bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neoadjuvant chemotherapy versus primary debulking surgery in advanced ovarian cancer: Experience in Mexican population.
Authors: Dip Borunda Abdel Karim , Leon Rodriguez Eucario , Armengol Alonso Alejandra 
Published: March 2020

e15567 Background: Primary debulking surgery is considered the standard of treatment in advanced ovarian cancer (AOC) while neoadjuvant chemotherapy is used in non resectable stages. Methods: We retrospectively analyzed 68 AOC cases from January 2000 to December 2011. 35 received neoadjuvant chemotherapy (NAC) while 33 were resected primarily and received adjuvant chemotherapy (AC). To compare both groups we used T standard test and 2 sided chi -squared. Non parametric variables were analyzed with U Mann – Whitney. Overall survival(OS) was analyzed using Kaplan Meier method with log rank test. We considered statistically significant p<0.05. (SPSS v 17). Results: The median age was 60 (NAC) vs 53(AC) years respectively. The NAC group had more advanced stage disease (FIGO IIIC/IV stage; 71/29% vs 91/9%; p=0.04). The most frequent histologic subtype in both groups was serous - papillary and histologic grade was poorly differentiated in 71 vs 72% (p=0.41). At diagnosis the median levels of ca-125 were 1,896 U/ml for NAC group vs 768 U/ml for AC group (p=0.025). After the primary treatment received the median levels of ca – 125 were 29 U/ml vs 84 U/ml (p=0.76). Platin based chemotherapy was used in 95% vs 70% respectively. Complete resection of macroscopic disease was observed in 68% of NAC vs 63% in AC respectively. No statistical differences were observed in surgical time (median 192 min vs 204 min; p=0.55) and surgical bleeding (468 vs 510ml; p=0.79). Median survival time was 23 +/-26 months for neoadjuvant and 27+/- 35 months for primary surgery (p=0.56). In a subgroup analysis of patients who received 6 neoadjuvant cycles vs perioperatory chemotherapy (3 pre and 3 postoperatory) we observed a significant survival difference, with a median of 62 months (95% CI 12-38) vs 12 months (95% CI 54 – 178) respectively (p=0.010). Conclusions: Non inferior survival or differences in surgical outcomes were observed with neoadjuvant therapy. Significant survival increase was observed in patients who received complete chemotherapy schedule before surgery, this evidence allowed to design a prospective trial in our Institution.
Retrospective analysis of stage IIIc uterine carcinoma patients: A single center experience.
Authors: Yalcin Selim , Rahatli Samed , Kucukoztas Nadire , Ozen Ozlem , Haberal Nihan , Tarhan Cagla , Dursun Polat , Dizdar Omer , Yildiz Ferah , Altundag Ozden , Ayhan Ali 
Published: March 2020

e15572 Background: Stage IIIC comprises 8% of all endometrial cancers. Both local and systemic relapse risks are high. Current standard of care is adjuvant chemotherapy; however the addition of radiotherapy seems to improve outcomes in retrospective series but prospective data is lacking. We herein report outcomes of our patients with stage IIIC endometrial cancer operated and treated with adjuvant chemotherapy±radiotherapy. Methods: 29 patients with stage IIIC endometrial cancer diagnosed between 2006-2011 were included. Demographic features, tumor characteristics, treatment regimens and patient outcomes in terms of DFS and OS were analyzed. Results: Median age was 64 (41-82). Surgical procedure was TAH+BSO+BPPLND and omentectomy in 26 patients. 4 patients who were operated (TAH+BSO) in another center were restaged and BPPLND and omentectomy were performed. 13 patients (45%) had endometrioid histology, 11 (38%) had papillary serous carcinoma, 2 (7%) had clear cell carcinoma, 2 (7%) had mixed carcinoma and 1 (3%) had undifferentiated carcinoma. 6 patients had ovarian, 9 had uterine serosal involvement, 1 had positive cytology of abdominal washing, 18 (62%) had lymph node-only disease. 14 patients (48%) had positive nodes both in pelvic and paraaortic region, 9 (31%) only in pelvic region and 6 (21%) only in paraaortic region. 24 patients (83%) received chemotherapy with paclitaxel and carboplatin, 13 (45%) received external RT, 4 (14%) received brachytherapy and 3 (10%) patients received chemoradiation with weekly cisplatin or carboplatin. Median follow-up was 19 months. 10 patients recurred during follow-up and 6 patients died. All of the recurrences except one were intraabdominal. 3-year PFS was 64% and OS was 71.6%. Conclusions: With the use contemporary chemotherapy regimens and radiotherapy, we achieved ~70% 3-year survival rate in stage IIIC endometrial carcinoma patients with 45% of the patients having high risk histologies (serous and clear cell). We propose that combined adjuvant chemotherapy and radiation might improve survival in patients with advanced stage disease compared to either modality alone. Results of GOG258 and PORTEC 3 trials should be awaited for definitive conclusions.
In vitro chemoresponse assay results and population clinical response rates in women with ovarian cancer.
Authors: Richard Scott Daniel , McClure Candace , Leath Charles A. , Herzog Thomas J. , Gan Christine M. , Krivak Thomas C. , Cibull Michael , Coleman Robert L. 
Published: March 2020

e15578 Background: While platinum-based chemotherapies have been identified as the most effective agents in ovarian cancer, they are not effective in all women. An in vitro assay that determines whether platinum agents are likely to be effective for individual patients could have clinical utility. This study determines whether in vitro platinum sensitivity rates are similar to published population response rates for ovarian cancer and examines differences in platinum sensitivity across histologic subtypes. Methods: In vitro chemoresponse testing (ChemoFx, Precision Therapeutics, Pittsburgh, PA) was performed on tumors from 3,130 patients with primary or recurrent epithelial ovarian cancers. Histologic subtypes included serous, endometrioid, clear cell, and mucinous. Primary cancers, stages II-IV, were examined. Tumors were classified as responsive (R), intermediately responsive (IR), or non-responsive (NR) to chemotherapy. The rates of pan-resistance (Pan R), defined as non-responsive to all agents tested, was also examined in both primary and recurrent tumors. Statistical analyses were conducted using the Chi-square test with Bonferroni correction where appropriate. Results: Of 3,130 eligible patients, 2,335 had stage II-IV primary tumors (75%); the remaining 795 (25%) were recurrent. Overall, 77% of primary tumors were responsive (R or IR) to combination carboplatin/paclitaxel (CP). CP response rate was significantly different across histologic subtypes (p<0.001), with serous tumors exhibiting the highest response rate (79%). CP response was significantly greater in serous tumors (79%) when compared to mucinous tumors (65%; p=0.03). CP response was significantly greater in primary tumors (77%) when compared to recurrent tumors (65%)(p<0.001). In addition, the rate of pan R was significantly greater in recurrent tumors (26%) compared to primary tumors (15%)(p<0.001). Conclusions: ChemoFx response rates to PC are consistent with expected population response rates. As anticipated, more aggressive histologic subtypes were less responsive to CP in vitro. These data suggest that the ChemoFx assay provides tumor-specific information that may assist in chemotherapy decision making.
Toll-like receptor 7 and 9 (TLR 7 and TLR 9) expression in biopsies of in situ cervical cancer.
Authors: Moreno-Eutimio Mario Adan , Aragon-Franco Raul , Lopez-Macias Constantino , Silva Alejandro J. , Astudillo Horacio 
Published: March 2020

e15584 Background: In order to analyze the expression of TLR 7 and TLR 9 in cervix biopsies, we evaluated the expression of these TLRs in cervical carcinoma in situ tissue and peritumoral inflammatory tissue biopsies by immunohistochemistry. Methods: We reviewed 276 uterine cervix biopsies of Clinical Specialties Women's Health Directorate of the Ministry of National Defense (between 2009-2010); the biopsies have the following histopathological diagnosis: 124 CIN I, 68 CIN II, 34 CIN III, 21 invasive cancer and 29 cancer in situ. Results: It was observed that peritumoral inflammatory tissue receptor was expressed positively in 89.6% in cervical cancer tissue in situ, the receptor was expressed positively in 68.9% and the negative expression was 31.1%, proving that in the peritumoral inflammatory tissue compared with in situ cervical cancer was increased expression of TLR 7. In the case of the expression of TLR 9, peritumoral inflammatory tissue, expressed positively in 24 samples and 5 samples were negative expression in the tissue in situ cervical cancer samples identified 20 positive and 9 negative samples. By analyzing the intensity of the expression of TLR 7 in cervical cancer tissue in situ, we found 16 samples with focal positive (+), 3 samples with diffuse positive (+ +) and 1 sample with positive (+ + + ), while in peritumoral inflammatory tissue found 13 samples with focal positive (+), 10 samples with diffuse positive (+ +) and 3 samples with positive results (+++). By analyzing the intensity of the expression of TLR 9 in cervical cancer tissue in situ, we found 14 samples with focal positive (+), 5 samples with diffuse positive (+ +) and 1 sample with positive (+), in contrast to the peritumoral inflammatory tissue was found 7 samples with focal positive (+), 13 samples tested positive diffuse (+ +) and 4 samples with positive results (+++). Conclusions: These results show that no significant difference between the expression of TLR 7 () and TLR 9 () in the peritumoral inflammatory tissue and tissue in situ cervical cancer found a decrease in the expression of TLR 7 and TLR 9 in tissue in situ cervical cancer compared with the expression in the peritumoral tissue inflammation.
Neuroendocrine carcinoma of the cervix: A single institution’s experience.
Authors: Preston Megan , McCann Georgia Anne-Lee , O'Malley David M. , Boutsicaris Christina , Copeland Larry J. , Cohn David E. , Fowler Jeffrey , Salani Ritu , Eisenhauer Eric Lawernce 
Published: March 2020

e15585 Background: Neuroendocrine carcinomas (NEC) of the cervix comprise only 2% of all cervical cancers. As a result, prospective data is limited and treatment guidelines rely on literature from lung NEC. The objective of this study was to examine and report on our experience in the management of this rare, aggressive disease. Methods: This was an IRB-approved, single-institution, retrospective review. Study criteria included patients with cervical NEC diagnosed between 1990-2011. Demographic, treatment and survival data was collected. Progression-free survival (PFS) and overall survival (OS) was defined as the time from date of initial treatment until progression or death respectively, or date of last contact. Results: A total of 24 patients met inclusion criteria. The median age at diagnosis was 43. Median PFS was 13.6 months and median OS was 16.4 months. The majority of patients had advanced-stage disease (61% stage II-IV, 39% stage I). Of the 9 patients with stage I disease, 4 were treated with platinum + etoposide-based neoadjuvant chemotherapy and 5 were treated with initial radical surgery. Seven of the 9 patients had post-operative adjuvant therapy consisting of chemotherapy, chemo-radiation or radiation only. Seven of the 9 patients (78%) were alive at last follow-up. Of the two patients who were deceased, one had metastatic disease found at surgery and the other declined adjuvant therapy and died of recurrence. Patients with stage II-IV disease (n=15) had a median PFS and OS of 11.5 and 12.1 months, respectively. Only 2 had no evidence of disease at last encounter. The remainder died without achieving remission. Patients with metastatic disease had significantly worse survival when compared to those with loco-regional disease with a median OS of 8 vs. 28 months (p = .03), respectively. Conclusions: We report one of the largest single-institution experiences of neuroendocrine cervical cancer. Advanced-stage patients had a poor prognosis regardless of therapy. However, multi-modality therapy in early-stage disease resulted in an excellent prognosis (78% survival) for these rare, highly aggressive tumors. These findings support the goal of curative intent for early-stage disease using multi-modality therapy.
Cisplatin (CDDP) and radiation versus cetuximab (Cx) and radiation in locally advanced head and neck squamous cell cancer (SCHNC): A retrospective review.
Authors: Peddi Prakash , Shi Runhua , Panu Lori , Ampil Fred , Nathan Cherie-Ann , Armaghany Tannaz , Mills Glenn Morris , Jafri Syed Hasan Raza 
Published: March 2020

e16009 Background: SCHNC is a common malignancy and approximately 60% of patients present with locally advanced disease. There is paucity of data directly comparing Cx and CDDP with concurrent radiation in locally advanced SCHNC. We retrospectively reviewed charts of patients treated with CDDP and/or Cx along with radiation in locally advanced SCHNC comparing efficacy and outcomes in an academic cancer center. Methods: Ninety-five patients with locally advanced SCHNC were treated with concurrent CDDP (100 mg/m2 day 1, 22, 43) or Cx (400mg/m2 on day -7 and 250mg/m2 weekly) at our institution between January 2006 and June 2011. Forty-four patients were treated with CDDP (group A), 24 with Cx (group B) and 27 were initially started on CDDP but were switched to Cx secondary to toxicity (group C). All patients received concurrent radiation treatments (66-70 Gy, 2.0 Gy/fraction). The selection of CDDP versus Cx was largely based on ECOG performance status (PS) and baseline renal function of the patients. Chi-square test, analysis of variance, and log-rank test was used for analysis. The three groups had similar baseline characteristics except for mean age of 61, 56 and 55 years in group A, B and C respectively; T4 tumors consisted of 44%, 75% and 41% in groups A, B and C respectively. Groups A, B and C had a combined ECOG 0 and I (PS) of 93%, 75% and 92%. Patients with ECOG III PS were excluded. Results: Oropharynx was the most common treated site (38%) followed by Larynx (35%). Complete response (CR) was seen in 77%, 17% and 67% in groups A, B and C respectively (P<0.001). Median progression free survival (PFS) was 16.6, 4.3 and 22.8 in groups A, B and C respectively (P<0.001) and median overall survival (OS) was >35, 11.6 and >32 months in groups A, B and C respectively (P<0.0001). Conclusions: Concurrent CDDP with radiation leads to better response rate PFS and OS as opposed to Cx though many patients treated with CDDP could not complete treatment due to toxicity. Randomized trial comparing the two should be considered.
A comparative study of monoclonal antibody against EGFR (nimotuzumab) used in combination with chemoradiation versus chemoradiation alone in the treatment of locally advanced inoperable squamous cell carcinoma of the head and neck.
Authors: Bhatnagar Aseem Rai , Singh Dharam Pal , Sharma Rameshwaram , Sharma Om Prakash , Sharma Shantanu , Gupta Shivani , Kumbhaj Prashant 
Published: March 2020

e16012 Background: To determine the efficacy, safety and tolerability of concurrent Nimotuzumab (monoclonal antibody against epidermal growth factor receptor) used in combination with chemoradiation versus chemoradiation (CRT) alone in advanced inoperable squamous cell carcinoma of the head and neck (SCCHN). Methods: 56 patients were randomly assigned to either of the two treatment arms, nimotuzumab + CRT arm and CRT alone arm. Both arms received concurrent cisplatin 30 mg/m2 repeated weekly for 6-7 cycles along with external beam radiotherapy 64-70 Gy (200cGy/day for 5 days a week for 6-7 weeks). Nimotuzumab arm additionally received nimotuzumab 200 mg weekly for 6-7 cycles. The patients were followed for 6 months after completion of CRT. The study end points were tumor response evaluation according to the RECIST Criteria version 1.1 and safety analysis using RTOG Acute Radiation Morbidity Scoring Criteria. Patients were evaluated weekly with hematologic tests and for adverse events like mucositis and dermatitis during the CRT. Tumor assessment was performed with clinical and endoscopic methods regularly during the CRT and then at 1 month, 3 month and 6 month interval after CRT. One MR imaging was done before starting the CRT to evaluate the baseline tumor characteristics and another was done after the completion of CRT either at 3 months or 6 months or at both the intervals. Results: 25 patients each were evaluable in both the arms who completed the 6 months study. The overall response rate (complete response + partial response) was 96% in Nimotuzumab + CRT arm whereas it was only 72% in CRT alone arm after 6 months of completion of CRT, which is statistically significant (p-value = 0.0206 by chi square test). Additionally, nimotuzumab did not potentiate toxicities of CRT and there was no significant difference in the acute radiation mucositis, dermatitis or hematological toxicities in both the groups (p-value>>0.05). Conclusions: Nimotuzumab can be safely added to the standard CRT treatment for advanced inoperable SCCHN, to achieve better tumor response without potentiating toxicity.
A French national network for rare head and neck cancers (REFCOR).
Authors: Baujat Bertrand , Baglin Anne Catherine , Chabolle Frederic , Costes Martineau Valerie , Janot Francois , Testelin Sylvie , Thariat Juliette , Reyt Emile ,   REFCOR Collaborative Group
Published: March 2020

e16013 Background: Squamous cell carcinomas of upper aerodigestive tract and endemic undifferenciated nasopharyngeal carcinomas are the most frequent head and neck (H&N) cancers. Apart from these two entities, malignant H&N tumors are uncommon due to their location and/or their histological type. They account for 10% of H&N cancers (around 2,000 new cases/year in France). The rarity of these cancers limits the progress in all aspects. Treatments are based on low level scientific proofs. In most histological types, chemotherapy is uneffective. Prognosis is usually threatening. It was necessary to federate medical centers at a national level to enhance epidemiological knowledge, quality of patient management and to promote research projects. Methods: Structuration of the network included: 2008-2009: 4 working groups to edit recommandations of good practice in diagnosis and treatment of sinus cancers, salivary glands cancers, ear cancers, upper aerodigestive tract non squamous cell carcinoma cancers; 2009: A national database including sociodemographical, clinical, epidemiological, histological and follow-up data; 2009: Organization of biorepositories; 2010: A national group of expert pathologists for diagnosis advice (telepathology); 2011: Specialized multidisciplinary clinics at regional and national levels. Results: To date, 783 patients were included in the database by 29 centers. Tumor sites were sinus/nasal fossa (53%), Salivary glands (28%), Upper aerodigestive tract (18%), ear (1%). Stage at diagnosis repartition was 15% stage I, 24% stage II, 17% stage III, 44% stage IV. Main histological types are adenocarcinoma (17%), Adenoid Cystic carcinoma (9%), mucoepidermoid carcinoma (5%), muquous melanoma (5%). 337 biospecimens are referenced. Conclusions: The majority of french centers involved in H&N cancers treatment contribute to this project. This network is a unique tool for improving the knowledge of rare H&N tumors. Ongoing epidemiological studies will shortly be published. Translational studies based on biospecimens will follow. Collaboration with other networks such as the Salivary Gland Tumors Biorepository could be useful in the next future. Funding source: French National Institute of Cancer (INCa).
LIHNCS trial: Lugol's iodine in head and neck cancer surgery.
Authors: Dunn Janet A , Kulkarni Raghav , Gouldesbrough David , Mehanna Hisham , McMahon Jeremy McMahon , Shaw Richard , McCaul James Anthony 
Published: March 2020

e16042 Background: Residual dysplasia at margins of mucosal tumour resection is a cause of disease failure. While risk of transformation of dysplasia is difficult to assess, malignant cells within a field of dysplastic change indicate high transformation potential of this dysplastic field. Lugol's iodine assists in the assessment of surgical margins at tumour resection to ensure removal of margin dysplasia where present and resectable using the surrogate biomarker of glycogen storage. This multicenter RCT assesses efficacy of this technique in head and neck cancer surgery and is recruiting over the next two years. Methods: Patients undergoing primary surgery for oral cavity and oropharynx squamous carcinoma are randomised to gold standard surgical resection or to resection guided by Lugol's iodine application. Mucosal surfaces are irrigated with saline, carbocisteine solution applied to remove surface mucus and then irrigated with Lugol's iodine solution. Where present, adjacent visible surface dyplasia is resected with the tumour specimen. Histopathologists are blinded to the technique used. Histopathology is repeated centrally for quality control. Margin status is assessed for involved, close and clear for carcinoma and for presence of dysplasia at margins. Quality of life data are collected at baseline, six weeks, six, twelve and 24 months. Results: Our cohort study of 100 cases showed a reduction in margin dyplasia from 32% to 4% p<0.001. A feasibility pilot trial recruited 98 patients with 100% consent and data collection rates. Recruitment is progressing on schedule and at time of writing two sites are open. Forty six patients have consented in four sites and are included in the trial to date. A further 12 sites are in the trial set up process. We will report our interim data regarding sites open, screened and consented rates and outcomes so far. Conclusions: To date recruitment is on schedule. We have demonstrated the acceptability of the trial and techniques therein to both patients and surgeons. This is a promising technique which may modify head and neck cancer surgery by targeting dysplasia for inclusion at time of resection of primary cancer. Thus locoregional recurrence may be reduced in a proportion of patients undergoing curative surgical resection.