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Surgical Delays Not Life-Threatening in Early Breast Cancer

WEDNESDAY, Aug. 12, 2020 (HealthDay News) -- Surgical delays do not seem to be life-threatening for women with ductal carcinoma in situ (DCIS) or with early-stage estrogen receptor-positive (ER+) breast cancer, according to a study published online Aug. 6 in the Journal of the American College of Surgeons.

Christina A. Minami, M.D., from Brigham and Women's Hospital in Boston, and colleagues examined the potential implications of surgical delays for patients with DCIS and early-stage ER+ breast cancer. Data were included for 378,839 patients with DCIS or ER+ cT1-2N0 breast cancer treated from 2010 to 2016.

The researchers found that time to surgery (TTS) was within 120 days for >98 percent in all groups, among those undergoing primary surgery. Among patients selected for neoadjuvant endocrine therapy (NET), surgery was performed within 120 days in 59.6 and 30.9 percent of cT1N0 and cT2N0 patients, respectively. In DCIS patients, increased TTS correlated with increased odds of pathological upstaging; this was not the case in patients with invasive cancer, regardless of the initial treatment strategy. For DCIS or NET patients, overall survival did not differ by TTS.

"While the applicability of these data to the patients experiencing surgical delays during the COVID-19 pandemic is limited, surgeons and patients may find some reassurance in these findings, as these two groups represent patients significantly affected by the surgical triage recommendations of the COVID-19 Pandemic Breast Cancer Consortium," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text

CDC: Pediatric Hospitalizations for COVID-19 Increasing

WEDNESDAY, Aug. 12, 2020 (HealthDay News) -- While rates of hospitalization for children with COVID-19 remain low, they have been increasing, according to research published in the Aug. 7 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Lindsay Kim, M.D., from the CDC in Atlanta, and colleagues analyzed data from the COVID-19-Associated Hospitalization Surveillance Network (March 1 to July 25, 2020) and identified 576 pediatric COVID-19 cases (<18 years).

The researchers note that the cumulative COVID-19-associated hospitalization rate among children was 8.0 per 100,000 population, with the highest rate among children aged <2 years (24.8 per 100,000). During the study period, weekly hospitalization rates steadily increased among children (from 0.1 to 0.4 per 100,000, with a weekly high of 0.7 per 100,000). There were higher cumulative rates observed for COVID-19-associated hospitalizations among Hispanic or Latino and non-Hispanic black children (16.4 and 10.5 per 100,000, respectively) versus non-Hispanic white children (2.1 per 100,000). For the 208 hospitalized children with complete medical chart reviews, one-third (33.2 percent) were admitted to an intensive care unit, 5.8 percent required invasive mechanical ventilation, and one patient (0.5 percent) died during hospitalization.

"Although the cumulative rate of pediatric COVID-19-associated hospitalization remains low (8.0 per 100,000 population) compared with that among adults (164.5), weekly rates increased during the surveillance period, and one in three hospitalized children were admitted to the ICU, similar to the proportion among adults," the authors write.

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Sharp Drop in Non-Small Cell Lung Cancer Mortality Seen in Recent Years

WEDNESDAY, Aug. 12, 2020 (HealthDay News) -- Mortality from non-small-cell lung cancer (NSCLC) in the United States fell sharply from 2013 to 2016, while survival improved substantially, according to a study published in the Aug. 13 issue of the New England Journal of Medicine.

Nadia Howlader, Ph.D., from the National Cancer Institute in Bethesda, Maryland, and colleagues used data from Surveillance, Epidemiology, and End Results registries to assess lung cancer incidence and mortality.

The researchers found that mortality from NSCLC decreased even faster than its incidence. This decrease was associated with a substantial improvement in survival over time that corresponded to the timing of approval of targeted therapies. From 2013 through 2016, incidence-based mortality from NSCLC decreased 6.3 percent annually among men, while the incidence decreased 3.1 percent annually from 2008 through 2016. There was a corresponding improvement in lung cancer-specific survival among men from 26 percent for NSCLC that was diagnosed in 2001 to 35 percent among those diagnosed in 2014. Similar improvements in survival were seen across races and ethnic groups and women. However, for small cell lung cancer (SCLC), declines in mortality were almost entirely as a result of declining incidence and not improved survival. This finding correlates with limited treatment advances for SCLC during the same time period.

"The survival benefit for patients with NSCLC treated with targeted therapy has been shown in clinical trials, but our study highlights their possible effect at the population level," the authors write.

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