bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical predictors of response to sorafenib in patients with hepatocellular carcinoma.
Authors: Marinelli Sara , Granito Alessandro , Terzi Eleonora , Leoni Simona , Piscaglia Fabio , Venerandi Laura , Bolondi Luigi 
Published: March 2020

e15149 Background: Sorafenib is the only drug approved for the treatment of hepatocellular carcinoma (HCC). Little is known about clinical-laboratoristic parameters predicting treatment benefit. Methods: Between 2008-2012, 94 consecutiveclinically compensatedcirrhoticpatients [M/F=85/9, median age 69-years (38-88)] with advanced HCC (BCLC-C, n=57) and those with an intermediate HCC (BCLC-B, n=37) who failed to respond or not eligible to locoregional therapies, received sorafenib. Clinical-laboratoristic data were reviewed. RECIST criteria were used to assess objective benefit. Toxicities were classified using NCIC Toxicity Criteria v-3.0 and treatment managed according to drug label. Results: The median treatment duration (TD) was 3.9 months (range 0.1-48). The median survival was 9.2 months (range 0.4-45). On the basis of TD we identified two groups of patients with a significant different overall survival (OS): group A (TD>6.6 months, median-TD 11.4, 33 patients) and group B (TD<6.6 months, median-TD 2.3, 61 patients). Median OS in group A and B was 20.6 and 6.6 months, respectively (p<0.001). CPT score, BCLC stage and neoplastic portal vein thrombosis were similar in the two groups. On univariate analysis, group A showed an higher rate of ECOG-PS 0 (75% vs 50%, p=0.034), lower basal serum levels of alfa fetoprotein (best cut-off: AFP<19 ng/dl, p=0.006). Fatigue and nausea were more frequent in group B (67.2% vs 43.8%, p=0.044; 19.3% vs 3.2%, p=0.05, respectively). ECOG-PS 0, AFP serum levels and nausea were significantly associated with a longer OS (p=0.003; p=0.006; p=0.008, respectively, log-rank test). On multivariate analysis, basal AFP levels (>19 ng/ml) remained predictor of shortened OS (p=0.028, OR=4). Conclusions: Development of nausea and fatigue on sorafenib is associated with poorer OS. AFP basal levels <19 ng/ml indipendently predict a better survival. Clinical-laboratoristic parameters may be useful to identify patients more likely to benefit from sorafenib.
Baseline and dynamic plasma chromogranin A (CgA) level to predict clinical outcome and tumor response in Asian patients with gastroenteropancreatic neuroendocrine tumor (GEP-NET).
Authors: Chou Wen-Chi 
Published: March 2020

e15151 Background: The plasma CgA level is a reliable biomarker in diagnosing neuroendocrine tumors.The objective of this study is to correlate both the baseline value and the dynamic changes of plasma CgA level with disease status in Asian patients with advanced GEP-NET. Methods: Fifty-four patients with advanced GEP-NET were retrospectively evaluated between April 2010 and December 2012 in a single institution. Plasma CgA level and abdominal CT scan were obtained at diagnosis as a baseline and subsequently every 3 to 6 months after starting antitumor therapy.Statistical analysis of plasma CgA level was performed to predict the hazard ratio of clinical outcomes and also to correlate antitumor therapy responses with Response Evaluation Criteria in Solid Tumors Criteria 1.1. Results: Forty-six patients (85%) had elevated baseline CgA level. Twenty-one patients (39%) died at the end of the study with the medial follow-up duration of 292 days (range 12-992 days). Patients with baseline CgA level less than 2-fold of upper normal limit (UNL) had longer overall survival time than those with more than 2-fold of UNL (not reach vs. 272 days, hazard ratio = 0.39, 95% CI 0.15-0.99). Baseline CgA level less than 2-fold of UNL was still a favorable prognostic factor after adjusted for other variables (hazard ratio = 0.30, 95% CI 0.10-0.89). Twenty-eight patients with a total of 81 measurements of serial plasma CgA were available. An increase of plasma CgA level less than 15% predicted favorable antitumor response with a sensitivity of 86% and specificity of 91% (area under curve of receiving operating characteristics curves was 0.94). Conclusions: Baseline plasma CgA level and its dynamic change are useful values to predict clinical outcomes and antitumor responses in patients with GEP-NET.Baseline CgA level and serial measurements during antitumor therapy in patients with GEP-NET should be taken to assess their clinical outcomes.
Prognostic value of baseline 18F-FDG-PET (PET) in anal cancer (AC) patients (pts): A Bologna Multidisciplinary Rectal Cancer Group analysis (BMRCG-AC01).
Authors: Pini Sara , Di Fabio Francesca , Iacopino Bruno , Guido Alessandra , Castellucci Paolo , Cuicchi Dajana , Fanti Stefano , Lecce Ferdinando , Rojas Llimpe Fabiola Lorena , Giaquinta Stefania , Adua Daniela , Mazzarotto Renzo , Pinto Carmine 
Published: March 2020

e15154 Background: The incidence of AC has increased. In locally advanced disease treatment is curative radio-chemotherapy (RCT) followed by brachytherapy boost (BRT) or external beam radiotherapy (EBR). The aim of this analysis is to evaluate prognostic factors in predicting disease recurrence. Methods: We retrospectively evaluated pts with diagnosis of T2-3-4, N-/+ AC. External RT was delivered up to a dose of 4,500 cGy in 25 fr and CT consisted in 5-fluorouracil CI day 1-4 and Mitomicin-C bolus day 1 in the first and fifth weeks of radiotherapy as per Nigroregimen. BRT or EBR were performed at the end of RCT. A PET scan was performed at diagnosis before starting treatment. The standard uptake value (SUV) was determined from the most active tumor site. Results: Between March 2006 and August 2012, 50 pts with AC accessed the BMRCG. In this analysis we considered 29 pts evaluated by PET. The pt characteristics were: 8(27.6%) men, 21(72.4%) women; median age 63 (42-89) years; 17(58.6%) squamous cell carcinoma (scc), 12(41.4%) basaloid carcinoma (bc); 6(20.7%) cT2N0, 5(17.2%) cT3N0, 7(24.1%) cT3N+, 2(6.9%) cT4N0, 9(31.1%) cT4N+. Twenty-six (90%) pts received full-dose standard protocol RCT and subsequent radiotherapy boost. After a median follow-up of 25 months we observed 4 (13.8%) recurrences: 3 local and 1 lung metastasis. No disease-related death occurred. Stage at diagnosis (T2-3N0 vs T3N+T4N+/-) and tumor histotype (scc vs bc) did not relate to DFS (p=0.67 and p=0.86 respectively). ROC analysis identified a SUV cut-off of 12.5 at the baseline PET related to recurrence. In 15(51.7%) pts the baseline SUV was ≤12.5 (low SUV) and in 14 (48.3%) it was >12.5 (high SUV). Pts with high SUV had significantly worse DFS than those with low SUV (p=0.02). Multivariate Cox regression did not confirm any SUV prognostic value (p=0.95). Conclusions: These results suggest that high SUV could predict relapse in AC pts treated with curative RCT. The small number of pts rules out any definitive conclusion; a controlled trial should be conducted to explore the prognostic role of SUV to define good prognosis pts for “tailored” treatment and reduce therapy-related toxicities.
Hepatocellular carcinoma diameter and blood platelet levels in a large cohort of Chinese patients in Taiwan.
Authors: Carr Brian I. , Lin Chih-Yun , Lu Sheng-Nan 
Published: March 2020

e15157 Background: Cirrhosis is often associated with thrombocytopenia and predisposes to HCC. Platelets are known to produce several HCC growth factors. Methods: A cohort of 4,139 Chinese HCC patients from Taiwan was interrogated for baseline clinical, tumor and liver function characteristics in relation to blood platelet counts. Results: Trichotomization of the cohort by tumor size after log-linearization, revealed significant relationships of tumor size to blood platelet, AFP and GGTP levels. Patients with higher platelets had larger tumors, more tumor nodules and higher AFP and GGTP levels than those with lower platelet levels. 80% of patients with larger tumors had normal platelet counts, compared to 50% of patients with smaller tumors. Analysis of the cohort according to platelet sub-sets, revealed significant relationships of platelet counts to tumor size and AFP levels. By Spearman’s correlation coefficient, platelet counts correlated moderately with tumor size (rho=0.411), but weakly with tumor numbers, PVT, AST or AFP levels. Sub-set analysis of the cohort according to platelet levels showed that 38% of patients had thrombocytopenia and they had the smallest tumors, lowest tumor numbers, lowest percent with PVT and lowest AFP levels. Conclusions: There was a significant correlation between HCC size and blood platelet counts; patients with larger tumors had higher platelet levels.
Involved field irradiation compared with prophylactic nodal irradiation to unresectable esophageal carcinoma: A retrospective study.
Authors: Zhang Xiaoli , LI Minghuan , Kong Li , Yu Jinming 
Published: March 2020

e15180 Background: We retrospectively observed the failure patterns in patients of local advanced esophageal squamous cell carcinoma (ESCC) with involved field irradiation (IFI) or with intentional prophylactic nodal irradiation (PNI). Methods: The ESCC patients with unresectable lesion (length >6 cm or T4 or obvious node metastasis) were retrospectively analyzed between 2003 and 2009. All the reviewed patients received 3D-CRT with cisplatin based chemotherapy. For the IFI cases, the GTV was defined as any visible esophageal lesion(GTVe) and clinical involved node(GTVn). The CTVe was defined as the GTVe plus a 3-4cm margin superior and inferior to the primary tumor and a 1.0 cm radial margin. CTVn was defined as the GTVn plus a 0.5cm radial margin. The PTV was defined as CTV plus a 1.0cm margin. For the PNI cases, the same margins outside the primary tumor as that in IFI, and the adjacent regional lymphatics was included in the CTV according to the different location of primary tumor. The prescribed dose to PTV in IFI group was 60-64 Gy in 6-7 weeks and to PNI group was 40-50GY in 4-5weeks followed by 10-20Gy to PTVe+n. Results: Thirty-six cases received IFI and 49 cases underwent PNI. There were no difference between IFI and PNI group in tumor length and nodal status. The clinical response rates were 94.4% and 97.9% in IFI and PNI group, respectively, and no statistical difference was found ( P=0.785).The patterns of first failure in IFI and PNI group were listed as follows:(1) involved field failure, 17/36 vs 34/49 , P=0.046; (2) prophylactic nodal failure, 10/36 vs 4/49 P=0.02; (3) out field of regional nodal failure, 8/36 vs 15/49 , P=0.464; (4) distant metastasis, 17/36 vs 26/49, P=0.663. The medium PFS were 8.5m vs 12.0m( P=0.602), and the median OS were 14.0m vs 16.0m ( P=0.924)in IFI and in PNI group, respectively, and no statistical difference was found. Conclusions: Chemo-radiotherapy with PNI for unresectable ESCC showed better prophylactic field control, but had no advantage over the IFI in LC, PFS and OS.The involved field failure and distant metastasis were the main causes of failure in both groups, which suggests that the prophylactic irradiation may be not necessary for this sub-group patients.
Anal cancer in Oncólogos del Occidente from Colombia, South America 1997-2012.
Authors: Villegas Mejia Carlos Raul , Chacon Cardona Jose Arnoby , Sanchez Villegas Tomas 
Published: March 2020

e15189 Background: This work describes epidemiologic characteristics in anal cancer, in the United States is 1% to 2% of bowel cancers and 3.9% of anorectal carcinomas. Statistics for anal cancer are unknown in our specific Colombia region. Methods: We performed a descriptive preliminary retrospective analysis of 50% of our total patients from Oncologos del Occidente like a private treatment cancer center from January of 1997 to June 2012. Results: 10,000 records were reviewed with 663 colorectoanal cancer and 47 were anal cancer; median age 60.064 (range 32-88. SD. 12.595), 64% female and 96% urban areas; Clinical stage II 32%, stage IIIA 14%, stage IIIB 30%, and 23% were unknown stage; Squamous cell carcinoma including basaloid 79%, adenocarcinoma 17%; Well differentiated 32%, moderately 19% and poorly 19%; 6% had Radical perineal surgery, 81% received chemoradiation (QT/RT), 13% without treatment and 2% were treated with sequential QT+RT; 19% relapsed and 70% of them were local with 87% without any treatment. Gap of RT was 1 to 14 days (11%), 15 to 30 days (23%), 31 to 106 days (15%). No gap (0 days) 51%, Gap mean 13.085 (Range 0-106 SD. 19.534); The initial QT Regimen was 5FU/mitomycin 60%, 5 FU/cisplatinum 4%, capecitabine / mitomycin C in 11%; General survival to 5 years 60% Stage II and 38% Stage III, median survival for Stage III 35%; Mean follow up 43.10 months (range 0 - 178. SD. 45.5), Gap Survival to 5 years was 36% without rest with a median of 20 months, Gap of 1 to 14 days with a median of 35 months and 40% of survival to 5 years; and 55% from 15-30 days of survival to 5 years (p> 0.05). Conclusions: These results reflect the occurrence pattern of anal cancer in a specific area of Colombia, and the importance of a multidisciplinary treatment group.
ECX as neoadjvuant chemotherapy for gastric cancer in South America.
Authors: Colli Leandro Machado , Godoy Antonio Carlos , Filardi Bruno , Figueiredo Jose Marcio Barros , Santos José Sebastião , Zola Fabio Eduardo , Rapatoni Liane , Peria Fernanda Maris 
Published: March 2020

e15190 Background: Gastric cancer is a common malignant disease with a high mortality rate. Neoadjuvant treatment is efficient, but not the first option for treatment in all countries. Studies of neadjuvant chemotherapy in gastric cancer in South American countries are lacking. The aim of this retrospective analysis was to investigate the use of the ECX (epirubicin, cisplatin, and capecitabine) regimen in the neoadjuvant therapy in a Brazilian population. Methods: 25 patients (median age, 61; range 36-78 years; 14 pts >60 years) with locally advanced gastric adenocarcinoma received three courses of preoperative chemotherapy with epirubicin 50 mg/m², day 1, cisplatin 60 mg/m², day 1, and capecitabine 625 mg/m² bid, days 2-21, of a 21-day cycle. Toxicity was assessed by the Common Toxicity Criteria (CTC) after every cycle. Progression-free survival (PFS) was defined as time from diagnosis to disease progression assessed by CT. Results: 21 pts completed all three planned cycles of neoadjuvant chemotherapy. Four patients receiced surgery earlier than planned due to bleeding (1), toxicity (1), abdominal infection (1), and non-adherence to treatment (1). Three patients could not be operated due to disease progression. 70% of operated patients had curative resection with two pathologic complete response. Only six out 25 patients had disease progression and only two died after a median follow-up of 11.5 months (range 3.4-20.2). Median PFS and overall survival were not reached. Toxicities grade 3-4 were neutropenia (28%), febrile neutropenia (8%), bleeding (8%), and heart failure (6,2%). Conclusions: ECX is a efficacious neoadjuvant treatment in the Brazilian population and also well tolerated and safe. However, more studies with a larger South American population are needed.
Cisplatin and capecitabine with and without docetaxel as a first-line chemotherapy in patients with metastatic gastric carcinoma: Single clinical experience.
Authors: Narimanov Mekhty , Tryakin Alexey , Zarkua Varlam , Bazin Igor , Garin August , Tjulandin Sergei 
Published: March 2020

e15194 Background: Cisplatin and capecitabine and docetaxel are active agents for treatment of metastatic gastric carcinoma. We underwent analysis of efficacy and toxicity of douplet (CX ) and triplet (DCX) regimens which were used in our department as a first-line chemotherapy in patients with metastatic gastric carcinoma. Methods: Pts with metastatic gastric carcinoma were nonrandomly allocated to DCX regimen (docetaxel 75 mg/m2 i.v. day 1, cisplatin 75 mg/m2 i.v. day 1, capecitabine 1650 mg/m2 per os days 1-14) or CX regimen (cisplatin 75 mg/m2 i.v. day 1, capecitabine 2000 mg/m2 per os days 1-14 ). Up to 6 cycles were provided every 3 weeks. G-CSF was not routinely used for primary prophylaxis. Results: From 2008 to 2012 81 pts were included in the study (DCX – 37 pts, CX – 44 pts). Pts characteristics were similar in both groups (table 1). Median number of cycles in both groups was 5 (range, 1-6). Grade 3-4 toxicity (per cycle) in DCX and CX groups were neutropenia 24,9% and 16,1%, deep venous thrombosis – 2% and 0%, diarrhea – 6.2% and 7,4%, stomatitis – 3.8% and 2,2%, infection – 11% and 0%, anemia 14% and 13,5% pts, respectively. No toxic deaths were observed. Median progression-free survival (PFS) in DCX and CX were 7,5 months (95% CI 6,1-8,9) and 5,4 months (95% CI 5,0-6,2; p=0.0009), median overall survival (OS) 14,5 months (95% CI 10,1-18,9) and 9,3 months (95% CI 9,2-10,2; p=0.0018), respectively. Conclusions: Addition of docetaxel to the combination of cisplatin and capecitabine associates with significant improvement of PFS and OS. Higher rate of infection requires use of G-CSF in primary prophylaxis. [Table: see text]
Treatment efficacy in patients with advanced biliary tract cancer receiving gemcitabine and cisplatin and 21-h infusional 5-FU: An analysis of 17 cases.
Authors: Aznab Mozaffar , Eslam pia Kiumars , Setayeshi Khosro , Rezaei Mansour , Kavianymoghadam Kaveh 
Published: March 2020

e15195 Background:Biliary tract a group of tumors which only a minority of patients is eligible for curative surgery. The purpose of this study was to identify efficacy treatment of gemcitabine, cisplatin, and 21h infusional 5-FU in patients with advanced BTC receiving this therapy, and the median time to progression and OS time. Methods: The data of 17 patients with advanced biliary tract cancer who referred to clinic oncology of Kermanshah University of Medical Sciences, which received treatment from January 2009 to December 2012 were collected. Patients with gallbladder cancer with local invasion into near structures or metastatic to lymph node and or liver and or peritoneal seeding and also patients with cholangiocarcinom were randomized to recieveing chemotherapy consisting of cycles of continuous infusion of 5-FU for 21-hours (600 mg/m2) days 1, 2, 3, and 4. Gemcitabine was given at dose of 1,250 mg/m2 days 1 and 8 and cisplatin was given at dose of 60 mg/m2 day 1 with G-csf every support. Each cycle repeated every 21 days for 6-7 cycles. Results: A total of 17 patients with age range 41-61 years studied.58.8% female and 41.2% were male. The 11 patients were gallbladder cancer with only local invasion into surrounding structures in 7 pts and 2 pts with only lymph node and peritoneal involving and 2 pts with lymph node and peritoneal involving and liver metastasis, and 6 patients were cholangiocarcinoma with lymph node and peritoneal involving in 3 pts and one pts with lymph node involving and one pts with liver metastasis. Four out of the 11 patients with gallbladder cancer with local invasion survived above 29 months one pts above 20 months. Means and medians for TTP of 6 pts which disease progressed was 11.2 and 9.6 months, respectively. Means for OS Time of 17 pts was 32 months. The overall 75.5% of pts are alive. This regimen was well tolerated, with neutropenia and thrombocytopenia as the most significant toxicities. Conclusions: The triple therapy with Gemcitabine cisplatin, 5-FU showed efficacy with manageable toxicity in patients with advanced BTC and demonstrated that the addition infusional 5-FU to cisplatin and gemcitabine afforded significant PFS and OS benefits.
Occult hepatitis B virus infection in patients with chronic liver disease.
Authors: Diniz Paulo Henrique Costa , Faria Luciana Costa , Vidigal Paula Vieira Teixeira , Xavier Marcelo Antonio Pascoal , do Amaral Nayra Soares , Resende Alexandre Prado , Lima Agnaldo Soares , Miranda Debora Marques , Ferrari Teresa Cristina de Abreu 
Published: March 2020

e15199 Background: Occult hepatitis B virus (HBV) infection is characterized by persistence of HBV DNA into the tissue of hepatitis B surface antigen-negative individuals. The clinical relevance of this infection is still under debate. In particular, the impact of occult HBV infection in cases of hepatocellular carcinoma (HCC) is uncertain. Methods: We investigated the prevalence of occult HBV in patients with chronic liver disease, with or without HCC, that were submitted to liver transplantation or partial hepatectomy in Alfa Institute of Gastroenterology from Clinical Hospital - UFMG - Brazil. We tested the presence of VHB DNA in liver sample using nested PCR in four different regions of viral genome (pre-S/S, pre –core/core, polymerase and X). We also tested these patients’serum for HVB antigens (HBsAg and HBeAg)and antibodies (anti-HBs, anti-HBe and anti-HBC). Results: Our studied population included 71 patients, 50 (70.4%) were male and had median age of 51±12.5 years. Cirrhosis etiology was alcoholic (22 cases, 32.4%), viral hepatitis (17 cases, 25%), cryptogenic (16 cases, 23.5%), autoimmune (10 cases, 14.7%) and 3 cases of other etiologies. HCC was found in 22 patients (31.4%). Viral DNA was detected in 4 cases (5.6%), three of them with HCC. Among these three cases viral DNA was found in non-tumoral area in two of them and in HCC sample in the other one. Conclusions: The prevalence of occult hepatitis B infection was high in our population of cirrhotic patients submitted to liver transplant, especially with associated HCC.
Salvage high-dose chemotherapy for primary mediastinal nonseminomatous germ cell tumors: Single institute experience.
Authors: Walker John WT , North Scott A. , Basappa Naveen S. , Venner Peter M. 
Published: March 2020

e15503 Background: Primary mediastinal non-seminomatous germ cell tumors (PMNSGCT) bear a worse prognosis than stage-matched testicular primaries, with a five year survival rate of 50%. In contrast to relapsed testicular NSGCT, retrospective analyses have not shown benefit to high-dose chemotherapy and autologous stem-cell transplant (HDCT/ ASCT) in PMNSGCT patients. Since publication of these studies, advancements in treatment regimens and supportive care have occurred, with emerging evidence suggesting HDCT/ASCT may benefit patients with PMNSGCT - both as first-line sequential treatment after standard-dose chemotherapy and at relapse. Objectives: Review the experience of patients presenting with PMNSGCT to a regional referral cancer center as a quality control assessment. Assess the benefit of salvage HDCT/ASCT to relapsed PMNSGCT patients. Methods: Patients presenting with PMNSGCT from 1980-2010 were abstracted from a Provincial cancer registry and records were retrospectively reviewed. Data includes patient demographics, cancer treatments and outcomes. Results: Fourteen male patients (median age 29; range: 17-54 years) with PMNSGCT were identified. Seven of 13 (54%) patients remain continuously disease-free with 1 patient lost to follow-up. Mean duration of follow-up in these patients is 57 (34-100) months. Three patients died having received ≤ 1 cycle of chemotherapy; exclusion of these patients results in a treatment failure rate of 30%. Six of the 7 cancer-free patients required salvage surgery. Three patients received tandem HDCT/ASCT (carboplatin 550 mg/m2 and etoposide 150 mg/m2daily for 4 days) at subsequent relapse despite second-line chemotherapy. Two remain disease-free at 45 and 74 months respectively, while the third patient died of their disease 14 months post-transplant. Conclusions: Our experience with PMNSGCT is generally consistent with published outcomes in that ≈50% of patients are cured. However, in this series 2/3 heavily pretreated patients were salvaged with HDCT/ASCT, refuting the published historical experience. This study is limited by its small sample size, but provides impetus to re-examine HDCT/ASCT for high-risk patients.