bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal cumulative cisplatin dose for radio-sensitization in locally advanced head and neck cancer.
Authors: Bhattacharjee Atanu , Noronha Vanita , Patil Vijay Maruti , Abhayankar Anuja , Joshi Amit , Menon Nandini Sharrel , Prabhash Kumar 
Published: May 2020

e18553 Background: Evidence to choose the optimum chemotherapy between weekly and 3 weekly cisplatin for prolonging the duration of progression free survival in head and neck squamous cell carcinoma (HNSCC) is equivocal. This urged us to look into the cumulative dose of chemotherapy rather than the frequency of administration i.e. weekly or 3 weekly. The aim of this study was to determine the optimal cumulative dose of cisplatin to improve the progression-free survival (PFS). Methods: Between January 2011 and January 2018, a total of 836 consecutive patients with histologically proven primary squamous cell carcinoma of the oral cavity, larynx, hypopharynx, and oropharynx were included. The effect of the cumulative dose on progression-free survival was studied to obtain the optimal cumulative dose of cisplatin. Results: A total of 11 cohorts were generated to represent the cumulative doses. The cumulative doses were measured at 30, 60, 90,120,150,180,200,210,240 and 300 mg/m2 respectively. The maximum duration of progression-free survival (PFS) was considered to define the best effective cumulative dose. Conclusions: This study confirms that a cumulative cisplatin dose of ~ 210 mg/m2 is optimum for increasing PFS in patients with head and neck cancer. Therefore, doses with weekly 30 mg/m2 for seven cycles or 3-weekly 70 mg/m2 for 3 cycles could be equally effective to prolong the PFS. Clinical trial information: CTRI/2012/10/003062, CTRI/2014/09/004980.
Insulin-like growth factors in the blood of patients with oral squamous cell carcinoma receiving therapy with monoclonal antibodies (cetuximab).
Authors: Lyanova Aza A. , Frantsiyants Elena M. , Vladimirova Liubov Yu , Neskubina Irina V. , Surikova Ekaterina I. , Engibaryan Marina A. , Abramova Natalia A. , Popova Irina L. , Tikhanovskaya Natalia M. , Teplyakova Maria A. , Novoselova Kristina A. , Ryadinskaya Ludmila A. , Myagkova Valeriya S , Fomenko Yuriy A. , Kit Oleg I. 
Published: May 2020

e18564 Background: IGF-1 and IGF-2 are powerful mitogenic factors with anti-apoptotic effect. Their overproduction leads to neoangiogenesis and metastasis. Monitoring the level of these factors can serve as a potential predictive tool. The purpose of the study was to study blood levels of IGF-1 and IGF-2 in patients with squamous cell carcinoma (SCC) of the oral cavity depending of the efficacy of chemotherapy (CT) and cetuximab. Methods: The study included 50 patients with squamous cell carcinoma of the oral cavity T3-4N0-1M0, stage III-IV. The main group (n = 30) received 2 CT cycles with cetuximab: cisplatin 100 mg/m2, intravenously, day 1, 5-fluorouracil 1000 mg/m2/day, intravenously, 96-hour continuous infusion, in combination with cetuximab 400 mg/m2 on day 1 in a loading dose, then 250 mg/m2 on days 8 and 15. The control group (n = 20) received 2 CT cycles: intravenous cisplatin 100 mg/m2 on day 1, intravenous 5-fluorouracil 1000 mg/m2/day, 96-hour continuous infusion on days 1-4. Results were compared with the values in 20 non-cancer donors. Levels of IGF-1 (mcg/L) and IGF-2 (ng/mL) were measured in the blood serum by ELISA using standard test systems (Mediagnost, Germany). Statistical analysis of results was performed using the Statistica 6.0 program (Stat-Soft, 2001). Results: Before treatment, levels of IGF-1 and IGF-2 in patients were lower than in donors by 53.5% and 20.3%, respectively. In patients with partial regression after CT, IGF-1 levels significantly increased by 33% (p < 0,05), compared to the values before treatment, while IGF-2 was both within donor and initial values and the IGF-1/IGF-2 ratio was similar to the initial level but 33.3% lower than in donors. The patients in the main group with partial regression normalized IGF-1 levels increasing it compared to initial values – by 87%. IGF-2 levels did not differ statistically significantly from the initial values and were 32.5% lower than in donors. The IGF-1/IGF-2 ratio was 58% higher than before treatment. Conclusions: CT and cetuximab normalized blood levels of IGF-1 in oral cancer patients with partial tumor regression.
Current trends in the management of lacrimal gland tumors: A National Cancer Database study.
Authors: Ashok Kumar Prashanth , Wang Dongliang , Sivapiragasam Abirami 
Published: May 2020

e18573 Background: Lacrimal Gland (LG) tumors are rare with data limited to very few comparative trials. The original treatment is Orbital Exenteration followed by Radiotherapy (RT). Contemporary strategies like orbit sparing surgeries and Neoadjuvant Intra-arterial Chemotherapy (CT) are gaining popularity but remains controversial given the paucity of data. Our aim was to determine the pathological distribution and compare the treatment modalities used in LG tumors with the help of a large national database. Methods: From the 2004-2016 National Cancer Database (NCDB), we included Epithelial LG tumors. We excluded Lymphomas, Melanomas, Sarcomas and other metastatic lesions. Descriptive statistics, Hazard Ratio (HR) estimates and Kaplan Meier (KM) survival analysis were used. Results: A total of 669 LG tumors were identified. The distribution based on Pathology and treatment strategies used is represented in the table. The point survival estimate comparison between the surgical types and the various treatment groups showed no significance. Conclusions: SCC was the most common histological type. There was no difference in the overall outcome between radical and orbit sparing procedures. Adjuvant RT and adjuvant chemoradiation did not confer any additional survival benefit over surgery alone. Mallen-St Clair et. using the SEER database (321 LG patients) showed that RT improves Disease Specific Survival in SCC. Moving forward, larger population-based studies and prospective trials are needed to determine the most ideal management option. The NCDB is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The data used in the study are derived from a de-identified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator. [Table: see text]
Mental distress and mental health services receipt in foreign-born survivors of cancer: A national health interview survey analysis.
Authors: Arega Melaku A , Dee Edward Christopher , Muralidhar Vinayak , Nguyen Paul L. , Franco Idalid Ivy , Sanford Nina Niu , Mahal Brandon Arvin Virgil 
Published: May 2020

e19001 Background: There is a greater burden of mental illness, in survivors of cancer compared with the general population. Though mental health interventions may reduce mental distress and improve subsequent oncological outcomes, there are disparities in mental health service (MHS) receipt in immigrant populations. Therefore, we examined contemporary patterns of mental distress and mental health service receipt by immigrant status in cancer survivors in the United States. Methods: Data are collected in non-institutionalized civilian adults by the US National Health Interview Survey. For this study, harmonized data of participants reporting a cancer diagnosis were extracted from the Integrated Health Interview Series from 2009-2018. Sample weight-adjusted estimates of mental distress were defined by the validated Kessler 6 (K6). MHS receipt in the past 12 months was estimated, stratified by K6 status. Multivariable logistic regression defined adjusted odds ratios (AOR) and 95% confidence intervals (95CI) for the odds of MHS receipt, with birth status (US vs. non-US) as the primary independent variable of interest. Results: Among 14,653 adult survivors of cancer and 207,018 adults without cancer, 4.16% vs. 3.01% had K6 >13, respectively (AOR 0.96, 95CI 0.87-1.07, P = 0.504). Among survivors of cancer, younger age, female sex, and white race were associated with K6>13, while factors associated with lower MHS receipt included non-US born status, non-white race, and older age. The distribution of severe mental illness (K6>13) did not differ by place of birth. However, non-US birth status was associated with lower MHS receipt among survivors of cancer with K6 < 13 (5.61% vs 8.15%, AOR 0.67, 95CI 0.49-0.92, P = 0.013), and there was a greater disparity among those with K6>13 (9.43% vs 37.8%, AOR 0.19, 95CI 0.08-0.45, P < 0.001) (Pinteraction= 0.002). Conclusions: In this large contemporary cross-sectional survey, though there was a similar distribution of mental distress in survivors of cancer based on birth status, non-US born adults with severe mental distress (K613) were 81% less likely to receive MHS relative to US born adults. These data suggest that immigrant survivors of cancer who suffer from severe mental distress may be a greater risk not receiving appropriate MHS, which could lead to subsequent adverse outcome. Given the demonstrated gap in use of MHS in non-US born adults with cancer and severe mental distress, increased efforts are needed to screen for mental illness and the need for MHS in immigrant populations.
Differences in real-world liver cancer treatment patterns among people living with HIV/AIDS (PLWHA) compared to those without HIV/AIDS (PWoHA).
Authors: Falkenstein Angelica , Klink Andrew J. , Gajra Ajeet 
Published: May 2020

e19010 Background: Antiretroviral therapy (ART) has brought life expectancy among PLWHA on par with PWoHA, but the disparity in cancer incidence and mortality among PLWHA remains high. Hepatocellular carcinoma (HCC) is 4 times more common in PLWHA and an important cause of mortality. Guidelines now support treatment and management of cancer among PLWHA to follow those for PWoHA, but PLWHA have been excluded from registrational trials of novel agents. This study aimed to assess real-word differences in demographics and systemic therapy patterns for HCC among PLWHA and PWoHA. Methods: Adult patients with ≥2 claims for HCC between 1/1/13-12/31/18 (earliest claim = index date), ≥3 months data pre/post index date, and no evidence of clinical trial participation, pregnancy or other malignancy prior to index date were identified from Symphony Health longitudinal prescription and medical claims. Patient characteristics and treatment patterns were summarized by descriptive statistics, and comparisons across HIV status were made on univariate analyses. Times to discontinuation were estimated by Kaplan-Meier method and compared by log-rank tests. Results: There were 9,904 HCC PWoHA who received systemic therapy. Of 862 PLWHA with HCC, 162 (19%) received systemic therapy. PLWHA differed significantly from PwoHA: median age at diagnosis (60 v 63 years), male preponderance (84% v 71%), geography (Northeast, 41% v 19%; West, 22% v 45%), Charlson Comorbidity Score (median 7 v 1), depression (11% v 6%), chronic pulmonary disease (20% v 12%), liver disease (66% v 52%) and kidney disease (17% v 7%, all P< 0.05), respectively. First line (1L) therapy differed among PLWHA and PWoHA: sorafenib (34% v 25%), everolimus (1% v 4%), and doxorubicin-based regimens (42% v 33%; all P< 0.05). IOs were used in 1L and 2L among 584 (6%) and 223 (15%) of PWoHA and among 8 (5%) and 6 (19%) PLWHA, respectively (all P> 0.05). Median times from 1L start to 2L were numerically shorter among PLWHA and PWoHA (4.7 v 5.5 months; P= 0.77). The minority of patients among PLWHA and PWoHA continued onto 2L (20% and 15%, P> 0.05) and 3L (7% and 3%, P< 0.01), respectively. Conclusions: HCC is diagnosed at younger age among PLWHA v PWoHA. Important differences in comorbid disease burden in addition to HIV can impact clinical decision making in PLWHA. Future real-world research is needed to understand disparities in outcomes of PLWHA and develop guidelines specific to this group.
Material, psychological, and behavioral financial hardship and prostate cancer treatment type.
Authors: Tucker-Seeley Reginald , Tang Weizhou , Brown Colony , Bearse Jamie 
Published: May 2020

e19013 Background: A prostate cancer diagnosis can have a significant financial impact on the family; and, the various treatment options present a variety of economic consequences. Treatments can present short- and long-term sequelae leading to additional therapies, and the costs for the household can vary depending on the type of treatment received. Cancer survivorship research has shown that many survivors experience financial hardship following diagnosis. Financial hardship has recently been conceptualized in cancer survivorship research across three domains: material, psychological, and behavioral. The material domain refers to the lack of financial resources (e.g. material hardship), the psychological domain refers to how one feels about the lack of financial resources (e.g. financial worry), and the behavioral domain captures the financial adjustments made in response to a lack of financial resources. The purpose of this study was to investigate the association between the material, psychological, and behavioral domains of financial hardship and the type of prostate cancer treatment received. Methods: The prostate cancer non-profit organization, ZERO - The End of Prostate Cancer, conducted an online “Prostate Cancer Education Survey” to determine information needs among individuals diagnosed with prostate cancer (N = 1,000). We used bivariate tests and simple and adjusted multivariable logistic regression models to test the association between financial hardship and the type of treatment received. Results: The results revealed no statistically significant differences across the treatment types for material hardship. Patients who received chemotherapy and primary hormone therapy had higher odds (OR = 1.84; CI: 1.01-3.33) of reporting psychological hardship compared to those reporting active surveillance/watchful waiting; and those reporting active surveillance/watchful waiting had higher odds (OR = 1.50; CI: 1.07-2.11) of reporting psychological hardship compared to those reporting surgery. Patients who received chemotherapy also had higher odds (OR = 2.52; CI: 1.30-4.88) of reporting behavioral hardship compared to those reporting active surveillance/watchful waiting treatment. Conclusions: Explicating the material, psychological, and behavioral correlates of prostate cancer treatment types provides greater specificity for potential intervention targets where programs can be designed for reducing specific types of financial hardship following prostate cancer diagnosis and during survivorship.
Racial and socioeconomic disparities in the treatment of resectable hepatocellular carcinoma.
Authors: Rho Young soo , Pagano Ian , Acoba Jared David 
Published: May 2020

e19026 Background: Cancer surgeries performed at high case volume centers (hCVCs) are associated with improved surgical and clinical outcomes. Resectable hepatocellular carcinoma (rHCC) is not common in the US and the impact of surgery at hCVCs has not been well assessed. We analyzed the impact of surgery at hCVCs on survival, and the potential racial and socioeconomic disparities associated with obtaining care at hCVCs. Methods: We collected demographic, diagnostic, treatment, and survival data of 96,215 patients with stage I-III HCC diagnosed between 2004 – 2015 from the National Cancer Database. To estimate the average surgical volume/year, number of reported cases were divided by the number of years the facility was represented in the database. Logistic regression was used to determine the associations between case volume, facility type and the demographic and clinical variables. We assessed demographic and clinical predictors of overall survival (OS) using Cox proportional hazards regression. Results: In total, 10,419 resected HCC patients were included in the analysis. The median age was 64 (18 – 90), 68.4% were male and 69.5% were white. Facilities were divided into quartiles by average number of surgical CV/year: 1st quartile (1Q) 0.08-1.60, 2Q 1.61 – 3.91, 3Q 3.92 – 8.34, and 4Q 8.35 – 45.34. In a multivariate model, improved OS was seen with each increase in quartiles with the highest CVCs (i.e 4Q) HR 0.70 (95% CI 0.63 – 0.77). Treatment at academic centers did not show an OS advantage (HR 0.93; 95% CI 0.86 – 1.01). Factors including black race (OR 0.83; 95% CI 0.75-0.93), age 65+ (OR 0.91; 95% CI 0.82 – 1.00), and living in a metro area with a population of 250,000 – 1 million people (OR 0.68; 95% CI 0.62 – 0.74) were less likely to be associated with treatment at hCVCs. Conversely, Asians/Pacific Islanders (OR 2.28; 95% CI 2.04 – 2.55) and those with private insurance (OR 1.33; 95% CI 1.18– 1.40) or Medicare (OR 1.21; 95% CI 1.05 – 1.38) were more likely to be treated at hCVCs. Conclusions: rHCC is not common in the US and having surgery at hCVCs improves OS. However, racial and socioeconomic disparities exist in receiving care at these hCVCs.
Incidence of colon cancer in younger population and lower incidence in Asians and females in central balley of California: Health disparity and epigenetic study model.
Authors: Sodavarapu Soujanya , McGrew Tyler , Hobbins Mark , Haddad Sami , Ramdass Prakash , Obad Nashwan , Gill Amandeep Singh , Vyas Dinesh 
Published: May 2020

e19028 Background: California acts as a boiling pot for immigration and the perfect ecosystem to study epigenetic changes from dietary and environmental factors in various ethnicities. It has a significant immigrant population, with approximately a quarter of the 40 million residents being foreign-born. The impact of migration on colon cancer incidences over time has not yet been characterized on a broad-scale level in the Northern Central Valley. This provides a unique opportunity to study the influence of migration, socio-economic gradient, environmental, and racial identity on the incidence of cancer in a subset of California’s San Joaquin County Population. Colon cancer affects around 100,000 annually, with white and African Americans being more often affected than Asians or Hispanics. Methods: This study is a retrospective, single-institution study that compared the socio-demographic variables and clinical characteristics of the patients who had a history of colon cancer in an academic central valley institution. We reviewed all the patient charts with a diagnosis of colon cancer from 2014-2019 and compared the age, demographics, socioeconomic status, comorbidities, pathology, treatment, and outcomes in the population. Appropriate statistics have been used for analyzing the data. Results: A retrospective chart review of all patients diagnosed with colon cancer from our Hospital from 2014-2019 which revealed that 23.9% of patients were younger than 50 years at diagnosis, and mean age of diagnosis is 56.6 years, compared to the national average where younger population constituted at 11% and mean age for men and women are 68 years and 72 years respectively. 36.5% were 50-60 years old, and 39.2% were > 60 years old. Women constituted 31% in our group compared to compared to 35.6% nationally. Asians are 23% of the central California population, but only 11.4% of patients in our group of colon cancer patients were Asian/pacific islanders, with 6.4% being average weight. 36.7% of patients have obesity. 67.4% were > 25 BMI, of which 12.8% were younger Hispanics with BMI 25-30. Adenocarcinoma is seen in 91.4% of patients. Conclusions: The younger population with male predominance is seen. Asians see a surge in colon cancer incidence, but the incidence rate is still lower. Epigenetic, western lifestyle, and environmental are responsible factors. Younger overweight Hispanics are increasing in number as well. We will present further subgroup analysis at presentation.
Impact of US population demographic changes on projected incident cancer cases from 2019 to 2045 in three major cancer types.
Authors: Nguyen Jimmy , Napalkov Pavel , Richie Nicole , Arndorfer Stella , Zivkovic Marko , Surinach Andy 
Published: May 2020

e19044 Background: The United States (US) Census Bureau has forecasted an unprecedented shift in the US demographics by 2045, in which there will be no single majority race/ethnicity. Due to well-characterized health disparities among different races/ethnicities in oncology and projected demographic changes, it is of interest to assess changes in the burden of three most frequent cancers: breast cancer (BC) for women, prostate cancer (PC) for men, and colorectal cancer (CRC) for both genders between 2019 and 2045. Methods: Historical age-adjusted rates (AARs) for BC in women, PC in men, and CRC in patients of all ages and stratified by race/ethnicity were collected from the SEER 18 database for 2000-15 period. AARs for cancers of interest were analyzed in Joinpoint Regression Program to obtain an average annual percent change (AAPC) for 2000-15. AARs were then projected to 2045 by assuming the rate behavior is equal to the AAPC. Projected absolute cases per 100,000 were generated by multiplying projected AARs with the associated projected population, retrieved from the US Census Bureau 2017 National Population Projects, and dividing by 100,000. The absolute change in projected patient numbers of cancer cases by race/ethnicity were assessed between 2019 and 2045. Results: From 2019 to 2045, a decrease of 4% is expected in the White Non-Hispanic (WNH) population while the Black (B), Hispanic (H), and Asian/Pacific Islander (API) populations are projected to increase 24%, 54%, and 57%, respectively. In the same time period, the projected number of BC incident cases for women of all ages decreased by 1% in WNH while the B, WH, and API populations were projected to increase 72%, 98%, and 120%, respectively. In both genders of all ages, a 39% and 17% reduction in the number of CRC incident cases in the WNH and B is expected compared to a 61% and 11% increase in the WH and API populations, respectively. Given observed reduction in PC incidence, especially in men 65+, the number of incident PC cases is projected to decrease by 2045 for all included races/ethnicities. Conclusions: Among racial and ethnic minorities, an increase in the number of BC and CRC cases is expected between 2019 and 2045. Projected decrease in PC cases is likely a result of decrease in incidence rates between 2010 and 2015 and should be assessed as new data become available. Currently, racial and ethnic minorities comprise < 20% of patients enrolled in clinical trials, demonstrating the need to understand biologic and social underpinnings of disparities in clinical outcomes in underrepresented groups.