br A strength of our study
A strength of our study is found in that our findings fill a void in the literature surrounding surgical menopause in endometrial cancer. We provide a comprehensive and qualitative analysis of one institution's experiences with surgical menopause in endometrial cancer patients aged 50 or younger. Additionally, our analysis controlled for factors as-sociated with menopausal symptoms including SSRI/SNRI treatment for psychiatric complaints before surgery, and smoking. Nonetheless, we note several limitations of our study. First, our study relied on retrospec-tive analysis of patient accounts of symptoms within the medical record and does not have long term follow-up. However, we would not expect underreporting to occur at a higher frequency among any specific group of patients with respect to BMI. Second, we recognize possible con-founders (over-the-counter remedies), such as personal biases that may increase or decrease a patient's acceptance of treatment for meno-pausal symptoms. Third, our Protease Inhibitor Cocktail was rather homogenous (84% white), and the results may not apply to other racial and ethnic groups.
In conclusion, when planning surgery for endometrial cancer in pre-menopausal women, the patient and her physician should discuss how women with a BMI N40 may have fewer side effects of surgical meno-pause than premenopausal women without obesity. Further research
should be undertaken to determine the long-term health impacts of high BMI and menopausal symptoms after surgery for endometrial cancer.
The authors report no conflict of interest or relevant disclosures.
1. J.C. Cripe, M.D.: lead author who designed the study, performed the majority of data collection and entry, and assisted with manuscript writing and editing.
2. T.R. Buchanan, M.D.: performed data collection and assisted with manuscript writing and revisions.
3. L.M. Kuroki, M.D., M.S.C.I: assisted with manuscript writing and editing.
4. L. Wan, M.P.H: assisted with statistical analysis and approval of final submitted version. 5. K.A. Mills: Assisted with manuscript writing and revisions.
6. AR Hagemann, M.D., M.S.C·I: assisted with manuscript revisions and approval of final submitted version. 7. L.S. Massad, M.D.: assisted with manuscript revisions and approval of final submitted version 8. K.C. Fuh, M.D., Ph.D.: assisted with manuscript revisions and ap-proval of final submitted version. 9. D.G. Mutch, M.D.: assisted with manuscript revisions and approval of final submitted version. 10. M.A. Powell, M.D.: assisted with manuscript revisions and approval of final submitted version. 11. K. Matsuo, M.D.: assisted with manuscript revisions and approval of final submitted version
design. Assisted with manuscript revisions and approval of final submitted version.
and ovarian cancer surveillance. Patient perceptions and satisfaction, J. Reprod. Med.
Contents lists available at ScienceDirect
journal homepage: www.elsevier.com/locate/suronc
Association between diabetes and oncological outcomes in patients undergoing neoadjuvant chemo-radiotherapy for rectal cancer
Tina Fransgaarda,∗, Jesper Hallasb, Lau Caspar Thygesenc, Ismail Gögenura,d a Zealand University Hospital, Department of Surgery, Lykkebækvej 1, 4600, Køge, Denmark
b Clinical Pharmacology and Pharmacy, University of Southern Denmark, J. B. Winsløws Vej 19, 2, 5000, Odense C, Denmark
c National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark
d Institute for Clinical Medicine, Copenhagen University and Danish Colorectal Cancer Group, Copenhagen, Denmark
Purpose: The aim of the study was to investigate, in a nationwide study, if diabetes and especially metformin exposure during neoadjuvant chemo-radiotherapy improves the oncological outcomes in patients with rectal cancer.
Methods and materials: Patients undergoing neoadjuvant chemo-radiotherapy and curative intended resection for rectal cancer in Denmark between January 1, 2003 and July 1, 2015 were identified. Diabetes was defined as medically treated diabetes. Only patients who were either active users of antidiabetic medication at the be-ginning of the radiotherapy or never-users were included. Active users were matched with never-users 1:2 by propensity score. Subgroup analyses concerning metformin treatment were performed. The primary outcome of the study was disease-free survival and the secondary outcomes were recurrence free survival and all-cause mortality.
Conclusion: Our study does not support ground system diabetes or metformin use are associated with response to neoad-juvant chemo-radiotherapy in terms of disease-free survival, recurrence-free survival or all-cause mortality.