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7. Factors Predicting Readmission and Mortality in Patients Admitted for Malignant Bowel Obstruction.

Author

Xu, Nova, Sun, Beatrice J., Yue, Tiffany M., and Lee, Byrne

Subjects
*BOWEL obstructions, *PATIENT readmissions, *GASTROINTESTINAL cancer, *MANAGEMENT by objectives, *GASTROINTESTINAL surgery
Abstract

Introduction: Malignant bowel obstruction (MBO) is a common complication of patients with advanced malignancies and has poor prognosis. Currently, there are limited guidelines for MBO management or predicting outcomes for these patients. Objective: To identify patient factors associated with readmission and mortality after hospital admission for MBO. Participants: A 5-year retrospective review was performed from 2017 to 2022 at a single tertiary institution to evaluate patients admitted for MBO. All patients had advanced cancer of gastrointestinal or gynecologic primary. Patient demographics, socioeconomic factors, tumor characteristics, and inpatient outcomes were collected. Multivariable analyses were performed to determine variables predicting hospital readmission for recurrent MBO and 90-day mortality. Results: 210 patients were included. Mean age was 61 years, 28% were male, and 19% did not primarily speak English. 35% of patients lived over 50 miles from the hospital. On multivariable analysis, non-English speaking patients exhibited increased risk of readmission forMBO (OR = 2.82, P = .039).Older age was associated with decreased risk forMBO readmission (OR = .96, P = .007). Ascites was associated with increased mortality (OR = 2.17, P = .043). Earlier palliative care (PC) consultation predicted decreased readmission (OR = .24, P < .001) yet increased mortality at 90 days (OR = 3.20, P = .003). Conclusion: Patient age, primary language, and PC consult were predictors for MBO readmission, which may impact 90-day mortality. Given the palliative nature of MBO, modifiable factors such as PC consultation and multidisciplinary goals of care discussions should be prioritized in order to reduce readmissions and focus on quality of life (QOL) for this patient population. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Dysregulated Repeat Element Viral-like Immune Response in Hepatocellular Carcinoma

Author

Coley, Avril K., primary, Lu, Chenyue, additional, Pankaj, Amaya, additional, Emmett, Matthew J., additional, Lang, Evan R., additional, Song, Yuhui, additional, Xu, Katherine H., additional, Xu, Nova, additional, Patel, Bidish K., additional, Chougule, Abhijit, additional, Nieman, Linda T., additional, Aryee, Martin J., additional, Ferrone, Cristina R., additional, Deshpande, Vikram, additional, Franses, Joseph W., additional, and Ting, David T., additional

Published
2023
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9. Supplementary Data from Reverse Transcriptase Inhibition Disrupts Repeat Element Life Cycle in Colorectal Cancer

Author

Rajurkar, Mihir, primary, Parikh, Aparna R., primary, Solovyov, Alexander, primary, You, Eunae, primary, Kulkarni, Anupriya S., primary, Chu, Chong, primary, Xu, Katherine H., primary, Jaicks, Christopher, primary, Taylor, Martin S., primary, Wu, Connie, primary, Alexander, Katherine A., primary, Good, Charly R., primary, Szabolcs, Annamaria, primary, Gerstberger, Stefanie, primary, Tran, Antuan V., primary, Xu, Nova, primary, Ebright, Richard Y., primary, Van Seventer, Emily E., primary, Vo, Kevin D., primary, Tai, Eric C., primary, Lu, Chenyue, primary, Joseph-Chazan, Jasmin, primary, Raabe, Michael J., primary, Nieman, Linda T., primary, Desai, Niyati, primary, Arora, Kshitij S., primary, Ligorio, Matteo, primary, Thapar, Vishal, primary, Cohen, Limor, primary, Garden, Padric M., primary, Senussi, Yasmeen, primary, Zheng, Hui, primary, Allen, Jill N., primary, Blaszkowsky, Lawrence S., primary, Clark, Jeffrey W., primary, Goyal, Lipika, primary, Wo, Jennifer Y., primary, Ryan, David P., primary, Corcoran, Ryan B., primary, Deshpande, Vikram, primary, Rivera, Miguel N., primary, Aryee, Martin J., primary, Hong, Theodore S., primary, Berger, Shelley L., primary, Walt, David R., primary, Burns, Kathleen H., primary, Park, Peter J., primary, Greenbaum, Benjamin D., primary, and Ting, David T., primary

Published
2023
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10. Data from Reverse Transcriptase Inhibition Disrupts Repeat Element Life Cycle in Colorectal Cancer

Author

Rajurkar, Mihir, primary, Parikh, Aparna R., primary, Solovyov, Alexander, primary, You, Eunae, primary, Kulkarni, Anupriya S., primary, Chu, Chong, primary, Xu, Katherine H., primary, Jaicks, Christopher, primary, Taylor, Martin S., primary, Wu, Connie, primary, Alexander, Katherine A., primary, Good, Charly R., primary, Szabolcs, Annamaria, primary, Gerstberger, Stefanie, primary, Tran, Antuan V., primary, Xu, Nova, primary, Ebright, Richard Y., primary, Van Seventer, Emily E., primary, Vo, Kevin D., primary, Tai, Eric C., primary, Lu, Chenyue, primary, Joseph-Chazan, Jasmin, primary, Raabe, Michael J., primary, Nieman, Linda T., primary, Desai, Niyati, primary, Arora, Kshitij S., primary, Ligorio, Matteo, primary, Thapar, Vishal, primary, Cohen, Limor, primary, Garden, Padric M., primary, Senussi, Yasmeen, primary, Zheng, Hui, primary, Allen, Jill N., primary, Blaszkowsky, Lawrence S., primary, Clark, Jeffrey W., primary, Goyal, Lipika, primary, Wo, Jennifer Y., primary, Ryan, David P., primary, Corcoran, Ryan B., primary, Deshpande, Vikram, primary, Rivera, Miguel N., primary, Aryee, Martin J., primary, Hong, Theodore S., primary, Berger, Shelley L., primary, Walt, David R., primary, Burns, Kathleen H., primary, Park, Peter J., primary, Greenbaum, Benjamin D., primary, and Ting, David T., primary

Published
2023
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11. Supplementary Figure from Reverse Transcriptase Inhibition Disrupts Repeat Element Life Cycle in Colorectal Cancer

Author

Rajurkar, Mihir, primary, Parikh, Aparna R., primary, Solovyov, Alexander, primary, You, Eunae, primary, Kulkarni, Anupriya S., primary, Chu, Chong, primary, Xu, Katherine H., primary, Jaicks, Christopher, primary, Taylor, Martin S., primary, Wu, Connie, primary, Alexander, Katherine A., primary, Good, Charly R., primary, Szabolcs, Annamaria, primary, Gerstberger, Stefanie, primary, Tran, Antuan V., primary, Xu, Nova, primary, Ebright, Richard Y., primary, Van Seventer, Emily E., primary, Vo, Kevin D., primary, Tai, Eric C., primary, Lu, Chenyue, primary, Joseph-Chazan, Jasmin, primary, Raabe, Michael J., primary, Nieman, Linda T., primary, Desai, Niyati, primary, Arora, Kshitij S., primary, Ligorio, Matteo, primary, Thapar, Vishal, primary, Cohen, Limor, primary, Garden, Padric M., primary, Senussi, Yasmeen, primary, Zheng, Hui, primary, Allen, Jill N., primary, Blaszkowsky, Lawrence S., primary, Clark, Jeffrey W., primary, Goyal, Lipika, primary, Wo, Jennifer Y., primary, Ryan, David P., primary, Corcoran, Ryan B., primary, Deshpande, Vikram, primary, Rivera, Miguel N., primary, Aryee, Martin J., primary, Hong, Theodore S., primary, Berger, Shelley L., primary, Walt, David R., primary, Burns, Kathleen H., primary, Park, Peter J., primary, Greenbaum, Benjamin D., primary, and Ting, David T., primary

Published
2023
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12. Reverse Transcriptase Inhibition Disrupts Repeat Element Life Cycle in Colorectal Cancer

Author

Rajurkar, Mihir, primary, Parikh, Aparna R., additional, Solovyov, Alexander, additional, You, Eunae, additional, Kulkarni, Anupriya S., additional, Chu, Chong, additional, Xu, Katherine H., additional, Jaicks, Christopher, additional, Taylor, Martin S., additional, Wu, Connie, additional, Alexander, Katherine A., additional, Good, Charly R., additional, Szabolcs, Annamaria, additional, Gerstberger, Stefanie, additional, Tran, Antuan V., additional, Xu, Nova, additional, Ebright, Richard Y., additional, Van Seventer, Emily E., additional, Vo, Kevin D., additional, Tai, Eric C., additional, Lu, Chenyue, additional, Joseph-Chazan, Jasmin, additional, Raabe, Michael J., additional, Nieman, Linda T., additional, Desai, Niyati, additional, Arora, Kshitij S., additional, Ligorio, Matteo, additional, Thapar, Vishal, additional, Cohen, Limor, additional, Garden, Padric M., additional, Senussi, Yasmeen, additional, Zheng, Hui, additional, Allen, Jill N., additional, Blaszkowsky, Lawrence S., additional, Clark, Jeffrey W., additional, Goyal, Lipika, additional, Wo, Jennifer Y., additional, Ryan, David P., additional, Corcoran, Ryan B., additional, Deshpande, Vikram, additional, Rivera, Miguel N., additional, Aryee, Martin J., additional, Hong, Theodore S., additional, Berger, Shelley L., additional, Walt, David R., additional, Burns, Kathleen H., additional, Park, Peter J., additional, Greenbaum, Benjamin D., additional, and Ting, David T., additional

Published
2022
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13. HCC spatial transcriptomic profiling reveals significant and potentially targetable cancer-endothelial interactions.

Author

Lu C, Pankaj A, Raabe M, Nawrocki C, Liu A, Xu N, Patel BK, Emmett MJ, Coley AK, Ferrone CR, Deshpande V, Bhan I, Hoshida Y, Ting DT, Aryee MJ, and Franses JW

Subjects
Humans, Cell Communication genetics, Transcriptome, Male, Signal Transduction genetics, Female, Gene Expression Regulation, Neoplastic, Prognosis, Liver Neoplasms genetics, Liver Neoplasms pathology, Carcinoma, Hepatocellular genetics, Gene Expression Profiling, Endothelial Cells metabolism
Abstract

Background: HCC is a highly vascular tumor, and many effective drug regimens target the tumor blood vessels. Prior bulk HCC subtyping data used bulk transcriptomes, which contained a mixture of parenchymal and stromal contributions., Methods: We utilized computational deconvolution and cell-cell interaction analyses to cell type-specific (tumor-enriched and vessel-enriched) spatial transcriptomic data collected from 41 resected HCC tissue specimens., Results: We report that the prior Hoshida bulk transcriptional subtyping schema is driven largely by an endothelial fraction, show an alternative tumor-specific schema has potential prognostic value, and use spatially paired ligand-receptor analyses to identify known and novel (LGALS9 tumor-HAVCR2 vessel) signaling relationships that drive HCC biology in a subtype-specific and potentially targetable manner., Conclusions: Our study leverages spatial gene expression profiling technologies to dissect HCC heterogeneity and identify heterogeneous signaling relationships between cancer cells and their endothelial cells. Future validation and expansion of these findings may validate novel cancer-endothelial cell interactions and related drug targets., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.)

Published
2024
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14. Dysregulated Repeat Element Viral-like Immune Response in Hepatocellular Carcinoma.

Author

Coley AK, Lu C, Pankaj A, Emmett MJ, Lang ER, Song Y, Xu KH, Xu N, Patel BK, Chougule A, Nieman LT, Aryee MJ, Ferrone CR, Deshpande V, Franses JW, and Ting DT

Abstract

Purpose: Dysregulation of viral-like repeat RNAs are a common feature across many malignancies that are linked with immunological response, but the characterization of these in hepatocellular carcinoma (HCC) is understudied. In this study, we performed RNA in situ hybridization (RNA-ISH) of different repeat RNAs, immunohistochemistry (IHC) for immune cell subpopulations, and spatial transcriptomics to understand the relationship of HCC repeat expression, immune response, and clinical outcomes., Experimental Design: RNA-ISH for LINE1, HERV-K, HERV-H, and HSATII repeats and IHC for T-cell, Treg, B-cell, macrophage, and immune checkpoint markers were performed on 43 resected HCC specimens. Spatial transcriptomics on tumor and vessel regions of interest was performed on 28 specimens from the same cohort., Results: High HERV-K and high LINE1 expression were both associated with worse overall survival. There was a positive correlation between LINE1 expression and FOXP3 T-regulatory cells (r = 0.51 p < 0.001) as well as expression of the TIM3 immune checkpoint (r = 0.34, p = 0.03). Spatial transcriptomic profiling of HERV-K high and LINE-1 high tumors identified elevated expression of multiple genes previously associated with epithelial mesenchymal transition, cellular proliferation, and worse overall prognosis in HCC including SSX1, MAGEC2, and SPINK1., Conclusion: Repeat RNAs may serve as useful prognostic biomarkers in HCC and may also serve as novel therapeutic targets. Additional study is needed to understand the mechanisms by which repeat RNAs impact HCC tumorigenesis., Competing Interests: COMPETING INTERESTS STATEMENT DTT has received consulting fees from ROME Therapeutics, Sonata Therapeutics, and Tekla Capital. DTT is a founder and has equity in ROME Therapeutics, PanTher Therapeutics and TellBio, Inc., which is not related to this work. DTT is on the advisory board for ImproveBio, Inc. DTT has received honorariums from Moderna and Ikena Oncology that are not related to this work. DTT receives research support from ACD-Biotechne, AVA LifeScience GmbH, and Incyte Pharmaceuticals, which was not used in this work. DTT’s interests were reviewed and are managed by Massachusetts General Hospital and Mass General Brigham in accordance with their conflict-of-interest policies.

Published
2023
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