Search

The weight of the breasts affects women's center of gravity; thus, the loss of a unilateral breast directly causes a change in body posture when a patient undergoes unilateral modified radical mastectomy. This study examined the effects of an external prosthesis (EP), immediate breast reconstruction (IBR), and body shape training (BST) on body posture, body image, and quality of life in patients with breast cancer with unilateral mastectomy through an 18-month follow-up. Of 810 individuals screened for eligibility, 722 were enrolled and randomly assigned into three comparison groups (EP [n = 157] vs. IBR [n = 157]; EP [n = 143] vs. BST [n = 143]; IBR [n = 61] vs. BST [n = 61]). IBR was superior to EP and BST, with the smallest trend of changes in body posture, the least body image distress, and a higher quality of life. EP was superior to BST, with the smallest trend of changes in body posture, the least body image distress, and a higher quality of life. IBR can effectively maintain body posture and improve body image, thereby reducing body image distress and improving quality of life. It is the best choice for breast cancer patients with unilateral mastectomy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to improve the prediction of postoperative survival outcomes for patients with gastric cancer (GC) using a nomogram based on preoperative bio-indicators. Patients and Methods: This retrospective study included 303 GC patients who had undergone radical gastrectomy from 2004 to 2013 at the First Affiliated Hospital, Shihezi University. The patients were followed up for 175 months after surgery and then divided into short-term (n=201) or long-term (n=102) survival groups. We used an expectation-maximization method to fill any missing data from the reviewed patient files. We then employed the Cox proportional hazard regression to identify biochemical markers that could predict 5-year overall survival (OS) as an endpoint among GC patients. Based on the results from the biochemical analysis, we developed a nomogram and assessed its performance and reliability. Results: The variables significantly associated with OS in a multivariate analysis were age, body mass index (BMI), cell differentiation, high-density lipoprotein cholesterol (HDL-C), as well as serum potassium or serum magnesium. Combining all these predictors allowed us to establish a nomogram (C-index=0.701) whose accuracy of predicting survival was higher than the TNM staging system established by the 8th American Joint Committee on Cancer (C-index=0.666; p=0.016). Furthermore, decision curve of this nomogram was shown to have an ideal net clinical benefit rate. Conclusion: We have developed an algorithm using preoperative bio-indicators and clinical features to predict prognosis for GC patients. This tool may help clinicians to strategize appropriate treatment options for GC patients prior to surgery. [ABSTRACT FROM AUTHOR]

The negative synergistic effect of cancer and a peripherally inserted central catheter could significantly increase the incidence of thrombosis. Rather than identifying risk factors for peripherally inserted central catheter–related thrombosis, exploring the effect of these risk factors might be a promising method to improve the outcomes of thrombosis. To analyze the effect of systemic and local risk factors on triggering peripherally inserted central catheter–related thrombosis in the first two weeks post–insertion in cancer patients. A prospective cohort study. The study was conducted at a 4500-bed university-affiliated medical center in China. One hundred seventy-three cancer patients with peripherally inserted central catheters were included. Peripherally inserted central catheter–related thrombosis was assessed using ultrasound at a series of timepoints, once every two days post–insertion. Data on age, body mass index, blood hypercoagulation, insertion attempts, catheter-to-vein ratio, and blood flow velocity were collected as risk factors. Descriptive statistics and structural equation modeling were used to describe the study samples and analyze the effects of systemic and local risk factors. Among the 173 cancer patients included, 126 (72.8%) patients were diagnosed with peripherally inserted central catheter–related thrombosis. Most thromboses (n = 118, 93.7%) were detected within five days, and 100% were detected within nine days post–insertion. Structural equation modeling analysis showed that local risk factors [catheter-to-vein ratio (standardized path coefficient = 0.32, p < 0.05) and blood flow velocity (standardized path coefficient = −0.35, p < 0.05)] had a greater effect than systemic factors [age (standardized path coefficient = 0.13, p < 0.05) and blood hypercoagulation (standardized path coefficient = 0.17, p < 0.05)] on triggering peripherally inserted central catheter–related thrombosis. Peripherally inserted central catheter–related thrombosis is quite common and can occur very early post–insertion in cancer patients. Among the common risk factors, local risk factors reflecting peripherally inserted central catheter technology itself had a greater effect than systemic risk factors reflecting predisposition to thrombosis. Clinical Registration: Clinical Trials ChiCTR1900024890. [ABSTRACT FROM AUTHOR]