bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-treatment [18F] fluorodeoxyglucose positron emission tomography as a prognostic tool for progression-free survival in epithelial ovarian cancer
Authors: Chung H. , Kim J. , Park N. , Song Y. , Kang S. , Lee H. 
Published: March 2020

16029 Background: The aim of this study was to evaluate response to therapy using post-treatment molecular imaging with [18F] fluorodeoxyglucose (FDG), and to compare the response with outcome in patients with epithelial ovarian cancer (EOC). Methods: This was a retrospective medical record review of 179 patients with EOC. All patients underwent post-treatment whole-body positron emission tomography (PET) imaging scan with [18F] FDG from August 1998 to April 2005. Patients were treated with surgical staging procedure followed by platinum-based combination chemotherapy at least 3 cycles. Post-treatment whole-body FDG-PET was performed 1 to 7 months (median, 3 months) after completion of treatment. Results: One hundred fourteen patients showed no abnormal FDG uptake while 65 patients had abnormal FDG uptake at the scan. One hundred thirteen patients experienced recurrence or metastasis during follow-up. Median progression-free survival (PFS) was 44 (range 2–83) months, and 5-year PFS rate was 34.3%. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of [18F] FDG PET images in the diagnosis of ovarian cancer recurrence or metastases were 46.1%, 82.8%, 59.2%, 82.8%, and 46.1%, respectively. A Cox proportional hazards model of survival outcome indicated that abnormal post-treatment FDG uptake (persistent or new) was the most significant prognostic factor for developing metastatic disease and death from EOC (hazard ratio, 0.432; 95% CI 0.296 to 0.630; P <.0001). However, there was no relation between the maximal standardized uptake value (SUVmax) and the PFS. Conclusion: Post-treatment abnormal FDG uptake (persistent or new) detected by whole-body PET measures tumor response and might be predictive of poor prognostic ourtcome from EOC. No significant financial relationships to disclose.
Decreased survival in cervical cancer patients with thromboembolic events
Authors: Jacobson G. M. , Goodheart M. , Smith B. , Lammli J. 
Published: March 2020

16034 Background: We have previously reported on the incidence of thromboembolic events (TE) in cervical cancer patients treated with definitive chemoradiation.Patients with TE seemed to have decreased survival compared to those without TE. We reviewed a larger cohort to compare the survival of cervical cancer patients with and without TE. Materials and Methods: We performed a retrospective chart review of cervical cancer patients diagnosed and treated at the University for Iowa from January 1997 until December 2003. Data sources included the University of Iowa Tumor Registry, the Gynecologic Oncology Tumor Data Base, and the relevant ICD-9 codes to identify cervical carcinoma and types of TE in both inpatients and outpatients. Statistical analysis included the Pearson chi-squared test for categorical variable, and the two-sample t-test for continuous factors. Log-rank tests were used for survival analysis along with the generation of Kaplan-Meier survival curves. Multivariate analysis was performed with Cox proportional hazards regression. All tests are two sided and carried out at the 5% level of significance. Results: Three hundred and fifty nine (359) patients were treated with surgery or chemoradiation; thirty-six patients (10%) developed TE. There were significant associations between thromboembolic status and pelvic irradiation (p=0.0493), chemotherapy (p=0.0118), and stage (p=0.0197). Survival could not be estimated for patients not experiencing a thromboembolism; survival did not drop below 50% by the end of follow-up. Median survival time for patients with thromboembolism was 4.5 years. According to log-rank test, this difference was significant (p-value<0.0001). Conclusion: The incidence of thromboembolic events in this cohort of cervical cancer patients was 10%. TE was associated with a significant decrease in survival. No significant financial relationships to disclose.
Improved survival for ovarian cancer patients stage IIIC treated at the Norwegian Radium Hospital between 1984 - 2001
Authors: Trope C. , Oksefjell H. , Sandstad B. 
Published: March 2020

16044 Background: The aim of this study was to evaluate the treatment of FIGO stage IIIC patients who were primarily treated completely or partially at the Norwegian Radium Hospital (NRH) during a 15-year period in order to discover possibilities for improvement of prognosis of advanced ovarian cancer. Methods: A retrospective study based on record information from all patients with epithelial ovarian cancer stage IIIC treated at NRH 1985 - 2000, in total 776 patients. Results: We found age, amount of residual tumour after surgery for primary treatment and type of chemotherapy to be the most significant prognostic factors for overall survival. During the last 5-year period primary surgery was increasingly centralised, surgery was improved with lymph node staging and paclitaxel was used. Survival was significantly best during the last 5-year period and after macroscopically radical surgery. Also progression-free survival was best with no macroscopic tumour left. Conclusions: Improved survival during the last 5-year period is partly attributed to improved surgery, partly to the addition of paclitaxel. We believe that a further centralisation of primary surgery for advanced ovarian cancer can contribute towards a better prognosis. No significant financial relationships to disclose.
Overexpression of the osteopontin correlates with the aggressiveness of endometrial cancer
Authors: Cho C. , Cha S. , Kwon S. , Kwon Y. , Kang S. , Lee J. , Kim K. , Yea J. 
Published: March 2020

16048 Background: To test the hypothesis that expression of osteopontin (OPN), an integrin-binding glycoprotein, can independently predict the potential aggressiveness of endometrial cancer. Methods: The status of OPN expression in benign and malignant endometrial cancer cell lines and tissues was analyzed by real time PCR, Western blot, and immunohistochemistry. Nonparametric Spearman's correlation coefficient method was used to assess the statistical significance of the correlation between clinicopathologic characteristics of tumor and OPN expression. Results: An increased expression of OPN was observed in the endometrial cancer compared to normal endometrial tissue samples. When the level of OPN in normal tissue was set at 1, its level in benign endometrial hyperplasia was slightly increased at 1.2, whereas the OPN level in the highly malignant endometrial carcinoma tissue was greatly increased by nearly 3–5 folds. Amongst the 160 cases examined immunohistochemically, of the 43 grade 1 endometrial carcinomas, 31 were unstained and 12 stained weakly positive (+). For the 41 grade 3 or serous type endometrial carcinomas analyzed, 25 (60%) stained strongly positive (+++), 8 (19%) stained moderately positive (++) and 4 (9%) stained weakly positive (+). These results showed that the level of OPN expressed between grade 1 and grade 3 or more was significantly different (Spearman's correlation coefficient method, p = 0.001). However, Kaplan-Meier survival analysis showed that the increased level of OPN expression was not significantly associated with reduced survival time of the patients. Conclusion: The results suggest that the increased OPN level may be involved in the malignant transformation of endometrial adenocarcinoma cells. No significant financial relationships to disclose.
The regulatory mechanism involved in paclitaxel-induced apoptosis: The role of ATF-3 on apoptosis in cervical cancer cell line (HeLa cell)
Authors: Kwon Y. 
Published: March 2020

16052 Background: Paclitaxel, which is a potent anti-cancer drug and microtubule-binding agent, has been found to be effective against several tumors, including cervical cancer. However, the exact mechanism underlying the apoptotic effects of paclitaxel is poorly understood. Methods: We show that paclitaxel induces apoptosis, as demonstrated by DNA fragmentation, TUNEL assay, and flow cytometry analysis in cervical cancer HeLa cells, correlating with enhanced caspase-3 activation and p73 as well as p21, which are inhibited strongly by p73 siRNA. Results: The paclitaxel treatment followed by the overexpression of wild type ATF3 potentiated apoptosis is by enhancing p73 expression, but these events were attenuated in C-terminal deleted ATF3 or ATF3 siRNA-transfected cells. Interestingly, paclitaxel-induced ATF3 colocalizes with transfected GFP-p73 in nucleus, but not in p73 siRNA-transfected cells. Conversely, p73 may not affect ATF3 expression, as increase of ATF3 expression did not detect in p73-overexpressing cells. Furthermore, we observed that ATF3 binds to DNA binding domain of p73, confirmed by GST-pull down assay for ATF3. Additionally, ATF3 potentiates p21 gene, a downstream target of p73, promoter activity and p73-p21 binding activity induced by paclitaxel and also we have obtained similar data in the tissue of cervical cancer patient treated with paclitaxel. Conclusions: Collectively, these results demonstrate that overexpression of ATF3 potentiates paclitaxel-induced apoptosis in HeLa cells, at least in part, through stimulating the p73 expression and its transcriptional activity. ATF3 may function as a tumor-inhibiting factor by regulating directly p73 and may suggest a functional link between ATF3 and p73. No significant financial relationships to disclose.
Endometrial stromal sarcomas: A retrospective analysis of 28 patients, single center experience for 20 years
Authors: Kim J. , Nam E. , Kim Y. , Kim J. , Kim S. , Kim S. , Yoon B. 
Published: March 2020

16053 Background: Little is known about the pathogenesis, risk factors, optimal therapy or outcomes of endometrial stromal sarcoma (ESS). The aim of this study is to evaluate the behavior of ESS in relation to its clinical and pathogenic features and to find the better treatment strategy. Methods: A retrospective analysis was performed of 28 patients with histologically proven ESS treated at our institution between 1987 and 2006. Results: The median follow-up time was 54.7±63.1 months and 5-year survival rate was 82.0%. 16 (57.1%) patients were referred to our institution from private clinics for further treatment of the ESS. They were previously undergone either hysterectomy, myomectomy, or hysteroscopy for presumed benign gynecological conditions. 22 patients (81.5%) showed low grade and 5 patients (18.5%) showed high grade disease. A univariate analysis revealed that histologic grade according to mitotic count is associated with longer survival (p=0.004). However, among those with low grade tumor, 5/20 patients (25%) had recurrence and 2/21 (9.5%) had distant metastasis during the follow-up period. Except for 2 cases, 26 patients with ESS had hysterectomy for their primary treatment. Adjuvant treatment after surgery was performed in 14/26 cases (53.8%). Hormone therapy by progesterone, chemotherapy and/or radiotherapy individually did not influence the overall survival of the patients. However, postoperative adjuvant therapy group regardless of the treatment modality was associated with relatively increased overall survival when compared to the surgery only group (p=0.054). Conclusions: Differential diagnosis of ESS from other benign gynecologic diseases before surgery is a difficult problem. Furthermore, it is advised that postoperative adjuvant therapy should be performed after hysterectomy to prevent recurrence or distant metastasis. No significant financial relationships to disclose.
Stromal reaction of adenomyosis protects from uterine endometrial cancer invasion to myometrium
Authors: Fujiwara H. , Nishisaka T. , Urabe T. , Miyoshi H. , Kudo Y. 
Published: March 2020

16064 Background: It is unclear that stromal reaction plays role in endometrial cancer (Em Ca) invasion to uterine muscle with adenomyosis. Methods: One hundred and five patients with Em Ca (stage 0=38, 1a=18, 1b=26, 1c=10, 2b=3, 3a=4, 3c=5, 4a=1) received operative therapy with hysterectomy. Evaluation of stromal reaction using immunohistochemical method with alpha-smooth muscle actin and h-caldesmon antibody. In case of alpha-smooth muscle actin had immunoreactivity and h-caldesmon had not immunoreactivity, there was stromal reaction with myofibroblast. Evaluation of cell proliferation, using immunohistochemical method with epidermal growth factor receptor (EGFR) by global score with six degrees and MIB-1 by labeling Index (LI). Results: All cases had stromal reaction with myofibloblast in myometrial invasion area in forty nine cases with myometrial invasion equal or more than stage 1b. Em Ca invaded near to and in adenomyosis lesion in eleven cases. In stroma of adenomyosis without cancer invasion, EGFR was positive in one case (9%) and global score was two (average 0.18). In contrast, EGFR was positive in eight cases (73%) with Em Ca invasion to adenomyosis stroma and global score was from two to three (average 1.6). LI of MIB-1 was from 0 to 0.2 (average 0.05) in adenomyosis stroma without Em Ca invasion and 0.2 to 0.75 (average 0.41) with Em Ca invasion. Conclusions: When Em Ca invades to adenomyosis, myofibloblast cell proliferation in stromal reaction increases more than in adenomyosis without Em Ca invasion. Stromal reaction of adenomyosis plays role in protecting from Em Ca invasion to uterine muscle and it may contribute to being good prognosis compared with Em Ca without adenomyosis. No significant financial relationships to disclose.
Correlation of serum CA125 levels with stage, grade and survival of patients with epithelial ovarian cancer
Authors: Osman N. , O'Leary N. , Higgins M. J. , Barrett N. , Wallis F. , Hickey K. , Gupta R. K. 
Published: March 2020

16066 Background: Serum levels of the tumor marker CA125 and its relation to disease stage, grade, tumor volume, survival and prognosis have been studied with conflicting results. This study was conducted in a single center serving a population of 340,000. Methods: Newly diagnosed patients referred between Jan 1 2001 and Dec 31 2005 were included. Serum CA125 levels were recorded before and after optimal debulking surgery and before each cycle of chemotherapy. Patients received standard adjuvant or palliative chemotherapy. Disease was staged using the FIGO staging system. Tumors were graded by the Broders Classification. CT scan within 6 weeks of surgery was used to quantify residual disease. Disease status as of Dec 2006 was used for measurements of overall survival (OS). The relationships between preoperative CA125 and stage, grade and OS were retrospectively evaluated. Post surgical levels of CA125 were also analysed and correlated to the same parameters. The influence of age and bulk of residual disease on OS were also examined. Kaplan- Meier (univariate) analysis was applied for survival analysis and Spearman's method was used to study the correlation of CA125 and the multiple variables. Results: 91 newly diagnosed ovarian cancer referrals were received in the study period. This report is based on the 75 patients of this total group for whom full data was available. Length of follow up ranged from 2 to 71 months (median of 24, mean of 28.2 months). Preoperative CA125 level did not correlate significantly with stage, tumor grade or OS (p=0.08. p=0.113 and p=0.847 respectively). A strong correlation was seen however between postoperative CA125 level (recorded prior to commencement of chemotherapy) and stage, tumor grade and OS (p<0.0001, p<0.0001 and p<0.01respectively) OS for the total group was 37%, and OS for those with stage III and IV disease (n=43) was 17%. The mean age of the patients was 59.6 years. Older age at time of surgery (p=0.009) followed by bulk of residual disease (p=0.011) correlated strongly with shortened OS. Kaplan-Meier curves will be available for presentation. Conclusion: In our study, CA125 levels after optimal surgery correlated well with FIGO stage, tumor grade and overall survival. No correlation was seen with preoperative CA125 levels. No significant financial relationships to disclose.
Cervical cancer patients’ preferences and use of various cancer information sources in South Korea
Authors: Noh H. , Lee M. , Yun Y. , Park S. , Bae D. , Nam J. , Park C. , Cho C. , Lee J. , Chang Y. 
Published: March 2020

16073 Background: Accessing appropriate facts is important in enabling cancer patients cope with the disease. This study focused on the utilization and preferences of cancer information sources by cervical cancer patients in terms of ease in receiving and searching the available data. Methods: The study included 830 women over the age of 18 years treated for cervical cancer at six hospitals in South Korea between 1983 and 2004. All the participants provided written informed consent, and the Institutional Review Board of the National Cancer Center approved the protocol. A questionnaire addressed the patients’ use of and preferences for sources and forms of cancer information. Data were collected by mail. Results: Television and/or the radio were the the most frequently cited sources of cancer information by the middle and oldest age groups: 45–64 years (52.0%), =65 years (47.3%), while patients in the youngest age group (<45 years) used the Internet (38.8%). Booklets and/or pamphlets (24.0%) were the source of cancer information preferred by the youngest age group, while patients in the middle and oldest age groups preferred TV/radio: 45–64 years (35.7%) and =65 years (55.0%). Life notes and/or experiences (43.2%), that is, personal accounts, comprised the most easily understood form of information regardless of age group. Conclusions: Our findings indicate that cervical cancer patients’ utilization of and preferences for sources of cancer information vary according to patient age. Tailored educational materials that consider the users’ age and condition should be customized to best fit their specific preferences. No significant financial relationships to disclose.
Phase II study of capecitabine in combination with cisplatin in advanced head and neck cancer: Preliminary results
Authors: Lorusso V. , Calvi N. , Ciccarese M. , Romano G. , Palumbo A. , Bonaduce S. , Santantonio M. , Latorre A. 
Published: March 2020

16502 Background: The cisplatin-5-fluorouracil (5-FU) combination is the current standard of treatment in head and neck cancer. However, this regimen is not devoid of toxicity, and it is not confortable, because its administration requires a central vein access for the continuous infusion (c.i.) of 5-FU. Capecitabine is an oral fluoropyrimidine, whose activity, mimic of c.i. 5-FU, is well known in malignancies as colorectal cancer and breast cancer. We are investigating the efficacy and tolerability of cisplatin and capecitabine combination in advanced head and neck cancer. Methods: Patients (pts) with untreated metastatic, recurrent, or inoperable head and neck cancer were enrolled. Eligibility criteria were: squamous histology, age 18 to 75 yrs, at least one measurable lesion according to RECIST criteria, ECOG performance status </=2, normal laboratory values. Pts received capecitabine (2,000 mg/m(2)/day, days 1 to 14) and cisplatin (100 mg/m(2), day 1) every 3 weeks. Results: Since June 2004, 25 pts were enrolled: 22 were male and 3 female; median age was 56 yrs (46–79 yrs). Primitive sites of disease were: 9 pts (36%) laryngeal, 5 pts (20%) oropharyngeal, 2 pts (8%) hypopharingeal, 4 pts(16%) rhynopharingeal, and 5 pts (20%) oral cavity. Two pts with lymphonode recurrence of laryngeal carcinomas achieved a complete response (8%) and 10 pts (40%) had partial response. Stable disease was observed in 6 pts (24%), and 7 pts (28 %) had progressive disease. By the intent-to-treat analysis, the overall response rate was 48% (95% CI, 30–65). At a median follow-up of 9.5 months (4.8–26.1 months) median TTP was 3.5 months (95% CI, 1.3–5.8), and median OS was 12.4 months (95% CI, 6.3–18.5). A total of 99 cycles of chemotherapy was delivered with a median of 5 cycles per pt (range 1- 6). Grade 3 neutropenia, anemia, and thrombocytopenia, were observed in 17%, 13%, and 1% of cycles respectively. Grade 4 anemia was observed in 2 pts (8%). With regard to non hematological toxicity, grade 3–4 asthenia, nausea and vomiting, stomatitis, diarrhoea and PPD were observed in 12%, 12%, 8%, 4% and 4% of pts, respectively. Conclusions The combination regimen of capecitabine and cisplatin showed a good antitumor activity with mild toxicity in patients with advanced head and neck cancer. No significant financial relationships to disclose.
Postoperative radiotherapy in head and neck squamous cell cancers: AIIMS experience
Authors: Malik M. , Puri T. , Mohanti B. K. , Rath G. K. , Julka P. K. 
Published: March 2020

16514 Background: Squamous cell cancers of the head and neck are one of the most common malignancies in India. Most patients present in advanced stages of disease. Postoperative radiotherapy is generally an integral part of management in these patients. Methods: Patients of head and neck squamous cell cancers treated with surgery and postoperative radiotherapy at AIIMS between January 1999 to December 2004 were retrospectively analyzed. Results: A total of 386 patients were treated of which 281 were available for evaluation. There were 233 males and 48 females. Median age was 46 years (range 18–73). Site-wise distribution was: oral cavity- 202, larynx-55, hypopharynx-14, paranasal sinus-4, oropharynx-4, neck nodes with unknown primary-2. Post-surgical margins were adequate in 241, close in 5 (2%) and positive in 35 (12%). Pathological stage grouping was: Stage I- 11(4%), Stage II- 52 (18%), Stage III- 63(22%), Stage IV- 155 (55%). Neck node dissection was done in 245 patients and nodes were pathologically negative in 119 (42%). Extracapsular extension (ECE) was seen in 19(7%) patients. Bone/cartilage invasion was seen in 62(22%). Patients with high risk features (close/positive margins, ECE, 4/> positive nodes) were prescribed a dose of 64 Gy while the rest were planned to receive 60 Gy. 85% of patients completed the intended course of radiation. At a median follow up of 37 months, local recurrences were seen in 28 (10%), regional recurrence in 25 (9%) and distant metastasis in 10 (4%) patients. A second malignant neoplasm occurred in 6 patients (3-oropharynx, 2-oral cavity, 1-lung). Disease free survival (DFS) was 68%. ECE, post-surgical margin status and pathological lymph node status were significantly associated with DFS. Duration of postoperative radiotherapy and the surgery to radiotherapy interval did not significantly affect DFS. Conclusions: ECE, postsurgical margin status and pathological lymph node status significantly impact DFS in patients of surgically treated squamous cell cancers of head and neck. These patients require doses of adjuvant radiation >/=64 Gy. No significant financial relationships to disclose.