Notes

Enhancement regarding asymmetric hypothyroid attention disease using teprotumumab.
Both nurses and doctors should be aware of their crucial role in demonstrating empathy towards parents/children affected by T1D. There is a need for training programs to develop a culture where empathy enhances nursing and medical practice.
Both nurses and doctors should be aware of their crucial role in demonstrating empathy towards parents/children affected by T1D. There is a need for training programs to develop a culture where empathy enhances nursing and medical practice.
Electronic patient-reported outcome (ePRO) measures have the potential to improve patient care, both at an individual level by detecting symptoms and at an organisational level to rationalise follow-up. The introduction of ePROs has many challenges, including funding, institutional rigidity and acceptability for both patients and clinicians. There are multiple examples of successful ePRO programmes but no specific feasibility studies in those who are less digitally engaged. Prostate cancer is predominantly a disease of older men and digital exclusion is associated with increased age. We assessed the feasibility of ePRO completion in older men receiving treatment for advanced prostate cancer both within the clinic and from home.

Men receiving palliative systemic treatment were asked to complete ePROs on a tablet computer in the outpatient department at 0 and 3 months. Participants were also offered optional completion from home. Feasibility was assessed via a mixed methods approach.

On-site ePRO completiting symptoms or stratifying follow-up.
For Hepatocellular carcinoma (HCC) surgery either through resection or transplantation often provides the only chance for cure. Since hepatocarcinogenesis and postsurgical prognosis is not only dependent on cirrhosis but also on immune activation and exhaustion, many studies have investigated tumor infiltrating leukocyte (TIL) subsets. This systematic review and meta-analysis aims at describing the cell groups and their predictive power regarding overall (OS), disease free (DFS) and recurrence free survival (RFS).

A systematic search of the PubMed database was conducted (PROSPERO 172324). Data on CD3
, CD8
, Treg, B cells, macrophages, neutrophil and NK-cells were collected from Pubmed and related references up to December 2018. Overall (OS), disease-free (DFS) and recurrence free survival (RFS) in dependence of high vs. low infiltration rates were compared using a random effects meta-analysis.

Altogether data from 3541 patients enrolled in 20 publications were included. Except for Tregs and Neutrophils, heterogeneity analysis was found to be moderate to high across the studies. High CD3
, CD8
, NK-cell infiltration predicted better survival (OS, DFS and RFS; p<0.05). Higher Treg and Neutrophil infiltration predicted lower OS and DFS. For Macrophages and B cells no difference in survival could be found.

As with other solid tumors immune infiltration has a great influence on survival after resection. However, a considerable publication bias cannot be ruled out in mostly retrospective analyses. Nevertheless, in light of novel immune modulatory treatments this opens a new avenue towards effective and well-tolerated adjuvant treatment.
As with other solid tumors immune infiltration has a great influence on survival after resection. However, a considerable publication bias cannot be ruled out in mostly retrospective analyses. Nevertheless, in light of novel immune modulatory treatments this opens a new avenue towards effective and well-tolerated adjuvant treatment.
Primary leiomyosarcoma (LMS) of the gastrointestinal (GI) tract is rare. Limited literature exists regarding the clinical characteristics and outcome for patients with localised and metastatic disease.

A retrospective chart review was performed for patients greater than 18 years of age diagnosed with GI LMS at The Royal Marsden Hospital between 1 January 2000-1 May 2020. Descriptive statistics were performed. Patients were censored at data cut-off date of 27 June 2020.

Forty-six patients with a median age at diagnosis of 54 years (range 25-85) were identified. Fifteen percent (n=7) of patients previously received abdominal radiation for an unrelated cancer. All patients with localised disease (n=36) had resection with oncological margins. For patients who underwent potentially curative surgery, median recurrence-free survival (mRFS) was 13 months (0.4-183 months), and half of these patients (n=18) developed recurrent disease post resection (distant n=16, local n=2). Median overall survival (mOS) was 27 months for patients with distant recurrence. Twenty-one percent (n=10) of patients presented with synchronous metastatic disease and their mOS was 19 months. Median progression-free survival (mPFS) for patients treated with conventional chemotherapy ranged from 2.0 to 8.0 months.

The risk of recurrence is significant, and recurrence-free survival was short even with complete oncologic resection. The relationship of prior abdominal radiotherapy to the development of GI LMS warrants further investigation. Outcomes with systemic therapy for metastatic disease were poor and there is a need for the development of more effective systemic therapies.
The risk of recurrence is significant, and recurrence-free survival was short even with complete oncologic resection. The relationship of prior abdominal radiotherapy to the development of GI LMS warrants further investigation. Outcomes with systemic therapy for metastatic disease were poor and there is a need for the development of more effective systemic therapies.
Recently, the Cancer of the Bladder Risk Assessment (COBRA) score has been introduced to estimate cancer specific survival (CSS) after radical cystectomy for bladder cancer.

Aim of our study was to validate the COBRA score, assessing the effect of age, tumor stage and lymph-nodes status on CSS after cystectomy in patients with bladder cancer.

A consecutive series of 2395 patients with primitive or recurrent bladder cancer treated with radical cystectomy in 4 centers were evaluated.

The role of COBRA score as predictor of CSS was assessed using the Kaplan Meier and Cox proportional hazards analyses. Accuracy of COBRA score was evaluated by Harrell's C test.

Median age was 66 (IQR 58/73) years. Overall, at a median follow-up of 48 (IQR 22/92) months, 642 patients (27%) died of bladder cancer. learn more On Cox proportional hazards analyses, COBRA score was a significant predictor of CSS (HR 1.54, 95%CI 1.47-1.61) (Table1). The predictive accuracy of the COBRA score was 0.71. A sub analysis including pooled COBRA score (0 vs 1-3 vs 4 vs 5-7) improved the clinical applicability with the same accuracy.
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