bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in prostate-specific antigen doubling time (PSADT) prior to and after treatment with hormonal therapy (HT) in men with biochemically recurrent prostate cancer (BRPC): A preliminary analysis.
Authors: Sinibaldi Victoria J. , Huang Peng , Antonarakis Emmanuel S. , Carducci Michael Anthony , Eisenberger Mario A. 
Published: March 2020

e15188 Background: PSADT is an important prognostic parameter in all clinical states of PCA. Intra -subject changes in PSADT prior to and after HT remains undefined. Methods: Men with rising serum PSA levels after local therapy were longitudinally followed from the hormone-sensitive (HS) to the castration-resistant (CR) state. PSADT was calculated according to standard formulas ( Pound et al., JAMA 1999) and previously identified prognostic subgroups (Antonarakis et al., BJU Int 2012; Freedland et al., JCO 2007) were used to evaluate the potential clinical significance of PSADT according to the following subgroups: [1] < 3 months (mo); [2] 3-8.9 mo, [3] 9-14.9 mo, and [4] ≥ 15 mo). Results: 55 men with BRPC who eventually developed CR disease on HT were retrospectively analyzed. The median age of HS men was 60 y (range (r) 43-78); CR men 66 y (r 43-87). Of all men, 28 had prior surgery (S), 5 had radiation (R), 14 had S+R, 7 had neoadjuvant /adjuvant HT + local therapy, and 1 had no local therapy. PSADT in the CR state was shorter than PSADT in the HS state (signed –rank test; p=0 .012). HS men with PSADT < 4 m had shorter overall survival than those with PSADT ≥ 4 mo ( 13.9 vs. 20.1 mo; HR ; 8.46). Changes in PSADT from the HS to the CR state are summarized in the Table below. The majority of men converted from a more favorable to a less favorable PSADT subgroup as they progressed from HS to CR states. Conclusions: PSADT tends to shorten from the HS to the CR states. The prediction of clinical outcome based on PSADT needs to account for the clinical state the patient is in, as PSADT may change within the same patient from state to state. [Table: see text]
Hormonal impact of salvage chemotherapy with carboplatin plus weekly docetaxel in patients with castration- and docetaxel-resistant prostate cancer (DRPC).
Authors: Reuter Christoph W. , Morgan Michael A. , Fenner Martin , Ivanyi Philipp , Grünwald Viktor , Ganser Arnold 
Published: March 2020

e15190 Background: Recent data suggest that carboplatin may be effective in combination with docetaxel in DRPC. Platinum(II)-complexes interfere with steroid biosynthesis lowering testosterone levels by inhibiting CYP11A1, HSD3B1,2 and CYP17A1. Methods: Docetaxel failure/resistance was defined according to the Prostate Cancer Working Group (PCWG2007) criteria. Since February 2005, 68 consecutive DRPC pts were treated with at least two cycles of carboplatin (C) AUC5 iv for 30 min on day 1 every 4 weeks (q4w), docetaxel (D) at a dose of 35 mg/m2 iv for one hour on days 1, 8, (15) plus prednisone 2x5mg/day orally after receiving informed consent until disease progression or occurrence of intolerable adverse effects. Efficacy measures were done following PCWG recommendations. Free testosterone levels were measured before (n=42) and during DC chemotherapy (n=36). Results: Response of prostate-specific antigen (PSAR; ≥50% PSA) was observed in 32/68 (47.1%) patients. At the time of the current analysis (9/30/11) the median follow-up time was 13.6 months, 42/68 patients had died and 48/68 had progressive disease. Median progression-free survival (PFS) for all patients was 7.5 months (CI 95% 5.4, 9.6) and median overall survival (OS) was 18.6 months (CI 95% 11.7, 25.5). This regimen was reasonably well tolerated, with leukopenia/neutropenia as the most common reversible grade 3/4 toxicity (45.6/39.7%). Median free testosterone levels were 0.935 pg/ml before and 0.185 pg/ml during DC treatment (nadir levels, p<0.001; detection limit <0.18 pg/ml). Median serum androgene levels (T+DHT) were 0.26 ng/ml before and below the detection limit of <0.05 ng/ml during DC treatment (median nadir levels). While free testosterone levels before DC treatment were associated with lower PSAR (HR 6.32 CI 1.60, 25,0; p=0.009), free testosterone nadir levels <0.18 pg/ml during DC treatment were associated with higher PFS (HR 0.126 CI 0.04, 0.46, p=0.002) and OS (HR 0.07 CI 0.01, 0.59; p=0.014). Conclusions: These data suggest that carboplatin plus weekly docetaxel may be an important second-line treatment option for DRPC patients by inhibiting the testosterone biosynthesis.
Next-generation point-of-care immunoassay system for rapid and accurate determination of cancer markers in the physician office.
Authors: Zappala Stephen M , Libertino John A , Wein Alan J. , Vaughan E. Darracott , Scardino Peter T. 
Published: March 2020

e15196 Background: Claros Diagnostics (Woburn, MA) has developed a novel multiplex immunoassay system designed to transition diagnostic tests performed at the centralized laboratory to the point-of-care (POC). The credit card-sized microfluidics disposable analyzes a fingerstick drop of whole blood with laboratory-quality results in 10 minutes, with significant ease-of-use. Total PSA was selected as an initial test to validate that this platform technology can achieve equivalent sensitivity, absence of interferences, etc. as compared to the reference laboratory. Further, the need to clinically validate the use incentives of such a POC system in optimizing the patient-physician encounter, practice efficiency, and overall quality of care were explored. Methods: We completed two consecutive studies measuring PSA in whole blood with the Claros system against the laboratory results in a matching serum sample. The first study entailed 72 patients from two sites and compared fingerstick samples against the laboratory Siemens Centaur serum assay, while the second study compared PSA results from 34 patients’ whole blood against the laboratory Roche E-170 serum assay. All studies were conducted under IRB approved protocols. Results: The PSA values measured in the 72 patients ranged from <0.1 to 8.3 ng/mL. Linear regression yielded a slope of 1.05 and a R2 value of 0.94. Range of PSA values in the second study on 34 patients were <0.1 to 13.5 ng/mL, from which the linear regression analysis yielded a slope of 1.04 and a R2 value of 0.98. In addition, specific data obtained between 0.1 and 1 ng/mL yielded an excellent correlation with a slope of 0.93 and a R2 value of 0.94. Overall (n=106) 7 patients were measured <0.1ng/mL by both assays. Conclusions: Quantitative results obtained with the Claros POC system using a fingerstick of whole blood correlated extremely well with laboratory assays over the clinically relevant range of PSA, including at very low PSA concentrations (essential to detect cancer recurrence post-intervention). Overall ease of use, the ability to use fingerstick blood and short time-to-result converge in improving physician practice efficiency and patient-physician interactions.
Clinical implications of insulin-like growth factor I (IGF-I) and II (IGF-II) in stage IIIB cervical cancer.
Authors: Patel Pooja Nandwani , Vyas Rakesh , Mehta Maitrik 
Published: March 2020

e15505 Background: The IGF (Insulin like Growth Factor) family has been implicated in the pathogenesis of cervical cancer. We aim to correlate pre and post treatment levels of IGF-I and IGF-II in stage IIIB cervical cancer and identify if serum IGF-I and IGF-II can be used as a marker to predict response to chemo-radiotherapy. Methods: We recruited 80 previously untreated patients of histopathologically proven squamous cell carcinoma of stage IIIB cancer of uterine cervix from January 2011 to May 2011. The age of patients ranged from 30 to 65 years and were of ECOG performance status of less than or equal to 2. Along with the routine investigations the pretreatment serum levels of IGF-I and IGF-II were done by ELISA kits in all the patients. The serum level of IGF-I was 246.3 ± 72.5 ng/ml and IGF-II was 1585 ± 352 ng/ml. All patients were given concurrent cisplatin (30 mg/m2) weekly along with radiation (50Gy/25#) with conventional portals followed by two sittings of intracavitory radiotherapy (7.5 Gy each) on mHDR. Blood samples for IGF-I and IGF-II levels were collected before the start of the therapy, 1 month after the completion of treatment and 6 months after the completion of the treatment. Results: The trend seen was that mean IGF-I levels were always in the lower range as compared to IGF-II levels in all individuals. The mean serum levels of IGF-I and IGF-II in patients who achieve complete response (45%) returned to normal whereas the mean serum levels of IGF-I and IGF-II in patients who achieved partial response (43%) was 149 ng/ml and 838 ng/ml respectively. The mean serum levels of IGF-I and IGF-II in patients who achieved no response (12%) was 331 ng/ml and 1840 ng/ml respectively. Conclusions: The serum levels of IGF-I and IGF-II may be a reliable prognostic and predictive marker in cervical cancer however further large randomized studies are required to validate the results. IGF-I and IGF-II can serve as potential markers in cervical cancer to risk stratify patients, assess treatment response and possibly act as therapeutic targets in the future.
Using hospital claims data to identify ovarian cancer recurrence: A validation study.
Authors: Livaudais Jennifer C. , Egorova Natalia , Hayes Monica Prasad , Howell Elizabeth A. , Wisnivesky Juan P. , Franco Rebeca , Bickell Nina 
Published: March 2020

e15513 Background: The use of administrative hospital claims data in research studies offers a promising alternative to conducting expensive chart abstraction to assess utilization and health outcomes. However, the validity of using claims data to capture ovarian cancer recurrence is unknown. Methods: We used two strategies to identify recurrent ovarian cancer: 1) a previously validated algorithm of secondary malignancy diagnosis codes used to identify recurrent breast cancer, adapted to ovarian cancer and 2) a new algorithm we created based on the timing and utilization of secondary chemotherapy or secondary debulking surgery for ovarian cancer. To identify secondary debulking surgery, which does not have its own billing code, weobtained codes used by gynecologic oncology billers from across the nation to identify these procedures. We identified all ovarian cancer patients who had undergone primary debulking surgery followed by initiation of primary chemotherapy at a single academic medical institution in NYC, between 2003 and 2010. We then ran the two recurrence algorithms on this population and randomly selected a sample of 50 patients to assess the sensitivity and specificity of each algorithm versus gold-standard chart abstraction data. Results: When applied to our sample of ovarian cancer patients, the sensitivity of the previously validated algorithm was 91% (95% CI: 57% to 99%), the specificity was 28% (95% CI 16% to 45%), the PPV was 26% (95% CI: 14% to 43%) and the NPV was 92% (95% CI: 66% to 99%). In contrast, the sensitivity of our newly developed algorithm to detect ovarian cancer recurrence based on hospital claims data was 100% (95% CI: 68% to 100%), the specificity was 87% (95% CI: 72% to 95%), the PPV was 69% (95% CI: 41% to 88%) and the NPV was 100% (95% CI: 87% to 100%). Conclusions: An algorithm culled from billers and clinical experts identifying timing and utilization of procedures measured ovarian cancer recurrence with a greater degree of accuracy than a previously validated algorithm to detect cancer recurrence. When complex chart reviews are not feasible, our claims-based algorithm can be used by researchers to answer important questions about ovarian cancer treatment effectiveness.
Features of clinical course of vulva cancer in reproductive patients.
Authors: Nerodo Ekaterina , Nerodo Galina A. 
Published: March 2020

e15519 Background: The significant increase of vulva cancer patients in young and middle age is observed during the last ten years. Methods: To compare the clinical course of vulva cancer in reproductive patients (under 50 years of age) with the one in elderly agewe performed the comparative analysis of clinical characteristics of 839 vulva cancer patients, aged 20-90, with stages I-IV carcinoma who underwent standard complex antitumour treatment. Results: The reproductive group included 64 patients (7.6%), 775 patients (92.4%) were over 50 years. These included prevailed groups of 61-70 years of age – 38% and 71-80 years of age – 34%. Early stages of the disease were observed in 48% of all cases, st. III-IV – in 52%. In the reproductive group st. I was observed in 18.75%, st. II – 51.56%, st. III – 23.43%, st. IV – 6.25%. 70.03% patients of reproductive age had early stages of the disease, that is significantly higher than in the group of elderly patients: 51-70 years of age – 55%, 71-80 years of age – 40%, more than 80 years of age – only 25%(p<0.05). Age characteristics of vulva cancer patients in reproductive group were the following: 20-30 years of age – 10.9%, 31-40 years of age – 32.8%, 41-50 years of age – 56.25%. Organ-preserving operations carried out according to strict individual indications were performed to 35 sexually active patients in early stages. Relapses of the disease were revealed in 11 patients out of 64 (17%) in the reproductive group, and in 180 out of 775 (23.2%) patients in the elderly group(p<0,05) Relapses occurred in 8% of reproductive patients with st. I of the disease, st. II – 9%, st. III – 46%. Med locoregional free-survival was in st.I-72,3 mon. ,in st. II-61,3 mon., in st III-17,3 mon. All patients with inoperable tumour relapse underwent chemotherapy with subsequent tumour removal. Conclusions: Vulva cancer in patients of reproductive age is revealed in early stages more often that in elderly patients. There is a possibility to perform organ-preserving operations in young patients, which doesn't lead to relapse increase.
Human papillomavirus pevalence and persistence after chemoradiotherapy for carcinoma of the uterine cervix.
Authors: Noriega-Iriondo Maria Fernanda , Martinez Garza Laura Elia , Gonzalez Guerrero Juan Francisco , Barboza Quintana Oralia , Ruiz Sanchez Daneli , Zamudio Osuna Michelle , Martinez Rodriguez Jorge Luis , Gonzalez Vela Jose Luis 
Published: March 2020

e15525 Background: Human papillomavirus (HPV) is associated with carcinoma of the cervix (CC). There is evidence that clearance of the virus occurs after chemoradiotherapy which is the standard treatment for this disease. Methods: Eligible patients with bulky IB to IVA CC were treated with once weekly cisplatin (40 mg/m2) chemotherapy and standard pelvic teletherapy and brachyterapy. HPV detection and typing was performed with DNA microarrays from liquid based cytologies before and 4 to 6 weeks after treatment completion. Clinical response was assesed by physical exam and liquid based cytology. Results: 23 patients (pt) with CC , were tested for HPV. Their age ranged from 33 to 80 years (mean 65), clinical stage I 8.6%, StageII 39%, stageIII 25.9% and stageIV 26.5%.VPH was found in 20 patients (87%). 34% of the patients had more than one type of HPV. 13 types of VPH were found,the most prevalent type was 16 in 47.8%, followed by type 72 in 13%.7 patients were lost to follow up during therapy. 16 patients were tested after completion of therapy ,there was HPV persistence in 5 patients (38.5%),whereas 61.5% cleared the virus. Of the persisting HPV the most prevalent type was 16 in two pt. and 61 in two pt. three pt had more than one HPV type after completion of therapy (types 11,81,35,39,56,84,66were found in different combinations in the pts). Response rate was as follows, 84.6% complete response,and two pt. had partial response. Viral clearance did not correlate with complete response in this study. Conclusions: HPV types 16 and 72 were the most prevalent in this population from northern Mexico. Infection with multiple viral types was common. Viral clearance occured in 61.5% and this did not correlate with complete clinical response. Persistence of multiple HPV types after completion of therapy may have unknown clinical and prognostic implications.
Clinical findings and medical management of hereditary breast-ovarian cancer without molecular diagnosis in a referral cancer center.
Authors: Morales-Vasquez Flavia , López-Basave Horacio Noe , Caballero Hector M , Mendez Herrera Maria del Carmen , Tirado Gomez Laura Leticia , Gallardo Rincon Dolores , Ruvalcaba Limon Eva , Herrera MaryTere , Urzua Lorena , Namendys-Silva Silvio A , Vidal Silvia ,   GICOM
Published: March 2020

e15527 Background: Ovarian cancer is the leading cause of death from gynecologic malignancies. Women at high risk of hereditary breast and/or ovarian cancer (HBOC) require specific management strategies. The goal of this study was to determine the prevalence of HBOC among patients in a referral cancer center. To analyze the pathologic and clinical characteristics of HBOC and examine whether survival is influenced by family history of breast or ovarian cancer. Methods: This retrospective study included all epithelial ovarian cancers seen at the National Cancer Institute of México from 2000-2009. Epidemiological and clinical variables were collected from the patients' medical records. Results: In 1071 cases, we found 15 patients with HBOC. The first pathology was breast cancer, and the ovarian cancer was diagnosed in average 8.23 years later. Only in 2 patients the ovarian cancer was before than breast cancer. The median age was 53 (35-69) years old at diagnosis for breast cancer and 51(40-75) years old in ovarian cancer. The advanced clinical stage was 13% for breast cancer versus 60% for the ovarian cancer. The histology was ductal carcinoma for breast cancer and serous papillary carcinoma for ovarian cancer with high grade. The recurrent disease was frequent for ovarian cancer. The median overall survival was 8 years (1-20 years). Conclusions: Recognition of when ovarian cancer is a substantial risk (in BRCA1 and BRCA2 carriers) is essential. However, the appropriate intervention is difficult to judge, and careful balancing is needed.
ESR-alpha promoter methylation to predict survival in low-grade ovarian cancer.
Authors: Engelstaedter Verena , Shi Rong , Heublein Sabine , Kuhn Christina , Friese Klaus , Mayr Doris , Jeschke Udo 
Published: March 2020

e15529 Background: Ovarian cancer is one of the most lethal gynecologic malignancies and the leading cause of death among women with gynecological cancers. Different molecular markers have been studied for their prognostic relevance, but to date only CA 12-5 is used in routine diagnostic. Aberrant methylation of the estrogen receptor promoter (ESRp) was first described in colorectal cancer. Previous studies that described methylation of the ESRp in ovarian cancer suggested a potential role in cancer development. The aim of this study was to examine the methylation of the ESRp in a cohort of ovarian cancer patients in regard to its prognostic relevance. Methods: The study cohort consisted of 77 ovarian cancer patients that were diagnosed between 2000 and 2009 at the Department of OBGYN of the LMU Munich. A total of 50 patients died, 25 are still alive, 2 were lost to follow-up. Genomic DNA was isolated from paraffin-embedded cancer tissue and followed by bisulfite treatment. For detection of the methylated ESRp we used a sensitive real-time PCR. Results: Survival was significantly shorter for patients with aberrant promoter methylation within the subgroup of borderline, G1 and G2 tumors (31 patients; survival for methylated cases was 3.48 vs 4.91 years for unmethylated cases (p=0.010)). Within the small subgroup of borderline and G1 tumors (10 patients) survival for methylated cases was 4.73 vs 6.08 years for unmethylated cases (p=0.014). No significant difference of survival was observed for high grade (G3) ovarian cancer patients (p=0.745). Conclusions: We demonstrated for the first time that the methylation status of the ESRp might be a promising prognostic marker in ovarian cancer. ESRp methylation does not seem to be of prognostic relevance in high-grade ovarian cancer. In our study cohort a three-step grading system was used, but recent publications favor a two-step grading system. Thus, the G2 cases should be reevaluated to see whether they are G1 or G3. The difference in tumor etiology of low and high grade ovarian cancer might be responsible for the different prognostic relevance of ESRp methylation. Since our subgroup of borderline and G1 tumors is very small, these are preliminary results that have to be confirmed in a larger patient cohort.
Correlation between marital status and adequate pap test screening among Canadian women: An analysis of sociodemographic factors from the Canadian community health survey, 2007–2008.
Authors: Moretto Patricia , Canil Christina M. , Weberpals Johanne Ingrid 
Published: March 2020

e15537 Background: Medical literature shows that marital status serves as an important factor which influences the likelihood of women undergoing cervical cancer screening. In Canada, women have universal access to health care as well as cancer screening facilities. This study was conducted to determine the association between adequate Pap test screening (APT) and marital status, stratified by age, and the prevalence of APT among the Canadian women. Methods: Data for the analysis were obtained from the Canadian Community Health Survey (CCHS), a national cross-sectional study, conducted during 2007 and 2008. The analysis included 22,530 women who were 18 to 69 years of age. The regression model used accounted for potential effect modification and confounders to assess the association between marital status (being married), and adequate cervical cancer screening (APT). Results: The weighted prevalence of APT was 75%, and was higher among married women (79%). The group with APT had a higher weighted prevalence of presence of a regular doctor, were white, had higher educational level and were non-obese, in comparison to the group with inadequate pap test (IPT). After adjusting for covariates, stratifying by age and weighting for the general population, married women, in the age groups 18-29 (RR 1.32, 95% CI 1.27;1.37), 40-49 (RR 1.07, 95% CI 1.03;1.12) and 60-69 years (RR 1.10, 95% CI 1.02;1.2) had a statistically significant increase in the risk of APT compared to non-married women. Conclusions: Marital status is associated with an increase in adequate Pap test screening in almost all age groups of the Canadian female population. This finding reinforces that providers of cancer screening services should target their efforts to improve the results among non-married women.