Clinical characteristics and risk factors for mortality in cancer patients with COVID-19

Patients with cancer are at increased risk of severe infections.From a cohort including 3060 patients with confirmed COVID-19,109(3.4%)cancer patients were included in this study.Among them,23(21.1%)patients died in the hospital.Cancer patients,especially those with hematological malignancies(41.6%),urinary carcinoma(35.7%),malignancies of the digestive system(33.3%),gynecological malignancies(20%),and lung cancer(14.3%),had a much higher mortality than patients without cancer.A total of 19(17.4%)cancer patients were infected in the hospital.The clinical characteristics of deceased cancer patients were compared with those of recovered cancer patients.Multivariate Cox regression analysis indicated that a Nutritional Risk Screening(NRS2002)score≥3(adjusted hazard ratio(HR)11.00;95%confidence interval(CI)4.60–26.32;P<0.001),high-risk type(adjusted HR 18.81;95%CI 4.21–83.93;P<0.001),tumor stage IV(adjusted HR 4.26;95%CI 2.34–7.75;P<0.001),and recent adjuvant therapy(<1 month)(adjusted HR 3.16;95%CI 1.75–5.70;P<0.01)were independent risk factors for in-hospital death after adjusting for age,comorbidities,D-dimer,and lymphocyte count.In conclusion,cancer patients showed a higher risk of COVID-19 infection with a poorer prognosis than patients without cancer.Cancer patients with high-risk tumor,NRS2002 score≥3,advanced tumor stage,and recent adjuvant therapy(<1 month)may have high risk of mortality.

Bone metastasis of hepatocellular carcinoma:facts and hopes from clinical and translational perspectives

Patients with hepatocellular carcinoma(HCC)and bone metastasis(BM)suffer from greatly reduced life quality and a dismal prognosis.However,BM in HCC has long been overlooked possibly due to its relatively low prevalence in previous decades.To date,no consensus or guidelines have been reached or formulated for the prevention and management of HCC BM.Our narrative review manifests the increasing incidence of HCC BM to sound the alarm for additional attention.The risk factors,diagnosis,prognosis,and therapeutic approaches of HCC BM are detailed to provide a panoramic view of this disease to clinicians and specialists.We further delineate an informative cancer bone metastatic cascade based on evidence from recent studies and point out the main factors responsible for the tumor-associated disruption of bone homeostasis and the formation of skeletal cancer lesions.We also present the advances in the pathological and molecular mechanisms of HCC BM to shed light on translational opportunities.Dilemmas and challenges in the treatment and investigation of HCC BM are outlined and discussed to encourage further endeavors in the exploration of underlying pathogenic and molecular mechanisms,as well as the development of novel effective therapies for HCC patients with BM.