bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malignancy following lung transplantation.
Authors: Khanshour Ammar , Abu Awwad Raed , Chapman Robert , Betensley Alan 
Published: March 2020

e12019 Background: Malignancy has been shown to be a frequent complication of solid organ transplantation. It has been reported more commonly in lung transplant patients compared to other solid organ transplant recipients presumably due to the greater degree of immunosuppression required for these patients; the International Society for Heart and Lung Transplantation (ISHLT) reported that malignancies account for 15% of all deaths of lung transplant patients between 5 and 10 years after transplant. The aim of this study is to describe malignancies observed in patients who underwent lung transplantation in a single, large tertiary center. Methods: A retrospective analysis of the medical records of all adult recipients of lung allografts transplanted at Henry Ford Hospital between 1994 and 2010 was performed. Main variables included age at transplant, type of transplant, smoking status and type of malignancy. Study end point was development of malignancy. Patients surviving less than 3 months were excluded from the final analysis. T-test and Chi-square tests were used in the statistical analysis. Results: 145 patients received lung transplants with 136 patients surviving at least 3 months. Of the 136 cases included; 31 (23%) patients developed post-transplant malignancy as follows: skin cancer in 17, lung cancer (in the native lung) in 10, colon cancer in 3, cervical cancer in 3, renal cell carcinoma in 2, post transplant lymphoproliferative disorder (PTLD) in 2, head and neck cancer in 2, bladder cancer in 1 and vulvar cancer in 1. Eight patients developed more than one malignancy. 83% of those who developed malignancy were smokers while 67% of those who did not develop malignancy were smokers (Chi-square is 3.41, P>0.05). Patients who developed malignancy were older at time of transplantation (mean ± SD, 58.0±7.5 vs. 55.6±9.0 years; P= 0.04). Conclusions: Malignancy is a common complication after lung transplantation, with skin cancer being the most common. Age at transplantation seems to be a risk factor for development of malignancy. Smoking as a risk factor did not reach statistical significance in the studied population.
Impact of diabetes and hyperglycemia on outcomes in advanced breast cancer patients.
Authors: Villarreal-Garza Cynthia Mayte , Shaw Robin J. , Lara-Medina Fernando , Bacon Ludwing , Rivera Daniel , Urzua Lorena , Aguila Christian , Ramirez-Morales Rebeca , Bargallo Rocha Enrique , Alvarado Miranda Alberto , Santamaria-Galicia Julieta , Sifuentes Erika , Mohar Alejandro , Herrera Luis A 
Published: March 2020

e12027 Background: Clinical experience and previous studies suggest that women with diabetes and breast cancer (BrCa) have worse outcomes than their non-diabetic counterparts. However, analysis of the contribution of diabetes to BrCa specific mortality is difficult because of the substantial mortality attributed to diabetes alone and because diabetes is commonly associated with adverse prognostic factors specific to BrCa. The purpose of this study was to examine the impact of diabetes and hyperglycemia on cancer-specific survival of patients with metastatic or recurrent BrCa. Methods: We performed a retrospective analysis of patients with advanced BrCa receiving palliative chemotherapy from 2006 to 2011 at the National Cancer Institute in Mexico, and compared breast cancer-specific mortality in diabetic and non-diabetic patients, as well as in patients that presented hyperglycemia during palliative treatment. Results: A total of 265 patients receiving palliative therapy were eligible for inclusion. Previous diagnosis or detection of diabetes at recurrence was recorded in 40 patients (15%). No difference was observed between diabetic and non-diabetic patients in terms of overall survival (OS). A statistically significant difference in OS was observed between patients without diabetes and diabetics who had hyperglycemia (p=0.003). OS in diabetic patients with proper metabolic control was shown to be superior compared to diabetics with hyperglycemia (p=0.01). Hyperglycemia was identified in 14% of non-diabetics at some point while receiving palliative treatment. For patients that experienced hyperglycemia during treatment or who had a mean glucose level > 130, either in the diabetic or non-diabetic subgroups, a worse outcome was noted compared to normoglycemic patients, with a HR of 1.5 (p=0.029) and HR of 2.04 (p=0.006) for death, respectively. Conclusions: Elevated glucose levels confer a poor outcome in diabetic and non-diabetic patients in contrast with patients with normoglycemic levels, conferring an elevated risk of death. According to these results, clinicians must monitor glucose levels during treatment for advanced BrCa disease, and should take action in order to maintain normal glucose levels.
Prognostic significance of NANOG and KLF4 for breast cancer.
Authors: Nagata Takuya 
Published: March 2020

e12028 Background: iPS cell inducing factors (Oct3/4, Sox2, Klf4, c-Myc, and Nanog ) are reported that they appears not only in ES cells(Embryonic stem cell), but also in normal cell or carcinoma cell, including breast carcinoma. We evaluated the expression of iPS inducing factors in the human breast cancer specimen with immunohistochemistry, and analyze the relativity of the relapse and the prognosis after the operation. Methods: 200 cases of breast cancer that were performed the surgical operation in this department were examined. Expression of c-MYC, KLF4, NANOG, OCT4 and SOX2 were determined by immunohistochemistry using a tissue microarray. Results: The average of the patient's age was 55.2 years old (29 - 87), and the advanced breast cancers in stage II or more were 122 cases (61%). About the hormone receptor and the HER2 appearance, Hormone receptor positively (HR+) types were 162 cases (81%), 10 cases (5%) were HER2 positively (HER2+) type, and 28 cases (14%) were triple negative (TN) type. During the following period from operation, the relapse was found in 48 cases (24%), and 18 cases (9%) were died. The average of survival time after the operation was 80.7 months (4 - 162). Patients with strong expression of NANOG had significantly lower disease-free survival and overall survival rates than those with weak expression of NANOG (p=0.004 and P=0.033, respectively). In contrast, patients with strong expression of KLF4 had better disease-free survival (p=0.014). Conclusions: Strong expression of NANOG was an indicator of a poor prognosis for breast cancer patients, while KLF4 was a favorable prognostic indicator. Our results suggest that NANOG stimulates the growth and metastasis of breast cancer cells, whereas KLF4 inhibits these processes.
Cancer sites and/or histologies with increasing incidence in elderly.
Authors: Thakkar Jigisha P. , McCarthy Bridget J. , Villano John L. 
Published: March 2020

e12036 Background: In the US, from 2004-2008, approximately 7.8% of all cancers were diagnosed and 15.2% of cancer deaths occurred in those age 85 and older. Due to the aging of the US population, a focus on the incidence of cancer in the elderly population is needed to advance knowledge on the prevention, diagnosis, and treatment of cancer in this age group. Methods: Data was retrieved from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Cancer Statistics Review and from the SEER website. Data from seventeen SEER registries for the years 2000-2008 were included. Cancer sites/histologies included invasive cases only, unless otherwise noted, and rates were per 100,000. Age-specific incidence rates for meningioma were obtained from Central Brain Tumor Registry of the United States (CBTRUS) Statistical Report: NPCR (National Program of Cancer Registries) and SEER (2004-2007). Results: The overall cancer incidence rate decreases in the elderly age group. The age-specific (crude) SEER incidence rate for all cancer sites combined for those aged 85+ is 2299.65/100,000. Elderly males have a higher incidence rate as compared to elderly females (3220.7 versus 1884.9). Despite the overall decline in the incidence rate in the oldest age group, the cancer sites and/or histologies with continued increasing incidence rates after 85 years of age are: colon, bones and joints, gall bladder, Kaposi’s sarcoma, leukemia, myelodysplastic syndromes, pancreas, soft tissue including heart, vulva, vagina, and meningioma. Conclusions: Among cancer sites with increasing incidence after age 85; colon cancer has the highest incidence rate. Screening and early diagnosis for cancer in the elderly should be critically considered for colorectal cancers.
Distribution and impact of research in hematology and oncology in Latin America (LATAM): A decade of uncertainty (ONCOLGroup).
Authors: Acevedo Andres , Cardona Zorrilla Andres Felipe , Rios Paola , Becerra Henry A. , Gomez Alexandra , Hernan Carranza , Vargas Carlos A. , Otero Jorge M. , Castro Carlos , Reveiz Ludovic 
Published: March 2020

e12039 Background: Brazil provides 1% of the worldwide scientific output registered in ASCO. However, contribution made by other LATAM countries remains unknown. The main objective is to evaluate LATAM countries’ scientific output regarding hematology and oncology and their global impact. Methods: Astructured search was made in ASCO, ASH, ESMO and ASTRO databases to identify abstracts recorded between 2000 and 2010 referring to any author, institution or population from LATAM. The search was expanded using Internet to find indexed or non-indexed publications referring to each selected reference. Simple random sampling was used to check 10% of the references and verify the quality of the data. Results: 1,858 of the 2,625 references that were identified fulfilled the inclusion criteria. Sixteen of 19 countries evaluated had at least one record during the 10 year target period; five countries represented 93.6% of scientific output (Brazil 51.1%/Argentina 19.9%/ México 14.1%/Peru 6.2%/Chile 2.4%) whilst Colombia only contributed 1.3%. Two-thirds of the work had been presented as abstracts, a third as posters and less than 2% orally; 17% of the abstracts had been published in a scientific journal (90% in international journals, with a mean impact factor and average citations rate of 3.5 and 14.2 respectively), 1.6 years after the meeting. Conclusions: Latin America’s contribution to scientific knowledge regarding hematology, oncology and radiotherapy is growing. The geographical distribution of such production depends on 5 countries; nevertheless, abstracts’ publication rate in journals is low.
Direct burden of oncologic disease in a socialized health care system: Using acute myeloid leukemia as an example.
Authors: De Correia Pereira Marta Isabel , Cortesao Emilia , Espadana Ana , Marques Gilberto P , Geraldes Catarina , Teixeira Adriana 
Published: March 2020

e12040 Background: Portugal has a socialized national healthcare system (NHS), rated 12th overall by WHO (2000), that exempts oncologic patients from paying the direct costs of treatment. It has a per capita Gross Domestic Product of $22 699 (International Monetary Fund, 2011), less than 50% of the US, and was severely affected by the international Financial Crisis, requiring a bail-out; in this scenario, the state budget for health for 2012 is approximately $9900 million. Adult acute myeloid leukemia (AML) is a relatively rare cancer, with standardized non-surgical inpatient treatment protocols (outside clinical trials) that are subject to little variation between centers and over time, characteristics that make it an ideal example to evaluate the impact of oncologic disease on a socialized healthcare system. Methods: We reviewed all new diagnoses of AML over a five-year period (2006 to 2010) in one of the 7 national centers that treat adult AML, to estimate the yearly expenditure with direct costs. Results: Over the period considered, 192 new adult cases were diagnosed (38.4 cases per year, 47% male), with a median age of 63 years; 43.8% were 65 or over. The 2009 National Directive assumes the daily cost of one hospitalization for uncomplicated adult “acute leukemia” [sic] to be $1250, with an average hospital stay of 12.2 days, amounting to $15 250; minor complications increase this to $2400 and 19.5 days, and major complications to $6 480 times 25 days, or $162 000. An allogeneic HSC transplant (allo-HSC) costs $9 605 daily, over 35.5 days, or $340 800. Assuming induction and one cycle of consolidation in under-65 cases, this Hospital would spend between $700 000 (no complications in either cycle) and $7 million (all cases with major complications in both cycles) on new cases per year. Additional cycles and allo-HSC push the estimate towards $1-10 million. Conclusions: While chronic metabolic, cardiovascular and respiratory diseases consume the bulk of resources, the burden of oncologic disease on a socialized NHS is marked. AML ideally exemplifies how a small number of patients can consume vast resources: as this estimate shows, Portugal could expect to spend $7-70 million of the 2012 health budget on new cases of AML alone.
Prevalence of angiomyolipoma among patients with tuberous sclerosis complex: A U.S. Healthcare Claims Database study.
Authors: Liu Zhimei , Sun Peter , Kohrman Michael , Bissler John 
Published: March 2020

e12042 Background: Angiomyolipoma (AML) are common benign neoplasm in the kidney, and are associated with tuberous sclerosis complex (TSC). The objectives of this study were to examine AML prevalence among TSC patients in a real world setting, and to explore the relationship between AML prevalence and ages, genders, or residential regions. Methods: A retrospective cohort study was conducted based on a large US commercial healthcare claims database. Patients with a TSC claim between 2000 and 2009 and with continuous 12-month enrollment after their first TSC claim were selected for the study. AML patients were identified based on ICD-9CM code (223.0X). Patients’ genders, residential regions, and age on their first TSC/or AML claim (if they had AML) were derived respectively from enrollment files and healthcare claims. Two-sample t tests and Chi-square tests were used to explore the relationships between AML prevalence, genders, residential regions and the age groups. Results: The study included 2,767 TSC patients with a mean age of 28.5 years on their first TSC claims, and 55.3% were female. AML prevalence among TSC patients was 7.8% in their first observed post-TSC year, and could be 78% at the end of the 10th observed post-TSC year if AML incidence rate (701.1 per 10,000 TSC patient years) remains constant. Associations between AML prevalence and age groups, genders, or residential regions were statistically significant (all p<0.05); and variations of AML prevalence by genders (Male: 5.6 vs. Female: 9.7%), residential regions (6.2-9.4%) and age groups at the first TSC claim (3.9% for age<1 year, 5.2% for age 1-5 years, 10.6% for 6-10 years, 8.4% for age 11-18 years, 13.6% for age 19-25 years, and 6.9% for age 26 years or more) were observed. Conclusions: In a real world setting AML occurred in 7.8% TSC patients in the first post-TSC year, and could increase to 78% within 10 years if the incidence rate remained at 701.1 per 10,000 TSC patient years. AML prevalence was associated with age, gender and residential regions, and varied significantly by ages, genders and residential regions. Further research is needed to explore the factors that resulted into these associations.
Acute toxicity profile of patients with low-grade gliomas and meningiomas receiving proton therapy.
Authors: Maquilan Genevieve , Grover Surbhi , Alonso-Basanta Michelle , Lustig Robert A. 
Published: March 2020

e12508 Background: Quality of life is not often studied but is an important outcome to measure when evaluating types of radiation treatment. This study attempts to provide data on the treatment effects of proton beam therapy on patients with low grade gliomas and meningiomas, using the National Cancer Institute Common Terminology Criteria (CTCAE) version 4.0 to analyze the severity and frequency of symptoms experienced acutely during and after radiotherapy. Methods: 23 patients diagnosed with low grade gliomas or meningiomas were enrolled in a prospective proton beam radiation treatment protocol (NCT01024907) and were treated and followed between April 2010 and August 2011 in the University of Pennsylvania Radiation Oncology Department. Patients received 54 Gy [relative biologic effectiveness (RBE)] in 1.8 Gy (RBE) per fraction and were assessed at the time of consult, weekly during treatment, and followed up at 1, 3, 6, and 9 months after treatment. Symptoms were graded based on the CTCAE version 4.0. Results: At week 1 of treatment, 4/23 patients experienced Grade 1 anorexia. At week 3, 5/23 patients had Grade 1 nausea, 10/23 patients had Grade 1 headaches, and 1/23 patients had a Grade 3 headache. At the end of treatment at week 6, 13/23 patients had Grade 1 fatigue, 6/23 patients had Grade 2 fatigue, 3/23 patients had Grade 1 nausea, 4/23 patients had Grade 1 headaches, 7/23 patients had Grade 1 insomnia, and 1/23 patients had Grade 2 insomnia. At the 1-month follow-up, 3/23 patients had Grade 1 fatigue, 1/23 patients had Grade 2 fatigue, 2/23 patients had Grade 1 anorexia, 1/23 patients had a Grade 1 headache, and 2/23 patients had Grade 1 insomnia. No patients were reported to have experienced vomiting at any of the 4 time points. Conclusions: Proton therapy has a favorable side effect profile--most patients experienced mild fatigue, headaches, and insomnia that largely resolved by one month after treatment. This study provides a useful starting point for larger-scale studies which could directly compare the acute side effects of proton and conventional radiotherapy.
Temozolomide (TMZ) maintenance in patients with primary brain cancer treated with postoperative TMZ plus radiotherapy (RT): A retrospective analysis.
Authors: Moscetti Luca , Fabbri Maria Agnese , Sperduti Isabella , Mansueto Giovanni , Fariello Anna Maria , Gamucci Teresa , Battista Michle , Loffreda Massimiliano , Pompei Luciano , Ruggeri Enzo 
Published: March 2020

e12514 Background: A systematic review of patients affected with primary brain cancer treated with post-operative TMZ+RT and TMZ maintenance was undertaken in order to evaluate the efficacy and toxicity in an unselected population. Methods: Ninety-nine patients were detected. Main characteristics were: median age 62 years (range 28-80); M/F: 58/41; PS 0/1: 92 pts; complete resection: 20; subtotal resection: 75, biopsy only: 4. The median RT dose delivered was 60 Gy (range 40-60 Gy). All the 99 pts received TMZ at 75 mg/m2 concomitantly to RT. Maintenance therapy with TMZ was given to non progressive pts, starting 6 weeks after chemoradiation, at the dose of 150 mg/m2 for the 1st cycle and 200 mg/m2 q 4 weeks d. 1-5 for subsequent cycles and continued until disease progression or intolerance. Results: Patients with evaluable disease (n=79 pts) had an overall response rate of 16% (12 partial response and 1 complete response), while a stable disease was observed in 49/79 pts (62%). Maintenance TMZ was given to 77/99 pts (78%). Hematologic toxicities (CTCAE v.3) include: Gr. 3/4 neutropenia (4%), febrile neutropenia (1%), Gr. 3/4 thrombocytopenia (13%), Gr. 3 anemia (1%). One pt developed a bone marrow aplasia and another one a Steven-Johnson syndrome recovered after high supportive treatment. Toxicities caused discontinuation of TMZ in 9 patients (11%). At 2-yrs, at both univariate and multivariate analysis, a significant improvement in progression-free survival (PFS) and in overall survival (OS) was observed in pts completely resected and in pts achieving a response or a stable disease >6 months. In pts achieving a response and in pts completely resected the HR for the 2-yrs PFS was 0.06 (95%CI 0.03-0.11, p<0.0001) and 0.02 (95%CI 0.01-0.04, p<0.0001), respectively. For the 2-yrs OS the HR was 0.08 (95%CI 0.04-0.16, p<0.001) and 0.02 (95%CI 0.01-0.06, p<0.0001). No difference was observed for sex, age, PS and histology. Conclusions: Complete resection, response or prolonged stabilization to maintenance TMZ are factors associated with a statistically improvement in OS and PFS.
Results of Australasian Gastrointestinal Trials Group (AGITG) Arctic study: An international audit of raltitrexed for patients with cardiac toxicity induced by fluoropyrimidines (FP).
Authors: Ransom David , Wilson Kate , Bishnoi Sarwan K. , Simes John , Yip Desmond , Karapetis Christos Stelios , Gebski Val , Gordon Stephen , Fournier Marion , Ferry David Raymond , Abbas Haider , Midgley Rachel A , Price Timothy Jay 
Published: March 2020

e13007 Background: Cardiac toxicity (CT) is an uncommon but potentially fatal side effect of FP. The incidence of further CT if the same chemotherapy is continued is reported to be 20% (Jensen SA et al. Risk factors and prevention of cardiac toxicity induced by 5-fluorouracil or capecitabine. Cancer Chemotherapy & Pharm. 58:487-93, 2006). Management of these patients remains poorly defined. Treatment options include continuing same dose and schedule of FP, adding a nitrate and calcium antagonist; switching to bolus FP; or substituting with raltitrexed. Previous publications of patients experiencing CT and switching FP to raltitrexed are limited to case reports. Methods: AGITG & OCTO (Oncology Clinical Trials Office – Oxford) members identified patients who had CT from FP, and were subsequently switched to raltitrexed. CT included angina, myocardial infarct (MI) or arrhythmia. A coronary angiogram was not mandatory. Results: 38 patients were included in clinical audit. Cancer diagnoses included colorectal (35pts), cervix (1), oesophageal (1) and ampullary carcinoma (1). Median age - 61 years (range 36-81). 24 patients (63%) were male. Median number of cycles prior to switching to raltitrexed was 2 (range 1-11). FP regimens included FOLFOX, CAPOX, continuous infusion 5FU, capecitabine alone. 35 patients had angina, 6 MI, and 1 arrhythmia with some patients experiencing >1 event at that time. 7 patients experienced two separate CT events, and 2 had three events prior to switching to raltitrexed. Following CT 8 patients received raltitrexed alone, 29 received raltitrexed in combination with other agents or radiotherapy and one received raltitrexed alone followed by combination. Median number of raltitrexed cycles was 5 (range 1-21). After switching to raltitrexed 2 patients experienced another cardiac event (5.3%, 95% CI:1.5-17.3), significantly different from 20% (p=0.023), the reported rate of cardiac toxicity due to continuing FP. Conclusions: For patients who experience CT from FP switching to raltitrexed is an option with the rate of additional cardiac events lower than previously reported for continuing same FP.