bluuebunny/crossref_metadata_2025_split huggingface dataset:
The advantages of circular stapling instrument compared with Albert-Lembert suture for anastomosis of Billroth I gastrectomy for gastric cancer
Authors: Imamura H. , Furukawa H. , Tatsuta M. , Kishimoto T. , Yamamoto K. , Yamamoto K. , Ohshiro R. 
Published: March 2020

14104 Background: In Japan, reconstruction with Billroth I using Albert-Lembert suture had been usually performed in distal gastrectomy for gastric cancer. However stapling instruments have within recent years gained wide acceptance not only in total gastrectomy but also in distal gastrectomy. We have introduced circular stapling instrument for anastomosis reconstructed with Billroth I since June 2001. Methods: 111 and 222 patients with gastric cancer underwent distal gastrectomy reconstructed with Billroth I using Albert-Lembert suture from June 1999 to May 2001 (Group A) and using circular stapling instrument from June 2001 to December 2003 (Group B) for anastmosis in our institute, respectively. Albert-Lembert suture was performed as end-to-end gastroduodenostomy followed by resection of proximal line stapled across with liner cutter instrument. The procedure of anastomosis using circular stapling instrument was as followed; the distal duodenum was clamped with the purse-string instrument, divided proximally, the anvil was attached, the purse-string was tied down, the circular stapler without anvil was inserted through a gastrotomy, brought out through a stab wound at the anastomosis site, the instrument was closed and fired, and gastrectomy involving the site of gastrotomy was closed with linear cutter instrument. The followed-up periods of all patients from surgery were more than 2 years. We retrospectively compared the incidence of anastomosis-related complications within 2 years from surgery consisting of anastomotic bleeding, leakage, and stenosis. P-values were calculated statistically using χ2-test. Results: Anastomotic bleeding occurred in 1 (0.45%) patient of Group B, but in none of Group A (P=0.48). Anastomotic leakage occurred in 2 patients (1.80%) of Group A, but in none of Group B (P=0.045). Anastomotic stenosis occurred in 2 patients (0.90%) of Group B, but in none of Group A (P=0.32). All complications were recovered and all patients left hospital in the safety. Conclusions: Our data indicated that circular stapling instrument for anastomosis of Billroth I gastrectomy for gastric cancer significantly reduced the incidence of anastomotic leakage compared with Albert-Lembert suture. No significant financial relationships to disclose.
A phase II trial of capecitabine and docetaxel in patients with previously treated pancreatic cancer
Authors: Lopes G. , Bastos B. , Ahn E. , Quesada J. A. , Allison M. , Flores A. , Ribeiro A. , Levi J. , Macintyre J. , Rocha-Lima C. M. 
Published: March 2020

14111 Background: There is no accepted standard treatment for patients with advanced pancreatic cancer who progress after gemcitabine-based therapy. Capecitabine and docetaxel have single-agent activity in pancreatic cancer and have documented synergy in both pre-clinical models and in the treatment of other solid tumors. Methods: A phase II trial with a 3-stage sequential design was planned to assess the efficacy (primary end-point: response rate) and toxicity of capecitabine 800 mg/m2 PO bid on days 1–14 in combination with docetaxel 30 mg/m2 IV on days 1 and 8 of each 21-day cycle in patients with advanced pancreatic cancer who failed first-line gemcitabine-based chemotherapy. If no responses are observed after 13 patients or less than 3 responses are seen after 26 patients, accrual will stop and the combination deemed ineffective. Results: Eight patients have been enrolled (5 women, 3 men). Median age was 67 years. ECOG PS was as follows: PS 1, three patients; PS 2, five patients. All patients had adequate organ function. A total of 26 cycles have been administered (median: 2 cycles, range 1 to 8). Four patients had stable disease (median duration 9 weeks, range 6 to 24), and 3 had progressed at the time of first evaluation (2 cycles). One patient has not yet completed 2 cycles and is therefore not assessable for radiologic response. Out of 7 patients with an elevated CA 19–9, four had a decrease of 50% or greater while on chemotherapy. Grade 1 or 2 toxicity was seen in 3 patients (diarrhea, 1 patient; fatigue, 2 patients). Grade 3 or 4 toxicity was as follows: fatigue, 2 patients; dehydration, 1 patient; neuropathy, 1 patient. There were no treatment related deaths. Enrollment continues. Efficacy data fulfilling the first stage sequential design should be available at the time of the meeting. Median survival for all patients is currently 13 weeks (range 7–23 weeks) Conclusions: Capecitabine in combination with docetaxel is a well-tolerated regimen in the treatment of patients with pancreatic cancer who have failed prior gemcitabine-based therapy. Four out of 8 patients have had stable disease. Four of 7 patients have had a decrease of 50% or greater in CA 19.9 levels. Enrollment continues. Median survival of 13 weeks underscores the poor prognosis of this patient population. [Table: see text]
A multicenter phase 2 consortium (P2C) study of triapine in patients (pts) with advanced adenocarcinoma of the pancreas
Authors: Groteluschen D. L. , Mahoney M. R. , Pitot H. C. , Laheru D. , Kolesar J. , Thomas J. P. , Erlichman C. , Holen K. D. 
Published: March 2020

14118 Background: Triapine is a small molecule iron chelator that has been shown to inhibit ribonucleotide reductase (RR) at the M2 subunit. Early trials suggested activity in pancreatic cancer. The P2C initiated a study of single agent Triapine as both first-line therapy and for pts with gemcitabine-refractory disease. Correlatives included: pharmacokinetics, MDR polymorphisms, and the effects of Triapine on cell cycle and electron paramagnetic resonance spectroscopy (EPR). Methods: Standard eligibility criteria were used, however, pts with G6PD deficiency were excluded. Triapine was given 96 mg/m2 IV over 2 hours, days 1–4 and 15–18, repeated q 28 days. Primary goals - evaluate survival (S) at 6 mos (previously untreated pts) and 4 mos (refractory pts). Interim analyses were planned when 28 previously untreated and 20 refractory pts were enrolled. Results: 14 eligible pts were enrolled in 10 mos (13 refractory, 9 male). The previously untreated pt received only 1 cycle secondary to progressive disease. Of the 13 refractory pts, 7 pts received at most 2 cycles; 6 received 1. Disease progression precluded further treatment in 11 pts. 6 pts had Gr 4 toxicities at least possibly related to drug, including: neutropenia-4, hyperkalemia-1, hyponatremia-1, leukopenia-1, thrombocytopenia-1, hypophosphatemia-1. 6 pts had a Gr 3 fatigue. One refractory patient expired on study. No responses were seen. Estimated 4 mos S in refractory pts is 16% (95% CI 3–94). EPR studies showed that Triapine led to a loss of the RR tyrosine radical EPR signal. Conclusions: Enrollment was suspended due to excess toxicity and lack of activity in pts refractory to gemcitabine. Correlative studies confirm the mechanism of action of Triapine as a chelating agent on RR. Supported by NCI Grant N01 CM17104 and the NCI Translational Research Fund. No significant financial relationships to disclose.
Concomitant chemoradiotherapy with orally used agents in locally advanced gastric carcinoma: Two years results
Authors: Akboru M. H. , Dincer S. T. , Yoney A. , Askaroglu B. , Unsal M. 
Published: March 2020

14127 Background: We designed a prospective study to evaluate tolerability, toxicity and effectiveness of concomitant chemoradiotherapy with oral tegafur-uracil (UFT) and leucovorin in locally advanced gastric carcinoma. 13 patients admitted to our center in 10 months of 2003 (March– December) were included. Methods: Only one of the patients was female (7.7%). Median age was 52 (34–72). All of them were operated with negative surgical margins (53.8% of them have undergone total gastrectomy and rest of them were operated subtotally). All of them have 0 and 1 performance status (ECOG). Their tumor were mostly located in antrum (53.8%). 4 (30.8%) of them in stage II and in stage IIIA, IIIB and IV were as follows: 2 (15.4%), 5 (38.5%) and 2 (15.4%). Median lymph node dissection was 14 (7–31). Median time interval between surgery and treatment was 49 days (25–63). All patients were treated 45 Gy (one patient 39.6 Gy and other patient 50.4 Gy) locoregional radiotherapy (RT) and UFT 300 mg/m2/day + leucovorin 90 mg/day in three times a day during RT. Results: All patients tolerated therapy well (RT was interrupted 3 times just in one patient because of grade III emesis). At the end of median two years follow up; recurrence was seen as metastasis in 4 (30.8%) patients and locoregional in 3 (23.1%). 8 patients (61.5%) died (one of them was not related). Median progression free survival was 17 months (6–34) with 53.8% in one year and 38.5% in two years. Median overall survival (OS) was 24 months (8–34), one and two years OS were 76.9% and 46.2%, respectively. Conclusions: Concomitant chemoradiotherapy with orally used agent (UFT and leucovorin) in locally advanced gastric carcinoma is well tolerated regimen. But to increase survival data by continuing therapy with these agent after chemoradiotherapy must be researched. To answer this question another study was conducted and is going on in our center. No significant financial relationships to disclose.
Outcome of advanced gastric cancer patients with disseminated intravascular coagulation and bone marrow metastasis is improved by weekly 24-Hour infusional high-dose 5-fluorouracil and leucovorin (HDFL)-based chemotherapy
Authors: Huang T. , Hsu C. , Cheng A. , Yeh K. 
Published: March 2020

14132 Background: Advanced gastric cancer (AGC) patients manifesting with acute disseminated intravascular coagulation (DIC) and diffuse bone marrow metastasis have inevitably led a fatal outcome within a median of 2–4 weeks. We previously reported that weekly 24-hour infusional high-dose 5-fluorouracil (5-FU) and leucovorin (LV) (HDFL: 5-FU of 2,000–2,600 mg/m2/wk and LV 300 mg/m2/wk) chemotherapy with negligible myelosuppression has been successfully used in the treatment of these patients (Yeh KH & Cheng AL, Br J Haematol 1998;100:769–72). The study planned to determine the treatment outcome in a larger group of this disease entity being treated with HDFL-based chemotherapy. Methods: This is a retrospective study. Bone marrow study is routinely done for gastric cancer patients with DIC in our institute. We searched for gastric cancer patients with DIC or bone marrow metastasis from 1994 to 2005. Results: A total of 21 AGC patients (M: 13, F: 8) who had unequivocal evidence of DIC or biopsy-proven bone marrow metastasis have been diagnosed at National Taiwan University Hospital between 1994 and 2005. At initial presentations, 18 patients had evident laboratory findings of DIC. Nine of them had symptomatic DIC and 8 patients had significant thrombocytopenia (< 50,000/mm3). All patients received HDFL-based chemotherapy as the initial treatment. Seventeen of them showed significant improvement in both clinical symptoms and laboratory abnormalities of DIC. The median overall survival (OS) of the whole group of patients since the diagnosis of DIC or bone marrow metastasis was 7 months (range: 1 week–3 years). Conclusions: Manifestations with acute DIC and bone marrow metastasis in AGC patients constitute a rare disease entity with a grave prognosis. Before introduction of HDFL for the treatment of AGC at our institute, this group of patients was extremely difficult to treat, and usually died within 2–4 weeks. Current analysis revealed that OS of this group of patients has been improved up to a median of 7 months, suggesting a significant improvement in the treatment outcome. No significant financial relationships to disclose.
Docetaxel, 5-fluorouracil and nedaplatin as second-line chemotherapy for patients with esophageal cancer after esophagectomy: A pilot study
Authors: Mafune K. , Yamada K. , Imamura K. , Kubota K. , Kaminishi M. 
Published: March 2020

14140 Background: We investigated the combination of docetaxel, 5-fluorouracil (5FU) and cisplatin analog, nedaplatin (CDGP) as second-line chemotherapy after esophagectomy. Methods: Eight patients with recurrent esophageal cancer who had undergone adjuvant 5FU/cisplatin after esophagectomy were included this study (7 male, 1 female; median ECOG performance status: 1). Histologic type of all esophageal cancer was squamous cell carcinoma. Patients received docetaxel 60 mg/m2 on day 1, 5FU 600 mg/m2 on days 1–5, and CDGP60 mg/m2 on day 4 every 3 weeks. A total of 17 chemotherapy cycles was administered. The median number of cycles was 2 (range 1–5). Results: The overall response rate was 62.5%. The median overall survival was 42 weeks, and the median progression-free survival was 26 weeks. Hematological and non-hematological toxicities were moderate (neutropenia WHO grade III/IV: 62.5%, alopecia grade II/III: 75%, nausea/vomiting grade II/III: 50%, neurotoxicity grade II: 12.5%). Conclusions: The combination of docetaxel, 5FU and CDGP is an active regimen with moderate toxicity in the treatment of patients with recurrent esophageal cancer. This pilot study suggests the feasibility of a combination treatment containing a taxan, 5FU and cisplatin or its analog in esophageal squmaous cell carcinoma. No significant financial relationships to disclose.
Outcomes of hepatocellular carcinoma
Authors: Yildirim Y. , Ozyilkan O. , Akcali Z. , Remzi E. , Sevmis S. , Demirhan B. , Bilezikci B. , Karakayali H. , Haberal M. 
Published: March 2020

14141 Background: Hepatocelluler carcinoma (HCC) related mortality remains high although recent advances in management in cancer therapy. Treatment options of HCC can be surgical resection, percutaneus alcohol injection (PAI), transcatheter arterial embolisation (TAE), radiofrequency ablation (RF), systemic chemotherapy or liver transplantation. However it is unclear how effective are these methods for treating HCC. Methods: We reviewed the treatment results of 56 patients diagnosed with HCC between 1996–2005. Local treatment (PAI or TAE) or systemic chemotherapy or curative surgery (resection or liver transplantation) or no therapy was applied. Our inclusion criteria for transplantation were (independent of tumor size and number of tumor nodules) no invasion of major vascular structures and no extrahepatic disease, negative surgical exploration including hilar lymph node frozen section. Kaplan-Meier survival analyses were used to evaluate outcome. Results: Median age at diagnosis was 57 years (range: 18–90). Of 56 patients 20 (35.7%) are alive, 14 (25%) are loss the follow-up and 22 (39.3%) are died. Sixty-eight percent of patients received therapy, and 32% received no specific therapy. Among patients who received therapy transplantation was the most common procedure (n: 18 patients, 47.4%). Three patients underwent surgery (70.9%); local therapies were applied 13 patients (34.2%). Twenty-three (46.4%) patients have single lesion in the liver, 27 (48.9%) patients have multiple lesions. No statistical difference was found in survival of patients with single lesion or multiple lesions (p > 0.05). Median follow-up of patients is 9 months (range: 1–41 months). Patients who underwent surgery or liver transplantation have statistically significant longer survival than patients treated with local therapies (PAI or TAE) (p < 0.01). Conclusion: HCC is a chemoresistant tumor. None of the used chemotherapy regimen demonstrated marked benefit in survival. Complete surgical excision can be curative but only small percentage of HCCs are resectable at the time of diagnosis. However liver transplantation in selected patients can cure both HCC and underlying cirrhosis. Expanded criteria for liver transplantation in our clinic seems to be beneficial on this disease. No significant financial relationships to disclose.
Low dose mitomycin c, capecitabine & radiation for HIV patients with anal squamous cell carcinoma
Authors: Wadleigh R. , Dinh K. , Manning J. , Kuntz A. , Dorn R. 
Published: March 2020

14148 Background: Chemoradiotherapy has replaced radical surgery as the initial treatment of choice for anal squamous cell carcinoma (ASCC). Optimal chemotherapy regimen for ASCC in HIV positive patients is not yet defined. The addition of mitomycin C to 5-FU and radiotherapy in the past improves local control, colostomy-free, and even disease-free survival in large tumors. The concern is hematologic toxicity if use in HIV positive patients. We report 2 cases safely using low dose mitomycin C, capecitabine and concurrent XRT. One of these patients has ESRD, which the use of cisplatin is not an option. Methods: 2 HIV positive patients, (CD4 range 106–113, at diagnosis of ASCC) were treated with low dose of mitomycin C on day 1 for 2 cycles (5mg flat dose), day 1–7 capecitabine titrated up to 1.5 gm/m2 divided b.i.d, and concurrent XRT (total dose 5040 cGy). Prior to treatment, 1 patient was diagnosed with squamous cell carcinoma in-situ and the other with stage 1 squamous cell carcinoma. 1 patient has end stage renal disease with SCr between 10 and 12 mg/dl at the time of treatment. Results: Both patients completed treatment. No grade 3 or 4 hematologic or gastrointestinal toxicities were noted. No hand-foot syndrome was observed probably due to low dose of capecitabine. Both patients are still alive and remain in remission (16–18 months post treatment). Conclusions: Our 2 cases suggest that the use of low dose mitomycin C in addition to capecitabine and XRT is well tolerated and is efficacious in HIV-positive patients with ASCC. No significant financial relationships to disclose.
Oxaliplatin, 5-fluorouracil, and folinic acid as first-line chemotherapy for elderly patients with advanced gastric cancer
Authors: Choi I. , Lee K. , Oh D. , Kim J. , Lee S. , Kim D. , Im S. , Kim T. , Heo D. , Bang Y. 
Published: March 2020

14155 Background: We investigated the efficacy and safety of an oxaliplatin, 5-fluorouracil (5-FU), and folinic acid (FA) as first-line chemotherapy for elderly patients with advanced gastric cancer. Methods: Chemotherapy-naïve patients (≥65 yr of age) with histologically confirmed, locally advanced or recurrent/metastatic gastric cancer were studied. Chemotherapy consisted of oxaliplatin 100 mg/m2 and FA 100 mg/m2 (2-hour intravenous infusion), then 5-FU 2400 mg/m2 (46-hour continuous infusion) every 14 days. Results: A total of 24 patients were enrolled between September 2003 and July 2005. Of 22 evaluable patients, none achieved complete response (CR) and 11 achieved partial response (PR), resulting in an overall response rate of 50%. Median progression-free survival (PFS) was 5.4 months (95% CI: 5.1–5.8 months) and median overall survival (OS) was 7.4 months (95% CI: 4.4–10.4 months). The main toxicities were anemia and leucopenia, which were observed in 39.8% and 19.0%, respectively, of the total cycles administered. There were 2 cycles of grade 4 leucopenia and febrile neutropenia was not observed. Conclusions: This oxaliplatin/5-FU/FA regimen shows good efficacy and an acceptable toxicity profile in elderly patients with advanced gastric cancer. No significant financial relationships to disclose.
A phase II trial of gemcitabine and docetaxel in hormone-refractory metastatic prostate cancer
Authors: Thakkar S. , Hutson T. , Garcia J. , Rothaermal J. , Bart M. , Dreicer R. 
Published: March 2020

14501 Background: Docetaxel is a microtubule stabilizing agent with demonstrated ability to improve survival in patients (pts) with hormone refractory metastatic prostate cancer (HRMPC). Gemcitabine is a nucleoside analogue that exhibits broad antitumor activity, although as a single agent has modest activity in advanced prostate cancer. The combination of docetaxel and gemcitabine has demonstrated significant activity in a variety of chemotherapy resistant neoplasms. We performed a phase II study of this combination to assess its safety and antitumor activity in chemotherapy naïve patients with HRMPC. Methods: Eligible pts had HRMPC with radiologic and/or biochemical evidence of progression following antiandrogen withdrawal with castrate testosterone levels, ECOG PS 0–2 and adequate organ function; no prior chemotherapy was permitted. Gemcitabine (800 mg/m2) was administered on days 1 and 8 and docetaxel (75mg/m2) on day 8 every 21 days for a maximum of 6 cycles. Results: Twenty-nine pts have been enrolled to date with 22 currently evaluable for response, all are evaluable for toxicity. The median age was 68. The average number of cycles completed was 4.9. Nine pts have experienced grade 4 neutropenia (1 neutropenic fever admission). Twelve of 29 pts have required dose delays secondary to wbc or platelets, two pts have required dose modification. Non-hematologic grade 3/4 toxicities include 1 pt with a PE, 1 grade 4 dyspnea, 1 grade 4 GI bleed. Four pts (18%) achieved measurable disease + PSA, partial response (PR), 7 (32%) additional pts had >50% decline in PSA, for a composite overall response rate of 50%. Conclusions: The combination of gemcitabine and docetaxel is moderately toxic primarily impacting bone marrow reserve. Although there is evidence of significant antitumor activity, the ulitmiate utility of this doublet remains undefined. Accrual to this study is ongoing. [Table: see text]
Safety and efficacy of intravesical bacillus Calmette-Guérin instillations in steroid-treated and immunocompromised patients
Authors: Yossepowitch O. , Eggener S. E. , Bochner B. H. , Donat S. M. , Herr H. W. , Dalbagni G. 
Published: March 2020

14507 Background: We assess the safety and efficacy of intravesical bacillus Calmette-Guérin (BCG) for high-risk superficial bladder cancer in steroid-treated and immunocompromised patients. Methods: We retrospectively reviewed charts of 697 patients treated with BCG instillations from 1991 to 2004. In 24 patients (3.5%), either an underlying comorbidity directly affecting the immune system was diagnosed before BCG administration, or steroids were administered at least 6 weeks before and at the time of BCG instillations. The immunosuppressive effect of the steroids was assessed by percentage of lymphocytes. End-points were BCG response at 6 months (defined as normal cystoscopy, cytology, and biopsy when available) and treatment-related toxicity. Results: Four patients (17%) had an active lymphoma or chronic lymphocytic leukemia during administration of BCG, and 21 (88%) had a concurrent condition for which oral steroids (11 patients), inhaled steroids (14 patients), or both (4 patients) were administered. Patients treated with oral steroids had a lower percentage of lymphocytes (12.3%) compared to patients treated with inhaled steroids (17.5%) or 15 age-matched patients with high-risk superficial bladder cancer and no steroid treatment (18.6%). The overall BCG response rate at 6 months was 58%. Of the 24 patients, 10 had disease recurrence and 3 had disease progression at a median follow-up of 63.5 months (IQR 19.5, 89). One patient treated with oral steroids developed a self-limited febrile disease and worsening of myalgia 48 hours after his third BCG cycle. No other systemic adverse event following BCG therapy was recorded, and all patients completed their scheduled treatments. Conclusions: Intravesical BCG is a viable therapeutic option for patients with high-risk superficial bladder cancer and concomitant lymphoma or chronic lymphocytic leukemia, treatment with low-dose oral steroids, or treatment with inhaled steroids. The BCG response rate at 6 months and the side effects profile associated with BCG therapy in these patients are comparable to patients with no evidence of immunosuppression. Further studies are warranted to assess the safety and efficacy of BCG instillations in critically immunocompromised patients. No significant financial relationships to disclose.