The value of surgery in the patients with de novo stage Ⅳ breast cancer

Breast cancer is one of the common malignant tumors in the world. About 6% of the patients are de novo stage Ⅳ breast cancer, which is incurable. Traditionally, the role of surgery has been confined to relieving symptoms, improving quality of life and reducing tumor load. Nowadays, a multidisciplinary team is a prerequisite for optimal management, and patients with oligometastatic lesion always live for a long time. R0 resection of the primary and metastatic foci can extend the time of progression-free survival (PFS), which may bring survival benefits. Therefore, whether to perform surgery has become a hot clinical issue. This article deeply discussed extensively the surgical value in de novo stage Ⅳ breast cancer patients

Patient-Reported Outcomes in OlympiA: A Phase III, Randomized, Placebo-Controlled Trial of Adjuvant Olaparib in gBRCA1/2 Mutations and High-Risk Human Epidermal Growth Factor Receptor 2–Negative Early Breast Cancer

PURPOSE The OlympiA randomized phase III trial compared 1 year of olaparib (OL) or placebo (PL) as adjuvant therapy in patients with germline BRCA1/2, high-risk human epidermal growth factor receptor 2–negative early breast cancer after completing (neo)adjuvant chemotherapy ([N]ACT), surgery, and radiotherapy. The patient-reported outcome primary hypothesis was that OL-treated patients may experience greater fatigue during treatment. METHODS Data were collected before random assignment, and at 6, 12, 18, and 24 months. The primary end point was fatigue, measured with the Functional Assessment of Chronic Illness Therapy-Fatigue scale. Secondary end points, assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30 item, included nausea and vomiting (NV), diarrhea, and multiple functional domains. Scores were compared between treatment groups using mixed model for repeated measures. Two-sided P values <.05 were statistically significant for the primary end point. All secondary end points were descriptive. RESULTS One thousand five hundred and thirty-eight patients (NACT: 746, ACT: 792) contributed to the analysis. Fatigue severity was statistically significantly greater for OL versus PL, but not clinically meaningfully different by prespecified criteria (≥3 points) at 6 months (diff OL v PL: NACT: –1.3 [95% CI, –2.4 to –0.2]; P = .022; ACT: –1.3 [95% CI, –2.3 to –0.2]; P = .017) and 12 months (NACT: –1.6 [95% CI, –2.8 to –0.3]; P = .017; ACT: –1.3 [95% CI, –2.4 to –0.2]; P = .025). There were no significant differences in fatigue severity between treatment groups at 18 and 24 months. NV severity was worse in patients treated with OL compared with PL at 6 months (NACT: 6.0 [95% CI, 4.1 to 8.0]; ACT: 5.3 [95% CI, 3.4 to 7.2]) and 12 months (NACT: 6.4 [95% CI, 4.4 to 8.3]; ACT: 4.5 [95% CI, 2.8 to 6.1]). During treatment, there were some clinically meaningful differences between groups for other symptoms but not for function subscales or global health status. CONCLUSION Treatment-emergent symptoms from OL were limited, generally resolving after treatment ended. OL- and PL-treated patients had similar functional scores, slowly improving during the 24 months after (N)ACT and there was no clinically meaningful persistence of fatigue severity in OL-treated patients

Health-related quality of life of postmenopausal Chinese women with hormone receptor-positive early breast cancer during treatment with adjuvant aromatase inhibitors: a prospective, multicenter, non-interventional study

Background: Estimating quality of life (QoL) in patients with breast cancer is of importance in assessing treatment outcomes. Adjuvant endocrine therapy is widely used for hormone receptor-positive (HR+) early-stage breast cancer (EBC), and evidence suggests that aromatase inhibitors (AIs) may improve QoL for these patients. This study evaluated QoL in postmenopausal Chinese patients with HR + EBC taking AIs. Methods: This was a prospective, multicenter, and observational study that had no intent to intervene in the current treatment of recruited patients. Eligible patients were recruited within 7 days of beginning adjuvant treatment with AIs. The Functional Assessment of Cancer Therapy-Breast (FACT-B) scale was used to evaluate the patients&apos; QoL. Data were collected at baseline and at 6, 12, 18, and 24 months. Results: From June 2010 to October 2013, a total of 494 patients with HR+ EBC were recruited from 21 centers. There was a 7.51-point increase in the patients&apos; mean FACT-B trial outcome index (TOI), from 90.69 at baseline to 98.72 at 24 months (P &lt; .0001). The mean TOI scores at baseline, 6, 12, and 18 months were 90.69, 94.36, 97.71, and 96.75, respectively (P &lt; .0001, for all). The mean (FACT-B) emotional well-being subscale scores at baseline, 6, 12, 18, and 24 months were 16.32, 16.55, 17.34 (P &lt; .0001), 17.47 (P &lt; .0001), and 17.85 (P &lt; .0001), respectively, and social well-being scores were 18.61, 19.14 (P &lt; .04), 19.35 (P &lt; .008), 18.32, and 18.40, respectively. In the mixed model, baseline TOI, clinical visits, prior chemotherapies, age group, and axillary lymph-node dissection presented statistically significant effects on the change of FACT-B TOI and FACT-B SWB, whereas only baseline TOI, clinical visits, and prior chemotherapies presented statistically significant effects on the change of FACT-B EWB. FACT-B TOI, being the most pertinent and precise indicator of patient-reported QoL, demonstrated significant changes reflecting clinical benefit of adjuvant AIs endocrine therapy in the QoL of HR + EBC patients. Conclusions: The study demonstrated significant improvements in the long-term QoL of postmenopausal Chinese patients with HR+ EBC at 6, 12, 18, and 24 months after starting treatment with AIs. The current study indicates improved long-term QoL with AI adjuvant treatment, which will aid clinicians in optimizing treatment to yield effective healthcare outcomes.AstraZeneca Pharmaceutical CompanySCI(E)[email protected]

Study on the Impact of Production Agglomeration of China’s Aquatic Products on Export Competitiveness

This paper collects the data of China’s aquatic products from 2002 to 2018 and studies the relationship between the production agglomeration and export competitiveness of aquatic products. This paper calculates the production Concentration Rate (CR) which reflects the degree of agglomeration of aquatic products and the Revealed Comparative Advantage (RCA) index which reflects the export competitiveness of aquatic products, and then uses variable intercept model with fixed effects to empirically analyze the impact of production agglomeration of three main aquatic products (fish, crustacean and shellfish) on the export competitiveness. The results show that there is an obvious phenomenon of production agglomeration of aquatic products in China. Overall, the improvement of production agglomeration of aquatic products is conducive to the promotion of export competitiveness.</jats:p

Study on the Impact of Production Agglomeration of China’s Aquatic Products on Export Competitiveness

This paper collects the data of China’s aquatic products from 2002 to 2018 and studies the relationship between the production agglomeration and export competitiveness of aquatic products. This paper calculates the production Concentration Rate (CR) which reflects the degree of agglomeration of aquatic products and the Revealed Comparative Advantage (RCA) index which reflects the export competitiveness of aquatic products, and then uses variable intercept model with fixed effects to empirically analyze the impact of production agglomeration of three main aquatic products (fish, crustacean and shellfish) on the export competitiveness. The results show that there is an obvious phenomenon of production agglomeration of aquatic products in China. Overall, the improvement of production agglomeration of aquatic products is conducive to the promotion of export competitiveness

Does Agricultural Export Promote Nepalese Economic Growth? ARDL Approach Using Structural Break

This study examines the impact of agricultural export on the economic growth in Nepal for the time period of 1970-2015. In this analysis, researchers used the ARDL model using structural break to investigate the relationship between agricultural exports and economic growth in Nepal. Agricultural land, exchange rate, foreign direct investment, trade openness and agricultural environmental pollution have all been included in this analysis. According to estimates, ARDL, tend towards short-run relationship has been validated. Whereas, in the long-run relation we found negative relation. Furthermore, this study found that agricultural land is directly affecting economic growth. This study recommends policies that improve agricultural production and trade should be strongly pursued to help boost a country’s economic growth</jats:p

Does Agricultural Export Promote Nepalese Economic Growth? ARDL Approach Using Structural Break

This study examines the impact of agricultural export on the economic growth in Nepal for the time period of 1970-2015. In this analysis, researchers used the ARDL model using structural break to investigate the relationship between agricultural exports and economic growth in Nepal. Agricultural land, exchange rate, foreign direct investment, trade openness and agricultural environmental pollution have all been included in this analysis. According to estimates, ARDL, tend towards short-run relationship has been validated. Whereas, in the long-run relation we found negative relation. Furthermore, this study found that agricultural land is directly affecting economic growth. This study recommends policies that improve agricultural production and trade should be strongly pursued to help boost a country’s economic growt