Immunosenescence in Childhood Cancer Survivors and in Elderly: A Comparison and Implication for Risk Stratification

Lázničková, Petra; Bendíčková, Kamila; Kepák, Tomáš; Frič, Jan

doi:10.3389/fragi.2021.708788

Cited by 5 publications

(3 citation statements)

References 285 publications

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“…The so-called immune senescence or impaired immune function, both innate and adaptive, along with cellular ageing elevates these patients to a ‘higher risk’ category after any major surgery. [ 11 , 12 ] Cellular hypoxia is often a component of these surgeries, particularly in the elderly, which develops as a result of failure to compensate for the increased oxygen demand either by a reduction in O 2 delivery or an elevation in O 2 extraction. [ 13 , 14 ]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of respiratory exchange ratio (RER) for predicting postoperative outcomes in elderly patients undergoing oncological resection for gastrointestinal malignancies – A prospective cohort study

Kar

Padhy

Gurajala

et al. 2023

Indian Journal of Anaesthesia

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Background and Aims: Predicting complications after major oncosurgery is particularly daunting in the elderly subcategory of patients owing to factors like preexisting age-related immune cellular senescence and a significant imbalance of oxygen delivery (DO 2 ) and consumption (VO 2 ) characteristic of major oncological surgeries. The respiratory exchange ratio (RER) indicates DO 2 –VO 2 balance and onset of anaerobic metabolism. We evaluated the ability of RER in predicting the occurrence of postoperative complications following geriatric oncosurgery. Materials and Methods: In the study, we enrolled 96 patients aged 65 years and above undergoing definitive surgery for gastrointestinal malignancy. The RER was calculated at predefined time points by a non-volumetric method from the respiratory parameters as RER = (end-tidal fractional carbon dioxide [FetCO 2 ] – fraction of inspired carbon dioxide [FiCO 2 ]/fraction of inspired oxygen [FiO 2 ] – end-tidal fractional oxygen [FetO 2 ]). Other indices of tissue perfusion, like central venous oxygen saturation and lactate levels, were also recorded. The patients were followed up for postsurgical complications. The predictive value of RER and other perfusion parameters was assessed and compared by appropriate statistical methods. Results: The patients who sustained major complications had a higher RER than the patients who did not sustain complications (1.47 ± 0.99 vs. 0.90 ± 0.31, P = 0.001). An intraoperative cutoff value of RER ≥0.89 was found to best predict postoperative complications at a specificity and sensitivity rate of 81.2% and 76%, respectively. End-operative partial pressure of carbon dioxide (pCO 2 ) gap of >5.2 mm and elevated arterial lactate could also predict postsurgical complications in this age group. Conclusion: The RER can serve as a noninvasive, real-time and sensitive indicator of tissue hypoperfusion and postoperative complications in geriatric gastrointestinal oncosurgery.

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Section: Discussionmentioning

confidence: 99%

Evaluation of respiratory exchange ratio (RER) for predicting postoperative outcomes in elderly patients undergoing oncological resection for gastrointestinal malignancies – A prospective cohort study

Kar

Padhy

Gurajala

et al. 2023

Indian Journal of Anaesthesia

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“…CCS have a higher incidence of developing serious health conditions compared to their siblings, and the incidence continues to increase with age [96,97]. These conditions largely relate to aggressive treatments to cure childhood cancer as these therapies generate free radicals and induce DNA damage and telomere attrition [98,99]. The endocrine, pulmonary, cardiac and circulatory, genital, urinary, and nervous systems are the most frequently affected and may contribute to the early onset of common diseases such as diabetes mellitus, cardiovascular disease, hypertension, and secondary cancers [100].…”

Section: Late Non-oral Sequelae That May Affect Oral Health and Provi...mentioning

confidence: 99%

Late Complications in Long-Term Childhood Cancer Survivors: What the Oral Health Professional Needs to Know

Al-Ansari,

Stolze,

Bresters

et al. 2024

Dentistry Journal

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With diagnostic and therapeutic advances, over 80% of children diagnosed with cancer become long-term survivors. As the number of childhood cancer survivors (CCS) continues to increase, dental practitioners become more likely to have CCS among their patients. CCS may develop late complications from damage caused by their cancer treatment to endocrine, cardiovascular, musculoskeletal, and other organ systems. These complications may surface decades after the completion of treatment. Adverse outcomes of childhood cancer treatment frequently involve oral and craniofacial structures including the dentition. Tooth development, salivary gland function, craniofacial growth, and temporomandibular joint function may be disturbed, increasing oral health risks in these individuals. Moreover, CCS are at risk of developing subsequent malignancies, which may manifest in or near the oral cavity. It is important that dental practitioners are aware of the childhood cancer history of their patients and have knowledge of potential late complications. Therefore, this narrative review aims to inform dental practitioners of late oral complications of cancer treatment modalities commonly used in pediatric oncology. Furthermore, selected common non-oral late sequelae of cancer therapy that could have an impact on oral health and on delivering dental care will be discussed.

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“…They demonstrated that CITK deletion in NeuroD-SmoA1 transgenic mice led to decreased MB tumor growth and increased overall survival, which were associated with an increase in apoptotic cells and the expression of senescence markers p16 INK4a , p21 Cip1 , and p27 Kip1 ( Figure 2 ). In addition to OIS, the survivors of pediatric cancers also show signs of therapy-induced senescence, which results in a higher risk of health complications later in life [ 35 , 36 ].…”

Section: The Impact Of Age On the Tumor Microenvironment Of Brain Mal...mentioning

confidence: 99%

The Tumor Microenvironment of Medulloblastoma: An Intricate Multicellular Network with Therapeutic Potential

Bree

Wilhelm

2022

Cancers

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Medulloblastoma (MB) is a heterogeneous disease in which survival is highly affected by the underlying subgroup-specific characteristics. Although the current treatment modalities have increased the overall survival rates of MB up to 70–80%, MB remains a major cause of cancer-related mortality among children. This indicates that novel therapeutic approaches against MB are needed. New promising treatment options comprise the targeting of cells and components of the tumor microenvironment (TME). The TME of MB consists of an intricate multicellular network of tumor cells, progenitor cells, astrocytes, neurons, supporting stromal cells, microglia, immune cells, extracellular matrix components, and vasculature systems. In this review, we will discuss all the different components of the MB TME and their role in MB initiation, progression, metastasis, and relapse. Additionally, we briefly introduce the effect that age plays on the TME of brain malignancies and discuss the MB subgroup-specific differences in TME components and how all of these variations could affect the progression of MB. Finally, we highlight the TME-directed treatments, in which we will focus on therapies that are being evaluated in clinical trials.

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Immunosenescence in Childhood Cancer Survivors and in Elderly: A Comparison and Implication for Risk Stratification

Cited by 5 publications

References 285 publications

Evaluation of respiratory exchange ratio (RER) for predicting postoperative outcomes in elderly patients undergoing oncological resection for gastrointestinal malignancies – A prospective cohort study

Evaluation of respiratory exchange ratio (RER) for predicting postoperative outcomes in elderly patients undergoing oncological resection for gastrointestinal malignancies – A prospective cohort study

Late Complications in Long-Term Childhood Cancer Survivors: What the Oral Health Professional Needs to Know

The Tumor Microenvironment of Medulloblastoma: An Intricate Multicellular Network with Therapeutic Potential

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