Highlights Bone is a common metastatic site in renal cell carcinoma (RCC). HGF/c-Met pathway is particularly relevant in tumors with bone metastases. c-Met/HGF pathway is involved in RCC progression, conferring poor prognosis. Several c-Met targeting therapies are currently in clinical development. c-Met expression is an important therapeutic target in RCC with bone metastases.

An online cross-sectional study on COVID-19 vaccination adhesion was conducted in Portugal nine months after vaccination rollout (September–November 2021). Logistic regression was used to identify factors associated with hesitancy to take the COVID-19 vaccine in the community-based survey, “COVID-19 Barometer: Social Opinion”. Hesitancy was 11%; however, of those, 60.5% stated that they intended to take the vaccine. Hesitancy was associated with factors such as lower monthly household income; no intention of taking the flu vaccine this year; perceived reasonable health status; having two or more diseases; low confidence in the health service response; worse perception of the adequacy of anti-COVID-19 government measures; low or no perceived risk of getting COVID-19; feeling agitated, anxious or sad some days; and lack of trust in the safety and efficacy of the vaccines. Confidence in vaccines, namely against COVID-19, is paramount for public health and should be monitored during vaccination rollout. Clear communication of the risks and benefits of vaccination needs improvement to increase adherence and public confidence.

Introduction: Breast cancer is the first cause of cancer-related death in Portuguese women. This study aimed to characterize female breast cancer mortality in Portugal in the period between 2002 and 2013, with a special focus on spatiotemporal patterns.Material and Methods: The breast cancer mortality rate was studied using descriptive analysis (unadjusted and age-adjusted), and spatiotemporal clustering analyses.Results: In 2002 – 2013 the breast cancer mortality rate was 28.47/100 000 inhabitants and the age-adjusted mortality rate was 19.46/100 000 inhabitants. In this period the Lisbon region (urban), Alentejo and Algarve (rural) presented higher breast cancer mortality rate, but Madeira (urban), Lisbon and Algarve had higher age-adjusted mortality rate. In the spatiotemporal analysis, the overall mortality rate showed an increasing trend of 1.218%/year, without spatial variations. Also, different patterns were detected in the < 50, 50 - 64 and ≥ 65 age-groups (+ 0.725%, - 1.781% and + 0.896%, respectively). One temporal (2004 – 2006) and one spatiotemporal cluster (North coast) presented significantly lower mortality rate than expected for the period and/or area (26.2 and 16.1/100 000 inhabitants, respectively). Conversely, two spatiotemporal clusters, located in the city of Lisbon (2002 – 2007) and in the Centre region (2008 – 2013), presented significantly higher breast cancer mortality rate than expected (48.6 and 34.9/100 000 inhabitants, relative risk: 1.74 and 1.26, respectively).Discussion: The annual female crude and adjusted breast cancer mortality rate matched previous publications. However the annual increase detected in the unadjusted rate clashes with the published literature. Overall, the presence of spatiotemporal clusters supports the uneven distribution of the breast cancer mortality reported previously in the different Portuguese regions.Conclusion: This study identified areas and trends of the female breast cancer mortality rate, showing high spatiotemporal variations that must support further detailed studies/interventions.

Aim: To compare the overall survival (OS) of patients with locoregional and metastatic breast cancer (BC) considering baseline demographic, clinical and contextual characteristics. Materials and Methods: A retrospective analysis of a cancer registry was conducted, using the Kaplan-Meier and Mantel-Cox analyses for the calculation of median OS and cumulative survival. Results: The median OS was 112 months, being longer in patients with locoregional versus those with metastatic BC at diagnosis (115 vs. 31 months, p<0.001). The cumulative survival at 1, 3 and 5 years were 94.9%, 85.6% and 76.5%, respectively. More recent year of diagnosis [hazard ratio (HR)=1.09] and age at diagnosis (≥65 vs. 40 years, HR=2.79) and presence of metastatic disease (HR=5.69) were associated with a shorter OS. The region of residence, morphology and topography of the tumor were also associated with survival in patients with BC. Rurality was only associated with lower survival in patients with metastatic BC. Conclusion: This study identified significant differences in the median OS of patients with locoregional and those with metastatic BC considering their baseline characteristics.Breast cancer (BC) is the most frequent malignant disease in women worldwide (1, 2), in Europe (2, 3) and in Portuguese women (3-9). Survival of patients with BC has expanded over time (10-16), an improvement that can be attributed to the increase in cases being diagnosed early (11,(17)(18)(19)(20), screening actions (11-13, 17, 20), and treatment advances (10-12, 17, 20-22). The survival of patients with BC has also been associated with other factors such as stage (10-14, 17, 20-23) and age at diagnosis (4, 5, 6-12, 14, 15, 16, 21, 24-26), rurality (25, 27), and other prognostic factors (16, 28) such as the histology of the tumor (13,16,28,29) and tumor location (30).To date, few publications have compared the overall survival of patients with locoregional and metastatic BC and correlated it with the patients' baseline characteristics. A study conducted in patients diagnosed with BC in 1990-1999 in 10 European countries identified 5-and 10-year all-cause overall survival rates of 89% and 80%, respectively ( 13). An analysis conducted in the Cote D'Or registry on patients with metastatic BC diagnosed in 2000-2011 showed survival rates at 1 and 2 years of 67.3% and 47.5%, respectively, with a median survival of 22.7 months ( 16). Another publication on this topic reported overall survival of 92.9%, 77.6% and 65.5% at 1, 3 and 5 years, respectively, in Italian women diagnosed in 1979-1981 (24). A further study conducted on Scottish women with non-metastatic BC diagnosed in 1987-1993 showed that the 8-year overall survival decreased with age (12), and another analysis of Turkish women conducted between 1995 and 2008 found a median survival of 120 months, with 90% survival at the 5-year cut-off date ( 22). Additionally, a retrospective study conducted on patients with metastatic BC diagnosed in 1980-2009 in Germany reported a median survival of 85 months, with w...

Breast cancer (BC) is the most frequent malignancy in Portuguese women, and more than half of the registered cases live in the south of the country. The main of this study was to characterize patients with locoregional and metastatic incident BC living in the Southern Portuguese and Madeira regions in 2005–2012 according to demographic, clinical and contextual characteristics. Additionally it aimns to find the associations and relative influences of these factors with locoregional or metastatic disease at diagnosis. After a descriptive approach, binary logistic regression models were used to estimate factors related to the presence of metastatic disease at diagnosis. A final multiple regression model was developed and presented graphically as a nomogram. The median age at diagnosis was 60.84 years, being statistically lower in locoregional cases (P < 0.001). Most patients presented a locoregional disease (78.4%) of unspecified location (44.5%) and had a ductal carcinoma (73.1%). The Lisbon region represented 50.5% of the analyzed cases. Metastatic disease significantly decreased over the period under analysis ( ≈ 7%/year). Demographic (age at diagnosis ≥ 50 years), clinical (lobular and ‘other’ morphologies, unspecified location) and contextual (residence in Portalegre) characteristics were statistically correlated with the presence of metastatic disease at the time of BC diagnosis in univariate logistic regression, with all but the last maintaining their significance in a multivariate model. Cases with metastatic BC disease at diagnosis are decreasing; however, additional information on their characteristics can improve the alignment of public health strategies, thus strengthening this trend, and contributing to the development of a graphically tailored screening tool.

This study identified critical areas of high IR and increasing trends for female BC-IR, providing evidence of heterogeneities in this area.

Introduction: Breast cancer (BC) is the most common cancer among Portuguese women and it is associated with high hospitalization rates. Therefore, this study aims to characterize the BC hospital admission rate (HAR) in women in the period of 2002-2016, with an additional focus on spatiotemporal patterns of hospitalizations by BC (main code). Methods: After a descriptive analysis of all BC hospitalizations, the main BC code HAR was studied using mapping techniques, analysis of spatiotemporal clusters, and analysis of spatial variations in temporal trends. Results: The BC-HAR was 118.72/10 5 women, showing a growth of 3.109% per year in this period. The median length of stay (LOS) in these patients was 5 days, and most cases were programmed surgical admissions. Several spatiotemporal clusters and spatial variations in temporal trends were detected. The seaside area of the country showed 4 high HAR clusters in the spatiotemporal analysis. Additionally, the seaside north of the country and 2 isolated counties presented significantly different temporal trends in BC-HAR versus the rest of the country. These clusters suggest regional asymmetries, as they showed differences in terms of: demographic characteristics (age at admission and rurality of county of residence), the type of admission, LOS, and outcomes of hospitalization. Conclusion: This study identified key areas of high BC-HAR and increasing trends for female HAR, providing evidence of spatial heterogeneities in this health indicator.