bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resource utilization among neuroendocrine tumor patients in the United States.
Authors: Casciano Roman , Chulikavit Maruit , Parikh Rohan , Stern Lee , Liu Zhimei , Wang Xufang , Grzegorzewski Kris , Strosberg Jonathan R. 
Published: March 2020

e14627 Background: Neuroendocrine Tumors (NET) constitute over 100,000 prevalent cases in the United States (US), with predicted increase of incidence in the future. Advanced NET is associated with significant morbidity and mortality. Resource use was assessed for managing advanced NET. Methods: As part of a global study, an online survey was administered to US physicians to quantify resource use among advanced pancreatic (pNET) and lung/gastrointestinal (GI) NET patients. The study collected resource use data (treatments, visits with survey and other physicians, surgery and hospitalizations) for baseline (diagnosis to 1st progression of disease [PD]), 1st and 2nd PD periods. PD was defined as measurable/radiographic evidence of tumor progression. As patients with 2nd PD were likely to be less, resources were estimated in a hypothetical scenario. Results: 55 US physicians provided data on 110 NET patients (36.4% pNET, 63.6% Lung/GI NET). Average follow up in baseline was 14.0 and 13.3 months for pNET and Lung/GI NET, respectively; in 1st PD period, it was 5.7 and 7.9 months, respectively. For 2nd PD, it was assumed to be 12 months. Table 1 shows resource use for baseline and 1st PD. Increased use of chemotherapy, somatostatin analogs, hospitalization and other physician visits was observed during 1st PD, especially for pNET patients. Targeted therapy use was minimal at baseline and 1st PD; however it may increase in 2nd PD. Conclusions: Among advanced NET patients, resource use is generally high and there appears to be an increase in resource use upon PD, especially in patients with pNET. [Table: see text]
Perioperative management of patients with distal esophagus and gastroesophageal junction tumors: Three years of results.
Authors: Zemanova Milada , Pechacova Zdenka , Harustiak Tomas , Fencl Pavel , Vitek Pavel , Petruzelka Lubos B. 
Published: March 2020

e14631 Background: In patients with operable gastroesophageal adenocarcinoma, a perioperative regimen ECF significantly improved survival (MAGIC trial - Cunnigham 2006) and has been accepted as standard treatment option. In our study we present experience with modified MAGIC protocol in patients with lower esophagus or GE junction tumors. Methods: 67 patients (pts) (60 men, 7 women), median age 59 years (37-74), with resectable adenocarcinoma in lower esophagus or gastroesophageal junction were included in period 01 Mar 2008 – 15 Jun 2010. Fifty one (76%) pts had clinical stage nodal positive. Chemotherapy (CT) consisted of three preoperative and three postoperative cycles of intravenous epirubicin (50 mg/m2) and cisplatin (60 mg/m2) on day 1, and a continuous infusion of fluorouracil (200 mg/m2 per day) for 21 days or oral capecitabine 1000 mg/m2 for 14 days. Postoperative radiochemotherapy (CRT) with fluorouracil or capecitabine after the end of CT was indicated in pts with two and more positive lymphnodes in surgical specimen if feasible. Results: Preoperative CT completed 64 (94%) pts, 52 (78%) had surgery, 46 (69%) had radical resection with 3 cases of complete pathological response, 22 pts had pN0 and 21 pts pN plus finding. Postoperative CT was started in 39 (58%) pts and was completed in 32 (48%) pts. 10 (22%) pts had postoperative CRT. Adverse events grade 3-4 were: neutropenia 10%, vomiting 8%, fatigue 5%, diarrhea 3%. Reasons for omitting surgery in 15 (22%) pts were: progression in 7 pts, medically unfit in 4 pts, other in 4 pts. With a median follow-up of 31 months (17-47) there were recurrences in 35 (52%) of all pts, in 5 (7%) pts locoregional only, in 7 (11%) distal plus locoregional and in 23 (34%) pts distal metastases. Recurrence rate in radically resected pts was 39%, in patients with pN0 28% and in pN1 86%, despite adding CRT. Thirty one patients are alive with 3-year survival 46%. Conclusions: Perioperative chemotherapy ECF/ECCap in our set was feasible and well tolerated. Patients with node positive postoperative stage had poor prognosis, despite completing adjuvant treatment including postoperative CRT. This work was supported by grant NO: IGA MZ(CR) NT/12331-5/2011.
Photodynamic therapy with temoporfin in combination with gemcitabine/capecitabine in biliary tract cancer: Feasibility and safety in a randomized phase II trial.
Authors: Hauge Truls , Warloe Trond , Hauge Petra Weber , Franco-Lie Isabel , Drolsum Anders , Johansen Cathrine , Viktil Ellen , Aabakken Lars , Buanes Trond , Konopski Zbigniew 
Published: March 2020

e14637 Background: Patients whocannot be offered curative surgical treatment for biliary tract cancer (BTC) have a poor prognosis. Photodynamic therapy (PDT) has been shown to improve survival and quality of life in patients with unresectable BTC. A combination of treatment modalities might improve survival further, but such data are still lacking. Therefore we have performed the first randomized trial on the combination of temoporfin/PDT and chemotherapy. Here we report data on the feasibility and safety. Methods: Randomized phase II trial, planned to include 20 patients with time to progression as primary endpoint, feasibility and toxicity as secondary endpoints. Inclusion criteria were unresectable BTC confirmed by histology or cytology, need for biliary stent, bilirubin level < 50 mmol/L and no previous cancer disease. The treatment arms were: A: Stent, temoporfin / PDT followed by gemcitabin / capecitabin (GemCap). B: Stent, GemCap. Only one initial PDT treatment was given. Results: Twenty patients with locally advanced and metastatic disease were included, 10 patients in each arm. Two patients in arm B did not receive any treatment (thrombocytopenia, study withdrawal) and two patients in arm A did not receive chemotherapy (ECOG>2, infection). PDT was feasible in all 10 patients without any acute procedure-related complication. During the first 30 days, two cases of cholangitis in arm A and three in arm B were observed. Cutaneous erythema (grade 1-2) was observed after PDT in two patients. Conclusions: PDT using temoporfin in combination with chemotherapy in BTC was feasible. Restrictions to light exposure were well tolerated. PDT in combination with chemotherapy did not increase the complication rate during the first 30 days follow-up. Three months follow-up data will be available at the time for presentation. Larger prospective trials are warranted to assess the efficacy of this treatment combination.
Multispecialty care among hepatocellular carcinoma patients in SEER-Medicare.
Authors: Breunig Ian Michael , Shaya Fadia T. , Mullins C. Daniel , Chirikov Viktor , Seal Brian S. , Hanna Nader 
Published: March 2020

e14638 Background: Multispecialty care has increased for many cancers yet little evidence exists for hepatocellular carcinoma (HCC). Methods: Medicare non-transplant patients with HCC 1ry diagnosis in 2000-07 were studied using SEER-Medicare data with HCC claims generated from Medicare parts A-B, including patients with >=1 claims for HCC-related physician visits post-diagnosis. Physician specialties were grouped as Gastroenterology (GE), General/Family/Geriatric/Internal (GF), Diagnostic/Intervention radiology (DIR), Hematology/Medical oncology (HMO), General surgery/Surgery oncology (GSO), Radiation oncology (RO), Multispecialty clinic/group practice (MG), or Others. Visits by specialty seen within 4 weeks, and trends, were explored by comparing distributions, using t-tests, of visits by specialty, from the 2000/01 diagnosis cohort and the 2006/07 cohort. Results: Out of 2284 HCC patients diagnosed in 2000/01, 1380 (60%) had at least one HCC-related physician visit post-diagnosis, and 1330 (58%) within 4 weeks. Excluding the “Others” category, 1015 (44%) visited within 4 weeks. Of 3155 patients diagnosed in 2006/07, 1782 (56%) had any HCC-related visit, 1689 (54%) within 4 weeks, and 1295 (41%) when excluding Others. Among patients with at least one post-diagnosis HCC-related visit ever, the percentage of patients who saw only 1 type of specialist within 4 weeks of diagnosis did not change (44% in 2000/01 vs. 43% in 2006/07; p=0.15); nor did the percentage visiting multiple specialists (52% vs. 53%; p=0.58). The percentage of patients visiting GE within 4 weeks went from 27% to 25% (p=.10), 11% to 10% (p=.41) for GF, 28% to 31% (p=.08) for HMO, 4% to 3% (p=.53) for RO, 65% to 67% (p=.33) for Others, and remained at 23% for DIR, 16% for GSO, and 1% for MG. Among patients who saw only 1 type of specialist within 4 weeks of diagnosis, the percentage visiting GE went from 14% to 12% (p=.29), 4% to 5% (p=.50) for GF, 11% to 10% (p=.55) for DIR, 11% to 12% (p=.36) for HMO, 4% to 3% for RO, 52% to 53% for Others, and remained at 5% for GSO, and <1% for MG. Results are robust when “Others” are excluded. Conclusions: Despite increased incidence of HCC since 2000, there was no significant trend toward multidisciplinary care.
Primary small cell carcinoma of the esophagus: Retrospective analysis of the Veterans Affairs Cancer Registry.
Authors: Abu Hazeem Mahmoud , Thota Ramya , Subbiah Shanmuga , Silberstein Peter T. 
Published: March 2020

e14641 Background: Small cell carcinoma (SCC) of the esophagus is a rare aggressive and rapidly fatal neoplasm, often diagnosed in late stages. Hence no prospective studies evaluating the most effective treatment strategies have been done. We aim to describe the clinicopathological features and treatment outcomes of this rare entity. Methods: Retrospective analysis of 49 patients diagnosed with SCC of the esophagus from 1995 to 2009 was done via the Veteran's Affairs Central Cancer Registry. Demographics, staging, treatment, and outcomes data was recorded. Staging was classified as limited (no distant metastasis) or extensive stage (metastatic disease). Results: Out of 10,540 patients with esophageal cancer, 49 were diagnosed with SCC (0.005%) and were mainly located in the middle and lower thirds of the esophagus (84%). Median age of diagnosis was 64.1 yrs (range: 26-90). 19 patients had limited disease, 26 patients had extensive disease and four patients who were not staged adequately were excluded. Patients received a variety of treatments (Table) with different survival outcomes. Limited stage SCC patients had a median survival of 6.3 mos with patients who received combined modality therapy showing a trend towards improved outcomes. Extensive stage patients who received no therapy had very poor outcomes compared to patients who received any therapy. Conclusions: SCC of esophagus should be considered a systemic disease and like pulmonary SCC, it is an aggressive tumor associated with a poor prognosis. Patient numbers are too low to draw definitive conclusions regarding choice of therapy. Extensive disease patients benefit from chemotherapy and combined modality therapy should be considered in limited stage disease. [Table: see text]
Ascitic derived primary pancreatic cancer cell cultures from different patients as a platform for personalized medicine.
Authors: Golan Talia , Atias Dikla , Avivi Camila , Barshack Iris , Berger Raanan 
Published: March 2020

e14646 Background: In Pancreatic Cancer (PC) challenges in drug development include: obtaining metastatic cancer tissue for research, developing and validating biomarkers predicative for personalized therapeutic decisions. We have recently developed a novel therapeutic model for PC to address these challenges based on the isolation of viable PC cells derived from ascitic fluid. Methods: Ascitic fluid was obtained from PC patients undergoing palliative paracentesis. In several patients ascites was obtained several times during the course of their disease. Ascitic-derived primary PC cells were isolated, cultured and identified for each patient in vitro. Informed consent was obtained for all patients. Results: We successfully established ascitic-derived primary cell cultures in 87% (53/61) of the ascites obtained. Homogeneous epithelial PC enriched cell cultures were identified; CK 7/8 (epithelial marker) staining by FACS in 90-95% of the cells, IHC strong staining of CK 7 and negative staining for CK 5/6 in the majority of cells in the cultures. We observed a wide range in doubling time and migration properties among the patients' cell cultures. The diverse nature of each individual patient's cell cultures were further demonstrated by varying chemo-sensitivity to gemcitabine and additional therapeutic agents. Morphological changes were observed at different stages of disease, most cells initially displayed a characteristic epithelial morphology. With more advanced disease a mixed morphological appearance "epithelial-mesenchymal" was seen and up regulation of various epithelial-mesenchymal-transition markers were observed by real-time PCR. Conclusions: We have developed a unique primary ascitic-derived PC cell culture model. These cell lines have the potential to serve as a relevant model to study signaling pathways in PC progression, and to assess the sensitivity to therapeutic agents in a short time frame, therefore supporting personalized treatment decisions.
Effect on survival of postoperative therapy in patients with primary small cell carcinoma of esophagus (SCCE): An analysis of multicenter clinical outcomes.
Authors: Wen Zou Bing , Tao Li , Yuan Ma Dai , Qiang Zhou , Xu Yong , Li Lu , Huang Meijuan , Zhu Jiang , Zhou Lin , Wang Jin , Zhang Yu , Lu You 
Published: March 2020

e14648 Background: To retrospectively evaluate the therapy pattern and survival in patients with dissection of primary SCCE. Methods: This study included 89 patients from four centers in southwest China who underwent radical section of SCCE without any preoperative therapy. 36 were treated with postoperative chemoradiotherapy (POCRT), and 53 with postoperative chemotherapy (POCT) alone. The radiation dose to clinical target volume (CTV) was 50 Gy (varying between 44 and 52 Gy), while the cycles of platinum-based chemotherapy ranged from two to six with a median of four. Results: The 5-year overall survival rate (OS) and 5-year disease-free survival rate (DFS) were 16.4% and 14.3% for all patients,respectively. The 5-year overall survival rate was 21.5% in the POCRT group, and 12.9% in the POCT group (p=0.013). The 5-year DFS was 21.3% in POCRT group and 9.3% in POCT group (p=0.028). There was significant difference in 5-year local recurrence-free survival (LRFS) between POCRT and POCT (LRFS: 74.6% vs. 45.3%, p=0.022), while no difference for 5-year distant recurrence-free survival (DRFS: 37.3% vs. 17.4%, p=0.101). Subgroup analysis revieled that there were obvious difference in 5-year OS and DFS between patients received radiotherapy less than 75 days after surgery and ≥ 75 days (OS: 35.6% vs. 8.6%, p=0.046; DFS: 24.9% vs. 7.3%, p=0.020), while received radiotherapy less than 75 days after surgery have worse DRFS (p=0.041). In a multivariate analysis, age ≥59 years was associated with significantly worse OS while with lymph node involved infulence DFS. Tumor size more than 3cm, absence of radiotherapy and less than 4 cycles chemotherapy were poor prognostic factors for both overall survival and disease-free survival. Conclusions: Our analysis shows that postoperative chemotherapy improved OS and DFS in patients with dissection of SCCE, while radiotherapy was given less than 75 days after surgery may improve DRFS and OS. In those patients received postoperative chemotherapy less than 4 cycles is the most important characteristic associated with decreased survival.
MicroRNA-218: A potential regulator of lymphatic metastasis in pancreatic ductal adenocarcinoma.
Authors: He Hang , Di Yang , Liang Min Rui , Yang Feng , Yao Lie , Hao Si Jie , Li Ji , Jiang Yong Jian , Jin Chen , Fu De Liang 
Published: March 2020

e14651 Background: Early lymph node metastasis is one of the most important characteristic features of pancreatic ductal adenocarcinoma (PDAC) with a dismal prognosis. MicroRNAs (miRNAs) have been shown to have a role in oncogenesis, invasion, and metastasis via epigenetic posttranscriptional gene regulation. However lymphatic metastasis related miRNAs of pancreatic cancer (PC) has not been well documented. Methods: Through microarray analysis aberrantly expressing miRNAs potentially regulating lymphatic metastasis in PC were gained from PDAC tissue specimens and cell lines. Candidate miRNAs were confirmed in total 40 resected PDAC cases and cell lines by quantitative reverse transcription-PCR (qRT-PCR). In situ hybridization was performed to elucidate the expression features of miRNA-218 in PDAC, precursor lesions, metastatic lymph nodes and cell lines. Results: MiRNA-218 and other five miRNAs were found aberrantly expressing both in PDAC and BxPC-3-LN5 (cell line with high-metastasis characteristics) by microarray analysis. Down-regulated expression of miRNA-218 was validated in PDAC tissue samples (4 fold decrease) compared to adjacent benign tissue (p=0.006) and cell line BxPC-3-LN5 (3 fold decrease) compared to BxPC-3 (p=0.01). Clinicopathological data demonstrated inverse correlation of miRNA-218 expression with lymph node metastasis (p=0.045). Expression of miRNA-218 was down-regulated in IPMN and even decreased in PDAC in a grade-dependent manner. Almost negative expression of miRNA-218 was revealed in metastatic lymph nodes. Conclusions: Down-regulated expression of miRNA-218 in PDAC and its expression features in precursor lesions suggests a tumor suppressor action of miRNA-218 in PDAC. Decreased expression of miRNA-218 may be associated with lymphatic metastasis of PDAC and interpret the high-metastasis ability of BxPC-3-LN5 cell line.
Survival analysis of maintenance therapy with capecitabine (Cape) in patients with resected pancreatic adenocarcinoma (PAC) after adjuvant therapy: A retrospective cohort study.
Authors: Yang Xuezhong , Weinberg Benjamin , Hwang Jimmy J. , Wu Christina Sing-Ying , Akram Madeeha , Pishvaian Michael J. , He Aiwu Ruth , Marshall John 
Published: March 2020

e14658 Background: The 5-year survival of PAC with surgery alone is below 10%, and with adjuvant chemotherapy increases to about 20%. The original GITSG adjuvant study demonstrating a survival benefit compared to surgery could be attributed to the use of 2-years of weekly IV bolus 5FU, and not only chemoradiation. In theory, the prolonged exposure to therapy could maintain pressure on dormant cancer cells that may remain in G0 arrest, by attacking them as they infrequently enter G1/S phase. To evaluate this hypothesis, we retrospectively evaluated our pts who were treated with or without maintenance Cape. Methods: Pts in the Georgetown/Lombardi Cancer Center EMR since Oct 2007 were sought for PAC that was resected with curative intent, received standard adjuvant chemotherapy with or without chemoradiation. The study group received maintenance cape for at least 2 months, and the control group was monitored until disease recurrence. Only pts with complete follow-up survival data were analyzed. Results: 20 pts met the criteria as study group, and 58 pts as the control group. In the study group, cape was usually given 1000mg orally twice a day, Monday through Friday following adjuvant therapy, for an indefinite period, up to 2 years. Pts received cape for median duration of 12.5 months (2 to 24 months), and the median follow-up duration was 33 months (16 to 78 months). The median overall survival (OS) for the study group was 48 months. The 2 year OS was 94%, and 5 year OS was 40%. The median recurrence free survival (RFS) was 39 months. The 2 year RFS was 67%, and the 5 year RFS was 25%. Common toxicities were mild hand-and-foot syndrome and fatigue. 4 pts discontinued cape due to toxicities: febrile neutropenia, severe fatigue, weight loss and diarrhea. The control group was of comparable staging, and the median OS was 22 months, 5 year OS rate was 16%, median RFS was 13 months, 2 year RFS was 19%. Conclusions: In this single institute retrospective controlled cohort study, Cape maintenance therapy following adjuvant therapy in resected PAC is associated with a significantly (p<0.05) higher OS and PFS compared to the control group. This approach should be studied in a RCT.
Chemoradiotherapy for locally advanced esophageal cancer using carboplatin, paclitaxel.
Authors: Battley Jodie E. , O'Keeffe Margaret , Mulvihill Erica , O'Reilly Seamus , Bennett Michael William , O Suilleabhain Criostoir , Flavin Aileen , Murphy Thomas J , Power Derek Gerard 
Published: March 2020

e14666 Background: Localized esophageal adenocarcinoma is usually treated with multi-modality therapy, i.e., chemotherapy or chemoradiotherapy (CRT) followed by surgery. Standard treatment for localized squamous cell carcinoma is controversial as definitive CRT can offer the same overall survival as CRT followed by surgery. Cisplatin and infusional 5FU is the accepted chemotherapy in combination with RT. However this regimen is cumbersome to administer and is associated with significant toxicities. Based on recent data combining weekly paclitaxel with radiotherapy in both the neoadjuvant and definitive settings we report our early experience with this regimen. Methods: All patients (pts) were staged with CT, EUS and PET/CT. Pts with localized, operable or inoperable disease were included. CRT consisted of paclitaxel 50mg/m2 and carboplatin AUC = 2 on days 1, 8, 15, 22, 29, 35 with concurrent RT (5 days/wk, 41.4-50.4Gy). Results: From December 2010 to January 2012, 24 pts: male/female 20/4, median age 67 yrs (29-88), adeno/squamous carcinoma 14/10, lymph node involvement (21pts) were treated. 13 pts treated with neoadjuvant (NA) intent, 11 pts underwent definitive CRT. In the NA group grade 3/4 toxicities were non-hematologic: cardiac (1pt), fatigue (1pt), 2 pts died from progression of disease prior to surgery. Eight pts have undergone surgery (3 awaited). RO resection rate 87.5%, 1 pt had a pCR, 4 pts had a near pCR. At 3mth follow-up 3 pts had no clinical or radiological evidence of disease, 5 pts await repeat imaging. In the definitive group grade 3/4 toxicities included hematologic: neutropenic fever (1pt), non-hematologic: esophagitis (3pts). At 3mth follow-up 7 pts have stable disease, 4 pts await repeat imaging. Dysphagia improved in 21 pts, worsened in 3 pts, and 5 pts required a feeding tube (4 prior to CRT). Conclusions: Carboplatin and paclitaxel combined with radiotherapy is a tolerable regimen in either the neo-adjuvant or definitive setting for locally advanced esophageal cancer. Rates of toxicity compare favorably to standard cisplatin and infusional 5FU. Prospective data with long-term follow-up using this regimen have been reported in the neo-adjuvant setting and are awaited in the definitive setting.