Background and Objectives Cancer carries one of the heaviest burdens globally in terms of mortality. Lebanon is a middle-income Middle East country also plagued with cancer, as such a study and analysis of cancer trends and projections would serve a great benefit in the fight against the disease. Materials and Methods All data pertaining to cancers in Lebanon were extracted from the National Cancer Registry of Lebanon Web site. Data were analyzed to produce trends over the years of our study (2008–2015). Ten-year projections were further calculated for the top cancers by the primary site using logarithmic models. Results The top cancers in Lebanon are the breast, lung, colorectal, bladder, and prostate. The top cancers affecting females are the breast, lung, and colorectal. The top cancers affecting males are the prostate, lung, and bladder. Cancer cases are projected to increase in Lebanon over the next 10 years. Conclusion Lebanon had a steady incidence rate of cancer cases during the time of our study. A more complete understanding of cancer trends and their ultimate reduction will require further research into the origins of specific cancers and the means of prevention and control.
Background: The purpose of this case series is to assess the safety and efficacy, as well as the overall survival (OS) and progression free survival (PFS) of patients with intrahepatic cholangiocarcinoma (ICC) treated with percutaneous ablation, transarterial arterial chemoembolization (TACE) or a combination of both at our institution.Methods: Ten patients with pathological diagnosis of adenocarcinoma treated at out institution between January 1 st 2013 and January 1 st 2019 were reviewed. Three patients received a combined TACE and ablation treatment, three patients received TACE without ablation and four patients were treated with ablation only.Ablation technical success was determined by absence of residual tumor in the ablation zone on follow-up imaging one-month post-ablation. TACE response was assessed using the Modified Response Evaluation Criteria in Solid Tumors (mRECIST). Technical success was defined as injection of chemoembolic material in the involved liver lobes. PFS and OS were calculated from the date of diagnosis.Results: In the TACE and radiofrequency ablation (RFA) group, OS was 12, 55 and 56 months; PFS was 5, 6 and 32 months, one patient died and two others remain alive. In the TACE group, OS was 29, 10 and 5 months; PFS was 15, 10 and 4 months. All three patients remain alive. In the ablation group, OS and PFS were 16, 31, 30 and 40 months. All patients remain alive. Overall, 9 of 10 patients are alive, with a Median OS and PFS of 29.5 and 15.5 months, respectively, with some patients remain alive over four years following initial presentation. Conclusions:Our study shows that ablation and TACE in combination with more traditional modalities such as chemoradiation and surgical resection can extend survival in patients with ICC significantly.Locoregional therapy is well tolerated with only minor adverse events. The use of stereotactic body radiation therapy (SBRT) with ablation demonstrated the synergistic nature of using multiple lines of interventions.
Background: Prostate cancer (PCa) is the most common non-skin cancer in American men. The aim of the study was to determine the nationwide prevalence, trends, and predictors of inpatient PCa screening encounters in patients with average risk of PCa using the National Inpatient Sample (NIS) database. Methods: The NIS database from 2006 to 2014 was used to evaluate PCa screening among hospitalized patients in the United States (US). All hospitalized male patients between the ages of 45 and 69 at average risk for PCa were included. The outcome was whether a patient had an encounter for prostate cancer as noted on their discharge record. Variables analyzed included demographic factors, hospital characteristics, and other concomitant diagnoses for prostate or male urinary problems. Results: The prevalence of inpatient PCa screening was 2.57 per 100,000 hospital discharges. In a multivariate setting, the following were significant factors associated with greater odds of inpatient PCa screening: Medicare (AOR: 3.07; P = 0.0016), Self-Pay or Uninsured patients (AOR: 1.74; P = 0.0371), rural (AOR: 11.9; P = < 0.0001) or urban nonteaching hospitals (AOR: 5.26; P = < 0.0001), receiving care in the Midwest (AOR: 4.90; P = < 0.0001), a diagnosis for urinary tract infections (P = 0.0367), genitourinary symptoms (P < 0.0001), hyperplasia of prostate (P = 0.0006), or other male genital disorder (P < 0.0001). Conclusion: According to current cancer screening guidelines, PSA screening should include shared decision making between physicians and patients. In light of unequal access to quality healthcare, there exist disparities in uninsured and rural patients for cancer screening. Screening tools such as prostate-specific antigen (PSA) are minimally invasive modalities in the inpatient setting that can help screen individuals at increased risk for the development of prostate cancer, allowing for early detection, prevention, improved rates of cure and ultimately, decreased rates of mortality.
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