bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survivorship patterns of a large nationwide cohort of elderly veterans with colorectal cancer
Authors: Virgo K. S. , Valentine M. P. , Dauz L. , Marietta L. H. , Adams B. , Devarajan S. , Longo W. E. , Johnson F. E. 
Published: March 2020

13525 Background: Administrative databases are not designed to permit cancer researchers to readily follow patients from the period pre-diagnosis through initial curative intent treatment, adjuvant therapy, post-treatment follow-up, to either death or loss to follow-up. One major hurdle to cancer research using such databases has been the lack of data such as stage at diagnosis, and histopathologic type and grade. A second major hurdle is that many patients use more than one system of care, in this instance, Department of Veterans Affairs (VA) and Medicare-reimbursed care. These dual users would be inaccurately represented in the analysis if only one source of data were analyzed. Methods: A retrospective analysis of 13 years of nationwide Medicare and VA inpatient and institutional outpatient data beginning with the three years pre-diagnosis (1986–1990) through a minimum of five years post-diagnosis (1994–1998) was conducted. Death data were available through June 2005. Data were also extracted from tumor registry files, Computerized Patient Record System Files, and paper medical records at each VA. The population studied included all VA patients diagnosed with colorectal cancer and surgically treated for cure during the five-year period 1989–1993, who were Medicare-eligible at diagnosis, and survived the index admission. Results: Of the 6612 patients treated with curative intent during the five-year period, 4924 (74%) could be staged. Of these, 4551 (92%) were deemed eligible for the study. Of the eligible patients, 77% were diagnosed with colon cancer and 23 percent with rectal cancer. The majority (89%) had adenocarcinoma. The histopathologic grade was moderately differentiated for 54% and well differentiated for 19%. As of June 2005, 77% had died. Including all stages (0- IV), the average survival in months after treatment was 86 (median=61). Survivorship differed significantly by stage at diagnosis (p < .001). Conclusions: This rich database provides a wealth of data for subgroup analyses of survivorship, recurrence patterns, and health services utilization patterns within and across systems of care. Identifying predictors of survivorship within subgroups of this population is currently under way [Table: see text]
Influence of the department on the resection rate in palliative treatment of metastatic colorectal cancer (CRC)
Authors: Wein A. , Liersch T. , Hofheinz R. , Fahlke J. , Wilke J. , Brueckl W. M. , Maennlein G. , Boxberger F. , Kohnen R. , Hahn E. G. , Hohenberger W. 
Published: March 2020

13528 Background: During the last years due to the application of Irinotecan, Oxaliplatin and “biologicals” for the first- and secondline treatment of CRC in palliative situation the efficacy of palliative treatment has considerably improved with an acceptable toxicity. The achievements of secondary metastatic resection after downsizing by palliative treatment have increasingly become the focus of interest in palliative patients and opened up new ways in terms of curative options (Folprecht et al. 2005; Wein et al. 2001). Here, we analyse the influence of different departments on the resection rate after palliative treatment. Methods: A prospective phase III trial in metastatic CRC with systemic treatment by 5-FU/sodium FA as a 24h-infusion (AIO) versus AIO plus Oxaliplatin followed by secondary metastatic resection. Trial start: 2000; end of trial: 2005. Randomized patients: n = 240 by 5 centers experienced in clinical trials. In order to achieve a homogeneous patient group, non-resectability of distant metastases was required according to pre-defined criteria. Stratification characteristics: In accordance to the participating departments; ECOG index 0.1 vs 2. Involvement of the hepatic tumour extension 25% vs other localisation; organ manifestation 1 vs > 1. Inclusion criteria: Definitively non-resectable metastases. Palliative first-line treatment: Histologically proven adenocarcinoma of the colon or rectum, unambiguous enlargement of metastatic masses in objective imaging procedures. At least one bidimensionally measurable tumour lesion. Age: > 18, < 75 years. Exclusion criteria: Concomitant treatment with other anti-neoplastic substances. Sensoric neuropathy. Results: Resected/randomized patients of 176 currently evaluable patients, both treatment groups combined: department (dep.) 01: 0/26 (0%), dep. 02: 10/27 (37.0%), dep. 03: 21/68 (30.9%), dep. 04: 8/43 (18.6%), dep. 05: 1/12 (8.3%), total: 40/176 (22.7%). Although in the total population, a remarkable resection rate could be achieved, the variation between the departments is high (p=.0043 for differences between departments). Conclusions: The resection rate after palliative CRC treatment essentially depends on the department. No significant financial relationships to disclose.
Influence of palliative surgical resection on overall survival in patients with Advanced Colorectal Cancer: A retrospective single institutional study
Authors: Kaufman M. S. , Radhakrishnan N. , Roy R. , Thomas A. , Gecelter G. , Tsang J. , Caramalis A. , Nissel-Horowitz S. , Mehrotra B. 
Published: March 2020

13532 Background: The role of palliative surgical resection in patients presenting with locally advanced or metastatic colorectal cancer (CRC) is unclear. Resection is often limited to symptomatic management of bleeding, obstruction, perforation or for relief of pain, in patients with an adequate performance status and an expected life span of over several weeks. An exploratory analysis to evaluate the influence of a palliative surgical resection on survival outcome in patients with advanced CRC is reported. Methods: A retrospective review of medical records of all patients diagnosed with advanced CRC at our institution between the years 1998–2003 was undertaken. Tumor registry data were reviewed to identify age, gender, modalities of therapy (i.e. surgery (S), chemotherapy (C), radiation), and overall survival. IRB approval was obtained for this study. Results: 185 patients were identified. Mean age was 67 years (range 30–99). M: F ratio was 1:1. 62% of patients (115/185) underwent a palliative surgical intervention. Mean survival of patients who underwent S and those that did not undergo S was 27.7 months (mo) and 8.7 mo respectively (p<0.0001). 48% of patients (79/185) underwent systemic C. Mean survival of patients who received C + S, and patients who received C alone was 39 mo and 17.3 mo respectively (p<0.0004). 51% of patients who underwent S, received C; 30% of patients who did not undergo S, received C. Chemotherapy data were available on 46 of 79 patients. Patients treated with S + C, and C without S, received a median of 9 mo and 6 mo of therapy respectively. The median number of regimens used were similar in both. Conclusions: These exploratory data suggest a positive influence of a palliative resection performed during the disease course of patients with advanced CRC. The increased frequency of utilization and the more prolonged duration of C in the surgically treated patients may in part contribute to this improved survival . This may also be reflective of performance status at the time of diagnosis. Future trials enrolling patients with advanced CRC should prospectively stratify for surgical intervention to further clarify the influence of this modality on the outcome of systemic therapy in this disease. No significant financial relationships to disclose.
Investigations of oral uracil and tegafur(UFT)-based adjuvant chemotherapy in patients with colon cancer
Authors: Noshima S. 
Published: March 2020

13535 Background: Surgical resection plays a major role in the treatment of colon cancers. However, surgical resection alone has limitation in its use and it is necessary to administer adjuvant therapy and it would be important to define clinical significance of adjuvant chemotherapy. Methods: A total of 95 patients diagnosed with colon carcinoma were randomly assigned to one of two groups, i.e., treatment-group or non-treatment group. UFT (400 mg/day) was administered daily to 40 patients (treatment-group), one week before surgery. 55 patients (non-treatment group) received no medication before undergoing surgery. In the present study, we have investigated how adjuvant chemotherapy inhibited proliferation of colon cancer cells in vivo through monitoring cell proliferative activities (using MIB-1 antibody), expression of abnormal p53 protein and apoptosis-assays. Two groups were subjected to analyses of these study parameters. Results: Effects of preoperative administration of UFT on cellular proliferative activities: MIB-1-positive rates were 21.21 ± 2.89 (%) for treatment group and 39.02 ± 2.27 (%) for non-treatment group, and there was significant difference in MIB-1-positive-rates between the two groups (P<0.0001). Effects of preoperative administration of UFT on mutated p53 protein expression: The incidence of mutated p53 protein was 20.27 ± 4.28 (%) for treatment group and 49.06 ± 4.46 (%) for non-treatment group, and there was significant difference in the incidence of mutated p53 protein expression between the two groups (P<0.0001). Effects of preoperative administration of UFT on apoptosis: Apo.I. was 1.24 ± 0.20 (%) for treatment group and 0.49 ± 0.06 (%) for non-treatment group, and there was significant difference in Apo.I. between the two groups (P<0.001). Conclusions: Taken together, these findings indicate that UFT-based adjuvant chemotherapy is potentially useful for treatment of colon cancer patients undergoing surgical resection. No significant financial relationships to disclose.
Randomized single institute pilot study of vaccinia-CEA(6D)-tricom and fowlpox-CEA (6D)-tricom with GM-CSF (V) in combination with docetaxel (D) in patients with colorectal cancer (CC)
Authors: He A. R. , Hwang J. , Malik S. , Park S. , Schlom J. , Marshall J. 
Published: March 2020

13538 Background: Our previous study demonstrated 40% patients with CC achieved stable disease at 4 months with V (JCO, 23(4):720–31, 2005.). Preclinical studies showed taxene enhanced tumor vaccine in delaying tumor growth and increasing the antigen-specific T cells. We report the results of a Randomized phase II pilot study of V in combination with docetaxel (D) in CC patients. Methods: 27 patients with metastatic CC were randomly assigned to 3 arms, stratified for HLA-A2. All patients received a ‘prime’ dose of vaccinia-Tricom on Day 0, followed by ‘boost’ doses of fowlpox-Tricom on Days 21 and q 21 days for 4 months; all vaccinations were followed by local GM-CSF (100 μg) for 4 days. Arm 1 received V; Arm II and III received V and D on D1, D8 during each fowlpox vaccination at 10mg/m2 and 30mg/m2, respectively. Patients with stable disease continued vaccinations monthly after study completed. Safety data was evaluated. Primary endpoints included the impact of varying doses of D on CEA-specific T cell immune responses (CTL) using the ELISPOT assay, the recommended dose for further study as defined by the best immune response with acceptable toxicity, and objective clinical response. Results: The most common AE related to the vaccines was grade (g) 1 injection site reactions. Other common AEs were g1 fatigue, nausea, vomiting, fever, headache, and myalgia. There were 1 g3 fever and 1 g3 abdominal pain. The AE from the combination arm were contributed by D as expected, included g3: hyperglycemia (1), fatigue (1), elevation of liver function tests (2), pulmonary infection (1), abdominal pain (1), vomiting (1) or diarrhea (1). 6/ 27 patients have died 17 months after starting V. Patients received 2 to 12 cycles of therapy before disease progression. Observed clinical benefit was significantly lower than the 40% previously documented with V alone. The immune data is to be presented. Conclusions: Inferior clinical benefit as compared to our previous experiment could be explained by more heavily pretreated patients in this trial or negative impact of D on V. CTL data should explain this observation. No significant financial relationships to disclose.
Toxicity and efficacy of four schedules of intensified neoadjuvant chemoradiotherapy (RCT) with irinotecan and 5-Fu or Capecitabine in patients with locally advanced rectal cancer (LARC)
Authors: Klautke G. , Ludwig K. , Klar E. , Freund M. , Fietkau R. 
Published: March 2020

13550 Background: After neoadjuvant RCT in patients with LARC the rate of complete response (pCR), nearly complete response (nCR)and also the ypN0 category influences survival. So four different schedules of neoadjuvant RCT with irinotecan and 5-Fu or Capecitabine were compared in efficacy (pCR, nCR, ypN0) but also in the main toxicity (diarrea III/IV CTC). Methods: Conventional radiation was given at daily fractions of 1.8Gy to a total dose of 50.4Gy and 5.4Gy boost in all schedules. In our first schedule 5-Fu (250mg/m2, d1–43) and irinotecan (40mg/m2, d1,8,15,22,29,36) (group A), in our next schedule capecitabine (1500mg/m2, d1–43) and irinotecan (40mg/m2, d1,8,15,22,29,36) (group B), and then next capecitabine (1500mg/m2, d1–14, 22–35) and irinotecan (50mg/m2, d1,8,22,29) (group C) and now capecitabine (1500mg/m2, d1–14, 22–35) and irinotecan (60mg/m2, d1,8,22,29) (group D) was applicated concurrently. Surgery was performed 4–6 weeks after RCT. Results: Group A-B-C-D: number of patients: 37 - 28 - 20 - up to now 11; clinical state UICC II/III: 6/31 - 2/28 - 5/15 - 1/10; diarrhea (III+IV): 12/37(32%) - 11/28(39%) - 2/20(10%) - 1/11(9%); pCR: 9/37(24%) - 4/26(15%) - 0/20(0%) -3 /9(33%); nCR: 10/37(27%) - 3/26(12%) - 5/20(25%) - 1/9(11%); ypNo: 25/37(68%) - 15/26(58%) - 12/20(60%) - 6/9(67%). Conclusions: Neoadjuvant RCT with 5-Fu or capecitabine in combination with irinotecan is high effective. The splitting of capecitabine with a break in the third week of radiation reduces toxicity but not efficacy. In our trials during RCT a total dose of 240mg/m2 irinotecan in combination with 5-Fu/capecitabine must be applicated to receive a high rate of pCR. No significant financial relationships to disclose.
Docetaxel and capecitabine for previously treated metastatic colorectal cancer
Authors: O’Brien T. E. , Newton E. , Trey J. , Crum E. 
Published: March 2020

13579 Background: Docetaxel (D) induces human colon cancer cell lines to upregulate thymidine phosphorylase, an enzyme which activates capecitabine (C) to its cytotoxic form. This provided rationale for adding low dose D to C in patients with colorectal cancer (CRC). Although this combination has been established in metastatic breast cancer, it has not been evaluated in CRC. Because of concerns of toxicity in a pretreated population, we performed a phase I trial in patients with previously treated CRC. Methods: Eligibility: At least 1 prior treatment for metastatic disease; ECOG PS 0–1; adequate organ function. Design: Phase I, dose escalation. D, IV, days 1 & 8, and C, PO BID days 5–18, repeated q21days. Dose Level 1: D=15mg/m2, C=1000mg/m2; Level 2: D= 15 mg/m2, C= 1100 mg/m2; Level 3: D= 20 mg/m2, C= 1100 mg/m2; Level 4: D=20mg/m2, C=1250mg/m2. Results: 13 patients have thus far been treated. 11 are evaluable for toxicity and 10 for response (1 at dose level 4 was taken off study due to non-compliance before completion of cycle 1; another died of progressive cancer before completing cycle 1 at dose level 4; another is evaluable for toxicity but not yet for response). 9 with colon, 4 with rectal primary sites. Median follow-up= 5 mo (1–19 mo). Med age= 59 (30–75); #prior regimens for met disease 1–2, all of which were 5-FU based. Toxicities No dose limiting toxicities (DLT) until Dose Level 4. Dose Level 1: 1/3 developed grade 2 diarrhea and hand-foot syndrome and delayed grade 3 hand-foot; Dose Level 2: 2/3 developed grade 2 toxicities (hand-foot in one and diarrhea in the other); Dose Level 3: 1/3 developed delayed grade 2 hand-foot; Dose Level 4: 1 patient with delayed grade 2 hand-foot and grade 1 eye tearing; another developed DLT (grade 4 stomatitis/dehydration). Response 6/10 patients progressed after 2 cycles; 2 pts had stable disease, one lasting 4.6 mo; 2 patients had a partial response, one of which lasted 9 mo. The latter case had refractory disease to FOLFOX 4 but a 78% reduction in her liver metastases to D+C. Conclusions: The combination of low dose docetaxel, used as chemosensitizing agent, with capecitabine in this pretreated group of patients with metastatic CRC appears to be well tolerated, with no DLTs seen until Dose Level 4, and has modest activity. MTD determination awaits further accrual. No significant financial relationships to disclose.
Surgical salvage of pelvic recurrences from colorectal tumors
Authors: Chacon M. , Varela M. , Huertas E. , Roca E. , Sanchez Loria F. , Kaplan J. , Pairola A. , O’Connor J. , Chacon C. , Chacon R. D. 
Published: March 2020

13580 Background: The morbidity of pelvic recurrences from colorectal tumors (PRCT) represents a challenge for the oncology multidisciplinary team. Surgical treatment is the best option for palliation and in several series it offers long term local control in 30% of the cases. Objective: To perform a retrospective analysis of patients (pts) surgically resected for PRCT in terms of: time to progression after surgical salvage (TP) and specific suvival (SS). Correlatives studies were performed with clinic and pathologic factors, surgical procedures (SP), and postoperative complications in terms of TP and SS. Methods: 64 pts treated (June 1994 - February 2005) were identified (women: 30), median age 63 years, site of the primary: rectum 48, sigmoid 16; Median number of resected nodes: 8 (r: 2 - 20) in pts with negative nodes and 15 (r: 6 - 42) in pts with positive nodes; primary treatment: surgery (S): 22 pts, S + chemotherapy (CT): 18, S + radiotherapy (RT): 4, S + CT/RT: 17, CT + S: 2 pts, QT/RT + CX: 1; in 7/64 a Miles procedure was performed as primary therapy, median disease free interval: 15 months; site of initial recurrence: locoregional 58 (90%), locoregional + systemic 10%. Pain and bleeding were the most frecuent symptoms. Results: The strategy in PRCT was: S: 29 pts, S + RT: 15, S + CT/RT: 9, CT/RT + S: 7, S + CT: 2, CT + S: 1, RT + S:1; IORT: 18/64; external beam RT: 17/64, 6 pts required Miles; type of resection: R0: 50/64 (78%), R1: 8/64 (12%), R2: 3/64 (5%) and 3 (5%) unknown. Median duration of surgery: 4 hours, abscesses and fistulas were the complications most frequently observed. Median time to progression (TP): 12 months, site of recurrence (56/64 pts) post salvage surgery: pelvic: 22 pts, extrapelvic: 6 pts, combined: 10 and unknown 18. Eleven pts are free of disease. In 16 pts more than one surgical salvage was perfomed. The specific survival was 21 months (IC 95% 37 - 61 m). Conclusions: In this serie surgical salvage of PRCT showed one year of local control disease, even in pts with R2 and with moderate morbidity. The surgical decision must be individualized and in the context of a trained surgical team. No significant financial relationships to disclose.
Combined regimen of Irinotecan (Iri), Fluorouracil (FU), Leucovorin (LV) with Oxaliplatin (Oxa), FU/LV, in elderly patients with metastatic colorectal cancer (MCRC) treated in second line therapy
Authors: Botto H. G. 
Published: March 2020

13583 Background: In previous trials in elderly patients (pts) with MCRC, treated with Iri-FU/LV combination in first line therapy (1st line therapy), we reported: Overall Response Rate (ORR) of 38%, (ASCO 343,2004) and with Oxa-FU/LV combination in 1st line therapy: ORR of 34%, (ASCO 3743,2005). The purpose of this trial was to study the feasibility, toxicity and response, with the combined regimen of Iri-FU/LV with Oxa-FU/LV in elderly pts with MCRC, treated in second line therapy (2nd line therapy), all of them recurrent after the 1st line therapies mentioned before. Methods: Sixteen pts with MCRC; M/9, F/7; PS: 0=9, 1=5, 2=2; median age 74,5 years (65–84 y), with normal hematological, cardiac and renal functions. Sites of disease: hepatic, 9 pts; locoregional, 7 pts. After the employment of Iri-FU/LV combination in 9 pts, and Oxa-FU/LV combination in 7pts, they have all shown recurrent disease. Treatment: Iri, 100 mg/m2, FU 350 mg/m2, LV 20 mg/m2, iv, day 1º and Oxa 75 mg/m2 and increases dosis of FU 550 mg/m2, LV 50 mg/m2, iv, day 8°, every 28 days. Pts evaluation was performed every two cycles, the median number of cycles was 5 (range 3–8), the total number of cycles was 84. All pts were examined for response, toxicity and survival. Results: PR: 31.2%; SD: 31.2%; PD: 37.5%. ORR: 31.2% (hepatic metastasis 19% and locoregional disease 12.2%). Toxicity: Gr 2/3, neutropenia 43.7%; anemia 37.5%; thrombocitopenia 12.5%; diarrea 12.5%; paresthesia 6.25%. The median time to progression was 6 months (range 2–12 m), the median survival time was 14 months (range 7–25 m). Conclusions: The combined regimen of Iri-FU/LV with Oxa-FU/LV, following this shedule in second line therapy, in elderly pts with recurrent MCRC proved feasibility, good activity, acceptable toxicity and good survival time. No significant financial relationships to disclose.
Correlation between the number of positive nodes, number of dissected nodes and survival of patiens with colorectal cancer
Authors: Marin Marmolejo J. C. , Villegas Mejia C. R. , Cardona Arcila J. P. , Mulett Vasquez E. , Osorio Chica M. , Osorio G. F. , Correa Ramirez L. A. , Chacon Cardona J. A. 
Published: March 2020

13585 Background: According to the TNM classification, the prognosis of patients suffering from colon and rectal cancer has been defined taking into account the number of nodes reported positively. Objective: This work is intending to establish a relation between the number of positive nodes and the number of dissected nodes, relating it with the overall survival. Methods: 5500 medical records of patients were reviewed. 771 out of these corresponded to gastrointestinal cancer (14%) from which 351(6.38%) corresponded to colorectal cancer. From this group, 291 patients (82.9%) underwent a surgery. A relation between the number of positive nodes and the number of dissected nodes was established and called proportion of positivity (positive nodes/ dissected nodes × 100) and this was in turn related to a five year overall survival. Two groups were analyzed: proportion of positivity > than 50% and proportion of positivity < than 50%. Results: A report of 209 patients showing nodes was obtained (59.5%), with a means of 10.4 (rank 0–31) of dissected nodes per patient and a means of positive nodes of 2.4 (rank 0–22). Comparing the two groups the statistic significance starts to be obvious from the 18 months and the difference between the two groups continues increasing until the five years. The survival to five years for the group with the proportion > than 50% was 39% (IC 95%:13.4–64.5) compared to the survival for the group with a proportion < than 50% that was 75.7% (IC 95%:67.6–83.7) p<0.05. Conclusions: The proposal shows that not only is the absolute number of positive dissected nodes as only prognostic indicator (TNM) but also that before nodes dissections with low number of them, it is possible to establish a reliable prognostic relationship by calculating the proportion of positivity. The above said does not consider that the nodal dissection can be less than recommended, on the contrary obtaining the biggest number of nodes will mean bigger equivalence of the proposal and a bigger possibility to detect positive nodes. No significant financial relationships to disclose.