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Sharon M. Weinstein, Dorothy Romanus, Eva M. Lepisto, Cielito Reyes-Gibby, Charles Cleeland, Rex Greene, Cameron Muir, and Joyce Niland

The National Comprehensive Cancer Network (NCCN), an organization of 19 of the world's leading cancer centers, developed and communicated a cancer pain treatment guideline. NCCN seeks to implement guidelines through performance measurement using a NCCN Oncology Outcomes Database. This is a preliminary report from the NCCN Cancer Pain Management Database Project. The primary objective of this NCCN Cancer Pain Management Database Project study is to evaluate the frequency, methods, and extent of documentation of cancer pain assessment and managementat NCCN institutions. A pain data dictionary and related data collection forms were first developed. The records of 209 breast cancer patients with bone metastases were then studied. The frequency of pain mentions, type of pain assessment tool used, pain characteristics, type of clinician documenting pain, location in the medical record, and pain treatment characteristics were noted. The majority of clinical encounters included pain mentions, although considerable variability was found in pain documentation between providers and between inpatient and outpatient settings. Nurses more frequently recorded pain, usually as a numeric pain intensity score. Pain specialists were more likely to record a complete description of pain. A significant minority of patients experienced moderate to severe pain. In a small subgroup of patients with moderate to severe pain, pain treatment was not recorded. The undertreatment of cancer pain has been a focus of investigation and review for the past two decades. Quality improvement efforts to raise the standard of pain management have been underway. The results of this study highlight the need for standardization of pain documentation in comprehensive cancer centers as a prerequisite for the proper assessment of cancer pain and the improvement of clinical outcomes of pain management.

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Yao Zhu, Yu Wei, Hao Zeng, Yonghong Li, Chi-Fai Ng, Fangjian Zhou, Caiyun He, Guangxi Sun, Yuchao Ni, Peter K.F. Chiu, Jeremy Y.C. Teoh, Beihe Wang, Jian Pan, Fangning Wan, Bo Dai, Xiaojian Qin, Guowen Lin, Hualei Gan, Junlong Wu, and Dingwei Ye

Background: Although China accounts for 7.8% of worldwide new prostate cancer (PCa) cases and 14.5% of new deaths according to GLOBOCAN 2020, the risk of PCa associated with germline mutations is poorly defined, hampered in part by lack of nationwide evidence. Here, we sequenced 19 PCa predisposition genes in 1,836 Chinese patients with PCa and estimated disease risk associated with inherited mutations. Patients and Methods: Patients were recruited from 4 tertiary cancer centers (n=1,160) and a commercial laboratory (n=676). Germline DNA was sequenced using a multigene panel, and pathogenic/likely pathogenic (P/LP) mutation frequencies in patients with PCa were compared with populations from the gnomAD (Genome Aggregation Database) and ChinaMAP (China Metabolic Analytics Project) databases. Clinical characteristics and progression-free survival were assessed by mutation status. Results: Of 1,160 patients from hospitals, 89.7% had Gleason scores ≥8, and 65.6% had metastases. P/LP mutations were identified in 8.49% of Chinese patients with PCa. Association with PCa risk was significant for mutations in ATM (odds ratio [OR], 5.9; 95% CI, 3.1–11.1), BRCA2 (OR, 15.3; 95% CI, 10.0–23.2), MSH2 (OR, 15.8; 95% CI, 4.2–59.6), and PALB2 (OR, 5.9; 95% CI, 2.7–13.2). Compared with those without mutations, patients with mutations in ATM, BRCA2, MSH2, or PALB2 showed a poor outcome with treatment using androgen deprivation therapy and abiraterone (hazard ratio, 2.19 [95% CI, 1.34–3.58] and 2.47 [95% CI, 1.23–4.96], respectively) but similar benefit from docetaxel. Conclusions: The present multicenter study confirmed that a significant proportion of Chinese patients with PCa had inherited mutations and identified predisposition genes in this underreported ethnicity. These data provide empirical evidence for precision prevention and prognostic estimation in Chinese patients with PCa.

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Surekha Yadav

case series one of its kind as per our knowledge. We aim to exemplify the recognition of carcinoma prostate to present as lytic skeletal metastases and the incremental value of GaPSMA PETCT over 99mTc bone scan in detecting such lesions. Material and

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Cintia Yoko Morioka, Marcel Cerqueira Cesar Machado, Jose Pinhata Otoch, Luma Princess Schneider, Edgard Mesquita Rodrigues Lima, Marcelo Engracia Garcia, Joelmir Silva, Alessandro Costa, Victor Herrera, Paulo Aguiar, Elenir Herrera, Talita Aguiar, Maycon Kublik, Amelia Silva, Kennedy Silva, Eduardo Morioka, and Ching Cheng Huang

pancreatic cancer,MS-PaS-1:a pancreatic metastatic cell line established from a “return trip” metastases of liver implanted tumor, which showed pancreatic metastases, and MS-PaS-2:a pancreatic remetastatic cell line established from metastases of MS-PaS-1

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Rona Yaeger

harbor a striking number of resistance alterations. 1 , 2 Tumor heterogeneity has thus been proposed as the key mechanism underlying incomplete response of CRCs to therapy. Analysis of paired primary tumors and metastases shows a high degree of

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Meic H. Schmidt, Paul Klimo Jr, and Frank D. Vrionis

The authors have no financial interest, arrangement, or affiliation with the manufacturers of any products discussed in the article or their competitors. References 1 Bohm P Huber J . The surgical treatment of bony metastases of

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Daniel B. Brown

metachronous metastases from her colon cancer, she had developed a new 3-cm focus deep in segment 4. The tumor had progressed on oxaliplatin and irinotecan. The hepatobiliary surgeon was hesitant about repeat surgery, out of concern that her short disease

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Donald A. Podoloff

Guntinas-Lichius O Peter Klussmann J Dinh S . Diagnostic work-up and outcome of cervical metastases from an unknown primary . Acta Otolaryngol 2006 ; 126 : 536 – 544 . 6 Gutzeit A Antoch G Kuhl H . Unknown primary tumors: detection with dual

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Angela Pecoraro, Francesco Porpiglia, and Pierre I. Karakiewicz

age, sex, histologic subtype, and Fuhrman grade, along with the rates of synchronous metastases, in a large contemporary population-based cohort (SEER 2002–2016). However, even if we know African Americans to be effectively subjected to higher rates of

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Yu-Jing Huang, Paula D. Ryan, Gregory L. Price, Gebra Cuyun Carter, Kristin M. Sheffield, Emily Nash Smyth, Claudia Morato Guimaraes, Sarah Rybowski, Jonathan Rajkumar, and Lavanya Sudharshan

, 142 abemaciclib, and 91 ribociclib). Among those with baseline performance status (n=307), 268 (87%) pts had an Eastern Cooperative Oncology Group performance status of 0-1. The most common metastatic sites at index were bone (74%), visceral metastases