bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of oral cancers referred for NACT, the demographics, clinical profile, and organ functions.
Authors: Rath Sushmita , Patil Vijay Maruti , Noronha Vanita , Joshi Amit , Bhosale Bharatsinha Baburao , Punatar Snehal , Poladia Bhavesh , Sahu Arvind , Juvekar S , Chaturvedi Pankaj , D'cruz Anil K , Prabhash Kumar 
Published: March 2020

e12520 Background: The use of neoadjuvant chemotherapy(NACT) in head & neck cancers is not well defined. Very few publications on this topic deal with the epidemiology ,clinical & biochemical profile. These factors have an important say in deciding the choice of regimen. Methods: An prospective analysis of oral cavity cancer patients ,who were referred for NACT at our center, was done. The analysis focussed on the demographics, clinical & biochemical parameters of these patients at presentation . Results: From 2010-2012 , 528 patients of oral cavity cancers were referred for NACT from the multidisciplinary clinic. The median age of patients was 45 years (22-78 years) ; 10.4% were above the age of 60 years and 83.7% were males. Only 16.5% of patients were from the city in which the hospital was located. 69.1% were tobacco users, 53.8% were smokers , 37.5% were alcoholic & 81.5% had in addition other local tobacco containing chewable preparations. Only 2.65% denied any addictions. Amongst the symptoms pain, facical swelling,oral ulcer , oral bleeding, foul smell, trismus & weight loss were present in 41.9%, 72.5%, 57.6% , 72.5% , 77.1%, 41.4% & 49.4% respectively. The ECOG performance status were 0,1,2 in 8.3%, 84.7%, 2.7% patients respectively. The subsite of the disease were buccal mucosa,tongue, floor of mouth, alveolus, hard palate in 67.8%, 24.4% ,4.7% , 0.9% ,1.1% respectively. 65.3% & 16.7% patients were in T4a and T4b stage. N2b(42%) and N2c (31.4% )were the most common N stage seen. All patients had stage IV disease. Comorbidites like diabetes mellitus, hypertension and cardiac disease were seen in 22.3%, 18.9% & 13.3%. The median BMI was 21.45 Kg/m2 & 24.3% had BMI below 18.5 Kg/m2 (severly malnourished). The need for NACT was mainly due to extensive disease ,edema reaching upto zygoma and edema upto hyoid bone .The regimens administered were TPF in 6.6% and Taxane with Platinum in rest others. The major reasons for not selecting TPF were logistics (75%) & malnourished status (25%). Conclusions: Patients referred for NACT at our center had locally advanced disease,nearly all were addicts, one fourth had severe malnourishment & current standard TPF could be administered in only a few of them.
Evaluation of chemotherapy benefit in patients who continue to smoke: Preliminary experience.
Authors: Jirillo Antonio , Rescigno Paola , Mazurek Magdalena , Trojniak Marta Paulina , di Maggio Antonio , Imbevaro Silvia 
Published: March 2020

e12534 Background: The smoking continuation during chemotherapy treatments affects positive results. As reported for instance by Mazza et al. in the review "Taking care of smoker cancer patients: a review and some recommendations" (Ann Oncol. 21(7):1404-9, 2010), nicotin seems to inhibit the potential of cisplatin in determining tumor cell death (Int J Oral Maxillofac Surg 2007; 36: 739–744), while some new anti-cancer drugs can give an excellent response only in people who have never smoked (Proc Natl Acad Sci U S A 2004; 101(36): 13306–13311). Methods: It is an observational monoistitutional analysis. The analysis covered 886 patients undergoing chemotherapy at the Veneto Oncology Institute of Padua during an observation period of six years (from 2006 to 2011). We have been taken into account all patients included in the Onco-AIFA national register for the monitoring of innovative anticancer drugs, focusing on the three big killer diseases: colon and rectum cancer (40% of the sample analyzed), lung cancer (36%) and breast cancer (24%). The Kaplen-Meier method was used to analyze the overall survival data. Results: Among the information collected, the aspect of smoking was taken into account: it was possible to extract the data for about half of the patients (n = 473), 48% of whom were non-smokers, 31% were smokers and the remaining 21% ex-smokers. Although there are three types of cancer that have three different natural histories, the study revealed that being a smoker or ex-smoker is a determinant of the OS of patients: in particular non-smokers showed a median survival of 27 months, ex-smokers of 18 and smokers of 13 (p <0.001). Conclusions: It should be noted then, that in the entirety of the sample smoking continuation reduces survival. Therefore, in addition to an increased risk, there is a reduced benefit in terms of clinical conditions and response since tobacco reduces the effects of anticancer chemotherapy. That being so, although the data are still preliminary, every effort must be made to ensure that a patient stops smoking during chemotherapy treatments as it has been demonstrated that the ex-smokers live an average 6 months longer.
Mammographic findings in locally advanced breast carcinoma treated with neoadjuvant chemotherapy.
Authors: Castañeda Carlos , Flores Raymundo , Rojas Katerin Ingrid , Flores Claudio J , Morante Zaida , Pacheco Christian , Ruiz Rossana Esther , Calderon Gabriela , Gomez Henry Leonidas , Vidaurre Tatiana 
Published: March 2020

e12538 Background: Breast Cancer (BC) is a heterogeneous disease. Mammograpy images of BC has been associated with tumor features. We evaluated relationship between radiologic features of pre-neoadjuvant chemotherapy (NAC) lesions and clinico pathological tumor features. Methods: We evaluated mammography films and clinicopathological information of BC patient who received NAC followed by tumor resection at Instituto Nacional de Enfermedades Neoplásicas from 2000 to 2011. Results: 495 BC cases were selected. Most cases were staged in clinical Tumor size stage 4 (48.2%) and node stage 1 (58.7%); and had a GIII histological grade (51.2%). Breast density (BD) was classified as BIRADS grade 1 in 17%, grade 2 in 22%, grade 3 in 35% and grade 4 in 25.3%. High BD has been associated to younger age (p<0.001) and obesity (p=0.012). An association between mammographic rounded shape and triple-negative (TN) phenotype was found (p=0.002). An association between the dusty microcalcification and HER2 group as well as between the casting and the TN BC group (p=0.001) is found. NAC included anthracyclines and taxanes in 422 (85.4%) cases. Four and 5 Miller Payne pathologic response (pR) in the primary lesion and absence of axilary lymph nodes involvement were found in14.8% of the whole population, and in 10.5% of luminal cases, 17.7% of HER2- enriched and 23% of TN BC. pCR was associated to patient age (p<0.001), tumor grade (p<0.001) and high breast density (p=0.001), as well as better DFS (p=0.05). Conclusions: Radiographic images are related to tumor features in pre-NAC BC cases. pCR is associated to high density breast as well as previously described clinicopathological features.
Risk of colorectal cancer and endoscopic screening in families of patients with hereditary nonpolyposis syndrome of colorectal cancer.
Authors: Belev Nicodim F. , Mindruta-Stratan Rodica , Iarovoi Diana , Kazubskaya Tatiana , Brega Diana 
Published: March 2020

e12543 Background: Relatives of patients with hereditary nonpolyposis colorectal cancer (HNPCC) have an elevated risk of colorectal cancer (CRC) and adenomas. To determine the efficacy of endoscopic screening among relatives of patients with HNPCC syndrome. Methods: 50 relatives of the first and 17 relatives of the second-degree relatives of 127 families of patients with HNPCC syndrome was subjected to endoscopic screening (colonoscopy). Results: The analysis of cancer register database of families, which includes clinical and genealogical information about 1,505 patients with colorectal cancer (CRC) and 407 with the primary multiple malignant neoplasms (PMMN), found 127 (6.6%) families, which are consistent with Amsterdam criteria of HNPCC. Among the 1057 first-degree relatives malignancies were detected in 238 (22.5±2.7%). The CRC among of the first degree relatives of patients with HNPCC syndrome was identified in 118 (11.2±2.9%), which is 20 times the population frequencies (0.56±0.004%) (p<0.001). The frequency of aggregation of PMMN and adenomas of the colon was 1.8±3.1% (19) è 0.6% (6), respectively. Prevalence of PMMN in the general population is 0.009±0.0005%, and adenomas - 4.7±1.4%. From 809 of first degree relatives 50 were available for the survey, and from the 924 second degree relatives - 20. The endoscopic screening of first degree relatives found the presence of different pathology in 35(60.0%±8.3%) surveyed persons, including CRC – at 19(38.0±11.4%) (p<0.01), primary multiple colorectal cancer – at 6(12.0±14.5%), adenomas - at 5(10.0%). Among the surveyed second degree relatives the pathology was identified at 8(40±18.5%), primary multiple colorectal cancer at 3(15.0%), and adenomas of the colon – at 5(25%). Conclusions: Colonoscopy is an effective method for identifying malignant and benign tumors of the colon at relatives in the families of patients with HNPCC syndrome. A high percentage of cancer detected in these families need to refine the survey mode in order to identify early forms of cancer and its secondary prevention.
Molecular profiles of screen-detected breast cancers from a Turkish breast cancer screening program.
Authors: Cabioglu Neslihan , Ozkan Gurdal Sibel , Kayhan Arda , Ozaydin Nilufer , Aribal Erkin , Ozmen Vahit 
Published: March 2020

e12545 Background: TurkishBahcesehir Breast Cancer Screening Project is a 10-year organized population based screening program carried out in one of the largest counties in Istanbul, Turkey. The aim of this study is to determine the biological features of screen detected breast cancers detected during the initial 4-year study period as an interim analysis. Methods: Between January 2009 and December 2012, a total of 5938 women with ages 40–69 years were recruited in this prospective study. Two-view mammographies were obtained by 2-year intervals, and classified according to Breast Imaging Reporting and Data System of the American College of Radiology (ACR). Patient and tumor characteristics were analysed for those diagnosed with breast cancer. Tumors were stained for estrogen (ER) and progesterone receptors (PR), HER2-neu and Ki-67 by immunohistochemistry. Results: A total of 49 breast cancers (% 0.83) were detected during the study period. The median age was 50 (40-70). The majority of patients (78%) were stage 0 or 1, whereas 23 patients (47%) were <50 age. Of 49 tumors, 38 (78%) were invasive cancers and 11 (22%) were ductal carcinoma in situ. Forty-four patients (90%) underwent breast conservation, whereas 35 patients (75%) had sentinel lymph node biopsy. Of 38 invasive cancers, 24 (63%) were ductal carcinoma and 8 (21%) were lobular cacinoma. Among 31 invasive cancers stained for ER, PR, HER2-neu and Ki67, the majority of them (92%) were hormone receptor positive, whereas 13% were HER2-neu positive and 58% had low Ki67 levels (<14). As molecular subtypes, the majority of them were found to be either luminal A (48%) or luminal B type (42%), whereas other nonluminal HER2 (7%) and triple negative cancers (3%) were less frequently detected. Conclusions: Our findings suggest that the majority of screen-detected breast cancers exhibit either luminal A or B subtype. However, more aggressive subtypes such as nonluminal HER2-neu or triple negative cancers are less likely to be detected by mammographic screening programs, requiring other preventive strategies.
Evaluating the hidden biology of cancer of unknown primary (CUP) in comparison to known metastatic disease.
Authors: Hannouf Malek Bassam , Mahmud Salah , Winquist Eric , Brackstone Muriel , Zaric Gregory S 
Published: March 2020

e12549 Background: No consensus exists yet on whether CUP is a group of metastatic tumours with undetected primary sites or a unique clinicopathological entity with distinct genetic and phenotypic characteristics. We aimed to characterize the clinical and pathologic features of a cohort of CUP patients who had their latent primary site subsequently detected during their life or at autopsy in comparison to a cohort of patient presented with metastatic known primary cancers at initial diagnosis. Methods: We used historical snapshot files available in the Manitoba Cancer Registry (MCR) to identify all patients diagnosed with histologically or cytologically confirmed metastatic tumours in Manitoba during the period from January 1, 2002 to December 31, 2012. We linked all identified patients with their updated tumour-specific files available in the MCR for the purpose of identifying our two study cohorts. The first cohort included all patients who were initially diagnosed with CUP and who had their latent primary cancer identified and confirmed using either histology, cytology or autopsy at least 2 months after their initial CUP diagnosis. The second cohort included all patients initially diagnosed with a metastatic known primary cancer and whose cancer diagnosis did not change during lifetime or at autopsy. Information on patient and tumour characteristics was obtained from the MCR. Results: Out of 16,085 patients diagnosed with metastatic tumours, 2654 (%16.5) patients were initially diagnosed with CUP and 13,431 (84.5%) patients diagnosed with metastases of a known primary cancer. Out of the CUP group, 1033 (39%) patients had their latent primary site subsequently detected. Distribution of primary sites did not differ significantly between CUP patients who had their latent primary detected and patients diagnosed with metastases of a known primary cancer (p=0.44, Wilcoxon rank sum test). With the exception of tumour size, all other patient and tumour characteristics did not differ significantly between the two study cohorts across primary tumour sites. Conclusions: The clinical and pathologic features of CUP patient do not appear to be fundamentally different from those with metastatic known primary cancers.
An epidemiologic study of lifestyle of cancer patients presenting at National Hospital and Cancer Research Centre Pvt. Ltd., Jawalakhel, Nepal.
Authors: Pun Rashmey , Acharya Sandhya Chapagain , Piya Madan Kumar 
Published: March 2020

e12572 Background: Nepal being one of the economically challenged developing countries has been lagging behind in all healthcare facilities. Cancer is now emerging as a major Non-communicable (NCD) disease accounting for 9% of all NCDs. Lack of preventive measures, screening and awareness programme is hindrance in the early diagnosis. Hence, we aimed to study the epidemiological variables of various cancers so that risk factors can be identified. Methods: A Prospective, observational, cross sectional study was conducted from July 2012 to December 2012 for a period of six months. All patients with histological diagnosis of cancer attending the National Hospital and Cancer Research Centre were enrolled. A Questionnaire was formed in English and patients were asked to answer the questionnaire. Results: Out of 142 patients diagnosed with cancer, 22 different types of cancer were noticed and the most common was lung cancer in both sex with 28% incidence followed by breast 18%, gynecological cancer 15%, colorectal 9%, hepatobillary 9%, gastrointestinal 8%, lymphoma 6%, Head and neck 4%. Out of them, 61% were females and 39% were males and 96% of patient were married. The most common age group at diagnosis was 41-60 years and comprised of 42% of total. About 37% of the patient earned their living by agriculture. About 44% of the patient has annual income of over USD 2500. The most common ethnic group with cancer was identified as Newar with 48% prevalence of cancer. About 36% of the patients were illiterate, 20% are literate. Total of 51% of the patient were smoker, 19% are taking alcohol till recently and 27% consume alcohol occasionally. Only 9% of the patient are vegetarian and the 91% non-vegetarian group mostly eat red meat. Significant number (64%) of the patient is consuming the commercial, canned food. Very few patients are aware of exercise (22%) and meditation (11%). Conclusions: This is a single institution study and with lots of limitation. However, this can be used to find risk factors associated with our ethnic and cultural variation and thus a multicentric study is advisable to formulate National level preventive and screening programme.
Glioblastoma and increased survival with longer chemotherapy duration.
Authors: Abou-Jaoude Dory , Moore Joseph A , Moore Matthew B , Twumasi-Ankrah Philip , Ablah Elizabeth , Moore Dennis F. , Moore Dennis F 
Published: March 2020

e13006 Background: The 5-year survival for patients (pts) with glioblastoma (GBM) is low at approximately 3%. Radiotherapy plus concomitant and adjuvant temozolomide (TMZ) remain the standard of care. The optimal duration of therapy with TMZ is unknown, though treatment periods of 6 months (mo), 12 mo and longer have been utilized. Whether or not there is a benefit with longer treatment duration is controversial. Methods: A retrospective chart review of all pts diagnosed with GBM who were treated at a regional referral center was conducted with data obtained from their electronic medical records. These pts were treated with TMZ for up to 2 years between January 1, 2002 and December 31, 2011. Survival was calculated as the time from initial surgical diagnosis until death. The Kaplan-Meier method with log-rank test was used to estimate the progression-free survival (PFS) as well as the overall survival (OS) distribution of pts after treatment. The results were compared to historical controls and data from previous clinical trials of pts treated up to 1 year. Results: Data from 56 pts were evaluated, the majority of whom had gross total resection and had external pathology review confirming the diagnosis of GBM. The OS probability was 55.4% (SE = 0.068) at 1 year, 26.9% (SE = 0.067) at 2 years and 20.1% (SE = 0.065) at 3 years. The median PFS time in this study group was 8 mo (95% CI = 4.0 – 9.0 mo). The probability of no progression at 2 years was 8.6% (SE = 0.05). Seven pts (12.5%) were treated with TMZ for 2 years. The probability of disease progression at 2 years among these pts was 33.3% with a median time-to-progression of 20 mo (95% CI = 5.0-28.0). These patients showed an increased survival probability at 3 years compared to pts who did not receive the 2 year treatment of TMZ (log-rank test Chi-square = 12.4, p = 0.0004). Conclusions: This analysis suggests that there may be an advantage for a longer duration of TMZ therapy in pts with GBM. In this review, treatment with TMZ for 2 years was associated with an increased survival benefit. While we consider the sample size to be too small for generalization, a prospective/multicenter study with a larger sample size might better evaluate the question of duration of TMZ therapy, particularly if both clinical and basic science data are paired.
Potential biomarkers for pseudoprogression in malignant glioma.
Authors: Momota Hiroyuki , Fujii Masazumi , Motomura Kazuya , Natsume Atsushi , Wakabayashi Toshihiko 
Published: March 2020

e13012 Background: Pseudoprogression (psPD) is defined as an increase of enhancing lesions on MRI without a real advancement of the disease, and it occurs in up to 20% of glioma patients who have been treated with temozolomide chemoradiotherapy. However, there are no reliable methods to distinguish psPD from true progression. Methods: To elucidate the utility of immunophenotypic markers in predicting psPD, we retrospectively investigated 21 consecutive patients with malignant glioma operated between August 2007 and December 2010 and treated with temozolomide therapy. Immunostaining for CD44, CD68, EGFR, and p53 was used to determine the immunophenotypic profile of these gliomas. Immunohistochemical scoring was made as follows: weak CD44 staining (1 point), weak CD68 staining (1 point), no strong EGFR staining (1 point), and strong p53 staining (1 point). Results: Fourteen glioblastomas (GBMs), 2 glioblastomas with oligodendroglioma component (GBMOs), and 5 anaplastic oligodendrogliomas (AOs) were included in this study. psPD occurred in 6 patients (3 GBMs, 1 GBMO, and 2AOs). In our scoring system, 2 tumors obtained 4 points and these tumors showed psPD (100%), 5 tumors obtained 3 points and 2 psPDs occured (40%), 5 tumors obtained 2 points and 2 psPDs occured (40%), and 9 tumors obtained 1 or 0 point and no tumors had psPD (0%). Median overall survial time was 36.3 mo in patients with psPD and 18.1 mo in patients without psPD, but there was no significant difference between the groups. Conclusions: Our study demonstrates that psPD can be predicted by simple immunohistochemical scoring method. In this scoring system, the sensitivity for psPD is 100% in patients with high score (4 points), 40% in patients with medium score (2–3 points), and 0% in patients with low score (0–1 point). Careful follow-up is needed after chemoradiation therapy in glioma patients with high to medium score.
Association of the development of bone metastases with the development of brain metastases in patients with non-small cell lung cancer.
Authors: Salem Mohamed , Elson Paul , Pennell Nathan A. , Sukari Ammar , El-Refai Sherif , Ali Khaled B. , Gadgeel Shirish M. , Szerlip Nicholas , Wozniak Antoinette J. 
Published: March 2020

e13030 Background: In patients (pts) with non-small cell lung cancer (NSCLC), it is unknown whether pts with bone metastases are predisposed to the development of brain metastases. The impact of bevacizumab (Bev) on the development of bone and brain metastases is not fully characterized. Methods: Retrospective review of pts with stage IV NSCLC without brain metastasis at diagnosis was undertaken. The primary endpoint was to determine whether the development of bone metastases is predictive of the development of brain metastases. Secondary endpoints involved the proportion of pts who developed brain and/or bone metastases while being treated with Bev. Data were analyzed using competing risks methods. Results: A total of 175 pts (52% males, median (range) age: 60 y (35-80)) were studied. Of whom 79% received Bev and 21% did not receive Bev as part of their treatment. Overall 34% of pts had bone metastases at the start of therapy. Pts with pre-existing bone metastases tended to develop new bone disease more frequently than pts who did not initially have bone metastases (39% vs. 19%, p =. 01). The incidence of the development of brain metastases among pts who had pre-existing bone metastases was 17% vs.16 % in pts without pre-existing bone metastases. However, the incidence of brain metastases among pts with pre-existing bone disease who developed new bone metastases was 33% vs. 6% in pts who did not develop new bone disease but had pre-existing bone metastases. Adjusting for initial bone disease, development of new bone metastases was associated with a shorter brain metastases-free interval HR 5.06 (2.03-12.65; p = 0.005). In a subgroup analysis based on Bev exposure, the likelihood of developing brain and bone metastases within 2 years of starting Bev was estimated to be 25% and 27%, respectively, while the likelihood of developing brain and bone metastases without Bev treatment was 33% and 43 %, respectively. Conclusions: In pts with NSCLC, the development of new bone metastases may be indicative of the subsequent development of brain metastases. Additionally, Bev therapy may have an effect on the development of both bone and brain metastases. A prospective investigation may be warranted.