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Survival outcomes in basaloid squamous cell carcinoma of the anorectal region: A Surveillance, Epidemiology, and End Results (SEER) database analysis (2025)

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Type of publication:

Conference abstract

Author(s):

*Arunachalam J.

Citation:

Annals of Oncology. Conference: The ESMO Gastrointestinal Cancers Congress. Barcelona Spain. 36(Supplement 1) (pp S87), 2025. Date of Publication: 01 Jul 2025.

Abstract:

Background: Basaloid squamous cell carcinoma (BSCC) of the anorectal region is a rare and aggressive variant of squamous cell carcinoma, arising primarily in the transitional zone of the anal canal and lower rectum. Historically referred to as cloacogenic carcinoma, BSCC is characterized by distinctive histological features. Chemoradiation remains the standard of care. Given its rarity, data on survival outcomes and demographic disparities are limited. We aimed to assess clinical characteristics and survival outcomes using a large U.S. population-based dataset. Method(s): We conducted a retrospective analysis using the SEER database (2000-2021) to identify patients with BSCC, defined by ICD codes 8083/3 and 8124/3, located in C21.0, C20.9, C21.1, C21.2, and C21.8. Variables extracted included age, sex, race, tumor stage, and treatments. Kaplan-Meier survival analyses were used to assess overall survival (OS) and cancer-specific survival (CSS). Group comparisons were evaluated using the log-rank test. Result(s): A total of 3,446 patients were identified. At diagnosis, 54% were under 65 years, 75% were female, and 80% were White. Metastatic disease was present in 11%. Median OS (mOS) was 120 months. The 1-, 3-, and 5-year CSS rates were 91.1%, 78.9%, and 73.3%, respectively; 10- and 20-year CSS rates were 67.4% and 61.5%. Male patients had poorer survival (mOS 66 months) compared to females (mOS 143 months; p < 0.0001; HR 1.595, 95% CI 1.420-1.791). Patients aged >=65 had a mOS of 72 months versus 219 months for those <65 (p < 0.0001; HR 2.124, 95% CI 1.926-2.342). Median OS by stage was 25 months (metastatic), 124 months (regional), and 175 months (localized) (p < 0.0001). Patients undergoing surgery had a mOS of 154 months, and those receiving radiation therapy had a mOS of 134 months. Lack of chemotherapy was associated with worse survival (mOS 50 months; HR 1.780, 95% CI 1.570-2.020; p < 0.0001). Race was not significantly associated with survival differences. Conclusion(s): Favorable outcomes were associated with younger age, female sex, early stage, and chemotherapy. Future studies should refine treatment strategies and explore targeted therapies in BSCC to guide precision medicine. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

DOI: 10.1016/j.annonc.2025.05.230

Prognostic impact of microsatellite instability and survival disparities in rectal cancer: A SEER-based retrospective analysis (2025)

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Type of publication:

Conference abstract

Author(s):

*Arunachalam J.; Nabeta G.; Naagendran M.S.; Hegde U.;

Citation:

Annals of Oncology. Conference: The ESMO Gastrointestinal Cancers Congress. Barcelona Spain. 36(Supplement 1) (pp S97), 2025. Date of Publication: 01 Jul 2025.

Abstract:

Background: Microsatellite instability (MSI), a molecular marker of defective DNA mismatch repair (MMR), is observed in ~7% of rectal cancers. MSI-high (MSI-H) tumors, arising from sporadic or germline MMR deficiency, are highly responsive to immune checkpoint inhibitors. We aimed to evaluate the prognostic significance of MSI in rectal cancer in the era of immunotherapy and to explore demographic disparities in survival using real-world data from the U.S. Method(s): We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) cancer database for patients diagnosed with rectal cancer between 2018 and 2021. We assessed cancer-specific survival (CSS) across MSI subtypes-MSI-H, MSI-low (MSI-L), and microsatellite stable (MSS)-and evaluated survival differences by age, gender, race, and stage. Analyses were performed using R. Kaplan-Meier curves visualized survival outcomes, and group comparisons were done using the log-rank test. <br/>Result(s): Among 17,487 patients, 3.6% were MSI-H (n=637), 1.9% MSI-L (n=332), and 94.5% MSS (n=16,518). Overall 1-year and 3-year CSS were 90% and 75%, respectively. In metastatic patients, median CSS (mCSS) was 25 months, increasing to 36 months in those with MSI-H tumors. By MSI status, 1- and 3-year CSS were 90.6% and 77.7% for MSI-H, 89.9% and 74.9% for MSS, and 84.8% and 68.6% for MSI-L (p=0.0087). Racial disparities were evident: 1- and 3-year CSS were 92% and 80% in White patients, 88% and 70% in Black patients, and 90% and 75% in Hispanic patients (p<0.0001). Age impacted survival significantly: 1- and 3-year CSS were 91% and 74% in patients <65 years vs. 86% and 61% in those >=65 (p<0.0001). Females had better long-term survival than males, with 3-year CSS under 80% for both, but significantly higher in females (p<0.0001). Conclusion(s): MSI-H status is associated with improved survival, reinforcing its role as a favorable prognostic biomarker in rectal cancer and highlighting the importance of routine MSI testing to guide treatment decisions. Worse outcomes among older adults, males, and Black patients reflect persistent disparities in rectal cancer care. These findings underscore the urgent need to identify and address the drivers of these differences to ensure equitable outcomes. Legal entity responsible for the study: The authors. Funding(s): Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

DOI: 10.1016/j.annonc.2025.05.261

Refractory Dyspnoea in Palliative Care: Implementing High Flow Oxygen Therapy AIRVO2 Into Palliative Care and End of Life Care in the Community (2025)

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Type of publication:

Conference abstract

Author(s):

*Raton M.; *Rowe N.; *Wood G.;

Citation:

American Journal of Respiratory and Critical Care Medicine. Conference: American Thoracic Society International Conference, ATS 2025. San Francisco, CA United States. 211 (no pagination), 2025. Date of Publication: 01 May 2025.

Abstract:

Palliative patients often present to secondary care settings with respiratory distress during the endstage of their disease. Conventional oxygen therapy alongside opioid therapy has widely been considered the treatment of choice for dyspnoea and symptom alleviation. With an increasing number of palliative patients and the national drive for service improvement, the Respiratory Team have identified an additional method to enhance current practice. Based on previous positive experience gained since 2013 from utilising High Flow Oxygen Therapy (HFOT) during the acute stages of respiratory disease, it was decided to extend this therapy to patients with chronic disease and palliative needs. The physiological and clinical benefits of HFOT include reduction in dyspnoea and decreased work of breathing, augmentation of respiratory drive, improved quality of life, and comfort level in this patient population. During work on the COVID cohort ward (March 2020- Dec 2021) AIRVO2 was used routinely as a first-line treatment in over 300 patients and continued in over 70 patients in the palliation/ End of Life (EoL) pathway. Since then, AIRVO2 in combination with lowdose opioids has been used in Palliative/ EoL care routinely. In 2022 the first discharge from the hospital was facilitated to continue optimised treatment. Benefits from HFOT in EoL/ Palliative usage should be focused on comfort and symptom control with optimised FiO2 requirements. We looked at three patients who were discharged from hospital on HFOT: two patients to the hospice and one home. With the combined HTOT and conventional palliative management, we observed a significantly decreased requirement of opioid use, leading to a reduction in side effects such as drowsiness or palliative sedation. This enabled patients to experience interaction with family and friends at the end of their life. On each occasion, good feedback has been received from the family, hospice, and patients. Extending HTOT usage to the community enhances best interest care for individuals and avoids abrupt termination of therapy initiated in the hospital. This prevents palliative patients with symptomatic breathlessness from having to compromise on either place of death or symptomatic breathlessness. HFOT usage out of the hospital decreases the number of readmissions with the focus on extended care in the community. Discharging patients to the community requires a clear advanced care plan and close cooperation within Multidisciplinary Team. Correct patients' selection for discharge on HFOT needs to be considered due to the limited FiO2 concentration delivery in the community.

DOI: 10.1164/ajrccm.2025.211.Abstracts.A4177

Real-World Outcomes of Transition From CGM-Augmented Non-Closed Loop (NCL) Omnipod Dash To Omnipod 5 Hybrid Closed Loop (HCL) Continuous Subcutaneous Insulin Infusion (CSII) in Adult Type 1 Diabetes(T1D) (2025)

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Type of publication:

Conference abstract

Author(s):

*Basavaraju N.; *Cane C.; *Cooksey M.; *Wilkes V.; *Brown H.; *Jones A.; *Moulik P.;

Citation:

Diabetes Technology and Therapeutics. Conference: 18th International Conference on Advanced Technologies and Treatments for Diabetes, ATTD 2025. Amsterdam Netherlands. 27(Supplement 2) (pp e179), 2025. Date of Publication: 01 Feb 2025.

Abstract:

Background and Aims: HCL CSII has recently been commissioned nationally by NHS England for type1 diabetes (T1D). We looked into the impact of transitioning from CGMaugmented non-closed loop (NCL) CSII to HCL CSII with the same insulin delivery system. Method(s): We analysed a database of T1D on CSII managed in a single district general hospital under one Consultant Diabetologist team. Patients were on Omnipod DASH with Freestyle Libre2/DexcomG6 CGM and transitioned to Omnipod 5 with Dexcom G6 with built in SmartAdjustTM technology. Data was analysed with paired sample T-test (SPSS) at baseline and 6months. Result(s): 53 patients were included, with 31females (59%) and 22males (41%). Baseline mean age was 47years (20-80), diabetes duration 24years (5-62), BMI 27.6kg/m2 (20-41), HbA1c 55-mmol/mol (30-80). At 6 months, mean weight increased by 1.2-kg (p=0.04), BMI increased by 0.2kg/m2 (p=0.617), HbA1c reduced by 3.4mmol/mol (p=0.002), Time in range: TIR (glucose 3.9-10mmol/L) improved from 63% to 71% (p <0.005). GOLD score remained unchanged at 2.0. Serum creatinine increased from 77 to 80umol/L (p=0.007), eGFR reduced from 92 to 80ml/ min (p<0.001), mean urine microalbumin, total cholesterol, grading of retinal screening remained unchanged. Diabetes Treatment Satisfaction Questionnaire, hypoglycaemia fear survey scores were unchanged and mean INSPIRE (Insulin delivery Systems: Perceptions, Ideas, Reflections and Expectations) score was 77 (40-100). Conclusion(s): This analysis demonstrates statistically significant improvement in glycaemic parameters (HbA1c and TIR) at 6 months with minimal but statistically significant weight loss. There were no significant changes in retinal screening but surprisingly some reduction in renal function was observed. Quality of life questionnaires remained unchanged but INSPIRE questionnaire for automated insulin delivery (AID) showed promising results.

DOI: 10.1089/dia.2024.78502.abstracts

Ambulatory Glucose Profile (AGP) Improvements Occur Early During Transition From Sensor Augmented Omnipod Dash to Hybrid Closed Loop Omnipod 5 in Adults With Type 1 Diabetes(T1D) (2025)

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Type of publication:

Conference abstract

Author(s):

*Basavaraju N.; *Cane C.; *Cooksey M.; *Brown H.; *Wilkes V.; *Jones A.; *Moulik P.;

Citation:

Diabetes Technology and Therapeutics. Conference: 18th International Conference on Advanced Technologies and Treatments for Diabetes, ATTD 2025. Amsterdam Netherlands. 27(Supplement 2) (pp e174-e175), 2025. Date of Publication: 01 Feb 2025.

Abstract:

Background and Aims: Significant glycaemic benefits with hybrid closed loop(HCL) continuous subcutaneous insulin infusion (CSII) over sensor augmented non-closed loop CSII must be balanced against the risks of worsening retinopathy and treatment induced neuropathy in diabetes (TIND). Method(s): We analysed a database of T1D on CSII managed in a single district general hospital. Patients on Omnipod DASH with Freestyle Libre2/DexcomG6 CGM transitioned to Omnipod 5(OP5) with Dexcom G6 with built in SmartAdjustTM technology. All patients had a target glucose of 6.1mmol/L on OP5. AGP data were analysed with paired sample T-test (SPSS) at baseline, 3months and 6months. Result(s): 53 patients (31females and 22males) with mean age 47years (20-80), diabetes duration 24years (5-62), BMI 27.6kg/m2 (20-41), HbA1c 55mmol/mol(30-80) were included. Conclusion(s): There was statistically significant and rapid improvement in GMI, level 1 & level 2 TAR, TIR and level 1 TBR between 0 and 3 months, sustained at 6 months but no significant change between 3 and 6 months. The early and rapid improvement in glycaemic control post HCL highlights the need for close monitoring of worsening retinopathy in the first year.

DOI: 10.1089/dia.2024.78502.abstracts

Mortality Related to Bariatric Surgery (MORSE Study): A Retrospective, International Collaborative Audit (2025)

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Type of publication:

Journal article

Author(s):

Balasubaramaniam, Vignesh; Wong, Geoffrey Yuet Mun; Martinino, Alessandro; *Riera, Manel; Abouelazayem, Mohamed; Pereira, Juan Pablo Scarano; Said, Amira; Graham, Yitka; *Jain, Rajesh Kumar; Imseeh, Helen; Aljaiuossi, Osama; Jayyab, Mustafa Ahmad Abu; Alyacoubi, Said N A; Mahawar, Kamal; Singhal, Rishi.

Citation:

Clinical Obesity. e70031, 2025 Jun 18.

Abstract:

Bariatric surgery is associated with low but definite early and late mortality. This study aims to further understand early (<= 90 days) and delayed (> 90 days) mortality related to bariatric surgery. This is a retrospective collaborative audit of patients who had undergone bariatric surgery and developed complications that ultimately led to death. Individuals who were 18 years or older and had undergone bariatric surgery (primary, revisional, and endoscopic procedures) and subsequently died within 90 days or after 90 days following the surgery between 1 January 2022, and 31 December 2022. A descriptive analysis was conducted. About 30 centres from 21 countries submitted data on 82 patients where patient death was deemed to be related to bariatric surgery. Mortality within 90 days post-surgery was observed in 58 individuals (70.7%), while 24 patients (29.3%) died after this period. Causes of mortality after SG include GI leak, PE, respiratory infection, and malnutrition. Causes of mortality after RYGB include GI leak, coronary heart disease, and bleeding. Reported common causes of early mortality in this study were gastrointestinal leaks, bleeding, coronary heart disease, and pulmonary embolism. Reported common causes of delayed mortality were gastrointestinal leaks and malnutrition. This study characterises patients where death was attributed to a bariatric procedure and identifies common causes of death in these patients. This could aid development of strategies for preventing and managing these complications in the future.

DOI: 10.1111/cob.70031

Link to full-text [NHS OpenAthens account required]

Trial of lateral flow devices for COVID/Flu A+B ±RS (2024)

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Type of publication:

Service evaluation

Author(s):

*Rebecca Kerrigan

Citation:

SaTH Service Evaluation

Abstract:

We attempted to evaluate the use of dual/triple lateral flow devices to screen patients for winter viruses (COVID, Flu A and B, RSV). Lateral flow kits were sent to Ward 17 at Princess Royal Hospital and Ward 24 at Royal Shrewsbury Hospital. Instructions were given to staff on how to take the samples and complete the paperwork, and how to return samples and paperwork.

No samples or paperwork were returned to the Microbiology department during the trial period, therefore no analysis can be performed, and no conclusions on the effectiveness of either lateral flow device can be drawn.

The Microbiology department recommends that the Trust contacts the POCT team if a repeat trial is required.

Link to full-text

Improving In-Hospital Falls Management Through In-situ Simulation (2024)

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Type of publication:

Conference abstract

Author(s):

*Claire Swindell, *Omar Hassouba

Citation:

Journal of Healthcare Simulation 2024;4(Suppl 1):A1–A102

Abstract:

Introduction: This quality improvement initiative focuses on utilising in-situ simulation techniques to promote active participation from the multidisciplinary healthcare team to improve in-patient falls management. The project focused on a simulated patient that had sustained a fractured neck of Femur after experiencing a fall on the ward. Safe transfer of the fallen patient and identification of equipment needed was central to the project’s objectives. In doing so, learner centred engagement assisted in the identification of organisational and systematic barriers that impinge on best practice. As in-situ simulation can proactively identify latent system issues that may be acting as barriers in achieving best practice, how effective can it be in improving staff management, in response to a fallen in-patient that has sustained a Fractured neck of Femur? Methods: A collaborative approach was initiated and fostered to allow key stakeholders to identify fall-related issues and areas most in need of improvement within the Trust relating to falls. Using in-situ simulation, a standardised patient was utilised to recreate a realistic scenario, where a patient falls on the way to the toilet. The standardised patient ‘role plays’ that they have sustained a hip injury which presents as a fractured neck of femur, hence unable to get up from the floor. The multidisciplinary ward team were then observed to see how they collectively managed the fallen patient and how they safely transfer the patient from the floor. A protected, inclusive debrief was then carried out to enhance understanding of the scenario undertaken and to highlight barriers encountered. Results: Although the multidisciplinary team appeared to have a good awareness of Trust policy and procedure pertaining to post-fall care, accessibility to essential equipment needed was lacking. A need for staff training in the safe use of this essential equipment was apparent. Discussion: By carrying out this immersive in-situ simulation, specific ward issues that required attention were identified, problems that may have gone unnoticed if not presented in a realistic scenario, recreating real-time patient care needs. Therefore, in-situ simulation is an ideal and effective modality in capturing authentic latent issues that may occur during the management of a fallen patient that has sustained a fractured neck of femur. The need for improvements were identified and cascaded to the relevant teams to remove barriers for best practice.

Link to PDF poster