bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower-limb drainage mapping for lymphedema risk reduction after pelvic lymphadenectomy for endometrial cancer.
Authors: Bats Anne-Sophie , Nos Claude , Bensaid Cherazade , le Frere-Belda marie-Aude , Collignon Marie-Anne , Faraggi Marc , Lecuru Fabrice 
Published: March 2020

e15558 Background: Pelvic lymphadenectomy is associated with a significant risk of lower-limb lymphedema. In this proof-of-concept study, we evaluated the feasibility of identifying the lower-limb drainage nodes (LLDNs) during pelvic lymphadenectomy for endometrial cancer. Secondary objectives were to map lower-limb drainage and to assess the diagnostic value of our mapping technique. Methods: Prospective study of patients with endometrial cancer requiring pelvic lymphadenectomy, with no neoadjuvant radiotherapy or chemotherapy and no history of lower-limb surgery. A radiopharmaceutical was injected into both feet on the day before surgery. LLDNs were identified using preoperative lymphoscintigraphy and intraoperative isotopic probe detection then removed before complete pelvic lymphadenectomy. LLDNs and pelvic lymphadenectomy specimens underwent separate histological analysis. Results: Of the 12 patients with early-stage endometrial cancer, 10 underwent preoperative lymphoscintigraphy, which consistently identified inguinal, femoral and pelvic LLDNs. The intraoperative detection rate was 83% (10/12). The 2 patients with no LLDNs detected intraoperatively had lymphoscintigraphy-detected LLDNs. Median number of hot nodes per patient was 5 (3-7) on the right and 3 (2-6) on the left. Of 107 LLDNs, 106 were in the external iliac area, including 38 in the lateral group and 45 in the intermediate and medial groups. None of the patients had node metastases at any site. No early complications related to the technique occurred. Conclusions: Our mapping technique appears feasible, safe, and associated with a high LLDN identification rate. LLDN mapping may allow the preservation of LLDNs, thereby decreasing the risk of lower-limb lymphedema and improving quality of life.
A proteomic analysis of surgical cytoreduction in patients with advanced ovarian cancer.
Authors: Lesnock Jamie L , Hood Brian L , Sun Mai , Bhargava Rohit , Conrads Thomas P , Krivak Thomas C. 
Published: March 2020

e15560 Background: Optimal surgical cytoreduction (<1 cm residual tumor) has been shown to improve overall survival compared to suboptimal (>1cm) debulking as primary treatment for advanced stage epithelial ovarian cancer (EOC). Molecular descriptions of optimally and suboptimally debulked ovarian tumors are lacking. We have performed a global, quantitative proteomic analysis of optimally and suboptimally debulked EOC tumor samples. Methods: A cohort of 16 optimally (8) and suboptimally (8) debulked patients with archival formalin-fixed, paraffin-embedded tumor specimens was identified. Homogenous tumor cell populations were collected and protein digests were prepared and analyzed by high resolution mass spectrometry for identification and quantification by spectral counting. Immunohistochemistry (IHC) was performed and slides were scored using a semi-quantitative method (H-score). Results: An average of 1,110 proteins were identified within each cohort, of which 21 possessed significant (p<0.05) differential abundances. Specifically, three proteins (annexin A1, S100-A11, and synuclein-gamma, or SNCG) which have significant roles in cell migration and cancer biology were identified. Although no H-score was statistically significant, comparison of positively-staining cells for SNCG showed a trend toward increased expression in suboptimally debulked patients, p=0.08. Conclusions: Overexpression of SNCG has been shown to be predictive of worse prognosis in papillary serous uterine cancer cell lines, and increased expression of SNCG in breast cancer correlates with advanced stage and aggressiveness of disease. Our data suggest SNCG may have similar predictive value in EOC, as tumors with elevated levels of this protein may be less amenable to optimal cytoreduction.
Expression of ERCC1 protein (excision repair cross complementing group 1) in patients with invasive carcinoma of the uterine cervix (CC) undergoing definitive chemoradiation (CR).
Authors: Caires Inacelli Queiroz de Souza , Caires-Lima Rafael , Colombo Renata , Ramos Clarissa CA , Machado Karime Kalil , Siqueira Sheila Aparecida Coelho , Carvalho Heloisa de Andrade , Fukushima Julia Tizue , Adra Thais Rodrigues , Hoff Paulo M. , Estevez-Diz Maria Del Pilar 
Published: March 2020

e15562 Background: CC is the leading cause of cancer death among women in developing countries. ERCC1 protein participates in DNA repair through the nucleotide excision repair pathway, involved in resistance to platinum-based chemotherapy. Its value as a predictive marker of tumor response to treatment, progression or death is still unknown. We evaluated ERCC1 protein expression and clinical variables as a predictive marker of progression-free survival (PFS) and overall survival (OS) in patients (pts) with CC submitted to CR. Methods: Retrospective data analysis of pts with histological diagnosis of CC, treated with CR between 2004-2009. Platinum-based chemotherapy was administered weekly (x6) concurrent to external beam radiotherapy (EBRT) to the pelvis (39.6 – 45.0 Gy), parametrial boost (14.0 – 20.0 Gy) when indicated and high-dose rate brachytherapy (HDR) (28.0 – 30.0 Gy). ERCC1 expression was assessed by immunohistochemistry (IHC). Results: We analyzed 75 pts, median age was 55 years (range 24-76), the performance status (PS) was 0 or 1 at baseline in 50 pts (66%) and 63 had squamous histology (84%). Thirty-two were stage IIB (43%) and 19 were IIIB (25%). Sixty-five patients received cisplatin 40mg/m2/w (87%) and 9, carboplatin AUC2/w (12%), median of 6 cycles (range 2-9). Median RT and HDR doses were 59.4 Gy (range 40.4 to 60.3) and 28.0 Gy (range 14.0 – 37.5), respectively. Thirty-two pts were available by ERCC1 IHC and all expressed the marker. Median PFS and OS were 35.5 (95% CI – 13.8 - 57.6) and 81 (95% CI- 21.2 - 140.8) months, respectively. In multivariate analysis, receiving < 6 chemotherapy cycles and baseline Hb <10.0 were correlated with disease progression and death, HR 0.302; p 0.011 (95% CI- 0.012-0.762) and HR 0.6; p 0.00 (95% CI- 0.474 – 0.760), respectively. PS at baseline did not correlate with PFS or OS, HR 0.985; p 0.614 (95% CI 0.930 – 1.044). Conclusions: In this population, since all pts expressed the protein, ERCC1 expression couldn't discriminate patients who most benefit from CR. Interestingly, a minimum of 6 chemotherapy cycles and a baseline Hb ≥ 10.0 seem to have a prognostic value.
Anticancer efficacy of the combination of low-dose cisplatin and trichostatin A or 5-aza-2’-deoxycytidine in ovarian cancer cells.
Authors: Meng Fanliang , Sun Guigin , Zhong Mei , Yu Yanhong , Brewer Molly 
Published: March 2020

e15563 Background: We investigated the combination of low dose cisplatin with histone deacetylase inhibitor trichostatin A and methyl transferase inhibitor 5-aza-2’-deoxycytidine to determine if these agents could improve the sensitivity of ovarian cancer cell lines to cisplatin. The goal was to improve efficacy and decrease the toxicity of conventional chemotherapy in human ovarian cancer. Methods: Two chemoresistant ovarian cancer cell lines HEY, SKOV3 and one immortalized cell line IOSE were were treated with increasing doses of each drug alone and in combination to determine optimal cytotoxicity at the lowest dose. Markers of adhesion, metastasis, proliferation, self renewal, and measures of epigenetic regulation were measured. Spheroids, treated with single and combination drugs, were measured for cell viability. SCID mice were injected with pretreated cells and with untreated cells and then treated sequentially. Results: TSA or 5-aza-2’-deoxycytidine combined with Cisplatin had a marked reduction in E-cadherin and N-cadherin (adhesion and migration), proliferation protein Akt and Akt-1, self-renewal markers Oct4/Nanog/Sox2, and the drug transporter ABCG2. DNA methylase, DNMT3a/3b, histone deacetylase HDAC1/2 and histone demethylase LSD1, measures of epigenetic regulation, were suppressed with combined treatment. Histone methylation markers H3K4 and H3K9 were regulated differentially, with the trimethyled-H3K9 significantly suppressed, suggesting bivalent chromatin regulation. Cisplatin/TSA suppressed spheroid formation, growth, and viability. Cisplatin/TSA suppressed tumorigenesis in SCID mice when cells were pretreated. Animals treated after tumor formation with epigenetic modifiers followed by cisplatin achieved significant tumor regression, suggesting that both approaches enhance anticancer effects. Conclusions: Our research suggests the combination of low dose cisplatin with epigenetic modifiers administered together or sequentially may be promising treatments for ovarian cancer with reduced toxicity and may reverse platinum resistance.
Serum concentration of VEGF, sFLT-1, and CD105 in patients with endometrial carcinoma.
Authors: Maenpaa Johanna , Saarelainen Sami Kristian , Peltonen Nina , Lehtimaki Terho , Vuento Maarit 
Published: March 2020

e15564 Background: Preoperative evaluation of the risk for metastases in endometrial carcinoma is challenging. The aim of this study was to compare preoperative serum levels of angiogenetic markers VEGF, sFLT-1, and CD105 (endoglin) in predicting a metastasized disease. Methods: Preoperative sera from 100 consecutive patients diagnosed for endometrial carcinoma were collected. The serum concentrations of VEGF, sFLT-1, and CD105 were assessed by enzyme-linked immunosorbent assay (ELISA). The results were correlated to the presence of metastases, presence of deep (≥50%) myometrial invasion and histologic grade of the tumor. Cases with other than endometrioid histology were excluded from the study. Results: Eleven patients had a metastasized disease (≥Stage IIIA, FIGO 2009 classification). The serum concentration of VEGF was higher in the group with metastases (median [range] 394 pg/mL [31-1524 pg/mL] vs. 801 pg/mL [631-1183 pg/mL], p=0.001). The concentrations of sFLT-1 and CD105 did not show statistical difference between the two groups. In the multivariable analysis, the concentration of VEGF was the sole independent factor for the presence of metastases (OR 1.003, 95% CI 1.000-1.005, p=0.019). Conclusions: Preoperative serum VEGF concentration correlates with the presence of metastases in endometrioid endometrial carcinoma.
Primary debulking surgery (PDS) for stage IIIc ovarian cancer: Quo vadis?
Authors: Garrett Leslie A. , Growdon Whitfield Board , Boruta David M. , del Carmen Marcela G , Priebe Anna M. , Goodman Annekathryn , Bradford Leslie , Clark Rachel Marie , Schorge John O. 
Published: March 2020

e15568 Background: The efficacy of PDS for advanced ovarian cancer has recently been challenged by data suggesting equivalent clinical outcomes for neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS). The strongest known predictor of prolonged survival in either group is the ability to achieve complete resection (CR) to no residual disease. PDS that results in a CR is associated with the longest overall survival of any sequence of treatment. The aim of this study was to determine what type of surgical approach is required to successfully perform PDS. Methods: All women with newly diagnosed stage IIIC epithelial ovarian carcinoma treated at our institution from 2000 to 2010 were identified. Pathology was prospectively reviewed by a faculty gynecologic pathologist. Treatment planning was discussed and documented at our weekly multidisciplinary tumor board conference. Data was retrospectively extracted from computerized medical records. Results: 344 (86%) of 401 women underwent PDS. Optimal debulking was achieved in 278 patients (81%): 35% had CR while 46% had 0.1-1.0 cm residual disease. 56 stage IIIC pts (19%) had a suboptimal surgical outcome with ≥ 1.0 cm. Compared to those having a CR, patients with 0.1-1.0 cm residual were more likely to require splenectomy (17 v 5%; P = 0.002) and transverse colectomy (19 v 10%; P = 0.042), with comparable rates of rectosigmoid resection (41 v 39%; P = 0.712) and en bloc pelvic resection including total peritonectomy (26 v 30%; P = 0.050). Patients undergoing CR were more likely to have diaphragmatic surgery (31 v 20; P = 0.068) and lymphadenectomy (67 v 33%; P < 0.001). Conclusions: PDS is the preferred treatment of stage IIIC epithelial ovarian cancer at high-volume centers demonstrating >75% rates of optimal cytoreduction. Tumor biology may lead to the need for more aggressive upper abdominal procedures in patients with 0.1-1.0 residual. Diaphragm resection, stripping or ablation is more often required in order to achieve CR. Since subclinical macroscopic nodal metastases are often present, lymphadenectomy is also frequently performed to ensure that all possible disease has been resected.
Diagnostic value of FDG-PET/CT for peritoneal carcinomatosis (PC) before hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer.
Authors: Razzouk-Cadet Micheline , Zwarthoed Colette , Desantis Mariangela , Viau Philippe , Mahamat Abakar , Mounier Nicolas , Bereder Jean Marc 
Published: March 2020

e15574 Background: Evaluate FDG-PET/CT utility for the detection of peritoneal carcinomatosis from ovarian cancer treated by chemotherapy by using surgical and histopathological findings as the standard of reference. Methods: 38 patients (46 to 68 years) with recurrent (n=35) or primary (n=3) ovarian cancer were reviewed for the presence of peritoneal lesions on FDG-PET/CT before cytoreductive surgery and HIPEC treatment. 30 had adenocarcinomas (13 papillary serous, 7 moderately differenciated, 6 poorly differentiated, 3 serous and 1 serous cystadenocarcinoma) and 2 endometrioid tumors. 9 had psammomatous calcifications. All were suspected cases of PC. 35 patients had received adjuvant chemotherapy and 3 neoadjuvant chemotherapy (primary cancer). FDG-PET/CT results were reinterpreted by two experienced nuclear medicine physicians who knew that PC was suspected. The FDG uptake was determined as SUVmax in the most active lesion in all abdomino-pelvic quadrants (average SUVmax= 6.1; range 1.1- 25). SUVmax in the liver was also measured (average SUVmax=2.9). All PET/CT exams were realised on the same machine. Results: FDG PET/CT diagnosed 18 in 32 patients with peritoneal metastases. There was no suspicious site of abnormal FGD uptake in the supradiaphragmatic regions. The sensitivity, specificity and accuracy of FDG PET/CT were respectively 59,100, 66%. The positive and negative predictive value of FDG PET/CT were 100 and 31%. 13 false negative PET/CT findings were due to millimetric or infracentimetric perihepatic, mesenteric and omental implants (unseen on PET/CT) and to nodules less than one centimeter with no significant FDG uptake (SUVmax lower than hepatic uptake). The true negative findings were found after chemotherapy. Conclusions: FDG-PET/CT can be considered as a useful tool for the selection of patients for HIPEC treatment in the absence of distant metastasis. It showed excellent results for the positive diagnosis and tumor burden for lesions more than 1 cm (PPV 100%). The sensitivity was low in the presence of millimetric disease with or without prior chemotherapy before HIPEC.
Metastatic parathyroid carcinoma: Treatment modalities illustrated with a case report.
Authors: White Alison Marie , Bowyer Samantha Elizabeth , Davidson John Andrew , Ransom David 
Published: March 2020

e16004 Background: We report a case of inoperable metastatic parathyroid carcinoma with life-threatening hypercalcaemia. We achieved rapid control of calcium with denosumab. Methods: Our patient presented with complications of hyperparathyroidism. He underwent a partial parathyroidectomy and hemithyroidectomy. Parathyroid carcinoma was confirmed. There was no metastatic disease. A year later he was hypercalcaemic, 4.15 mmol/L (2.15-2.60 mmol/L), with elevated PTH and creatinine. FDG activity was seen on PET at the thyroid bed and retrocrural space. Extensive pleural metastases limited resection to debulking. The calcium and PTH remained elevated. Hydration and zoledronic acid had little effect. Cinacalcet 90mg QDS led to no improvement in calcium. Weekly zoledronic acid was used to keep his calcium below 4 mmol/L. Two cycles of cyclophosphamide, 5-flurouracil and dacarbazine led to no decline in the calcium. Denosumab is a fully human monoclonal IgG2 antibody with a high affinity and specificity to bind RANK ligand, mimicking Osteoprotegerin, competitively blocking the binding of RANK to its ligand to inhibit osteoclast activation. Results: 120mg was given subcutaneously. By day 8 the calcium had dropped to 2.66 mmol/L. After a second dose, the calcium was 2.33 mmol/L. Bone turnover markers were rapidly suppressed. The calcium was in the normal range for four months with improved renal function. Further denosumab will be guided by serum calcium. Conclusions: Parathyroid carcinoma is rare. The mainstay of treatment is resection, even in metastatic disease. Often the disease is refractory to medical management leading to complications of hypercalcaemia. There is limited evidence for chemotherapy and few strategies to manage resistant hypercalcaemia have been published. In this case refractory hypercalcaemia dramatically responded to denosumab. Denosumab does not require dose adjustment for renal impairment, a common finding with hypercalcaemia. In this case denosumab offered prolonged control of serum calcium. We propose that denosumab should be considered for patients with hypercalcaemia due to parathyroid cancer.
Assessment of the life quality in head and neck cancer patients.
Authors: Atasever Akkas Ebru , Yucel Birsen , Kilickap Saadettin , Okur Yillar , Kacan Turgut , Eren Mehmet Fuat , Babacan Nalan Akgul 
Published: March 2020

e16005 Background: In this study, we aimed to investigate the effect of radiotherapy on the life quality in head and neck cancer patients. Methods: Between 2007 and 2010 years, 82 head and neck cancer patients who had taken radiotherapy at Cumhuriyet University Department of Radiation Oncology were assessed at the beginning, midline of the treatment and 1 and 6 months after radiotherapy with European Organization for Reseach and Treatment of Cancer Ouality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N35). Wilcoxon sign test were used in the statistical analysis in SPSS version 15.0. Results: Seventy two (%88) men, 10 (%12) women; were analyzed. The median age of the patients was 57 (20-80). Squamous cell carcinoma was the most frequently seen case in 69 (%84) patients. The distribution of the patients according to the localization: larynx carcinoma in 37 (%45) patients, oral cavity tumor in 21 (%26) patients, nasopharynx carcinoma in 14 (%17) patients, paraphypopharynx in 8 (%10) patients and primary unknown in 2 (%2) patients were present. All the symptom scores were affected negatively at the midline, the end, 1 mount after radiotherapy than before the radiotherapy. Pain, swallowing, speech, social eating, social contact, less sexuality, feeling ill, weight loss, weight gain of the symptoms scale scores showed significant improvement at 6 months after the radiotherapy (p<0,05). However it was seen that senses, teeth problems, dry mouth, sticky saliva were affected negatively in the 6th month of radiotherapy than the beginning. Conclusions: In radiotherapy, the life quality of the patients has significantly degraded during the treatment and 1 month after the treatment. However after six months, all the symptom scales were measured as in the beginning. [Table: see text]
Experience of cetuximab in the salvage treatment for recurrent/metastatic oral squamous cell carcinoma.
Authors: Lin Jin-Ching , Liu Shih-An , Wang Chen-Chi , Wang Ching-Ping 
Published: March 2020

e16006 Background: We investigated the efficacy, toxicity, and prognostic factors of salvage chemotherapy plus cetuximab in patients with recurrent/metastatic oral squamous cell carcinoma (OSCC). Methods: A total of 30 patients with recurrent/metastatic OSCC were treated by an outpatient weekly multi-drug combination chemotherapy plus cetuximab 400 mg/m2 loading in day 1, then 250 mg/m2 every week. The major chemotherapy regimen consisted of MEMOCLUB (methotrexate 30 mg/m2 d1, epirubicin 30 mg/m2 d1, alternating with mitomycin-C 4 mg/m2 d8, oncovin 1 mg/m2 d8, cisplatin 25 mg/m2 d8, leucovorin 120 mg/m2 d8, 5-fluorouracil 1000 mg/m2 d8, and bleomycin 10 mg/m2 d8) or GV (gemcitabine 1000mg/m2 d1, and vinorelbine 25 mg/m2 d8). Results: Baseline characteristics are as followings: median age=45 (range 32-73); male/female=28/2; Karnofsky performance status 80%/70%/60%/50%=7/18/3/2. Most patients had heavily treated history — first recurrence in 11 cases, second recurrence in 6, and third or more recurrence in 13. The disease extent consists of 25 (83.3%) locoregional recurrences, 3 (10.0%) distant metastasis, and 2 (6.7%) locoregional + metastatic diseases. Grade 3/4 toxicity included leucopenia (46.7%), anemia (33.3%), thrombocytopenia (6.7%), mucositis (6.7%) and skin rashes (20.0%). We obtained a high overall response rate of 66.7% (7 CR, 13 PR, 6 SD, 3 PD, and 1 unevaluable). So far, there are 22 deaths and 8 alive. The overall survival time ranges from 48-1365 days with a median of 312 days. One-year overall survival rate is 49%. Two favorable prognostic factors were found by univariate analysis- disease extent (locoregional vs. distant disease, HR=0.1509, 95%CI=0.0008-0.0592) and tumor response (CR+PR vs. SD+PD, HR=0.2255, 95%CI=0.0277-0.2984). Conclusions: Cetuximab plus weekly outpatient multi-drug chemotherapy has a high response rate and encouraging survival with acceptable toxicity in recurrent/metastatic OSCC patients.
Recombinant adenoviral human p53 gene combined with chemoradiotherapy in treatment of advanced unresectable head and neck cancer.
Authors: Shu Jihong 
Published: March 2020

e16011 Background: In head and neck cancer, p53 mutations are present in up 60% of head and neck cancers. Studies indicated p53 gene could increase both radio- and chemo-sensitivities. In this study, we investigate the effectiveness of recombinant adenoviral human p53 gene (rAd-p53) combined with chemoradiotherapy in treatment of advanced unresectable head and neck cancer. Methods: From May 2008 to Dec. 2011, 48 patients with an advanced unresectable head and neck cancer, 29 males and 18 females with an average of 61.3 years old, were included this study. Those patients were treated with intratumoral injection of rAd-p53 at a dose 1-3 ×1012 viral particles (VP) , once every 3 days for 6 times. Chemotherapy regimen consisted of cisplatin 60 mg/m2 on d1 and 5-Fu 600 mg/m2 on d1-5, given intravenously every 3 weeks for 3 cycles. Radiation were given at a dose of 2Gy/f, five fractions a week for a total dose 50~70Gy. Patients were monitored for response, long-term efficacy and adverse events. Results: The median follow-up time was 21.2 months (6~39 months). Overall response rate was 91.7% (44/48), 47.9% (23/48) of complete responses and 43.8% (23/48) of partial responses. One-year overall survival was 79.2% and local progression-free survival was 70.8%. At the last follow-up, the overall survival was 72.9%. Forty-six patients experienced self-limited fever after administration of p53. Conclusions: rAd-p53 gene therapy as a component of comprehensive treatment for advanced unresectable head and neck cancer showed significant beneficial effects.