المؤلفون: Carmona Bayonas, Alberto, Gordo Vidal, Federico, Beato, Carmen, Castaño Pérez, José, Jiménez Fonseca, Paula, Virizuela Echaburu, Juan, Garnacho Montero, José

مصطلحات موضوعية: Cancer, Respiratory failure, UCI

الوصف: Cancer patients comprise a vulnerable collective exposed to numerous, serious risks, beyond the cancer itself. In recent years, these individuals’ prognosis has improved substantially thanks to several advances, such as immunotherapy, targeted molecular therapies, surgical techniques, or developments in support treatment. This coincides with the prolonged survival of oncological patients hospitalized in the ICU for critical complications. Thus, the time has come to revisit intensive care support for these patients, which poses new professional as well as organizational challenges. An agreement was therefore signed in 2017 between SEOM and SEMICYUC with the aim of improving the quality of care of cancer patients with critical complications. It seeks to aid in decision-making, standardize criteria, decrease subjectivity, generate channels of communication, and delve deeper into the ethical and scientific aspects of these situations. This document sets forth the most important reasons that have led us to undertake this initiative. ; pre-print ; 653 KB

العلاقة: http://hdl.handle.net/10641/1462Test

الإتاحة: https://doi.org/10.1016/j.medin.2018.01.008Test
http://hdl.handle.net/10641/1462Test

المؤلفون: Castelo, Beatriz, Palao, Ángela, Carmona-Bayonas, Alberto, Jiménez-Fonseca, Paula, Jara, Carlos, Ayala, Francisco, Ghanem, Ismael, Higuera, Oliver, Hernández, Raquel, Calderón, Caterina

المصدر: Psicooncología; Vol. 15 Núm. 1 (2018); 11-22 ; 1988-8287 ; 1696-7240

مصطلحات موضوعية: coping, depression, pain, stoicism, risk, afrontamiento, depresión, dolor, estoicismo, riesgo

الوصف: Detecting an attitude of stoic coping in patients with cancer is important because it can favor or hinder oncological treatment. Objective: In this work, we analyze whether depending on age, gender, the presence of pain and the time elapsed since the symptoms began to the diagnosis of cancer, we can assign a positive or negative value to the stoic behaviors as a factor of protection or risk in patients. Material and Methods: We evaluated 540 patients who attended the Medical Oncology consultation for evaluation of adjuvant treatment after oncological surgery, between June 2015 and December 2016. The clinical and demographic data were obtained through the medical interview and were: gender, age, marital status, educational level, occupational area, location of the tumor, stage and time elapsed since the presence of symptoms and consultation with the doctor. The following questionnaires were administered on paper and in person: Brief Pain Inventory, Brief Symptom Inventory and Liverpool Stoicism Scale. Results: The men in our sample are almost 5 times more likely to have high stoicism scores than women and 7 times more likely to be associated with a declining state of mind and advanced age. Stoicism was greater in older patients. No relationship has been found between stoicism and pain scales. Conclusion: The three characteristics that best discriminate between patients with high and / or low scores in stoicism are gender, age and depressed mood. The fact that stoicism is associated with elderly men with depression makes us think that the Stoicism should be considered more as a risk factor than as a protection factor. Age-related maturity inevitably leads to greater acceptance of losses and a propensity to hide pain, or not seeking help to avoid showing weakness. Given this situation, it is important to have the information provided by the family and recognize the importance of family support for these people who may be more vulnerable at the outset. ; Detectar una actitud de afrontamiento estoica en los pacientes ...

وصف الملف: application/pdf

العلاقة: https://revistas.ucm.es/index.php/PSIC/article/view/59171/4564456546581Test; Wagstaff G, Fowledge AM. Stoicism: Its Relation to Gender, Attitudes Toward Poverty, and reactions to emotive material. J Soc Psychol 1995; 135: 181-4. doi:10.1080/00224545.1995.9711421; Becker LC. Human health and stoic moral norms. J Med Philos 2003;28: 221-38. doi:10.1076/jmep.28.2.221.14206; Addis ME, Mahalik, JR. Men, masculinity, and the contexts of help seeking. Am Psychol 2003; 58: 5-14. doi:10.1037/0003-066X.58.1.5; Murray G, Judd F, Jackson H, Fraser C, Komiti A, Pattison P, et al. Big boys don’t cry: An investigation of stoicism and its mental health outcomes. Pers Individ Dif 2008;44:1369– 81. doi:10.1016/j.paid.2007.12.005; Calderón C, Ferrando PJ, Urbano Lorenzo-Seva U, Carmona-Bayonas A, Jara C, Ayala de la Peña F, et al. Psychometric properties of Liverpool Stoicism Scale (LSS) in a cohort of patients with resected cancer in adjuvant treatment. Ann Psychol 2017;33: 621-9. doi:10.6018/analesps.33.3.277061; Buckley J, Ó Tuama S. “I send the wife to the doctor”– Men’s behaviour as health consumers. Int J Consum Stud 2010;34:587-95. doi:10.1111/j.1470-6431.2010.00908.x; Gaitniece-Putane A. Gender and age differences in in emotional intelligence, stoicism and aggression. Baltic J Psychol 2006;7:26-42.; Moore A, Grime J, Campbell P, Richardson J. Troubling stoicism: Sociocultural influences and applications to health and illness behaviour. Health (London) 2013;17: 159-73. doi:10.1177/1363459312451179; Yong HH. Can attitudes of stoicism and cautiousness explain observed age-related variation in levels of self-rated pain, mood disturbance and functional interference in chronic pain patients? Eur J Pain 2006;10: 399-407. doi. 10.1016/j.ejpain.2005.05.004; Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med 1994; 23:129-38. [Acceso 15 de enero de 2018] Disponible en: http://wwwTest. ncbi.nlm.nih.gov/pubmed/8080219; Kumar SP. Utilization of brief pain inventory as an assessment tool for pain in patients with cancer: a focused review. Indian J Palliat Care 2011;17:108-15. doi:10.4103/0973- 1075.84531; Badia X, Muriel C, Gracia A, Núñez-Olarte JM, Perulero N, Gálvez R et al. Validation of the Spanish version of the Brief Pain Inventory in patients with oncological pain. Med Clin (Barc) 2003; 120: 52–9. [Acceso 15 de enero de 2018]. Disponible en: http://wwwTest. ncbi.nlm.nih.gov/pubmed/12570914; Derogatis LR. BSI 18, Brief Symptom Inventory 18: Administration, scoring and procedures manual. Minneapolis, MN : NCS Pearson, Inc., ©2001.; Recklitis CJ, Blackmon JE, Chang G. Validity of the Brief Symptom Inventory-18 (BSI- 18) for identifying depression and anxiety in young adult cancer survivors: comparison with a structured clinical diagnostic interview. Psychol Assess 2017; 29: 1189-200. doi:10.1037/pas0000427; International ethical guidelines for biomedical research involving human subjects CIOMS Geneva 2002. [Acceso el 15 de enero de 2018] Disponible en: http://www.ciomsTest. ch/publications/layout_guide2002.pdf; Moore A, Grime J, Campbell P, Richardson J. Troubling stoicism: Sociocultural influences and applications to health and illness behaviour. Health (London) 2012;17:159-73. doi:10.1177/1363459312451179; Judd F, Komiti A, Jackson H. How does being female assist help-seeking for mental health problems?. Aust N Z J Psychiatry 2008;42:24-9. doi:10.1080/00048670701732681; Wrigley S, Jackson H, Judd F, Komiti A. Role of stigma and attitudes toward help-seeking from a general practitioner for mental health problems in a rural town. Aust N Z J Psychiatry 2005;39:514-21. doi:10.1111/j.1440-1614.2005.01612.x; Corboy D, McLaren S, Jenkins M, McDonald J. The relationship between geographic remoteness and intentions to use a telephone support service among Australian men following radical prostatectomy. Psychooncology 2014; 23: 1259–66. doi:10.1002/pon.3559; Stewart D, Harmon K. Mental health services responding to men and their anger. Int J Ment Health Nurs 2004; 13: 249-54. doi:10.1111/j.1440-0979.2004.00341.x; Witte TK, Gordon KH, Smith, PN. Stoicism and Sensation Seeking: Male vulnerabilities for the acquired capability for suicide. J Res Pers 2012;46:384-92. doi:10.1016/j.jrp.2012.03.004; Bao Y, Li L, Guan Y, Wang W, Liu Y, Wang P et al. Prevalence and associated positive psychological variables of anxiety and depression among patients with central nervous system tumors in China : a cross-sectional study. Psychooncology 2017; 26: 262-9. doi:10.1002/pon.4128; Sharpley CF, Christie DR. H, Bitsika V, Miller BJ. Trajectories of total depression and depressive symptoms in prostate cancer patients receiving six months of hormone therapy. Psychooncology 2017;26:60-6. doi:10.1002/pon.4100; Yeung NC, Lu Q. Affect as a mediator between self-efficacy and quality of life among Chinese cancer survivors in China. Eur J Cancer Care 2014; 23:149-55. doi:10.1111/ecc.12123; Helme RD, Gibson SJ. The epidemiology of pain in elderly people. Clin Geriatr Med 2001;17:417-31.; Johansson M, Rydén A, Finizia C. Mental adjustment to cancer and its relation to anxiety, depression, HRQL and survival in patients with laryngeal cancer - a longitudinal study. BMC Cancer 2011;11: 283. doi:10.1186/1471-2407-11-283; Oh YS. Communications with health professionals and psychological distress in family caregivers to cancer patients: A model based on stress-coping theory. Appl Nurs Res 2017;33:5-9. doi:10.1016/j.apnr.2016.09.008; https://revistas.ucm.es/index.php/PSIC/article/view/59171Test

الإتاحة: https://doi.org/10.5209/PSIC.59171Test
https://doi.org/10.1080/00224545.1995.9711421Test
https://doi.org/10.1076/jmep.28.2.221.14206Test
https://doi.org/10.1037/0003-066X.58.1.5Test
https://doi.org/10.1016/j.paid.2007.12.005Test
https://doi.org/10.6018/analesps.33.3.277061Test
https://doi.org/10.1111/j.1470-6431.2010.00908.xTest
https://doi.org/10.1177/1363459312451179Test
https://doi.org/10.4103/0973Test
https://doi.org/10.1037/pas0000427Test

المؤلفون: Jiménez Fonseca, Paula, Calderón Garrido, Caterina, Carmona Bayonas, Alberto, Muñoz, Maria del Mar, Hernández San Gil, Raquel, Mut-Lloret, Margarida, Ghanem, Ismael, Beato, Carmen, Cacho Lavín, Diego, Ivars Rubio, A., Carrión Galindo, Rafael, Jara, Carlos

المصدر: Articles publicats en revistes (Psicologia Clínica i Psicobiologia)

مصطلحات موضوعية: Càncer, Quimioteràpia del càncer, Relacions metge-pacient, Cancer, Cancer chemotherapy, Physician-patient relationships

الوصف: Purpose The aim of this study was to analyze differences in physician and patient satisfaction in shared decision-making (SDM); patients' emotional distress, and coping in subjects with resected, non-metastatic cancer. Methods 602 patients from 14 hospitals in Spain were surveyed. Information was collected regarding physician and patient satisfaction with SDM, participants' emotional distress and coping, as well as patient sociodemographic and clinical characteristics by means of specific, validated questionnaires. Results Overall, 11% of physicians and 19% of patients were dissatisfied with SDM; 22% of patients presented hopelessness or anxious preoccupation as coping strategies, and 56% presented emotional distress. By gender, female patients showed a higher prevalence of dissatisfaction with SDM (23 vs 14%), anxious preoccupation (26 vs 17%), and emotional distress (63 vs 44%) than males. Hopelessness was more prevalent in individuals with stage III disease than those with stages I-II (28 vs 18%). Conclusion Physicians must be mindful of the importance of emotional support and individual characteristics when communicating treatment options, benefits, and adverse effects of each alternative to oncological patients.

وصف الملف: 8 p.; application/pdf

العلاقة: Versió postprint del document publicat a: https://doi.org/10.1007/s12094-018-1870-zTest; Clinical & Translational Oncology, 2018, vol. 20, num. 11, p. 1392-1399; https://doi.org/10.1007/s12094-018-1870-zTest; http://hdl.handle.net/2445/154549Test; 680398

الإتاحة: https://doi.org/10.1007/s12094-018-1870-zTest
http://hdl.handle.net/2445/154549Test

المؤلفون: Calderón Garrido, Caterina, Jiménez Fonseca, Paula, Jara, Carlos, Hernández San Gil, Raquel, Martínez de Castro, Eva, Varma, Sonal, Ghanem, Ismael, Carmona Bayonas, Alberto

المصدر: Articles publicats en revistes (Psicologia Clínica i Psicobiologia)

مصطلحات موضوعية: Tractament adjuvant del càncer, Càncer colorectal, Quimioteràpia del càncer, Ansietat, Adjuvant treatment of cancer, Colorectal cancer, Cancer chemotherapy, Anxiety

الوصف: Context- Patients with gastrointestinal cancers are at high risk for functional problems that are generally accompanied by a decline in their overall status and intense psychological distress. Objectives- This study compares the level of functioning in individuals with gastric cancer (GC) and colorectal cancer (CRC) and analyzes whether improved functioning can be explained by patients' psychological status and coping strategies. Methods- Prospective, transversal, multicenter study in patients with non-metastatic GC and CRC prior to initiating adjuvant chemotherapy. Participants answered questionnaires evaluating quality-of-life, including functioning (EORTC-QLC-C30), coping strategies (Mini-MAC), and psychological distress (BSI-18). Results- Between December 2015 and July 2017, 266 patients with CRC and 69 with GC were consecutively recruited. A pathological level of functioning was more prevalent in people with GC than CRC (20% vs. 5%). Individuals with GC presented worse functioning and more psychological distress and displayed more hopelessness, anxious preoccupation, and cognitive avoidance as coping strategies than those with CRC. Psychological distress and fighting spirit accounted for 40% of the functional status in GC patients, whereas psychological distress and hopelessness represented 58% of CRC patients' functional status. Conclusion- Our findings suggest that level of functioning affects many subjects with GC and reveals the importance of developing interventions targeted at enhancing adaptive coping strategies before initiating adjuvant cancer treatment.

وصف الملف: 7 p.; application/pdf

العلاقة: Versió postprint del document publicat a: https://doi.org/10.1016/j.jpainsymman.2018.05.010Test; Journal of Pain and Symptom Management, 2018, vol. 56, num. 3, p. 399-405; https://doi.org/10.1016/j.jpainsymman.2018.05.010Test; http://hdl.handle.net/2445/146048Test; 680761

الإتاحة: https://doi.org/10.1016/j.jpainsymman.2018.05.010Test
http://hdl.handle.net/2445/146048Test

المؤلفون: Calderón Garrido, Caterina, Jiménez Fonseca, Paula, Ferrando Piera, Pere Joan, Gómez-Jara Díez, Carlos, Lorenzo Seva, Urbano, Beato, Carmen, García-García, Teresa, Castelo, Beatriz, Ramchandani, Avinash, Vila Muñoz, Maria del Mar, Martínez de Castro, Eva, Ghanem, Ismael, Mangas-Izquierdo, Montserrat, Carmona Bayonas, Alberto

المصدر: Articles publicats en revistes (Psicologia Clínica i Psicobiologia)

مصطلحات موضوعية: Càncer, Relacions metge-pacient, Presa de decisions, Cancer, Physician-patient relationships, Decision making

الوصف: Antecedentes/Objetivo: Este estudio analiza las propiedades psicométricas del cuestionario Shared Decision-Making (SDM-Q-9) en pacientes con cáncer resecado, no metastásico y elegibles para quimioterapia adyuvante. Método: Estudio multicéntrico, prospectivo, transversal en el que se reclutaron 568 pacientes que respondieron al SDM-Q-9 después de visitar a su oncólogo quien, a su vez, completó el SDM-Q-versión médico. Se estudiaron la fiabilidad, la estructura factorial [análisis factorial exploratorio (EFA), análisis factorial confirmatorio (CFA)] y la validez convergente de las puntuaciones del SDMQ-9. Resultados: La escala SDM-Q-9 mostró una estructura factorial clara, compatible con un factor general fuerte y replicable, y un factor de grupo secundario. La puntuación del factor general mostró una buena fiabilidad en términos de coeficiente omega: 0,90. La asociación entre la percepción del médico y del paciente en la SDM fue débil y no logró alcanzar significación estadística. Los hombres y los pacientes mayores de 60 años mostraron mayor satisfacción con la toma de decisiones compartidas con el oncólogo. Conclusiones: El cuestionario SDM-Q-9 puede ayudar en la evaluación de la toma de decisiones compartidas desde la perspectiva de los pacientes con cáncer y como indicador del grado de calidad y satisfacción en la relación médico-paciente.

وصف الملف: 9 p.; application/pdf

العلاقة: Reproducció del document publicat a: http://www.elsevier.es/en-revista-international-journal-clinical-health-psychology-355-resumen-psychometric-properties-shared-decision-making-questionTest; International Journal of Clinical And Health Psychology, 2018, vol. 18, p. 143-151; http://hdl.handle.net/2445/124664Test; 680760

الإتاحة: http://hdl.handle.net/2445/124664Test

المؤلفون: Calderón Garrido, Caterina, Jiménez Fonseca, Paula, Ferrando Piera, Pere Joan, Jara, Carlos, Lorenzo Seva, Urbano, Beato, Carmen, García-García, Teresa, Castelo, Beatriz, Ramchandani, Avinash, Muñoz, Maria del Mar, Martínez de Castro, Eva, Ghanem, Ismael, Mangas-Izquierdo, Montserrat, Carmona Bayonas, Alberto

المصدر: Articles publicats en revistes (Psicologia Clínica i Psicobiologia)

مصطلحات موضوعية: Presa de decisions, Qüestionaris, Psicometria, Decision making, Questionnaires, Psychometrics

الوصف: Background/Objective: This study sought to assess the psychometric properties of the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) in patients with resected, non-metastatic cancer and eligible for adjuvant chemotherapy. Method: A total of 568 patients were recruited from a multi-institutional, prospective, transversal study. Patients answered the SDM-Q-9 after visiting their medical oncologist who, in turn, completed the SDM-Q---Physician version. Reliability, factorial structures [exploratory factor analysis (EFA), confirmatory factor analysis (CFA)], and convergent validity of the SDM-Q-9 scores were explored. Results: SDM-Q-9 showed a clear factorial structure, compatible with a strong and replicable general factor and a secondary group factor, in patients with resected, non-metastatic cancer. Total sum scores derived from the general factor showed good reliability in terms of omega coefficient: .90. The association between patient and physician perception of SDM was weak and failed to reach statistical significance. Males and patients over 60 years of age displayed the greatest satisfaction with SDM. Conclusions: SDM-Q-9 can aid in evaluating SDM from the cancer patients' perspective. SDM-Q-9 is helpful in studies examining patient perspectives of SDM and as an indicator of the degree of quality and satisfaction with health care and patient-physician relationship.

وصف الملف: 9 p.; application/pdf

العلاقة: Reproducció del document publicat a: https://doi.org/10.1016/j.ijchp.2017.12.001Test; International Journal of Clinical And Health Psychology, 2018, vol. 18, num. 2, p. 143-151; https://doi.org/10.1016/j.ijchp.2017.12.001Test; http://hdl.handle.net/2445/122565Test; 675462

الإتاحة: https://doi.org/10.1016/j.ijchp.2017.12.001Test
http://hdl.handle.net/2445/122565Test

المؤلفون: Fernández, Ana, Salgado, Mercedes, García, Adelaida, Buxò, Elvira, Vera, Ruth, Adeva, Jorge, Jiménez-Fonseca, Paula, Quintero, Guillermo, Llorca, Cristina, Cañabate, Mamen, López, Luis Jesús, Muñoz, Andrés, Ramírez, Patricia, González, Paula, López, Carlos, Reboredo, Margarita, Gallardo, Elena, Sanchez-Cánovas, Manuel, Gallego, Javier, Guillén, Carmen, Ruiz-Miravet, Nuria, Navarro-Pérez, Víctor, De la Cámara, Juan, Alés-Díaz, Inmaculada, Pazo-Cid, Roberto Antonio, Carmona-Bayonas, Alberto

مصطلحات موضوعية: First-line chemotherapy, Gemcitabine, Metastatic pancreatic adenocarcinoma, Nab-paclitaxel, Real-life, Survival, Adult, Aged, Albumins, Antineoplastic Combined Chemotherapy Protocols, Comorbidity, Deoxycytidine, Female, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Paclitaxel, Pancreatic Neoplasms, Prognosis, Retrospective Studies, Survival Analysis, Treatment Outcome

الوصف: Treatment with nab-paclitaxel plus gemcitabine increases survival in patients with metastatic pancreatic cancer. However, the assessment of treatment efficacy and safety in non-selected patients in a real-life setting may provide useful information to support decision-making processes in routine practice. Retrospective, multicenter study including patients with metastatic pancreatic cancer, who started first-line treatment with nab-paclitaxel plus gemcitabine between December 2013 and June 2015 according to routine clinical practice. In addition to describing the treatment pattern, overall survival (OS) and progression-free survival (PFS) were assessed for the total sample and the exploratory subgroups based on the treatment and patients' clinical characteristics. All 210 eligible patients had a median age of 65.0 years (range 37-81). Metastatic pancreatic adenocarcinoma was recurrent in 46 (21.9%) patients and de novo in 164 (78.1%); 38 (18%) patients had a biliary stent. At baseline, 33 (18.1%) patients had an ECOG performance status ≥2. Patients received a median of four cycles of treatment (range 1-21), with a median duration of 3.5 months; 137 (65.2%) patients had a dose reduction of nab-paclitaxel and/or gemcitabine during treatment, and 33 (17.2%) discontinued treatment due to toxicity. Relative dose intensity (RDI) for nab-paclitaxel, gemcitabine, and the combined treatment was 66.7%. Median OS was 7.2 months (95% CI 6.0-8.5), and median PFS was 5.0 months (95% CI 4.3-5.9); 50 patients achieved either a partial or complete response (ORR 24.6%). OS was influenced by baseline ECOG PS, NLR and CA 19.9, but not by age ≥ 70 years and/or the presence of hepatobiliary stent or RDI 3 vs. ≤ 3 (p = 0.043), and baseline CA 19.9 > 37 U/mL vs. ≤37 U/mL (p = 0.004). Nab-Paclitaxel plus gemcitabine remain effective in a real-life setting, despite the high burden of dose reductions and poorer performance of these patients. A nomogram to predict survival using baseline ECOG performance status, NLR and CA 19.9 is ...

وصف الملف: application/pdf

العلاقة: http://hdl.handle.net/10668/13261Test; PMC6267080; https://doi.org/10.1186/s12885-018-5101-3Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267080/pdfTest

الإتاحة: https://doi.org/10.1186/s12885-018-5101-3Test
http://hdl.handle.net/10668/13261Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267080/pdfTest

المؤلفون: Nuñez-Valdovinos, Barbara, Carmona-Bayonas, Alberto, Jimenez-Fonseca, Paula, Capdevila, Jaume, Castaño-Pascual, Ángel, Benavent, Marta, Pi Barrio, Jose Javier, Teule, Alex, Alonso, Vicente, Custodio, Ana, Marazuela, Monica, Segura, Ángel, Beguiristain, Adolfo, Llanos, Marta, Martinez Del Prado, Maria Purificacion, Diaz-Perez, Jose Angel, Castellano, Daniel, Sevilla, Isabel, Lopez, Carlos, Alonso, Teresa, Garcia-Carbonero, Rocio

مصطلحات موضوعية: Gastroenteropancreatic, Heterogeneity, Ki‐67, Neuroendocrine neoplasms, Prognosis, Registry, Tumor differentiation, World Health Organization 2010, Adolescent, Adult, Aged, 80 and over, Carcinoma, Neuroendocrine, Cell Differentiation, Child, Female, Humans, Intestinal Neoplasms, Ki-67 Antigen, Male, Middle Aged, Neoplasm Grading, Neoplasm Staging, Neuroendocrine Tumors, Pancreatic Neoplasms, Proportional Hazards Models, Registries, Spain, Stomach Neoplasms

الوصف: Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a complex family of tumors of widely variable clinical behavior. The World Health Organization (WHO) 2010 classification provided a valuable tool to stratify neuroendocrine neoplasms (NENs) in three prognostic subgroups based on the proliferation index. However, substantial heterogeneity remains within these subgroups, and simplicity sometimes entails an ambiguous and imprecise prognostic stratification. The purpose of our study was to evaluate the prognostic impact of histological differentiation within the WHO 2010 grade (G) 1/G2/G3 categories, and explore additional Ki-67 cutoff values in GEP-NENs. A total of 2,813 patients from the Spanish National Tumor Registry (RGETNE) were analyzed. Cases were classified by histological differentiation as NETs (neuroendocrine tumors [well differentiated]) or NECs (neuroendocrine carcinomas [poorly differentiated]), and by Ki-67 index as G1 (Ki-67 20%). Patients were stratified into five cohorts: NET-G1, NET-G2, NET-G3, NEC-G2, and NEC-G3. Five-year survival was 72%. Age, gender, tumor site, grade, differentiation, and stage were all independent prognostic factors for survival. Further subdivision of the WHO 2010 grading improved prognostic stratification, both within G2 (5-year survival: 81% [Ki-67 3%-5%], 72% [Ki-67 6%-10%], 52% [Ki-67 11%-20%]) and G3 NENs (5-year survival: 35% [Ki-67 21%-50%], 22% [Ki-67 51%-100%]). Five-year survival was significantly greater for NET-G2 versus NEC-G2 (75.5% vs. 58.2%) and NET-G3 versus NEC-G3 (43.7% vs. 25.4%). Substantial clinical heterogeneity is observed within G2 and G3 GEP-NENs. The WHO 2010 classification can be improved by including the additive effect of histological differentiation and the proliferation index. Gastroenteropancreatic neuroendocrine neoplasms are tumors of widely variable clinical behavior, roughly stratified by the World Health Organization (WHO) 2010 classification into three subgroups based on proliferation index. Real-world data from 2,813 ...

العلاقة: http://hdl.handle.net/10668/12006Test; PMC5896708; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896708/pdfTest

الإتاحة: https://doi.org/10.1634/theoncologist.2017-0364Test
http://hdl.handle.net/10668/12006Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896708/pdfTest

المؤلفون: Calderón, Caterina, Jimenez-Fonseca, Paula, Jara, Carlos, Hernández, Raquel, Martínez de Castro, Eva, Varma, Sonal, Ghanem, Ismael, Carmona-Bayonas, Alberto

المصدر: Journal of Pain and Symptom Management ; volume 56, issue 3, page 399-405 ; ISSN 0885-3924

مصطلحات موضوعية: Anesthesiology and Pain Medicine, Neurology (clinical), General Nursing

الإتاحة: https://doi.org/10.1016/j.jpainsymman.2018.05.010Test
https://api.elsevier.com/content/article/PII:S0885392418302550?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0885392418302550?httpAccept=text/plainTest

المؤلفون: Calderon, Caterina, Jiménez-Fonseca, Paula, Ferrando, Pere Joan, Jara, Carlos, Lorenzo-Seva, Urbano, Beato, Carmen, García-García, Teresa, Castelo, Beatriz, Ramchandani, Avinash, Muñoz, María Mar, Martínez de Castro, Eva, Ghanem, Ismael, Mangas, Montse, Carmona-Bayonas, Alberto

المصدر: International Journal of Clinical and Health Psychology ; volume 18, issue 2, page 143-151 ; ISSN 1697-2600

مصطلحات موضوعية: Clinical Psychology

الإتاحة: https://doi.org/10.1016/j.ijchp.2017.12.001Test
https://api.elsevier.com/content/article/PII:S1697260018300012?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1697260018300012?httpAccept=text/plainTest