DR. MICHAEL FIOCCO, M.D.

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This study looked at kidney damage in children undergoing cancer treatment. Out of 1,525 young patients, 37% experienced acute kidney injury (AKI), and of those followed up after one year, 13.6% developed chronic kidney disease (CKD). Experiencing AKI while being treated significantly increased the risk of developing CKD, especially for those who had more than one episode of AKI or received certain harmful medications. Who this helps: This information benefits doctors and healthcare providers treating children with cancer.

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The PRIME-ROSE project studied how to combine data from different cancer trials to improve research in Precision Cancer Medicine (PCM). By merging data from over 300 groups involving more than 1,000 patients, the project showed that sharing data can speed up research efforts and help create larger study groups, which is crucial for understanding how well new treatments work. It found that at least 20 of these groups have made progress after initial evaluations, demonstrating that this approach can enhance cancer research. Who this helps: Patients and researchers in the field of cancer treatment.

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This study looked at how ignoring certain uncertainties in disease measurement affects evaluating how well illness-death models work in predicting patient outcomes. Researchers tested different methods to account for these uncertainties, particularly in patients with high-grade soft tissue sarcoma, analyzing data from 2,232 patients. They found that it's crucial to consider these uncertainties to accurately assess the model's performance in predicting disease progression and death. Who this helps: This helps doctors and researchers in better understanding and treating patients with sarcoma and other diseases.

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This study compared two surgical methods for total hip replacement in patients with osteoarthritis: the SuperPath and Direct Lateral approaches. The researchers found that patients who had the SuperPath procedure reported better pain and quality of life scores after surgery, with an average improvement of about 7.1 points in pain relief and 3.9 points in overall health compared to those who had the Direct Lateral approach. Although these differences were statistically significant, they were not large enough to be considered clinically meaningful. Who this helps: This research benefits patients undergoing hip replacement surgery by informing them about potential differences in surgical outcomes.

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This study looked at how acute kidney injury (AKI) affects patients with cirrhosis and the possibility of developing acute-on-chronic liver failure (ACLF). Researchers found that 47% of the 672 patients did not improve from AKI, and 60% already had ACLF when they were diagnosed with AKI. Importantly, the study revealed that 47% of patients died within 90 days after AKI diagnosis, highlighting the urgent need for better early detection and treatment strategies for these high-risk patients. Who this helps: This information is valuable for doctors treating patients with cirrhosis and kidney issues.

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This study focused on Stage IV neuroblastoma, a serious cancer in children, examining how a specific genetic marker (amplification) influences treatment response and the likelihood of returning cancer. Researchers found that out of 164 patients, 30% had this amplification, and those with it went into complete remission more quickly but experienced relapses more frequently; specifically, they had a 1.6 to 1.8 times higher chance of recurrence compared to those without amplification. Understanding these patterns helps doctors better predict outcomes and tailor treatments for their patients. Who this helps: This helps children with neuroblastoma and their doctors.

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This study looked at metabolic syndrome (a group of conditions that increase the risk of heart disease) in 2,338 adults who survived childhood cancer. They found that survivors had more than double the odds of developing metabolic syndrome compared to healthy adults, with 23.1% of childhood cancer survivors affected. The study identified risk factors like older age, smoking, low physical activity, and certain types of cancer treatments that contributed to this increased risk. Who this helps: This helps childhood cancer survivors by highlighting the need for monitoring and prevention strategies to reduce their long-term health risks.

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This study looked at the long-term effects of adding a drug called pazopanib to radiation therapy for patients with high-risk soft tissue sarcoma. Out of 34 patients in this study, the one-year survival rate was 97%, but when comparing to a larger group of 487 patients receiving standard treatment, pazopanib did not significantly improve survival rates. While some patients experienced long-term side effects, these were manageable and similar to those seen in patients who received standard treatment. Who this helps: This research helps doctors understand treatment options for patients with soft tissue sarcoma.

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This study looked at different methods for collecting stem cells from children undergoing treatment for cancer. Researchers found that using plerixafor along with G-CSF helped poorly mobilizing patients collect more stem cells, while PEG-G-CSF was successful in two-thirds of cases without harming recovery. These findings are important because they could improve stem cell collection techniques for kids, making their treatment more effective and safer. Who this helps: This helps pediatric cancer patients requiring stem cell transplants.

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This study looked at a new method of radiotherapy for patients with soft tissue sarcomas during the COVID-19 pandemic, changing from many smaller doses to fewer, slightly larger doses to reduce hospital visits. Out of 66 patients analyzed, 33% had wound complications after surgery, but there was no increase in severe issues, and the rates of local tumor recurrence after two years were low at 7.6%. This matters because it shows that the adjusted treatment schedule can effectively treat cancer without harming patients' recovery. Who this helps: Patients with soft tissue sarcomas.

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This study looked at how different patient characteristics, such as age and smoking, affect blood vessel growth in the meniscus, a cushion in the knee, among 174 people who had knee replacements. Researchers found that the depth of these blood vessels in the meniscus varied widely, with some having 0% to 78% penetration in the lateral part and 0% to 67% in the medial part, but there was no link between this depth and factors like age or health history. This is important because it means doctors cannot use these patient characteristics to judge blood supply in meniscal tears when treating patients. Who this helps: This helps doctors and healthcare providers treating knee injuries.

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This study looked at how well different materials used in the locking mechanism of knee replacements perform over time, specifically focusing on patients with cancer-related needs. Researchers reviewed data from 316 patients and found that 11% of them experienced issues like wear or breakage of the locking mechanism, with rates varying by material: 9% for polyethylene, 20% for polyether-ether-ketone, and 9% for metal-on-metal. The findings suggest that despite changing materials intended to improve durability, the risk of needing additional surgery due to these failures has not decreased, which highlights the need for better designs in these devices. Who this helps: Patients receiving knee replacements, especially those undergoing surgery for cancer.

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This study looked at diabetes in over 2,300 adults who survived childhood cancer. Researchers found that these survivors were three times more likely to have diabetes compared to people without a cancer history, with those who had previous abdominal radiation or were older than 35 being at greater risk. Understanding these risk factors is important for helping to detect and manage diabetes earlier in this group, improving their overall health. Who this helps: This helps childhood cancer survivors and their healthcare providers.

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This study looked at how often children with kidney tumors experience acute kidney injury (AKI) during their treatment and how this affects their long-term kidney health. Out of 147 children treated, 104 (71%) had AKI, mostly within 48 hours after surgery. About 13% of patients developed chronic kidney disease (CKD) a year later, especially those who had experienced AKI, used three or more medications, or had lower kidney function to start with. Who this helps: This research benefits pediatric cancer patients and their doctors by highlighting the need for careful monitoring and prevention strategies during treatment.

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This study looked at the relationship between certain chemicals found in urine, called catecholamines, and the outcomes for patients with high-risk neuroblastoma, a type of childhood cancer. Researchers measured these levels in 153 patients at different treatment stages and found that while high catecholamine levels were common, those who still had elevated levels after treatment were at a higher risk of relapse and dying. Specifically, only 38% of patients with high catecholamines remained event-free after achieving complete remission, compared to 80% of those with normal levels, highlighting the importance of these measurements in monitoring cancer treatment. Who this helps: This benefits doctors and healthcare providers in monitoring and treating children with high-risk neuroblastoma.

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This study investigated how different genetic mutations in gastrointestinal stromal tumors (GISTs) affect the response to a pre-surgery treatment called neoadjuvant imatinib. Out of 326 patients treated, 80.9% had surgery afterward, and those with a specific mutation (exon 11) showed a much better response—60.5% were partially responding compared to only 33.3% of patients with other mutations. This is important because it shows that genetic differences can lead to very different treatment outcomes, helping doctors tailor therapies to improve patient care. Who this helps: This helps patients with GISTs and their doctors by providing insights into which mutations may respond better to treatment.

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This study looked at the effectiveness of an online program called PanCareFollowUp (PCFU) that helps young cancer survivors adopt healthier lifestyles over four months. The results showed that 68% of participants achieved their personal health goals after the coaching, and this increased to 76% at the follow-up. Also, these survivors showed improvements in their body weight, diet, and physical activity levels. Who this helps: This benefits childhood, adolescent, and young adult cancer survivors by providing tools for healthier living.

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This study looked at children with acute lymphoblastic leukaemia (ALL) and found that 15% could not walk independently at diagnosis, and that number increased to 28.3% during the first part of treatment. Factors such as being younger at diagnosis, losing weight, and having longer hospital stays made it more likely for children to experience walking difficulties. This is important because losing the ability to walk can impact a child's independence and quality of life. Who this helps: This information benefits patients and their families by highlighting the risks of walking problems during treatment.

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This study looked at how long it takes for someone infected with the Delta variant of COVID-19 to become contagious in Vietnam, specifically focusing on individuals who had not been previously infected or vaccinated. Researchers found that the average time from infection to being infectious was about 3.2 days, with half of those infected becoming contagious in 1.8 days and a few taking up to 11 days to do so. These findings highlight the importance of accurate data collection and analysis in managing infectious disease outbreaks effectively. Who this helps: This helps public health officials and policymakers in controlling the spread of COVID-19.

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This study looked at patients with low and moderate-grade brain tumors (gliomas) who stopped taking their seizure medications and whether their seizures came back. Researchers followed 71 patients over time and found that 48% of those who stopped medication had a seizure return within 4 years, compared to 28% of those who continued their medication. This matters because it suggests that while stopping medication doesn’t significantly increase the risk of seizures for stable patients, there is still a notable chance that seizures can reoccur, meaning doctors need to be careful when deciding to stop treatment. Who this helps: This helps patients with gliomas and their doctors in making informed decisions about seizure medication.

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This study focused on patients with soft tissue sarcoma, a rare type of cancer, and developed a new tool to measure their quality of life during and after treatment, particularly when receiving preoperative radiotherapy. Researchers combined existing questionnaires with new questions about specific issues faced by these patients, like pain and stiffness, after consulting with both patients and doctors. The new tool aims to give a clearer picture of how treatment affects patients' lives, ultimately helping to enhance their well-being and enabling better comparisons across future studies. Who this helps: This helps patients with soft tissue sarcoma and their healthcare providers.

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This study compared the need for follow-up surgeries after breast reconstruction using different types of implants: smooth, textured, and polyurethane-covered. Out of nearly 4,000 implants analyzed, the revision rates after four years were 11.1% for textured, 13.0% for smooth, and 16.1% for polyurethane-covered implants, but the overall differences weren’t significant. However, polyurethane-covered implants were more likely to need revisions for issues like capsular contracture and asymmetry. Who this helps: This information benefits patients considering breast reconstruction options and doctors who guide them.

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This study looked at different ways to measure outcomes in clinical trials that compare new treatments to existing ones, focusing on how long patients survive without their condition worsening. Researchers analyzed data from 65 trials and found that using the difference in restricted mean survival time—essentially a way to capture how long patients lived without issues—was more powerful for detecting treatment effects than the traditional hazard ratio. Specifically, this method showed a notable increase in detecting differences, giving an advantage of a percentage points in power. Who this helps: This helps researchers and clinicians by providing a more effective way to assess treatment outcomes in clinical trials, leading to better informed decision-making in patient care.

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This study looked at how different imaging settings affect measurements of tumor response in children with a rare cancer called rhabdomyosarcoma. Researchers analyzed scans from 114 patients across 22 treatment centers and found that while there were variations in imaging techniques, these didn't significantly change the overall tumor measurements. However, they did discover that changing a specific imaging setting, called the highest b-value, could influence how treatment responses were tracked over time, leading to an average drop of 2.8% in measurements with each adjustment. Who this helps: This information benefits doctors and medical teams treating pediatric rhabdomyosarcoma by guiding them on how to consistently measure treatment responses.

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This study examined how to better analyze cancer data when the samples used are not balanced, particularly when young patients with specific cancers are overrepresented. Researchers proposed a new method that improves the way they weigh data to correct for this bias, showing its effectiveness through simulations and real data on colorectal and breast cancer. This is important because it helps researchers make more accurate conclusions about how certain genetic factors influence cancer risk. Who this helps: This helps cancer researchers and geneticists studying cancer susceptibility.

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This study looked at how well different surgical methods work for rebuilding the upper arm bone in patients with cancer-related damage. It involved 165 patients, and the researchers found that 16% of the implants needed further surgery due to mechanical problems or infection. They discovered that reverse shoulder arthroplasty (RSA) offered better movement compared to other methods, making this approach preferable for restoring function. Who this helps: Patients undergoing surgery for upper arm bone tumors.

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This study looked at how different schedules for pre-surgery radiation therapy affect patients with soft tissue sarcomas (a rare type of tumor). Researchers found that standard radiation therapy had an 18% chance of causing major wound complications, while a moderately intense approach raised that risk to 29%. This research matters because it helps guide doctors in balancing effective treatment with the potential side effects of radiation, especially in a complex area of cancer care. Who this helps: Patients with soft tissue sarcomas.

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This study looked at two tools, PERSARC and Sarculator, used to predict the risk of serious health problems in patients with localized soft tissue sarcoma, a type of cancer. Researchers reviewed data from 664 patients and found that about 32% and 39% were classified as high-risk by Sarculator and PERSARC, respectively, with a strong agreement between the two models for most patients. The study showed that chemotherapy improved overall survival and disease-free survival in high-risk patients, which is important because it helps identify those who may benefit from treatment. Who this helps: This research benefits patients with localized soft tissue sarcoma and their doctors by improving treatment planning.

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This study looked at more sensitive methods for detecting tiny amounts of tumor cells in the bone marrow of high-risk neuroblastoma patients, which is important because undetected tumor cells can lead to worse outcomes. Researchers tested these advanced methods on samples from 108 patients, finding that the new techniques improved detection rates significantly—out of 395 samples, they achieved accurate results in 223 cases. This matters because catching these hidden tumor cells early can help doctors choose better treatments and potentially improve survival rates. Who this helps: This helps patients with high-risk neuroblastoma and their doctors.

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This research examined how well certain MRI measurements predict the response of high-risk soft tissue sarcomas to treatment, specifically after patients took a medication (pazopanib) and underwent radiation therapy. The study involved 15 patients and looked at different MRI markers, finding that the repeatability of these measurements was relatively low: for one MRI marker, it varied by 17%, and others had a 5% and 65% variation. Despite changes in MRI values during treatment, there was no clear link between these MRI results and how much of the tumor remained viable after treatment. Who this helps: This helps patients with soft tissue sarcomas and their doctors in understanding treatment effectiveness.

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The VALUE-PERSARC study looked at whether a new risk prediction tool called PERSARC could help improve treatment decisions for patients with high-grade soft tissue sarcomas. The study involved 120 patients across seven hospitals and found that while PERSARC did not significantly increase patients' knowledge about their treatment options or reduce their anxiety about decisions, it did lead doctors to discuss more treatment options with patients (93% of doctors in the PERSARC group discussed multiple options compared to only 35% in the control group). This is important because having more treatment discussions can help patients feel more involved in their care choices. Who this helps: This helps patients with soft tissue sarcomas by promoting better discussions about their treatment options.

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This study looked at how the OPTIModel could better predict survival for patients with kidney cancer that has spread to the bones, specifically those with varying numbers of bone metastases. Researchers found that among 178 patients, the median overall survival was 12.1 months, with longer survival for those with fewer metastases: 19.6 months for one spot, 14.8 months for two to four spots, and 6.1 months for more than four spots. By including a specific group of patients with fewer metastases in the model, the predictions for survival were improved, which can help doctors make better treatment decisions. Who this helps: This helps patients with kidney cancer and their doctors.

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This study looked at how effective two different methods, trephine biopsies (TBs) and bone marrow aspirates (BMAs), are in detecting cancer in the bone marrow of neuroblastoma patients. The researchers evaluated 197 patients and found that TBs were more accurate, showing cancer presence in 35.5% of cases compared to only 19.7% for BMAs. Since TBs provide clearer results and are sufficient for diagnosis, using BMAs may not be necessary, potentially simplifying the testing process. Who this helps: This helps doctors and patients by providing clearer guidelines on the most effective diagnostic methods.

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This research looked at how electronic health records can help doctors identify the right moments to start advance care planning (ACP) for older patients. The study found that certain health issues, like cancer consultations or hospital admissions, significantly indicated when ACP should be discussed, with some issues being up to 8 times more likely to occur before death. Recognizing these triggers can help ensure that patients receive important end-of-life care discussions at the right time. Who this helps: This benefits patients and their families by ensuring they have timely conversations about their healthcare preferences.

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This study looked at how treatment for brain tumors in children affects the structure of the brain over time. Researchers examined MRI scans of 57 children treated for low- and high-grade posterior fossa tumors over five years. They found that children treated for low-grade tumors had an increase in a brain area called the hippocampus, while those with high-grade tumors experienced a decrease; specifically, the hippocampal volume decreased in high-grade patients, showing how treatment impacts brain development differently depending on the tumor grade. Who this helps: This helps pediatric patients and their doctors understand potential long-term effects of brain tumor treatments.

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This study looked at how detecting tiny amounts of neuroblastoma-related genetic material in the blood of patients with high-risk neuroblastoma could help predict their chances of surviving the disease. Researchers found that when at least 1% of the blood sample tested positive for neuroblastoma mRNA at diagnosis, patients had a higher risk of worse outcomes, with those patients being 2.37 times more likely to experience disease progression and 2.60 times more likely to have shorter overall survival. These findings suggest that testing blood samples could be a useful, less invasive way to monitor and assess the prognosis of patients with neuroblastoma. Who this helps: This helps patients with high-risk neuroblastoma by improving monitoring strategies for their treatment.

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This study looked at the risk of broken bones after a specific surgery (intralesional curettage) for patients with atypical cartilaginous tumors (ACT) in the lower thigh bone. Researchers found that using cement as a filling material after the surgery significantly increased the risk of fractures—about five times higher compared to using bone chips. Additionally, larger tumors were also linked to a greater fracture risk. This matters because selecting the right filling material during surgery can help lower the chances of future bone fractures for patients. Who this helps: Patients with atypical cartilaginous tumors undergoing surgery.

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This study examined the immune cells in the bone marrow of children with acute myeloid leukemia (AML) to better understand their tumor environment. Researchers found that about one-third of pediatric AML cases had a significant number of immune cells in the bone marrow, and these areas had specific types of immune cells, including CD8 T cells and memory B cells, that could be important for developing effective therapies. This information is crucial because it opens up new possibilities for improving treatment options for children with AML. Who this helps: This helps doctors and researchers developing new treatments for children with acute myeloid leukemia.

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This study looked at young patients under 55 who had total hip replacements due to different conditions: osteoarthritis, developmental dysplasia, and Legg-Calvé-Perthes disease. Researchers found that after 10 years, the risk of needing another surgery due to problems with the hip replacement was similar for all groups—about 3.4% for osteoarthritis and developmental dysplasia, and 1.7% for Legg-Calvé-Perthes disease. This is important because it shows that having hip surgery for these conditions doesn't lead to a higher risk of complications compared to more common causes like osteoarthritis. Who this helps: This helps young patients with hip disorders and their doctors by providing reassurance about surgery outcomes.

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This research focused on comparing machine learning tools and traditional statistical methods to predict how long patients with osteosarcoma are likely to survive. The study looked at data from a clinical trial and found that machine learning models generally provided better and more accurate predictions than traditional methods. Specifically, the use of advanced machine learning approaches like random survival forests and survival neural networks outperformed the older Cox models, which is important for improving treatment decisions for patients. Who this helps: This helps doctors and healthcare providers in making better treatment plans for osteosarcoma patients.

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This study looked at how changes in taste and smell during cancer treatment affect what children eat, their eating behaviors, and their overall health. Researchers followed 87 children with various types of cancer and found that energy intake increased over time, especially in older children and those with better taste, while eating problems decreased. Additionally, overall health-related quality of life improved, but issues like low BMI and tube feeding were linked to worse experiences with taste and smell. Who this helps: This research benefits children with cancer and their families by highlighting the importance of tailored dietary advice during treatment.

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This study focused on how the overall health of patients affects survival rates in those with high-grade chondrosarcoma, a type of bone cancer. Researchers looked at 249 patients and found that factors like a poor health score (ASA score III), tumor grade, and older age significantly lowered survival chances, with a long-term survival risk about 2.6 times higher for patients with severe systemic health issues. Understanding these factors can help doctors make better treatment decisions and improve patient care. Who this helps: This helps patients and their doctors in making informed decisions about treatment options for high-grade chondrosarcoma.

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This study focuses on how to involve children and young adults more in the decision-making process when they need surgery for a primary malignant bone tumor around the knee. Researchers created a shared decision-making model that includes an online tool to help patients and their families understand their options better. Early results from using this model show that when patients are more involved, they experience less stress and regret about their choices, which is crucial for their care and emotional well-being. Who this helps: This benefits patients and their families facing surgery, as well as doctors involved in their care.

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This study looked at the health of 2,338 adults who survived childhood cancer to see how often they had dyslipidemia, which means unhealthy levels of fats in the blood that can lead to heart disease. The findings showed that nearly 21% had high triglycerides, and 30% had low levels of good cholesterol. Overall, childhood cancer survivors are at a higher risk for these issues, which highlights the need for tailored health monitoring for them to prevent heart problems later in life. Who this helps: This information benefits childhood cancer survivors and their healthcare providers.

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This research examined the survival rates of 409 children with diffuse intrinsic pontine glioma (DIPG), a serious brain tumor, based on different treatment methods. The study found that children who received a combination of radiation therapy and chemotherapy lived the longest, with a median survival of 11.7 months after diagnosis, compared to just 3.0 months for those who did not receive any treatment. The findings highlight the importance of treating DIPG with effective therapies to improve survival outcomes. Who this helps: This helps patients with DIPG and their families by providing insights into the most effective treatment options.

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This research studied how the intensity of chemotherapy doses given to osteosarcoma patients affects their survival. The findings showed that reducing chemotherapy doses improved survival for patients with poor histological responses, giving them an average gain of 10.2 months with reduced doses and 15.4 months with highly-reduced doses. However, for patients with good responses, higher dose reductions worsened their survival outcomes. Who this helps: This helps osteosarcoma patients, particularly those who respond poorly to chemotherapy.

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This study looked at how well a new blood test, called RT-qPCR, can detect cancer cells in bone marrow for children with high-risk neuroblastoma. They found that if more than 10% of the bone marrow showed cancer cells at diagnosis, patients had a higher risk of worse outcomes, with survival chances dropping to about 26.6% compared to 60.4% for those without significant cancer presence. This is important because it can help doctors identify which patients need more aggressive treatment early on by using this sensitive test for ongoing monitoring. Who this helps: Patients with high-risk neuroblastoma and their doctors.

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This study examined factors that affect the survival of patients with low- or intermediate-risk neuroblastomas, a type of cancer, which usually has a good prognosis over five years (over 90%). Researchers found that certain genetic changes—like losses on chromosome 1 and gains on chromosome 17—were linked to lower survival rates; specifically, those with 1p loss had worse overall survival and event-free survival rates. These findings are important because they could help refine how doctors assess risks for these patients, allowing for better treatment planning. Who this helps: This helps doctors and patients diagnosed with non-high-risk neuroblastoma.