bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of inflammation-based prognostic score to predict survival in patients with advanced gastric cancer receiving biweekly docetaxel and S-1 combination chemotherapy.
Authors: Kunisaki Chikara , Takahashi Masazumi , Ono Hidetaka , Oshima Takashi , Fujii Shoichi , Kosaka Takashi , Makino Hirochika , Akiyama Hirotoshi , Endo Itaru 
Published: March 2020

e14624 Background: The Glasgow Prognostic Score (GPS), an inflammation-based prognostic score composed of C-reactive protein (CRP) and albumin measurements, has been reported to be a prognostic factor in patients with various cancers. This study was conducted to determine the prognostic value of GPS for patients with advanced cancer. Methods: The GPS was classified according to a previous study. A total of 83 advanced gastric cancer patients receiving bi-weekly docetaxel/S1 treatment (DS) were included. Correlation of clinicopathological factors and the GPS was assessed. To identify the impact of GPS as prognostic factors for disease-specific survival (DSS) and progression-free survival (PFS), univariate and multivariate analyses were performed. Results: Of these 83 patients, unresectable tumors were observed in 78 patients and recurrent tumors were detected in 5 patients. Of these, 13 patients underwent surgery and 12 patients underwent gastrectomy. There were significant correlations between the GPS and the neutrophil to lymphocyte ratio (NLR). Univariate analysis revealed that the GPS, ECOG-PS and gastrectomy after DS treatment significantly affected prognosis. The Cox proportional regression hazard model showed that the GPS, age and gastrectomy independently influenced DSS, and that the GPS and gastrectomy also influenced PFS. The Cox proportional regression hazard model restricted patients without gastrectomy showed that the GPS and age independently influenced DSS, and that the GPS influenced PFS. Conclusions: The GPS may be an useful prognostic factor for advanced gastric cancer patients receiving uniform first-line treatment (DS). The impact of the GPS should be confirmed in a well-designed prospective trial in many patients.
Correlation of expression of microRNA miR-21 with prognostic characteristics in gastric cancer.
Authors: Cai Jian-Chun , Wang Lin-Pei , Tang Ya-Ling 
Published: March 2020

e14629 Background: MicroRNAs may play an important role in earlt stage gastric cancer. Methods: We studied the expression of MicroRNAs in gastric cancer to understand the expression characteristics of one of the key MicroRNAs miR-21 using 65 cases of early-stage gastric cancer identified from our cancer center records between October 2007 and March 2010. First, we used an MicroRNA array (miRCURY LNA Array) that contained 1,348 known probes and compared the expression profile of these MicroRNAs in six cases of gastric cancer specimen with their surrounding normal tissues. We then studied the expression of miR-21 and correlated it with the histologic characteristics of the 65 cases by RT-PCR. Results: The expression of seven MicroRNAs (miR-374b*, miRPlus-E1212, miR-338-5p, miR-297, miR-21, miR-135b, and miR-18a) was significantly up-regulated, while nine MicroRNAs (miR-29b-2*, miR-1260, miRPlus-E1241, miR-S1-5p, miR-148a, miR-29c, miR-647, miR-196b*, ebv-miR-BART5) significantly down-regulated. Because miR-21 was highly overexpressed in gastric cancer compared to its normal surrounding tissue, we next studied if the expression of miR-21 in sixty-five cases of gastric cancer was associated with clinical and histologic characteristics of early stage gastric cancer. We found that the increased expression of miR-21 was correlated with poorly differentiated histology (high grade), T3-4 stage and nodal involvement. The average level of miR-21 expression was two to five folds higher in the cases that are poorly differentiated, T3-4 stage, or with lymph node involvement compared to the cases that were well or moderately differentiated, T1-2 stage or with negative nodal involvement. The high-grade gastric cancers were associated with the highest level of miR-21 compared to the surrounding normal tissues. These results suggest that miR-21 is a potential biological marker indicative of the aggressiveness nature of this malignancy. Conclusions: Our results demonstrate that expression of several MicroRNAs may play important roles in the development and progression of gastric cancer and the increased expression of miR-21 is associated with poor prognostic characteristics.
Neoadjuvant therapy with nanoparticle albumin-bound (nab)-paclitaxel to enhance the resectability of locally advanced pancreatic cancer (LAPC).
Authors: Cooray Prasad , Dean Andrew Peter 
Published: March 2020

e14644 Background: Resection offers the only probability of cure for pancreatic adenocarcinoma but only a minority have resectable disease at diagnosis. Effective neo-adjuvant therapy for LAPC could down-size the tumor rendering it resectable. Neo-adjuvant therapy may retard cancer dissemination thought to occur early in pancreatic cancer. The aim of this study was to retrospectively evaluate if neo-adjuvant treatment with nab-paclitaxel in patients with LAPC could result in tumor down-sizing to allow resection and improve outcomes. Methods: Data was collected from the medical records of pancreatic cancer patients who presented to two clinics from 06/2009 to 12/2011 and were treated with nab-paclitaxel (n = 63). Resectability was assessed by review of imaging by the radiologist and the treating surgeon. Twenty three of 63 patients had LAPC and 40/63 had stage IV disease. Of the LAPC patients, 8/23 (35%) were classified as borderline resectable (BR) and 15/23 (65%) were classified as unresectable (UR). Patients received nab-paclitaxel (100-125 mg/m2 D1,8,15) in combination with gemcitabine or carboplatin. The BR/UR patients (n=23) received a median 5 cycles of chemotherapy. They were re-evaluated for suitability for surgical resection. Results: Following neo-adjuvant treatment, 16/23 (69%) had a radiological PR and 17/23 (74%) had a major biochemical response (defined as >70% decline in Ca19.9 level). A total of 6/23 patients (26%) were then able to undergo surgical resection, with resections planned for further 2/23 (8%) patients.Of the 6 resected patients, 4 had R0 resections and 2 had R1 resection. After a median follow up of 18 months, all 6 resected patients are alive and 4 of them remain free of cancer recurrence. The median survival for patients who remained unresectable (15/23) was 9 months. The median survival for converted patients (6/23) has not yet reached. Conclusions: These results suggest that a subgroup of patients with LAPC could be converted to a resectable stage with the use of nab-paclitaxel as neo-adjuvant therapy. Such converted patients may enjoy durable improved outcomes and this approach warrants further investigation in a phase II clinical trial.
New WHO classification for pancreatic endocrine tumors: Is time to leave the previous one?
Authors: Ricci Claudio , Campana Davide , Macchini Marina , Vecchiarelli Silvia , Taffurelli Giovanni , Sina Sokol , Santini Donatella , Di Marco Mariacristina , Tomassetti Paola , Biasco Guido , Casadei Riccardo , Minni Francesco 
Published: March 2020

e14647 Background: In 2010 WHO released a new classification (NWHO) system for endocrine pancreatic tumours (NETs). The aims of this study was to compare the NWHO and previous one (OWHO) in patients affected by NETs. Methods: From January 1980 to December 2010, 89 consecutives patients underwent surgical intervention for PNETs Data regarding sex, age, presence of symptoms, hormonal status, presence of MEN1, surgical procedure, R status, TNM stage, older and new WHO classification and disease specific survival (DSS) were prospectively collected. Multivariate analysis, including OWHO and NWHO, was carried out to evaluate the independent factors related to DSS. A sensitivity analysis was performed to include patients in which NWHO was impossible to be calculated. Results: Mean age of patients was 54.7 ± 14.2 years. There were 46 (51.7%) female and 43 (48.3%) male. Symptoms were present in 68 (76.4%) patients. Fifty-two (58.4%) patients had non-functioning NETs. Left pancreatectomy was performed in 48 (53.9%) cases, atypical resection in 22 (24.7%), pancreaticoduodenectomy in 12 (13.5%), total pancreatectomy in 2 (2.2%) and palliative surgery in 5 (5.6%). R0/1 resection was carried out in 79(88.7%) cases. According TNM stage there were: I, 27 (30.3%); II 29 (32.6%); III, 22 (24.7%); IV, 11 (12.4%). According OWHO 46 (51.7%) patients had a well differentiated tumours (WDT), 32 (36%) well differentiated carcinoma (WDCa), 11(12.4%) poorly differentiated carcinoma (PDCa). The NWHO was available only in 49 (55.1 %) patients: 20 (22.5%) NET G1, 25 (28.1%) NET G2, 4 (4.5%) neuroendocrine carcinomas (NEC) G3. At multivariate analysis OWHO and R2 status were the only independent factors related to DSS (RR=6.7, p<0.001 and RR 2.0, p=0.018 respectively). OWHO stratifies DSS better than NWHO: RR 0.12 (C.I. 95% 0.01-0.99; p=0.049) and RR 0.16 (C.I 95% 0.16-0.05; p=0.002) comparing WDT vs WDCa and WDCa vs PDCa, respectively. The sensitivity analysis confirmed in two model the superiority of OWHO while in others two we did not find any difference. Conclusions: In our experience OWHO still remains the best prognostic factor to predict DSS in patients with NETs .
Single institution experience of chemoradiation with gemcitabine versus capecitabine in borderline resectable and locally advanced pancreatic cancer.
Authors: Kotowski Adam S. , Yarlagadda Naveen , Salerno May Kilian , Warren Graham Walter , Kuvshinoff Boris W. , Wilkinson Neal W. , Tan Wei , Iyer Renuka V. , Ma Wen Wee 
Published: March 2020

e14659 Background: To retrospectively evaluate the outcome of borderline resectable (BR) and locally advanced unresectable (LA) pancreatic cancer patients treated with concurrent chemoradiotherapy (CRT) with gemcitabine (G) or capecitabine (C). Methods: Retrospective chart review of patients treated between August 2005 and September 2011 generated 30 BR and 40 LA pts. Cases were analyzed for patient and treatment characteristics including age, gender, weight loss, ECOG PS, albumin, stage, grade, location, pathology, laboratory values, chemotherapy (CT) regimens, radiotherapy dose and technique, and toxicity using CTCAE v.4.0. Endpoints evaluated were surgical resection rate, progression free survival (PFS), and median overall survival (mOS). Results: Patient characteristics were comparable between CRT/G and CRT/C in both BR and LA patients. Gemcitabine iv 300mg/m2 weekly or capecitabine po 825mg/m2 BID were used during CRT. Among BR patients who received CRT (n=21), 17 (56.6%) received CRT/G, 4 (13.3%) CRT/C, and others received CT alone. For BR, surgical resection was performed in 52.9% of CRT/G patients. The PFS were 17.4 months (m) and 4.8m (p=0.009), and mOS were 21.9m and 5.7m (p=0.004) for CRT/G and CRT/C respectively. For LA patients who received CRT (n=25), 18% of CRT/G underwent surgical resection and none of CRT/C did. The PFS 8.4m and 10.4m (p=0.63) and mOS were 14.9m and 11.5m (p=0.11) for CRT/G and CRT/C respectively. Comparing CRT and CT groups, mOS were not significantly different for LA patients, and longer for BR patients (14.4m vs. 5.5m) although this is likely due to confounding factors such as physician preference and patient selection. No significant differences were noted for grade 3/4 toxicities between both CRT groups. Conclusions: In this series, CRT/G in both BR and LA setting were associated with a high surgical resection rate with acceptable toxicity and potentially improved survival for patients not felt to be surgical candidates at presentation. These data warrant validation in larger prospective randomized studies.
Response evaluation using RECIST and CHOI criteria in patients with well-differentiated pancreatic neuroendocrine tumors (pNET) treated with sunitinib or everolimus.
Authors: Hentic Olivia , Dreyer Chantal , Zappa Magaly , Hammel Pascal , Mateescu Cristian , Bouattour Mohamed , Faivre Sandrine J. , Ruszniewski Philippe , Raymond Eric 
Published: March 2020

e14660 Background: Despite low response rate by RECIST, sunitinib and everolimus improved the progression-free survival of patients (pts) with well-differentiated pNET in two large phase III controlled trials. RECIST being a poor surrogate endpoint for PFS, this study aimed evaluating the value of CHOI criteria in PNET pts. Methods: Data for this analysis were collected from pts with well-differentiated PNET treated consecutively with sunitinib or everolimus in our center between 10-2006 and 11-2010. All pts had tumor progression within 12 months (m) prior to treatment. Pts were considered evaluable if CT-scans were performed within 6 weeks prior treatment and <3 months following treatment initiation. A radiologist blinded for clinical data evaluated responses according to RECIST and CHOI criteria. Best responses were correlated with Kaplan Meier estimates of time-to-progression (TTP) and overall survival (OS). Results: A total of 25 pts were treated with either sunitinib or everolimus. Among them, three pts were evaluated using MRI and thus were not evaluable in this study. Twelve pts received sunitinib and ten pts were treated with everolimus (Male/female: 8/14, median age: 57, range 38-76). All pts had tumor progression within 12 m prior to sunitinib or everolimus. Pts were either treated in 1st line (n=6), 2nd line (n=9), 3rd line (n=7) or 4th line (n=1) after cytotoxic chemotherapy. At the first CT-scan evaluation, 2 pts presented a partial response (PR), 18 pts had a stable disease (SD), and 2 pts had a progressive disease (PD) by RECIST. Using CHOI criteria, 11 PR, 8 SD, and 3 PD were observed. Nine of 18 pts (50%) with SD according to RECIST were reallocated to the responders (PR) using CHOI criteria. Median TTP and OS for all pts were 14.0 m and 35.8 m, respectively. According to RECIST, TTP was higher in pts with PR+SD compared to PD (14.2m vs 3.3m, p<0.0001). According to CHOI criteria, TTP was 26.1m in pts with PR, 8.7m in pts with SD, and 3.5m in pts with PD (p=0.038). Conclusions: Response byCHOI criteria is a prognostic factor for TTP and may identify among SD pts by RECIST those benefiting the most of targeted therapy.
Survival outcome of small bowel adenocarcinoma (SBA) in the last 12 years: Meta-analysis.
Authors: Armaghany Tannaz , Shi Runhua , Shows Joseph Ryan , Mills Glenn Morris 
Published: March 2020

e14667 Background: Due to rarity, management of SBA is currently controversial. Despite results from several single institutional studies showing no survival benefit with adjuvant chemotherapy, data extrapolated from established colorectal cancer studies are commonly used to manage this cancer. Here we report results of a meta-analysis on data from 14 retrospective studies published in English between years 2000 and 2011. Methods: PubMed database was searched using relevant keywords. Patients with SBA were included. Studies involving ampulary, periampulary and ileocecal valve tumors were excluded. The combined location and stage distribution were adjusted by sample size of each study. Primary outcome for the magnitude of benefit analysis were OS. Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted. A random-effect model according to the method of DerSimonian and Laird was used; a heterogeneity test was used. The effect of adjuvant chemotherapy and/or radiation treatment after curative surgery was evaluated. Effect of stage, grade, and positive lymph node ratio was also evaluated. Results: With available information within 14 studies, mean age of patients was 59.3(95% CI: 56.4 and 62.1). Duodenum was the most common site of primary tumor followed by the jejunum, ileum and not specified sites (59.27%, 23.49%, 11.42%, and 3.03%), respectively. Overall median survival was 17.2 months (95% CI: 13.9 and 20.5). Adjuvant treatment vs. non adjuvant treatment showed a HR of 1.17 (95% CI: 0.71-1.93) that was not statistically significant. HR for low grade vs. high grade tumors was 3.90 (95% CI: 2.15- 7.06). HR for stage was 3.09 (95% CI: 0.89-10.67, p=0.07) comparing high stage with low stage which suggested a marginally statistically significant effect. HR for positive lymph node ratio (LNR) was 4.63 (95% CI: 2.67-8.03). Conclusions: Our meta-analysis suggests adjuvant treatment after cancer directed curative intent surgery does not improve overall survival compared to observation in SBA. Grade of tumor and positive LNR are significant predicators of overall survival whereas stage has marginally significant effect on survival. Future trials investigating new or innovative adjuvant therapy in SBA are needed.
The relationship between HER-2 and TOPO-2A gene expression and clinicopathologic results in gastric cancer.
Authors: Ozkan Metin , Turak Esra Ermis , Karaca Halit , Inanc Mevlude , Berk Veli , Deniz Kemal , Eroglu Celalettin 
Published: March 2020

e14670 Background: HER-2 and Topo-2A genes are settled on a chromosome 17 and their co-amplification rates are high. In this study, early gastric cancer patients who received adjuvant chemo-radiotherapy and chemotherapy were evaluated with HER-2 and Topo-2A expression in association with clinical and histopathologic findings. Methods: A total of 103 gastric cancer patients were included the study. The HER-2 and Topo-2A levels were measured by immunohistochemistry in postoperative tumor materials. A standard evaluation method was admitted for HER-2 positivity, while Topo-2A nuclear staining 3+ and 4+ were considered as overexpression. Those with level 2+ or 3+ of HER-2, the FISH test were attempted. Results: The median follow-up was 19 months (ranges 2–70 months). Forty-six patients (44%) relapsed during follow-up whereas 60 patients (58%) had died. The median overall survival (mOS) was 23 months. Histopathologies of HER-2 positive patients were intestinal type in 7 (87.5%) and diffuse type in one (12.5%) patient. In the follow-up period 4 patients (50%) were died (mOS was 17 months in this group). Median overall survival was 23 months in HER-2 negative group (p=0.6). Histopathologies of Topo-2A positive patients were intestinal type in 9 (64.2%) and diffuse type in 5 (35.8%) patient. In the follow-up period 8 patients (57%) were died (mOS was 22 months in this group). Median overall survival was 23 months in Topo-2A negative group (p=0.8). Three patients (37.5%) who had HER-2 positive histopathologies also had Topo-2A positivity. Conclusions: Overexpression rates of HER-2 in gastric cancer were reported 6.8-34%. Racial differences and different scoring techniques thought to be impact the results. Co-amplification rate of HER-2 and Topo-2A was reported 34% in gastric cancer. In our study HER-2 and Topo-2A overexpression rates were 7.7% and 13.6% respectively and co-amplification of HER-2 with Topo-2A rate was 37.5% is also similar to the other studies. Stages of patients with HER-2 and Topo-2A overexpression were similar to the distribution of the overall patients. While intestinal subtypes showed a higher rate of HER-2 overexpression, the median survival times tend to be shorter in HER-2 positive patients.
Sorafenib (SFB) treated elderly patients (E) with hepatocellular carcinoma (HCC): Chromogranine A (CGA) plus vascular endothelial growth factor (VEGF) as predicting factors (PF) of treatment outcome.
Authors: Carreca Ignazio Ugo , Piazza Dario , Castagneto Bruno , Condemi Giovanni , Cova Dario , Gambardella Antonio , Foa Paolo ,   on behalf of A.I.R.O.N.A. Italian Association of Oncogeriatry Research
Published: March 2020

e14676 Background: HCC accounts for approximately 90% of all primary liver cancers, and is the fifth most common cancer in the world and prognosis is so far very poor,particularly in E patients.Between all tentative of treatment till know SFB seems to be the most promising drug in patients with advanced or metastatic HCC.Aim of the study is to investigate if SFB is efficient and safe also in E HCC patients despite the comorbidities and other problems. Objectives: To investigate if CgA and VEGF work as predicting factors of Sorafenib treatment outcomes. Methods: 51 patients, mean age 68,9 (65-85) with HCC were enrolled . Serum CgA, VEGF and αFP were evaluated at baseline and after end of treatment (SFB 400mg p.o. bid), until disease progression. Clinical response (RECIST), Comprehensive Geriatric Assessment and PFS were considered as well. Results: CgA mean value (baseline: 77.9 – after treatment: 26.25 UI/L) and VEGF levels (baseline: 67.3 – after treatment 47.2 pg/ml) seems to have a predictive role in clinical benefit. A correlation between lower values of CgA and VEGF was noted in pts with longer PFS. Furthermore 3-4 toxicity was not observed in these pts. OS median was 11 months. Conclusions: The most relevant data in this study refer to the role of serum CgA and VEGF levels, for prediction of tumor response. If these findings were confirmed in future largest studies, it could be sufficient to measure these markers levels for identification of those HCC patients who have more probability of obtaining clinical benefit from a sorafenib treatment.
High C-reactive protein (CRP) level and leukocytosis as a prognostic factor for metastatic pancreatic cancer (MPC) patients with good performance status.
Authors: Ozaka Masato , Ishii Hiroshi , Yukisawa Seigo 
Published: March 2020

e14677 Background: Prognostic factor for metastatic pancreatic cancer patients (pts) with good performance status has not been fully evaluated. The objective is to investigate the prognostic factor for metastatic pancreatic cancer patients with good performance status. Methods: Data was collected from the medical records of patients at our hospital. The selection criteria were as follows: 1) histologically proven MPC, 2) ECOG performance status 0 or 1, 3) inoperable or recurrent metastatic disease treated with systemic chemotherapy between Sep. 2007 and June 2011. Results: There were 123 pts who met selection criteria in this study. The median age was 65 years (range, 41-86); male/female, 70/53 pts; the metastatic site was liver/peritoneum/lung/lymph nodes/others in 75/31/15/10/ pts. Median overall survival was 9.5 months, respectively. Of the 123, 11 pts showed leukocytosis (WBC>10000) and 19 pts showed High CRP level (CRP>2.0). Pts with leukocytosis and high CRP level showed significantly poor overall survival (4.44 and 4.44 months). A multivariate analysis demonstrated that a leukocytosis and high CRP level were independent unfavorable prognostic factors. Conclusions: High CRP level and leukocytosis may be a poor prognostic factor for MPC patients with good performance status.