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      Does the distance to the cancer center affect psycho-oncological care and emergency visits of patients with IDH wild-type gliomas? A retrospective study

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          Abstract

          Background

          Malignant isocitrate dehydrogenase wild-type (IDHwt) gliomas impose a high symptomatic and psychological burden. Wide distances from patients’ homes to cancer centers may affect the delivery of psycho-oncological care. Here, we investigated, in a large brain tumor center with a rural outreach, the initiation of psycho-oncological care depending on spatial distance and impact of psycho-oncological care on emergency visits.

          Methods

          Electronic patient charts, the regional tumor registry, and interviews with the primary care physicians were used to investigate clinical data, psycho-oncological care, and emergency unit visits. Interrelations with socio-demographic, clinical, and treatment aspects were investigated using univariable and multivariable binary logistic regression analysis and the Pearson’s Chi-square test.

          Results

          Of 491, 229 adult patients of this retrospective cohort fulfilled the inclusion criteria for analysis. During the last three months of their lives, 48.9% received at least one psycho-oncological consultation, and 37.1% visited the emergency unit at least once. The distance from the cancer center did neither affect the initiation of psycho-oncological care nor the rate of emergency unit visits. Receiving psycho-oncological care did not correlate with the frequency of emergency unit visits in the last three months of life.

          Conclusion

          We conclude that the distance of IDHwt glioma patients’ homes from their cancer center, even in a rural area, does not significantly influence the rate of psycho-oncological care.

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          Most cited references30

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          The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary.

          The 2016 World Health Organization Classification of Tumors of the Central Nervous System is both a conceptual and practical advance over its 2007 predecessor. For the first time, the WHO classification of CNS tumors uses molecular parameters in addition to histology to define many tumor entities, thus formulating a concept for how CNS tumor diagnoses should be structured in the molecular era. As such, the 2016 CNS WHO presents major restructuring of the diffuse gliomas, medulloblastomas and other embryonal tumors, and incorporates new entities that are defined by both histology and molecular features, including glioblastoma, IDH-wildtype and glioblastoma, IDH-mutant; diffuse midline glioma, H3 K27M-mutant; RELA fusion-positive ependymoma; medulloblastoma, WNT-activated and medulloblastoma, SHH-activated; and embryonal tumour with multilayered rosettes, C19MC-altered. The 2016 edition has added newly recognized neoplasms, and has deleted some entities, variants and patterns that no longer have diagnostic and/or biological relevance. Other notable changes include the addition of brain invasion as a criterion for atypical meningioma and the introduction of a soft tissue-type grading system for the now combined entity of solitary fibrous tumor / hemangiopericytoma-a departure from the manner by which other CNS tumors are graded. Overall, it is hoped that the 2016 CNS WHO will facilitate clinical, experimental and epidemiological studies that will lead to improvements in the lives of patients with brain tumors.
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            Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial.

            There is growing interest to enhance symptom monitoring during routine cancer care using patient-reported outcomes, but evidence of impact on clinical outcomes is limited.
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              CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2014–2018

              The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention (CDC) and National Cancer Institute (NCI), is the largest population-based cancer registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy and is the first CBTRUS Report to provide the distribution of molecular markers for selected brain and CNS tumor histologies. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.25 (Malignant AAAIR=7.06, Non-malignant AAAIR=17.18). This overall rate was higher in females compared to males (26.95 versus 21.35) and non-Hispanics compared to Hispanics (24.68 versus 22.12). The most commonly occurring malignant brain and other CNS tumor was glioblastoma (14.3% of all tumors and 49.1% of malignant tumors), and the most common non-malignant tumor was meningioma (39.0% of all tumors and 54.5% of non-malignant tumors). Glioblastoma was more common in males, and meningioma was more common in females. In children and adolescents (age 0–19 years), the incidence rate of all primary brain and other CNS tumors was 6.21. An estimated 88,190 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US population in 2021 (25,690 malignant and 62,500 non-malignant). There were 83,029 deaths attributed to malignant brain and other CNS tumors between 2014 and 2018. This represents an average annual mortality rate of 4.43 per 100,000 and an average of 16,606 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 35.6%, for a non-malignant brain and other CNS tumors the five-year relative survival rate was 91.8%.
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                Author and article information

                Contributors
                Journal
                Neurooncol Pract
                Neurooncol Pract
                nop
                Neuro-Oncology Practice
                Oxford University Press (US )
                2054-2577
                2054-2585
                October 2023
                27 April 2023
                27 April 2023
                : 10
                : 5
                : 446-453
                Affiliations
                Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg, Germany
                Center for Quality Assurance and Health Services Research, University of Regensburg , Regensburg, Germany
                Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg, Germany
                Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg, Germany
                Department of Internal Medicine III, Regensburg University Hospital , Regensburg, Germany
                Center for Quality Assurance and Health Services Research, University of Regensburg , Regensburg, Germany
                Department of Radiotherapy, Regensburg University Hospital , Regensburg, Germany
                Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg, Germany
                Department of Neurosurgery, Regensburg University Hospital , Regensburg, Germany
                Department of Internal Medicine III, Regensburg University Hospital , Regensburg, Germany
                Department of Neuropathology, Regensburg University Hospital , Regensburg, Germany
                Department of Neurosurgery, Regensburg University Hospital , Regensburg, Germany
                Department of Internal Medicine III, Regensburg University Hospital , Regensburg, Germany
                Department of Internal Medicine III, Regensburg University Hospital , Regensburg, Germany
                Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg, Germany
                Department of Neurology and Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg, Germany
                Author notes
                Corresponding Author: Elisabeth Bumes, MD, Department of Neurology – NeuroOncology, Franz Josef Strauß-Allee 11, 93053 Regensburg, Germany ( elisabeth.bumes@ 123456ukr.de ).
                Author information
                https://orcid.org/0000-0001-6915-3206
                Article
                npad023
                10.1093/nop/npad023
                10502780
                37720387
                cb1de645-65bb-4703-91b1-6c1b5237ecdb
                © The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 May 2023
                Page count
                Pages: 8
                Categories
                Original Articles
                AcademicSubjects/MED00300
                AcademicSubjects/MED00310

                brain tumor,emergency,glioblastoma,psycho-oncology,spatial distance

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