bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life (QoL) and symptoms evaluation in metastatic breast cancer (MBC) patients (pts) treated with eribulin: Preliminary results of a prospective observational study.
Authors: Gamucci Teresa , Mentuccia Lucia , Quadrini Silvia , Moscetti Luca I. , Vici Patrizia , Sperduti Isabella , Pizzuti Laura , Franco Daniela , Giampaolo Maria Anna , Fabbri Maria Agnese 
Published: March 2020

e12031 Background: Eribulin (E) is a nontaxane microtubule inhibitor currently indicated for third-line chemotherapy (CHT) of MBC. To evaluate its tolerability and impact on QoL and symptoms improvement in MBC pts, from April 2012, we conducted a prospective observational study. Methods: Pts pretreated with anthracycline (A) and taxane (T) who has received 2 CHT lines for MBC, scheduled to be treated with E were considered eligible. Pts complete the Edmonton Symptoms Assessment Scale (ESAS) at each cycle and the Functional Assessment of Cancer Therapy-Breast (FACT-B) every 2 cycles. Outcome of QoL included the FACT-B total score, FACT-General (FACT-G) score and the Trial Outcome Index (TOI) score. Groups of data were analyzed using ANOVA and the Friedman test. Kaplan-Meier method was used for survival calculation. Overall Survival was calculated by the Kaplan-Meier product-limit method. Results: 25 consecutive MBC pts entered the study. Median age 65 (range 31-77), PS (ECOG) 0-1 96%, 24% had triple-negative MBC, 70% ER/PgR positive and 5% HER2 positive. All pts were pretreated with A and T, 19 (76%) also with capecitabine. Median cycles 6 (range 3-13), 36% received more than 6 cycles. Five pts are to early for evaluation. Of the 20 evaluable pts main toxicity were: alopecia G1 58% and G2 42%, asthenia G2 40% peripheral neuropathy G2 25% neutropenia G2 0% and G3-G4 10%.At a median follow-up of 6 months 16% of pts achieved partial response (PR) 44% stable disease (SD) and 20% progressive disease; disease control rate (PR+SD ≥ 6 m) occurred in 40% of pts. Median PFS is 5 m (95% CI, 4-6) currently 70% of pts are alive. Data of ESAS and QoL are reported in table. Conclusions: Our preliminary results shows that treatment with E is associated with a significant improvement of ESAS scores (p=0.03) mainly in responders pts (p=0.02) and with a good maintenance of QoL with expected and manageable toxicities. Data collection is ongoing and update results will be presented. [Table: see text]
Taxanes-based neoadjuvant chemotherapy in advanced nonmetastatic breast cancer.
Authors: Mehmood Tahir , Ali Muhammad , Saeed Kamran , Munawar Atif , Usman Sadaf , Rashid Asma , Irfan Nabia , Ghaffar Abdul , Shah Mazhar Ali , Syed Aamir Ali , Jamshed Arif 
Published: March 2020

e12033 Background: Pakistan has the highest rate of breast cancer for any South Asian population and majority of the patients present with locally advanced or metastatic disease. We report on response and survival of primary locally advanced non-metastatic breast cancer in women treated with neoadjuvant Adriamycin/Taxanes (AT) based regimens at our institute. Methods: Between 1995 to 2009 the hospital information system identified 517 women with pathologically confirmed locally advanced breast cancer. All patients received neoadjuvant chemotherapy with AT based regimen followed by surgery. Median age was 43 years (range 17-71 years). AJCC stage; stage II 54% and stage III 46% of the patients. Axillary nodes were palpable in 72% of the patients at presentation. Histological sub-types; infiltrating ductal carcinoma 95%, infiltrating lobular carcinoma 3% and others 2% respectively. Pathological grade was I/II in 44% and grade III 56% of the patients. ER, PR, and Her2-neu receptors were positive in 44%, 40% and 24% of the patients respectively. Twenty one percent of the patients had triple negative breast cancer. Post operative radiotherapy was delivered to 94% of the patients. Patients with positive ER/PR receptors also received hormonal manipulation. Results: Following neo-adjuvant chemotherapy, pathological response was; complete response (CR) 13.5%, partial response 21%, stable disease 52% and progressive disease in 13% of the patients respectively. Breast conservation was possible in 36% of the patients. The 5 year disease free survival in patients with and without CR was 81% and 36% respectively. On multivariate analysis, T stage (p = 0.001) and response to neo-adjuvant chemotherapy (p = 0.001) were found to be independent predictors for disease free survival. Conclusions: Pathological response to neoadjuvant chemotherapy is a predictor of long term survival. Chemotherapy regimens with high response rates merit evaluation in randomized trials to improve outcome in locally advanced breast cancer.
The discordance of the ER, PR, and HER2 status after neoadjuvant chemotherapy in breast cancer.
Authors: Oven Ustaalioglu Basak , Bilici Ahmet , Aker Fugen Vardar , Erkol Burcak , Aliustaoglu Mehmet , Gurleyik Gunay 
Published: March 2020

e12037 Background: Neoadjuvant chemotherapy(NAC) is the accepted approach for women with locally advanced breast cancer with technically inoperable disease. Systemic treatment is mainly based on the presence of the Estrogen (ER) receptor, Progesterone (PR) receptor and HER2 status on the core needle biopsy prior to treatment. Previously, discordance of the hormone receptor (HR) status was reported as 8-33% in the breast cancer patients after NAC. In here, we evaluated the HR and HER2 discordance after NAC in locally advanced breast cancer patients. Methods: We reviewed the data of 849 breast cancer patients retrospectively. The pathological specimens of core needle biopsy and operation specimens were re-evaluated for HR and HER2 status in 38 patients who had been treated with NAC. The changing of HR and HER2 status after chemotherapy was defined as discordance. The relationship between clinicopathological parameters and discordance and significance of them for disease-free survival (DFS) was analyzed by chi-square and univariaty test. Results: Over 80% of patients were clinically stage III breast cancer. Out of 24 patients were premenapouse and median age was 44.5(30-94). The patients were received median 4(1-6) cycles of NAC as 2 of them were only hormonotherapy, 8 were only antracycline and others were both antracycline and taxanes. Nearly 80% of patients were performed modified radical mastectomy(MRM).Postoperatively median tumor size was 1.6cm(0-10) and median dissected lymph nodes was 14(0-28). After operation, 4(10.5%), 8(21.1%) and 8(21.1%) discordance were detected for ER, PR and HER2 respectively. While HER2 discordance were related with recurrence(p=0.01) and PR discordance(p=0.04), ER discordance was related with only patological stage(p=0.03). At the median follow-up of 15.7 months, 5 year DFS rate and time were 30% and 30.4 months(18.7-42.2), respectively. Operation type, stage, lymphovascular invasion, perineural invasion were found to be significant for DFS, HR and HER2 discordance was not related with DFS. Conclusions: Until more definitive results will be obtained from future studies, receptor status of the residual tumor after NAC should be retested.
Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer (TNBC) in a Peruvian institute.
Authors: Rojas Katerin Ingrid 
Published: March 2020

e12038 Background: TNBC is defined by the lack of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 expressions (HER-2). This molecular classification is an excellent prognostic and predictive method in breast cancer (BC). This is an aggressive malignancy with a poor prognosis despite the high rates of response to chemotherapy. Methods: Observational descriptive. We included 165 patients with TNBC stage I-III who received neoadjuvant chemotherapy at National Cancer Institute of Peru from 2000 to 2010. Clinical and pathologic complete response rates, survival measurements, and organ-specific rates of relapse were evaluated. Overall survival (OS) and disease free survival (DFS). Results: The mean age at diagnosis was 48.6 years (range, 24-74 years). The mean size tumor before treatment was 7.7 cm (range, 1-25 cm). One hundred and fifty seven patients (95.2%) had ductal carcinoma. One hundred twenty nine cases (78.2%) were histological grade III. According to T stage, 65 (39.4%) T3 and 83 (50.3%) T4. Thirty four cases (20.6%) were N0. Seventy three patients (44.2%) received AC-Paclitaxel schedule. Thirty four patients (20.6%) had CR to neoadjuvant chemotherapy. There is a significant difference about tumor size before and after neoadjuvant treatment (7.7 vs. 3.6, p<0.05).OS at 5 years for patients with residual disease was 83.5%. In patients with complete response the DFS at 5 years was 55.1%. Locoregional and lung were the most frequent site of recurrence (15.8%) and (13.9%) respectively. According Miller and Paine to grade tumor response, 17 patients(10.3%) I ,33 (20.0%) II, 33 (20.0%) III, 20 (12.1%) IV and 27 (16.4%) V. Node response, 20 patients (12.1%) had type A, 51 (30.9%) type B, 23 (13.9%) type C and 34 (20.6%) type D. Conclusions:These results suggest that most TNBC are in accordance with literature data, especially concerning young age at diagnosis, high grade tumors, advances locally stage at diagnosis, and short time to relapse, high response rate to chemotherapy and excellent OS and DFS. We know it is a heterogeneous disease; however the clinical characteristics still play an important role to predict treatment response and survival.
Inequities in Pap smear screening for cervical cancer between Brazilian urban and rural populations.
Authors: Martínez-Mesa Jeovany , Werutsky Gustavo , Sampaio-Filho Carlos Alberto , Calabrich Aknar , Barrios Carlos H. 
Published: March 2020

e12510 Background: Cervical cancer (CC) represents an important public health problem in Brazil being the second most common cancer in women. The expected incidence rate in 2012 was 17.5 per 100,000 women while the age-standardized mortality rate in 2010 was 4.04 per 100,000 women. Inequities in access to health preventive programs contribute to this figure. The goal of this analysis is to identify inequities in Pap smear screening in women from urban and rural populations from Brazil. Methods: Using the Health Supplement of the National Household Sample Survey 2008 (PNAD) with 102,108 Brazilian women aged 25-64 years Pap smear screening was analyzed dichotomously as women having ever or never been screened. Residence area was categorized as urban or rural. Age-adjusted prevalence of never-screened was analyzed using chi-squared test. Poisson regression modeling, crude and full adjusted for age, income, number of children, education, skin color, having visited a physician in the previous 12 months and healthcare insurance were performed for Brazil in general and for Brazilian major regions. Results: The prevalence of never-screened women for CC was 12.9% in Brazil, 11.5% in urban and 22.2% in rural areas. The poorest Brazilian major-regions showed the highest prevalence of never-screened women: North (17.4% in general, 14.7% in urban and 27.3% in rural areas) and Northeast (14.7% in general, 12.8% in urban and 23.7% in rural areas). After full-adjustment, the rural population showed a higher relative risk for never-screened as compared to those living in urban areas [PR=1.23 (95%CI 1.14; 1.31); p<0,001]. The highest risk was also found in the North [PR=1.39 (1.13; 1.31); p=0.002]. However, South and Central-west regions showed no association between never-screened and area [PR=1.06 (0.88; 1.28); p=0.541; PR=1.18 (0.87; 1.58); p=0.270, respectively]. Conclusions: Our findings point out inequities in Pap smear screening between Brazilian urban and rural population. These inequities possibly contribute to the high incidence and mortality rate of CC in Brazil.
The role of chemotherapy in hormone receptor-positive and HER2-positive breast cancer patients over age 70.
Authors: Caggiano Vincent , Parise Carol 
Published: March 2020

e12511 Background: Standard adjuvant therapy for HER2 positive female breast cancer patients that are estrogen receptor (ER) positive is chemotherapy, trastuzumab, and endocrine therapy. For patients older than 70 years of age, the combination of chemotherapy and trastuzumab may increase the toxicity profile. The purpose of this study was to evaluate the role of chemotherapy in for the ER+/PR+/HER- and ER+/PR+/HER+ subtypes in patients over age 70. These subtypes differ only by HER2 status. Methods: We identified 13,167 cases of patients over age 70 with stages 1-3 first primary invasive breast cancer from the California Cancer Registry diagnosed between January 1, 2000 and December 31, 2010. Of these, 9,710 were ER+/PR+/HER- and 988 were ER+/PR+/HER+. Cox regression analysis adjusted for race/ethnicity, socioeconomic status, grade, and year of diagnosis was used to compare risk of mortality for combination endocrine and chemotherapy versus endocrine therapy alone. Analyses were conducted separately for each stage. Results: For the ER+/PR+/HER- subtype, there was no difference in the risk of mortality for patients given endocrine and chemotherapy versus endocrine therapy alone for stages 1 and 2. For stage 3, there was a 57% reduced risk of mortality (HR = 0.43; 95%CI: 0.27-0.69) for patients given combination chemo and endocrine therapy. For the ER+/PR+/HER+ subtype, there were no differences in risk of mortality in any stage due to treatment. Conclusions: With the exception of stage 3 patients with the ER+/PR+/HER- subtype, chemotherapy appears to add little or no benefit to risk of mortality for patients over 70 years of age. These results support the use of endocrine therapy and anti-HER2 therapy without chemotherapy in elderly patients with early stage, estrogen receptor positive, HER2 positive breast cancer.
Association of cigarette smoking and glutathione S-transferase M1 polymorphism with risk for uterine cervical cancer.
Authors: Nishino Koji 
Published: March 2020

e12540 Background: To elucidate the role of tobacco smoking and polymorphisms of carcinogen metabolism genes in cervical carcinogenesis. Methods: We analyzed genotypes of nine genes, 11 polymorphisms encoding carcinogen metabolizing enzymes, information on smoking, and the presence of human papillomavirus in 124 Japanese cervical cancer patients and 125 healthy controls. Results: The incidence of human papillomavirus infection (95.5% vs 9.9%; P < 0.001; odds ratio (OR), 231.98; 95% confidence interval [CI], 57.17-941.22), and smoking (41.1% vs 18.4%; P < 0.001; OR, 3.40; 95% CI, 1.88-6.17) were both significantly higher in patients than in controls. The genotype distributions of CYP1A1, CYP2E1, CYP2A6, NQO1, NAT2, mEH, MPO and GSTT1 genes were not statistically different; however, the ratio of the GSTM1 null genotype was significantly higher in patients than in controls (62.1% vs 47.2%; P = 0.019; OR, 1.83; 95% CI, 1.11-3.04). The incidence of GSTM1 null was significantly higher in the non-smoking group (63.0% vs 47.1%; P = 0.038; OR, 1.92; 95% CI, 1.04-3.54), and not in the smoking group (60.8% vs 47.8%; P = 0.300; OR, 1.69; 95% CI, 0.63-4.56). Conclusions: In the current study, risk factors for developing cervical cancer were tobacco smoking and GSTM1 null; however, no association was observed between these two factors. We could not prove that smoking-GSTM1 null interaction was responsible for the increase in cervical cancer among young Japanese, and further studies with more detailed smoking status, not only active but passive smoking, will be required.
The sensitivity and specificity of screening mammography in primary care setting in Saudi Arabia.
Authors: Alkhenizan Abdullah , Hussain Aneela , Alsayed Adher 
Published: March 2020

e12551 Background: Breast cancer is the leading cancer diagnosed in women in Saudi Arabia, accounting for 25% of all cancers diagnosed in women. The mammogram screening program at King Faisal Specialist Hospital and Research Center (KFSHRC) is the only structured screening program in the country. KFSHRC provides primary care services for a catchment population of 30,000 patients. This program covers all women above the age of 40 within this catchment population. Methods: A retrospective review of electronic and paper records were reviewed for mammograms done between January 2002- January 2012. Summary statistics were used to describe patient and examination characteristics. Results from mammograms were reported using the Breast Imaging Reporting and Data System (BI-RADS) of the American College of Radiology. The stage of diagnosis was reported using the American Joint Committee on Cancer (AJCC) system using stages one through four. ACR BIRADS classification and cancer status definitions mammograms were linked with cancer outcomes to identify true-positive, true-negative, false-positive, and false-negative examinations. On the basis of these classifications, sensitivity, specificity, positive predictive value, and negative predictive value were estimated. All mammograms and tissue biopsies were read by board certified specialists. Results: During the first round of screening 1694 mammograms were analyzed, and 12 cases of cancer were diagnosed. Cancer detection rate (per 1000 examination) was 7.1. Biopsy rate was 3.7 per 100 mammograms. Follow up ultrasounds rate was 2.7 per 100 mammograms. Sensitivity of mammogram screening was 80%, and specificity was 76%. Conclusions: The yield of a structured mammogram screening program in Saudi Arabia is high. There is a need to implement a national program for breast cancer screening in Arabian world in general and within Saudi Arabia in particular.
Gastric malignancy presenting after elective Roux-en-Y gastric bypass for treatment of morbid obesity.
Authors: Nau Peter N , Meireles Ozanan 
Published: March 2020

e12559 Background: Obesity has become a significant public health problem in westernized societies. Medical attempts at weight loss are fraught with failures and recidivism. Bariatiric surgery provides for reliable and durable weight loss. The rate of gastrointestinal pathology in this population is significantly higher than in the non-obese. Gastric malignancy following Roux-en-Y gastric bypass (RYGB) is an uncommon presentation. Symptoms occur late secondary to the properties of the RYGB complicating a curative approach. Methods: A retrospective review of the Massachusetts General Hospital bariatric surgical history and PubMed literature search were performed. Data points recorded include the patient age and risk factors for cancer, use of preoperative screening, presenting symptoms, and outcomes of gastric malignancy following RYGB. Statistical analysis was performed using SPSS 20.0. Results: Including the one case treated at Massachusetts General Hospital, that are 11 reported cases of gastric malignancies following RYGB in the literature. The average patient age was 53 years. In four cases preoperative risk factors for gastric cancer were identified. No reports identified pre-bypass evaluation of the stomach. Seventy percent of the cases involved malignancies arising from the gastric remnant. The median time between operation and presentation was 8 years (range 1 – 26). The most common chief complaint was pain (70%). Additional symptoms included nausea and vomiting (50%), and dysphagia (30%). At the time of diagnosis 4 patients had advanced disease rendering surgical resection impossible. Conclusions: Surgical management of obesity provides for durable weight loss and improvement in obesity-associated medical comorbidities. This population is at a higher risk for harboring asymptomatic gastrointestinal pathology. There are 11 cases of gastric malignancies following RYGB in the literature. In four cases the diagnosis of advanced cancer dictated palliative measures only. Diagnosis of this disease is complicated by its subtle presentation and the inability to access the remnant stomach. Given this, it is reasonable to screen all patients prior to exclusion of the gastric remnant.
Prostate cancer incidence in a large cohort of Peruvian men affiliated to a prepaid system.
Authors: Aguilar Alfredo , Iberico Jorge , Neciosup Silvia P , Flores Claudio J. , Valdiviezo Priscila I. , Pinto Joseph A. , Suazo Juan F. , Aguilar Marin Ivan Carlos , Vallejos Carlos S. 
Published: March 2020

e12566 Background: Prostate cancer (PC) is the most common malignancy and the leading cause of death by cancer in Peruvian men (age-standardized rate [ASR] of 37 new cases/100,000 men estimated by GLOBOCAN 2008). The purpose of this study was to assess the incidence of PC in a cohort of men at Oncosalud, an oncologic pre-paid system that currently has 600,000 affiliates. Methods: We evaluated a dynamic cohort (period 1989 to 2011) of men affiliated to Oncosalud – Auna, an oncologic prepaid system.The crude incidence rate per year (number of new cases/men at risk), the specific rate according to age (number of new cases / persons-year), and cumulative risk were calculated. Results: Overall, during the assessment period, the PC incidence rate per year was 183.7 and the ASR incidence was 145 per 100,000 affiliates respectively. In our cohort of affiliates there were no PC cases before 1995 (with 3061 men at risk for that year). The highest incidence rate was 160.5 registered in 1999 (12,461men at risk). Incidence rates showed a decreasing tendency since 2008 (159.7 with a population at risk of 86,408 men), reaching its lowest value in 2011(92.3 with 213,531men at risk). According to age-groups, there were no PC cases under 35 years old except for the 20-24 year old group (incidence rate 2.3). Specific incidence rates per age-group increases from the 40 year old-group (38.5). The peak of PC incidence was between 75 to 79 years old (1506.05). In the same way, the cumulative risk increases after 40 years old. Conclusions: In our cohort of affiliates, the incidence of PC is greater than the general population, it could be due to the process of negative selection; on the other hand, specific incidence rates per age-group and cumulative risk are increased after 40 years, as seen in the general population.