinary-tract infection or receiving prescriptions for antibiotics. These observations can likely be explained by detection bias, which highlights the importance of data on the diagnostic work-up when studying potential risk factors for PCa.