bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does 18-fluorodeoxyglucose (FDG) uptake by positron emission tomography/computed tomography (PET/CT) predict survival in advanced pancreatic cancer? A single-institution experience.
Authors: Ashraf Noman , Razzaque Saqib , Weber Jill M. , Malafa Mokenge Peter , Kim Richard D. 
Published: March 2020

e14715 Background: Pancreatic cancer is associated with a poor prognosis. Histological grade, stage and serum tumor markers are well established prognostic factors for survival. Some studies suggest that 18-fluorodeoxyglucose (FDG) uptake by positron emission tomography/computed tomography (PET/CT) correlates with survival in pancreatic cancer. In this study, we aimed to determine whether standardized uptake value (SUV), a measure of FDG uptake by fusion PET/CT, had prognostic significance in patients with advanced pancreatic cancer. Methods: Using a comprehensive pancreatic cancer database at H. Lee Moffitt Cancer Center, we identified patients who underwent PET/CT scan as initial workup for resection but were found to have advanced disease (stages III and IV) when surgery was attempted. Data from January 2006 to December 2010 was retrospectively analyzed and correlated with the maximum SUV determined by PET/CT. Other prognostic factors including stage, age, gender, serum tumor marker CA 19-9 levels and the use of chemotherapy were also evaluated using multivariate analysis. Results: We identified 41 consecutive patients who were deemed resectable by virtue of staging workup with CT, PET/CT and endoscopic ultrasound (EUS), but found to have locally advanced/metastatic disease intra-operatively. At the time of analysis, there were a total of 30 deaths. Twelve patients had metastatic disease and 29 had stage III pancreatic cancer. SUV uptake ranged from 2.9 to 16.2 with a mean of 6.4. Median overall survival for the 28 patients with SUV less than or equal to the mean (≤ 6.4) was 14 months (95% confidence interval 10 – 25 months) vs. 9.1 months for the 13 patients with SUV > 6.4 (95% confidence interval 4-17 months). This difference was not statistically significant (p=0.178). On multivariate analysis, use of chemotherapy was the only independent predictor of survival. Conclusions: Glucose uptake by PET/CT, reflected by SUV, was not found to be a predictor of survival in patients with advanced pancreatic cancer. The retrospective nature and limited sample size are limitations of our study, however further research is warranted.
Intensity modulation of chemoimmunotherapy for late stages of liver carcinoma.
Authors: Yu Baofa , Ma ZhenLu , Guan Changjiang , Han Wei , Che Yebin , Fu Qiang ,   Shandong Baofa Cancer Therapeutic Groups
Published: March 2020

e14716 Background: Provenge (Dendreon Co.) is an autologous cellular vaccine and represents a significant milestone for cancer immunotherapy and generates renewed interest in the field. Chemoimmunotherapy as a highly attractive way for cancer treatment has been studied over years but this is not generated a specific powerful immunotherapy yet. Intensity Modulation of Chemoimmunotherapy (IMCIT) is similarly with Provenge function and plays in kill tumor cells and induces patient’s own immunological effect against micro size cancers more than just Introtumoral Chemotherapy(ITCT) alone. Methods: Introtumoral injection of IMCIT into late stages of liver Cancer (447 cases) which is a proprietary therapeutic regimen composed of three components for intensity modulation of chemoimmunotherapy, i.e., an oxidant, a cytotoxic drug and a hapten. Results: After intratumoral injection, coagulate tumor mass for sustained drug release and drug kills tumor cells, a small molecule hapten binds to these antigens and other large carriers for intensity modulation, then autologous tumor antigens released from the dead tumor cells and trigger immune response as a self-vaccination to further boost systemic humoral and cellular immunity for suppression and eradication of tumor recurrence. For single liver tumor, 6 months survival rate for IMCIT 63.03% and ITCT 36.17%(p<0.01), 12 months survival rate for IMCIT 32.77% and ITCT 21.28% (P.0.05);for mutable liver tumors, 6 months survival rate for IMCIT 54.44% and ITCT 20.93%(p<0.01),12 months survival rate for IMCIT 21.11% and ITCT 6.98%(p<0.05). Therefore, more importantly, IMCIT provides a new option for cancer treatment by integrating local chemotherapeutic effect with systemic anti-tumor immunity; cell death induced by chemotherapeutic drugs is a priming event and allows the injected tumor act as its own vaccine. Conclusions: Introtumoral injection of IMCIT is a safe, aggressive and cost-effective clinical treatment for solid tumors. IMCIT displays the following advantages: clinically effective for single and multiple masses liver cancer and minimal side effects and better quality of life; simple and cost-effective treatment and strong intellectual property position..
Totally laparoscopic pancreaticoduodenectomy: Learning curve.
Authors: Khatkov Igor , Tsvirkun Viktor , Izrailov Roman , Tiutiunnik Pavel 
Published: March 2020

e14717 Background: Laparoscopic pancreaticoduodenectomy (LPDE) has become increasingly popular in the world and now is considered to be a technically feasible and safe procedure for patients with tumors of the head of the pancreas and the periampullare area. At the same time, according to the literature data, a lot of surgeons stop performing totally laparoscopic pancreaticoduodenectomy (TLPDE) after 5 – 15 procedures because of the difficulties of learning curve. Aim of thew study: to evaluate the learning curve of totally laparoscopic pancreaticoduodenectomy. Methods: The data of 43 patients who were planed for LPDE during 5 year were analyzed. All the procedures were performed by one surgical team. 35 patients underwent totally laparoscopic pancreaticoduodenectomy (TLPDE). For 8 patients the procedures were palliative or converted. Patients were divided in three groups. Group A, B and C – 12;12;11 patients respectively. Operative time, intraoperative blood loss and the level of postoperative morbidity were examined. Results: Among the 43 patients, 35 patients underwent TLPDE. The conversion rate was in the group A - 33% (4 patients), group B – 33%(4 patients) and group C – no conversions. Mean operative time of TLPDE for the group A was - 542min; group B – 542min and group C less than 360min, minimally - 280). Mean blood loss was for group A - 683ml, group B – 612ml and group C 250ml. Total level of all kinds of postoperative morbidity was: group A - 66,5%, group B – 65,5% and group C – 36,0%. Postoperative mortality was: group A - 8,3%(one of the patients died from insufficiency of the pancreatojejenostomy, another – because of acute heart failure without any surgical complications); group B – 0% and group C - 0%. Conclusions: The results of TLPDE become significantly better after 25 procedures. The most difficult and potentially dangerous for intra and postoperative complications were: dissection along superior mesenteric and portal vein and suturing of pancreaticojejuno anastomosis. Performing TLPDE by the same team, including nurses, is a very important factor for quick learning curve and safety.
I-131-lipiodol therapy in local disease control and survival in patients with advanced hepatocellular carcinoma: An observational study.
Authors: Kallur Kumar G. , Aditi Bhatt , Prashanth Gothlu Ramachandra , Sridhar Papaiah Susheela , Indushekar Subbanna , Govindarajan Mallarajapatna , Nagaraj Kanakapura Ramanna , Gopinath Kodaganur Srinivasachar , Diwakar Ravi B , Patil Shekhar , S Ramesh Bilimagga , Somorat Bhattacharjee , Ajaikumar Basavalinga S. 
Published: March 2020

e14721 Background: In patients with Locally advanced/metastatic HCC, the median survival is 3 months. Most of these patients have altered liver functions which makes them unsuitable for any therapy. In this exploratory study we aim to test the effectiveness of I-131-lipiodol in prolonging survival in these patients. Methods: 15 patients with locally advanced HCC (unresectable) and metastatic HCC with altered liver functions (CHILDS B and C) were given I-131-lipiodol. Patients had received prior chemotherapy, prior TACE therapy, prior sorafenib and had treatment refractory progressive disease. We compared effects of I-131-Lipiodol in prolonging survival beyond three months in these patients. We performed a non parametric one sample kolmogorov Smirnov test comparing survival with I-131-lipiodol to an average 90 days survival reported in patients with advanced HCC. Results: Survival ranged from 46 to 417 days with a median survival of 144 days. However one sample test showed significant improvement in survival with I-131-lipiodol therapy compared to standard of care (z = 1.4, p = 0.04). Conclusions: I-131-lipiodol is a useful local therapy in management of patients with advanced HCC, randomized controlled trials are needed to validate its findings in adjuvant and palliative settings.
Comparison of efficacy between irinotecan and paclitaxel monotherapy as second- or third-line chemotherapy after S-1 containing regimen for advanced or recurrent gastric cancer.
Authors: Kusumoto Tetsuya , Oki Eiji , Hiroshige Shoji , Hashimoto Kenkichi , Suzuki Kousuke , Hirashita Teijiro , Matsumoto Toshifumi , Takeuchi Hideya , Matsuura Hiroshi , Muto Yoichi , Maehara Yoshihiko 
Published: March 2020

e14722 Background: S-1 is effective and clinically important agent in the initial chemotherapy against advanced or recurrent gastric cancer (ARGC) in Asia. Although several prospective studies on the second-line chemotherapy for ARGC are currently in progress in Japan, the sufficient investigation on the proposition has not been made. We assessed here the clinical efficacy of irinotecan (CPT-11) and paclitaxel (PTX) as the second or thirdline chemotherapeutic agents following the S-1 based treatment, as those has been frequently used in practice. Methods: We conducted the retrospective review of the data of 30 patients with unresectable ARGC who received CPT-11 or PTX monotherapy after administration of S-1 as prior treatment. Each 15 patients were given chemotherapy including CPT-11 and PTX monotherapy treatments, after S-1 containing regimens, as second or third line treatments. The objective response, adverse events, progression-free survival (PFS), and overall survival (OS) were compared between CPT-11 and PTX monotherapy groups. Results: The similar data of the overall response rates (ORRs) were obtained between two groups. Survival data showed that the MST was 329 days and the median PFS was 220 days for the administration of CPT-11, compared with 297 days and 132 days in PTX group from the beginning of these drugs administration, were not significantly different. The OS was 707 days in CPT-11 group, compared with 751 days in PTX group, were not significantly different. Conclusions: There is no order of priority of regimens including CPT-11 or PTX after S-1 containing chemotherapy treatments. We believe that both awareness of the next line chemotherapy and the selection of drugs were important of survival prolongation for patients with ARGC.
Biliary tract cancer in a Moroccan medical oncology unit.
Authors: Bouyahia Nezar , Brahmi Sami Aziz , Chad Amine Mohammed , Daoudi Khaoula , Hijri Fatima Zahra , Ibrahimi Adil , EL Haoudi Khalid , Maazaz Khalid , Arifi Samia , Nawfel Mellas , El Mesbahi Omar 
Published: March 2020

e14726 Background: Biliary tract cancers (BTC) are relatively rare (3% of digestive cancers), they mainly affect older women and are located in the gallbladder in about 70% of the cases. Methods: In this retrospective study, we reviewed 63 cases of BTC admitted in the medical oncology unit of HASSAN II university center between January 2007 and December 2011. The aim of this study is to define epidemiologic, diagnostic and therapeutic aspects of this disease in a Moroccan population. Results: In our study, BTC account for 4,9% of digestive cancers. The mean age of our patients was 58,2 years ranged from 32 to 81 years, female gender represent 69%. The tumors were located in the gallbladder (GB) in 70% of the cases divided into adenocarcinoma (79%) and squamous cell carcinoma (21%). The other locations were hilar cholangiocarcinoma (24%) and intrahepatic cholangiocarcinoma (6%). Magnetic resonance cholangiographic was performed (n=15) and suspected cancer in all cases. Incidental finding of GB cancer at surgery was recorded in 21 patients: intraoperatively in 8 cases or after pathological study in 13 cases. Staging of the disease was divided into localized stage (7%), locally advanced stage (13%) and metastatic stage (80%). A complete surgery in GB cancer was performed in 13 patients, a palliative surgery was done in 20 patients: cholecystectomy (n=7) and biliary drainage (n=13). For metastatic patients (n=44), a palliative chemotherapy was administred as following: combination of cisplatin and gemcitabin (n=18), gemcitabin (n=7), combination of cisplatin and 5 fluoro uracile (n=5), combination of oxaliplatin and gemcitabin (n=3), capecitabine (n=3), FUFOL Mayo clinic (n=2) and combination of capecitabine and oxaliplatin (n=2). While 9% of the patients received supportive care because of their comorbidities and the deterioration of the performans status and liver blood tests. Conclusions: Because of the silent evolution of BTC, the diagnosis is therefore delayed, the prognosis is poor and treatment is usually palliative. Our results are consistent with those of the literature concerning the epidemiological finding and diagnosis aspects.A multidisciplinary approach is recommended to improve the prognosis of patients with BTC.
Prognosis and patterns of failure after curative pancreaticoduodenectomy for early-stage ampullary adenocarcinomas.
Authors: Ribeiro Adriana Regina G. , Silva Milton Jose B , Costa Wilson Luiz , Maia Joyce Maria L. , Padua Fernando Vidigal , Diniz Alessandro Landskron , Ribeiro Heber Salvador de Castro , Coimbra Felipe José Fernandez , Mello Celso Lopes , Begnami Maria D. , Dettino Aldo A. , Formiga Maria Nirvana , Pereira Augusto Akikubo Rodrigues , Fanelli Marcello Ferretti 
Published: March 2020

e14728 Background: Ampullary cancer (AC) is a rare malignancy. There is no consensus about the role of adjuvant radiotherapy and chemotherapy, mainly for early-stage tumors. Methods: Between 2007 and 2012 we performed a retrospective analysis of patients with AC that underwent a pancreaticoduodenectomy (PD) with curative intent in our institution. Results: Twenty-four patients underwent (PD), (M:F=13:11), median age was 63 (range35-83), 87% had R0 resection, median of resected lymph-nodes was 8.5 (range 2-30), 29% had positive lymph-nodes, 46% had perineural invasion, 21% had vascular invasion, 29% had lymphatic invasion, 50% had tumors > 2 cm, 54% had moderately differentiated tumors. AJCC stage pathologic grouping was: I=37,5%, II=29%, III=33%; Median follow-up was 27 months, median progression free survival was 29 months and median overall survival was 101 months. Only lymph-node status was independent prognostic factor for disease free survival on multivariate analysis (p=0,045, HR: 7,8). Among patients with early-stage tumors (n=13), only one received adjuvant therapy. The relapse rate was 23% and 50%, for stage I and IIa tumors, respectively. Among the recurrences, 80% of relapses were distant metastasis without local relapse. In patients with stage IIb and III tumors (n=11), 63,6% received adjuvant treatment (57% chemotherapy and 43% radiochemotherapy). The relapse rate was 100% and 75%, respectively, and 66% of these relapses were distant metastasis without local relapse. 75% of patients who had local recurrence had tumors in stage IIb or III. Conclusions: Our study shows a high disease relapse rate in well-operated patients, even in early-stage tumors, with no nodal involvement, mainly with distant disease. The majority of patients who had local relapses had a more advanced stage and systemic relapses associated. This information can help guide decisions on the choice of adjuvant therapy.
Serial application and development of a new treatment paradigm for pancreatic cancer.
Authors: Stega Jeanetta , Bruckner Howard , Schwartz Myron E. , Hirschfeld Azriel 
Published: March 2020

e14729 Background: New "paradigm driven" treatments (rx) “doubled” phase II survival (S) for 250 pts (ASCO, Bruckner 01, 04, 05, 08, 11). Addition or repartnering of drugs which failed trials or individual use (all in cost saving doses) produced synergism and reversed drug resistance. New rxs and safer doses were rapidly discovered by application of game theory to models of rxs, testing human pancreatic ca (PC) in vitro. Some measures of response (R) and extreme drug resistance as selection criteria were downgraded. Priority went to disease specific in vitro “R” rate (RR), increased number of simultaneously impacted drugs, activity at low doses and avoiding both duplication of targeting and antagonism. Clinical objectives now included wider eligibility, safety and 50% cost saving. Methods: With prospective registration and IRB consent rxs evolved: GFLIP>GFLIO>GFLIO -/+ docetaxel (D) -/+Mitoymcin-C (M). GFLIO and on progression GFLIO-D-M was the rx for 107 new tests (biopsy high risk ductal PC, PS 0-2, no active obstruction). Pts: unresectable (U) or metastatic (IV), G1; failing prior rx with some rx drugs, G2 or resected PC +/- margin G3 (G1, G2 all with progressive disease). Serial findings were compared (ASCO 05, 08). Results: OS for U/IV (G1 and G2) adding D-MMC to GFLIO was: n=70, at 24 mos 22/38 (S) (61%) alive; at 36 mos 8/20 (40%) vs prior 32 and 21%. Adjuvant, G3: n=37 at 18 mos 15, (50%) PFS, 28/30 S; alive S at 24 mos 10, (43%) PFS 20/23 S; at 36 mos 6, 40% PFS 14/15 S. Cumulative RR depending on R criteria meet models for 40-60% R per treatment with benefit rx (61-84%). Rxs were safe, no induction hospital AEs. Conclusions: This 350 pt prospective Phase II further supports testing of low dose rx; use of D-MMC as additions and adjuvant GFLIO rx (see Reni, Fine, Isakoff). The pts large N and long OS have testworthy practice changing: consent, reimbursement and trial (algorithm) “design” implications. Cost of drugs per unit of survival (S) can often be saved, safely while possibly improving QL and OS. Palliative applications of dose intensity, drug efficacy, tumor resistance and one drug at a time testing as rx concepts are (sometimes) questionable. improving QL and OS.
Efficacy and tolerability of biweekly gemcitabine plus cisplatin (GEMCIS) or gemcitabine plus paclitaxel (GEMPAC) as neoadjuvant chemotherapy in patients with muscle invasive urothelial carcinoma of the bladder.
Authors: Karaoglu Aziz , Nieh Peter , Canter Daniel , Master Viraj A. , Carthon Bradley , Harris Wayne , Shelton Joseph , Rossi Peter John , Jani Ashesh B. , Khan Mohammad K. , Osunkoya Adeboya O. , Ogan Ken , Pattaras John , Ritenour Chad , Kucuk Omer 
Published: March 2020

e15006 Background: Cisplatin, gemcitabine and paclitaxel are active chemotherapeutic agents for invasive urothelial carcinoma of the bladder (UCB). Biweekly administration of gemcitabine in combination with cisplatin (GEMCIS) or paclitaxel (GEMPAC) has been reported to have better tolerability than other schedules. Methods: Between 2009- 2011, we have treated 34 patients (median age 69 years, range 56-85) with muscle invasive UCB using gemcitabine (1500 mg/m2) in combination with cisplatin (50 mg/m2) or paclitaxel (150 mg/m2) given on days 1 and 15, every 4 weeks, for 3 cycles prior to radical cystectomy (RC) with bilateral pelvic lymph node dissection and urinary diversion. Patients deemed unsuitable for GEMCIS due to old age, frailty, multiple comorbidities or poor renal function received GEMPAC (n=9); all others received GEMCIS (n=25). Results: Clinical staging revealed T2, T3 and T4 disease in 20 (58.8 %), 8 (23.5 %) and 6 (17.6 %) patients, respectively. Patients were re-evaluated after 2 cycles with MRI or CT scans, which showed improvement in 21 (61.8 %) patients, no change in 12 (35.3 %) and progression in 1 patient (2.9%). Pathologic examination of the surgical specimens revealed T0, Tis, T2, T3 and T4 disease in 8 (23.5 %), 6 (17.6 %), 10 (29.4 %), 6 (17.6 %) and 4 (11.8 %) patients, respectively. Overall, pathologic downstaging was observed in 41.1% of patients. In the GEMCIS group, 12 patients (48%) had pT0 or pTis; in the GEMPAC group, 2 pts (22.2%) had pT0 disease. The most commonly observed toxicities are tabulated below. Conclusions: Biweekly GEMCIS or GEMPAC regimens were active and exceptionally well tolerated in the neoadjuvant setting in patients with muscle invasive UCB, producing favorable pathologic outcomes in an initial cohort of patients. To our knowledge, these data represent the first report detailing clinical results with these regimens in this setting. [Table: see text]
Biomarker profiling of bladder cancer patients undergoing radical cystectomy: Relevance of thrombotic and inflammatory processes.
Authors: Clark Melanie , Quek Marcus Lee , Kahn Daniel , Hoppensteadt Debra , Cunanan Josephine , Fareed Jawed 
Published: March 2020

e15008 Background: Postsurgical thrombosis represents a serious comorbidity in bladder cancer. Inflammation and hemostatic activation mediators contribute to thrombotic pathogenesis. Our study profiles biomarkers antiphospholipid antibody, IgG subtype (APA), procoagulant microparticles (MP) and antiglycosaminoglycan antibody (AGA). Protein and peptide biomarkers were profiled using SELDI-TOF mass spectrometry. Methods: This study was done retrospectively using an IRB approved protocol with 134 baseline serum samples collected from patients undergoing radical cystectomy. The samples were banked at -70C and thawed prior to analysis. The APA were measured with an ELISA for IgG specific antibodies (American diagnostica, Stanford CT). The MP were measured using an anexin capture chromogenic substrate to quantify functional procoagulant activities (Hyphen Biomedical, Paris France). The AGA were measured with a commercially available method with a polysulfonate polymer capture probe for the antibodies (GTI Madison, WI). The proteomic profile was analyzed on a GoldChip in the range of 5-150 kDa. Results: Although a wide scatter in values was noted in the test samples, they exhibited a higher prevalence of elevated biomarkers compared to normal. The average MP value was 3.1 5.8 (range 0.1-34.6nM) with 26 of 134 samples above normal. The average APA value was 6.7 11 (range 4-65nM) with 32 above normal. The average AGA value was 0.22 0.09 (range .01-.8OD) with 10 above normal. The SELDI analysis showed unique biomarkers in the area of 11-12kDa, 15.1-15.4kDa, and 15.8-16.2kDa. Conclusions: The biomarker upregulation suggests that bladder cancer patients have subclinical activation of thrombotic and inflammatory processes. The MP may be generated in cellular damage whereas the APA and AGA suggest vascular endothelial damage and activation. The unique proteomic biomarkers in these patients suggest endogenous protease activation. A clinical correlation in the subset with higher markers may provide insight into the biomarker role in prognosis, risk stratification and treatment of bladder cancer.