bluuebunny/crossref_metadata_2025_split huggingface dataset:
Induction of hypertrophy of the left hepatic lobe by unilateral right hepatic arterial radioembolization (RE) using 90Y-labeled resin microspheres in patients with right-sided secondary malignant liver tumors.
Authors: Garlipp Benjamin , Seidensticker Max , Irmscher Romy , Damm Robert , Ricke Jens , Stuebs Patrick , Meyer Frank , Lippert Hans 
Published: March 2020

e14630 Background: In patients with unilateral liver tumors who are candidates for extended liver resection but demonstrate insufficient future liver remnant (FLR) size, induction of FLR hypertrophy by contralateral portal vein embolization (PVE) is an established approach but concerns exist regarding tumor progression during the interval from PVE to liver surgery. We hypothesized that unilateral hepatic arterial radioembolization (RE) using 90Y-labelled resin microspheres achieves a similar degree of contralateral hypertrophy as PVE. Methods: 32 patients with right-sided secondary liver cancers (metastases from colorectal [n=20], breast [n=7], head and neck [n=2], and other [n=3] cancers) were treated with unilateral right hepatic arterial RE. Before and 44 (22-81) days following RE MRI-based volumetry of the total liver (TLV), the right (RLV, segments 4-8) and left (LLV, segments 2 and 3) hepatic lobes was performed. TLV, RLV, and LLV as well as the LLV/TLV ratio before and after RE were compared using the Mann-Whitney U-test. Results: Median values for TLV, RLV, LLV, and the LLV/TLV ratio are shown in table. Compared to baseline, RLV and TLV showed no significant change after right hepatic arterial RE (-3.7 [min/max, -37.7/+56.5] per cent [p=0.158] and +3.2 [-16.5/+47.4] per cent [p=0.282], respectively). In contrast, LLV as well as the LLV/TLV ratio were significantly increased after RE (+34.9 [-3.1/+146.2] per cent [p<0.001] and +29.4 [-24.3/+155.3] per cent [p<0.001], respectively). Conclusions: Right hepatic arterial RE achieved superior contralateral liver hypertrophy compared to hypertrophy reported after PVE and may be an alternative to PVE since it provides simultaneous treatment to the liver tumors during the interval from treatment to liver surgery, reducing the risk for tumor progression. These two methods should be directly compared within a prospective trial. [Table: see text]
Decrease in CA-19-9 after neoadjuvant chemoradiation therapy to predict survival in locally advanced pancreatic cancer.
Authors: Singh Jaswinder , Jafri Syed Faisal , Pabla Maninder , Freilich Bradley L , Cates Joe , Sheldon John M. , Shaeffer David , Connor Michael , Shah Raj , Rath Niharika , Cope Reed , Burt Michael , Mukherjee Srijita , Parikh Unnati , Feeback Jennifer Wanpen 
Published: March 2020

e14632 Background: Carcinoma of the pancreas is among the most lethal of human cancers. Data on the overall survival rates of patients treated in the community hospital setting are limited; the purpose of this retrospective data collection study was to assess – Does CA-19-9 change during the neo adjuvant treatment of locally advanced pancreatic cancer patients predicts the overall survival (OS) at high volume community hospital setting. Methods: Eligibility included cytological or histological evidence of locally advanced unresectable and borderline resectable adenocarcinoma of the pancreas, not amenable for complete surgical resection. Their respectability was determined with EUS and CT scan / MRI and was discussed in the multi disciplinary conference. Patients diagnosed before July 2009 were essentially treated with continuous 5-FU 200 mg/m2 for 5 weeks with radiation of 1.8 Gy per daily fraction, for a total dose of 50.4 Gy over 5.5 weeks. Patients diagnosed after July 2009 received gemcitabine 400 mg/m2 intravenously (over 60 minutes) beginning on the first day of radiation therapy (before radiation), then weekly thereafter during radiation. Results: Data were abstracted on 64 patients (40 deceased; 24 alive) diagnosed between 6/2005 and 4/2011. The median age was 68 years (range: 41-87), and 52% were male. The majority of patients (97%) were diagnosed by endoscopic ultrasound (EUS) with biopsy. At diagnosis, 56 (88%) patients were locally advanced unresectable(without metastasis) or borderline unresectable; 49 of these had neoadjuvant treatment, and 13 were later resected. Median OS for all 64 patients was 45.4 weeks (95% CI: 29.6-61.3), with no significant differences in OS by sex of patient (p = 0.210) or smoking history (p = 0.625). Twenty-two patients (34%) had >75% decreases in CA19-9 from baseline; median OS was 89.4 weeks in this group compared to 41.3 weeks in patients with changes in CA19-9 <75% (p = 0.025). Conclusions: This trial demonstrates improved overall survival in patients for patients with locally advanced pancreatic cancer , who had significant decrease in CA -19-9 (>75% decreases in CA19-9 from baseline) in response to neo adjuvant chemotherapy and radiation.
Metabolomic discrimination of intestinal- and diffuse-type gastric cancer tissues using capillary electrophoresis time-of-flight mass spectrometry.
Authors: Terashima Masanori , Kusuhara Masatoshi , Tokunaga Masanori , Tanizawa Yutaka , Bando Etsuro , Kawamura Taiichi , Fujimori Tamaki , Yamamoto Hiroyuki , Kami Kenjiro , Ohashi Yoshiaki 
Published: March 2020

e14635 Background: Clinicopathological characteristics of gastric cancer patients strongly depend on histological type. In contrast with gene and protein expressions, metabolic properties of intestinal- and diffuse-type gastric cancer have been largely unknown. Here, we conducted metabolome analysis of paired non-tumor and tumor gastric tissues by using capillary electrophoresis and liquid chromatography combined with time-of-flight mass spectrometry (CE- and LC-TOFMS, respectively) in order to metabolomically characterize non-tumors (NTs), intestinal-type tumors (ITs), and diffuse-type tumors (DTs). Methods: Tumor and surrounding non-tumor tissues were surgically excised pair-wise from 27 gastric cancer patients (18 ITs and 9 DTs) who underwent gastrectomy at our institution between February and May 2011. Following tissue homogenization and metabolite extraction, we measured 254 and 138 metabolites, respectively, by CE-TOFMS and LC-TOFMS. Results: Metabolomic profiles of tumor tissues, especially ITs, were well-distinguished from those of NTs: Lactate and most glycolytic intermediate levels in ITs were significantly higher than those in NTs, which reaffirms the Warburg effect of cancer, but the significance was lesser in DTs. Levels of all the measured amino acids were significantly higher in ITs and relatively higher in DTs than in NTs, showing high capacities of cancer cells for protein synthesis. Although levels of ATP, GTP, and energy charge in ITs and DTs were lower than those in NTs, purine contents were rather higher in the tumors than in NTs, which may support their high demand for DNA replication. Moreover, reduced glutathione in DTs were the lowest among others, implying their potential vulnerability against oxidative stress. Conclusions: Metabolomic profiles of NTs, ITs, and DTs were discriminated by CE- and LC-TOFMS analyses: Considerably high lactate, amino acid, and purine levels highlighted the metabolome of tumors, especially of ITs. Relatively low energy and redox statuses of DTs, however, could be targeted for developing more effective cancer therapeutics.
Correlation between serum tumor markers, tissue proliferative activity, and clinicopathologic factors in patients with locally advanced esophageal squamous cell carcinoma.
Authors: Sunpaweravong Somkiat , Sunpaweravong Patrapim , Puttawibul Puttisak , Boonyaphiphat Pleumjit , Nitiruangjaras Anupong 
Published: March 2020

e14639 Background: Squamous cell carcinoma antigen (SCCA) and CYFRA 21-1 have been reported as useful tumor markers for esophageal squamous cell carcinoma (ESCC), but no information has yet been reported about the relationship between these serum tumor markers and tissue proliferative activity (Ki-67). The aim of this study was to compare SCCA, CYFRA 21-1 and Ki-67 with clinicopathological factors and survival in locally advanced ESCC patients. Methods: Pre-treatment SCCA and CYFRA 21-1 serum levels were measured by enzyme-linked immunoassays while the expression of tissue Ki-67 activity was calculated by immunohistochemical nuclear staining on paraffin-embedded tumor samples of locally advanced ESCC patients. The association between these biomarkers, clinicopathological factors, and overall survival were analyzed by Cox proportional hazards model. Results: 166 locally advanced ESCC patients from our institution (2002-6) were evaluated. Their median age was 62 years (39-90), M:F 144:22, location of tumor (upper:middle:lower 31:83:53) and histological grade (well:moderate:poor 50:73:43). 43% had received surgery, 22% chemoradiation and 35% best supportive care. Follow-up times ranged from 2 months to 38 months, and the median survival was 11.0 months. Elevated SCCA (>1.5 ng/mL) and CYFRA 21-1 (>3.5 ng/mL) before treatment were found in 79.1% and 50.4% of the patients, respectively, while 42.6% had both serum markers elevated. The SCCA and CYFRA 21-1 levels were not correlated (p=0.128) to each other, nor either to age, sex, T, N, M, location, grade or Ki-67. High Ki-67 expression levels were significantly correlated with T4 (p=0.010), M1 (p=0.010) and poor grade (p=0.015) but not to age, sex, N or location. Levels of SCCA, CYFRA 21-1 and Ki-67, alone or in any combination, were not correlated to survival of patients. Conclusions: This study suggests that the evaluation of SCCA and CYFRA 21-1 are of no particular correlation to clinicopathological factors and survival in locally advanced ESCC, but Ki-67 is correlated with T, M and grade.
Prognostic effects of 25-hydroxyvitamin d levels in gastric cancer.
Authors: Ren Chao , Xu Rui-hua 
Published: March 2020

e14653 Background: Results from large epidemiologic studies on the association between vitamin D and gastric cancer are controversial. Vitamin D significantly promotes apoptosis in the undifferentiated gastric cancer cell, but the prognostic effects of its levels are unknown. Methods: 197 gastric carcinoma patients who received treatment in the cancer centre of Sun Yat-sen University from January 2002 to January 2006 were involved in the study. The stored blood drawn before any treatment was assayed for 25-hydroxyvitamin D levels. The clinicopathologic data were collected to examine the prognostic effects of vitamin D. Results: The mean vitamin D levels of the 197 gastric patients was 49.85±23.68nmol/L, among whom 114(57.9%) were deficient in Vitamin D(<50nmol/L), 67(34%) were insufficient (50-75nmol/L) and 16(8.1%) were sufficient (>75nmol/L). Clinical stage (p=0.004) and lymph node metastasis classification (p=0.009) were inversely associated with vitamin D levels. The patients with high vitamin D levels group (≥50nmol/L) had a higher overall survival compared with the low vitamin D levels group (<50nmol/L)(p=0.018). Multivariate analysis indicated that vitamin D levels were an independent prognostic factor of gastric cancer (p=0.019). Conclusions: Vitamin D deficiency may be associated with poor prognosis in gastric cancer.
The tumor-log odds of positive lymph nodes-metastasis staging system, a new staging system for gastric cancer after D2 resection in China.
Authors: Xu Rui-hua , Qiu Miao-zhen 
Published: March 2020

e14655 Background: In this study, we established a hypothetical tumor-lodds-metastasis (TLM) and tumor-ratio-metastasis (TRM) staging system. Moreover we compared them with the 7th edition of American Joint Committee on Cancer tumor-nodes-metastasis (AJCC TNM) staging system in gastric cancer patients after D2 resection. Methods: A total of 1000 gastric carcinoma patients receiving treatment in our center were selected for the analysis. Finally, 730 patients who received D2 resection were retrospectively studied. Patients were staged using the TLM, TRM and the 7th edition AJCC TNM system. Survival analysis was performed with a Cox regression model. We used two parameters to compare the TNM, TRM and TLM staging system, the -2log likelihood and the hazard ratio. Results: The cut points of lymph node ratio (LNR) were set as 0, 0-0.3, 0.3-0.6, 0.6-1.0. And for the log odds of positive lymph nodes (LODDS), the cut points were established as≤-0.5, -0.5-0, 0-0.5, >0.5. There were significant differences in survival among patients in different LODDS classifications for each pN or LNR groups. When stratified by the LODDS classifications, the prognosis was highly homologous between those in the according pN or LNR classifications. Multivariate analysis shown that TLM staging system was better than the TRM or TNM system for the prognostic evaluation. Conclusions: The TLM systems was superior to the TRM or TNM system for prognostic assessment of gastric adenocarcinoma patients after D2 resection.
Risk factors for peritoneal carcinomatosis in gastric cancer patients, and outcomes following resection and hyperthermic intraperitoneal chemotherapy (HIPEC).
Authors: Kim Ki Won , Chow Oliver , Parikh Kunal , Blank Sima , Jibara Ghalib , Labow Daniel M. , Hiotis Spiros P. 
Published: March 2020

e14656 Background: Gastric cancer (GC) contributes significantly to the burden of cancer death in the United States. Unfavorable prognosis in patients with gastric cancer and peritoneal carcinomatosis (GCPC) is well-documented. In this study, a model predictive of GCPC is proposed, and outcomes in patients with GCPC treated with surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) are assessed. Methods: A single-institution analysis of 112 patients treated for GC between the years 2000 and 2011 was performed. Demographic and clinical-pathologic criteria were entered into univariate and multivariate analyses, to identify criteria independently predictive of GCPC. Overall survival in each cohort was determined via Kaplan-Meier analysis. Results: GCPC developed in 28/112 (25%) of GC patients. Several variables were associated with GCPC by univariate analysis (age, p = 0.018; tumor stage, p = 0.004; tumor location, p = 0.046), but only age (≤60) and tumor stage (T3/T4) were independently predictive of GCPC by multivariate analysis (HR = 3.949, p = 0.024; HR = 3.942, p = 0.049, respectively). Intermediate-term survival was not significantly impacted in nine GCPC patients treated with HIPEC (65% 1-year, 39% 3-year without HIPEC; vs. 73% 1-year, 39% 3-year with HIPEC, p = NS). Conclusions: A model to identify gastric cancer patients at highest risk for GCPC is proposed. Although intermediate term survival in a small number of GCPC patients (9) treated with HIPEC is not significantly improved, emerging experience with increased follow-up with HIPEC in larger cohorts is needed. Earlier application of HIPEC targeted at patients at highest risk may be feasible in utilizing a model predictive of GCPC.
Optimizing supportive measures for the safe administration of FOLFIRINOX as first-line treatment in advanced, inoperable pancreatic cancer (aPDAC) patients (pts) in routine clinical practice.
Authors: Vaccaro Vanja , Bria Emilio , Sperduti Isabella , Pino Maria Simona , Massari Francesco , Gelibter Alain , Auriemma Alessandra , Torsello Angela , Melisi Davide , Nuzzo Carmen , Frizziero Melissa , Vari Sabrina , Lucchini Eleonora , Garufi Carlo , Cottini Silvia , Zeuli Massimo , Ferraresi Virginia , Cognetti Francesco , Tortora Giampaolo , Milella Michele 
Published: March 2020

e14661 Background: FOLFIRINOX is an important addition to our therapeutic armamentarium for the treatment of aPDAC; however, safety and tolerability issues (hematologic toxicity, increased risk of AE in pts carrying biliary stents) may limit its use in routine clinical practice. Methods: We reviewed the clinical charts of 36 aPDAC pts receiving first-line FOLFIRINOX at two different institutions and analyzed toxicity and outcomes according to the presence or absence of a biliary stent and whether they received (n=21) or not (n=15) primary prophylactic G-CSF (d 7-9-11). Results: 36 pts (M/F: 22/14; median age: 57 yrs, range: 37-70; stage III/IV: 10/26; ECOG PS 0/1: 33/3) and 241 cycles were analyzed. Toxicity was mild with G3/4 adverse events (AE) in <1% of cycles, except for G3/4 neutropenia (16.6% of pts, 3.7% of cycles); dose was reduced to 75% in 48/205 cycles (23%); 3 pts discontinued treatment after 1 cycle (G3 gastro-intestinal toxicity in 1 pt and early progressive disease, PD in 2 pts). Overall and G3/4 toxicities were not significantly different in 7 pts carrying a biliary stent. G3/4 neutropenia was observed in 5/155 (3.2%) and 4/86 (4.6%) cycles among pts receiving or not G-CSF prophylaxis (p=n.s.); anemia and thrombocytopenia (any grade) were more common among pts receiving G-CSF (p<0.001 and p=0.009, respectively). Palonosetron/aprepitant/dexamethasone achieved complete control of nausea/vomiting at cycle 1 in 72% (95% CI: 58-87%) and 86% (95% CI: 75-97%) of pts. Partial response (PR) occurred in 25% and stable disease (SD) in 43% of 28 evaluable pts (disease control rate, DCR: 68%, 95% CI: 51-85%). A >50% reduction in CA19.9 occurred in 61% of pts. Median PFS was 8 mos (95% CI: 6-9 mos). Conclusions: FOLFIRINOX is well tolerated and easily manageable on an outpatient basis in young (<70 yrs) and fit (PS 0-1) aPDAC pts and can be safely used in pts carrying biliary stents. Routine G-CSF prophylaxis is not currently recommended, but may be useful to carefully extend FOLFIRINOX use to older/less fit/comorbid pts with aPDAC.
Survival analysis of Hispanics with hepatocellular carcinoma at a large academic institution.
Authors: Lin Daniel , Kaubisch Andreas , Goel Sanjay , Lo Yungtai , Aparo Santiago 
Published: March 2020

e14682 Background: Hepatocellular carcinoma (HCC) appears to have worse prognosis among Hispanics in the United States who have a higher mortality when compared toBlacks and Non-Hispanic Whites based on statistics from the Surveillance Epidemiology and End Results (SEER) database. There is paucity of data directly comparing Hispanics vs. Non-Hispanics. The aim of this study is to compare the overall survival (OS) of Hispanics and Non-Hispanics with HCC at a large academic institution. Methods: Men and women diagnosed and treated for HCC at Montefiore Medical Center (MMC) from 2000 to 2009 were identified using data from the MMC Cancer Registry. Patient’s characteristics obtained included age at diagnosis, gender, race, tumor stage, Model for End-stage Liver Disease (MELD) scores, Hepatitis B, C and HIV status, alcohol use, presence of cirrhosis, alpha-feto protein levels, performance status and treatment. A Cox proportional-hazard model was used to assess survival differences between Hispanics and Non-Hispanics adjusting for clinically relevant and statistically significant variables. Results: A total of 513 patients were identified from the Cancer Registry database. 76 patients were excluded (58 due to inability to confirm the diagnosis of HCC based on current radiologic criteria, 18 due to unavailable ethnicity data). The remaining 437 patients were used for modeling and final analysis. Of the final cohort of 437 patients, 49% (n=212) were Hispanic and 51% (n=225) were Non-Hispanic. Among Non-Hispanics, 55% were Black, 35% were White and 10% were “other” race. Median time of follow up for Hispanics was 13.5 months and for Non-Hispanics was 12.1 months. The median OS among Hispanics was 14.5 months and was not statistically different from the Non-Hispanic group (median OS of 13.1 months) with a p value of 0.49. In a multivariate analysis model the hazard ratio (HR) for survival among Hispanics was 0.81 (95% CI 0.61 to 1.07, p= 0.15) when compared to Non-Hispanics; after adjusting for gender, age at diagnosis, tumor stage, treatment, alpha-feto protein levels and MELD scores. Conclusions: Hispanics diagnosed and treated with HCC at Montefiore Medical Center do not seem to have worse survival when compared to Non-Hispanics.
A phase II trial of gemcitabine in combination with oxaliplatin and capecitabine in previously untreated metasetatic or recurrent pancreatic cancer.
Authors: Sym Sun Jin , Hong Junsik , Jung Minkyu , Koo Yang Seo , Park Yeon Ho , Kim Koen Kook , Park Jinny , Cho Eun Kyung , Lee Jae Hoon , Shin Dong Bok 
Published: March 2020

e14685 Background: Treatment with single agent gemcitabine provides modest benefits in patients with metastatic pancreatic cancer.This study was performed to determine the efficacy of gemcitabine in combination with oxaliplatin and capecitabine in patient with recurrent or metastatic pancreatic adenocarcinoma. Methods: This was a prospective, single-arm, single center study in patients with chemotherapy-naive metastatic or recurrent pancreatic adenocarcinoma. The primary endpoint was objective response. The study was designed as a Simons two-stage optimal design and was divided into two stages. The first stage was to recruit up to 18 patients. If at least two objective responses were obtained, then a further 25 patients would be enrolled into the study. If no more than two responses were obtained among these 18 patients, the study would be halted. The study patients received gemcitabine 800 mg/m2 on day1, plus oxaliplatin 100 mg/m2 on day 1 and capecitabine 800 mg/m2/day on days 1-7 every 14 days. Treatment was to be administered until disease progression or until withdrawal from the study due to unacceptable toxicity or other reasons. Results: Eighteen patients were enrolled. Median age was 63 years (range, 39-73 years). Among these 18 patients, only one patient (5.5%) achieved an objective response. Therefore, the accrual terminated. The median time to disease progression was 2.1 months, and the median overall survival duration was 4.9 months. One-year overall survival rates were 35.3%. The most frequently reported grade 3 or 4 adverse events were asthenia (16.6%), and nausea (5.5%). There were no unexpected toxicities. Conclusions: The addition of oxaliplatin and capecitabine to gemcitabine did not improve objective response in the first-line treatment of advanced pancreatic cancer patients.