bluuebunny/crossref_metadata_2025_split huggingface dataset:
The evaluation of peritoneal lavage tumor markers for gastric cancer
Authors: Yamamoto M. , Ishida T. 
Published: August 2020

e15643 Background: We have found that elevation of preoperative peritoneal lavage CEA levels is associated with an earlier detection of recurrent peritoneal dissemination and a poor prognosis. Methods: We have now examined findings with the combined of peritoneal lavage CEA, CA125 and CA72–4 levels with regard to prediction of the prognosis of gastric cancer patients. Ninety-four patients who were underwent surgery with gastric cancer were intraoperatively measured for tumor markers, CEA, CA125 and CA72–4 in peritoneal lavage using a chemiluminescent enzyme immunoassay. We examined whether the stage with patients were related with tumor markers in peritoneal lavage. Results: The averages of peritoneal lavage CEA, CA 125 and CA72–4 levels in patients with peritoneal carcinoma were 24.3, 299, 6.70, respectively, while those in patients without peritoneal carcinoma were 0.77, 258, 0.95, respectively. The averages of peritoneal lavage CEA and CA72–4 levels in patients with peritoneal carcinoma were significantly increased with those in patients without peritoneal carcinoma (p<0.0001). In patients who were performed a curative surgery, the averages of peritoneal lavage CEA level were 0.55, 0.51, 0.51, 1.98, 0.50, 11.0 in cases of stage IA, IB, II, IIIA, IIIB and IV. Similarly, the averages of peritoneal lavage CA125 level were 254, 260, 307, 148, 366 and 280, and the average of peritoneal lavage CA72–4 level were 0.88, 1.06, 0.98, 0.90 and 3.23. The peritoneal lavage CEA or CA72–4 level in cases of stage IV was increased than in cases of other stages. The RFS of patients in the CEA level above cut-off was shorter than that in the CEA level below cut-off. However, the RFS of patients in the CA72–4 level above cut-off was not differ with that in the CA72–4 level below cut-off. In a multivariate analysis, the peritoneal lavage both CEA and CA72–4 levels above cut-off were found to be significant and independently prognostic factor (p= 0.0427). Conclusions: This combined assay of peritoneal lavage both CEA and CA72–4 levels will aid in estimating the prognosis. No significant financial relationships to disclose.
Radiologic detection of bone metastasis in patients with hepatocellular carcinoma: A single-center experience
Authors: Farrand E. , Ferrante L. , Staron R. B. , Brown R. S. , Siegel A. B. 
Published: August 2020

e15644 Background: We investigated current practices and their relative abilities to effectively screen for and detect bone metastases (mets). It is unknown what percentage of HCC bone mets are blastic versus lytic, and what imaging modality best identifies them. Methods: We retrospectively assessed all adults diagnosed with HCC at our center from 1/1997 - 8/2008. Primary outcomes were the percentage of lytic lesions, and the sensitivity and specificity of bone scans in detecting bone mets. Results: 462 patients were included. Mean age at diagnosis was 60 years; 80% were male, and hepatitis C was the most common etiology of HCC (58%). 54% of all patients received bone scans. 67% were considered diagnostic, whereas the remaining scans required a confirmatory test(s) (23% PET, 41% plain X-ray, 54% CT, and 10% MRI). 5% of all patients were diagnosed with bone mets (n=24), of which 42% were diagnosed at presentation, 20% during continued follow-up, and 38% during post-operative surveillance. 96% of all bone lesions were lytic, of which 13% were undetected by bone scan (sensitivity = 79%, specificity = 98%). None of the lesions were blastic and 4% remained indeterminate after independent review with an attending bone radiologist. Of those patients who underwent resection or liver transplantation (n=205) 35 patients recurred (31% with bone recurrence and 6% with bone mets as their only site of disease). Within this surgical group, patients with bone mets only had higher 1,3,and 5 year survival rates compared to patients with other extrahepatic lesions, although only significant for 3 year survival (p=0.013). 4 of the 24 patients with bone mets received a biopsy. All 4 confirmed metastatic HCC. Conclusions: Due to the high specificity, bone scans serve as a good initial screening test to rule out bone mets in the HCC population. However in populations at higher risk of presenting with bone mets (post-tranplantation/resection) a more sensitive test may be needed. Additional studies are warranted to determine whether other modalities, such as PET/CT or skeletal survey, are more sensitive tests for the detection of bone mets. No significant financial relationships to disclose.
Effect of the serine proteases inhibitor gabexate mesylate (GM) on the activity of gemcitabine (G) in cell lines of pancreatic cancer (PC)
Authors: Brandi G. , Paterini P. , Tavolari S. , Da Pozzo G. , Nobili E. , Di Cicilia R. , Di Marco M. , Pantaleo M. , De Rosa F. , Biasco G. 
Published: August 2020

e15645 Background: Negligible advances for PC treatment have been done over the last decade and G remains the standard. Proteolitic degradation of extracellular matrix (ECM) is essential for early local invasion, metastasis and desmoplastic reaction characterizing PC. Differently from MMPs, the serine proteases (uPA and TAT) action is earlier and larger, degradating not only ECM, but also basement membrane, and activating trypsin, plasmin, angiogenesis via TGF-β1 and proliferation via PAR-2. GM is an inhibitor of u-PA,TAT, trypsin and plasmin, used in Italy and Japan for prophylaxis of acute pancreatitis after ERCP. In a previous study, GM demonstrated antinvasion and antimetastatic activity. Study aim: to evaluate if GM increases G efficacy on pancreatic cancer cell line. Methods: In vitro study of phenotypic effects of GM and G in poor differentiated PANC-1 PC cell line using:1) Cell vitality test (Trypan blu);2) Invasion test (Matrigel invasion assay);3) Cell cycle analysis (cytofluorimeter);4) Antiangiogenic test (tube formation assay in extracellular matrix using E.A.hy926 endothelial cells with matrigel). Different doses of G and GM (100,200,250,500 μM;1mM) alone or combined (concomitant or sequential) have been tested vs controls (PANC-1 without any treatment). All tests have been done in triplicate. Results: G alone (250 μM) decreases invasion by 40% (±5,6%) and cell vitality by 15% (±1,3%.). GM alone (100 μM) decreases invasion by 30% (±4,6%.) but 1mM is needed for similar vitality decrease. GM+G together are detrimental vs G alone while sequential treatment (GM before G with or without 24 hours of interval) enhances G activity. GM (200 μM) and G (250 μM) in immediate sequence show better results decreasing ability of invasion by 75% (±8,3%). Cell vitality is better inhibited from GM (100)/G (250) 24 h-delayed sequence by 28% (±3,8%). Combined treatment mainly blocks cells in G1 phase of cell cycle (5%±0,5%) vs controls. Concerning antiangiogenic assay, the administration of G alone is ineffective to inhibit angiogenesis, while pre-treatment with GM results in a strong anti-angiogenic effect. Conclusions: Association of GM to G could represent a new effective approach to inhibit invasion, angiogenesis and growth in pancreatic cancer. No significant financial relationships to disclose.
The clinical significance of oophorectomy in gastric patients
Authors: Song H. , Kim J. , Do Y. , Lee W. , Ryu S. , Kim I. , Sohn S. 
Published: August 2020

e15646 Background: The oophorectomy in isolated metastasis of ovary can lead to long term survival in patients with gastric cancer, but the clinical significance of oophorectomy in stage IV gastric cancer patients is not known well in this time. Methods: We reviewed the medical record of the 55 gastric cancer patients who were metastasis or recurrent in ovary at Dongsan Medical Center, Kimyung University School of Medicine, Daegu, Korea from 1985 to 2008. Results: Twenty-one patients were metastasis to ovary at the time of diagnosis of gastric cancer, and 34 patients were recurrent in ovary after the gastric resection. The mean age was 45.3 ± 11.6 years in metastatic cancer and 46.8 ±12.6 years in recurrent cancer patients. The stage at the time of gastric resection in 34 recurrent patients were I in 3, II in 1, III in 18, and IV in 10. Adjuvant chemotherapy were performed in 26 (76.5%) patients. Oophorectomy were performed in 33 (97.1%) of recurrent cancer, and 17 (81.0%) of metastatic cancer. The 1-year and 2-year survival rate of metastatic cancer were 14.7%, and 0%, and 1-year, 2-year, and 3-year survival rate of recurrent cancer were 47.2%, 18.1%, and 0%, respectively. The median survival duration of metastatic cancer were 8.9 ±1.0 months, and recurrent cancer were 11.4 ±2.3 months. Recurrent cancer were better survival than metastatic cancer patients (p=0.014). The long-term survival (over 2 years) was noted in 5 patients of recurrent cancer patients. The stage of gastric cancer was correlated to overall survival time in total patients (p=0.028). But, the relapse-free survival time after gastrectomy is the only factor to predict survival duration after oophorectomy in recurrent cancer patients (p=0.029). Age, stage of gastric cancer, extent of involvement of ovary, and systemic chemotherapy were not related to survival time of recurrent cancer patients. Conclusions: The survival time in patients with oophorectomy in recurrent gastric cancer was correlated to relapse-free survival time after gastric resection. No significant financial relationships to disclose.
Therapeutic vaccination against advanced pancreatic cancer by autologous dendritic cells pulsed with a MUC1 peptide: Preclinical results of a clinical phase I trial
Authors: Jin D. , Rong Y. , Lou W. , Qin X. , Wu W. , Nin X. , Nin X. , Wang D. , Kuang T. , Qin Y. 
Published: August 2020

e15652 Background: Pancreatic ductal adenocarcinoma has a particularly poor prognosis. Therefore, novel therapeutic strategies such as immunotherapy are required. The aim of the present phase I study was to evaluate the safety, immune responses and clinical activity of a vaccine based on autologous dendritic cells (DC) pulsed with a specific MUC1 peptide in advanced pancreatic cancer patients. Methods: Five patients who had pancreatic cancer ductal adenocarcinoma expressing MUC1 in stage of III/IV were enrolled to the clinical trial. Patients underwent leukapheresis to generate dendritic cells by culture in vitro with granulocyte macrophage colony-stimulating factor and interleukin-4 for 5 days. Dendritic cells were then pulsed overnight with MUC1 peptide (GVTSAPDTRPAPGSTAPPAH) and harvested for vaccination. Dendritic cells (3×106-6×106) were injected intradermally every 2 weeks for 3–4 times. Results: All patients remained with progressive disease. Four patients developed strong T-cell IFN-γ and Granzyme B Elispot responses to the vaccine. Most interestingly, the patient who was treated with the highest number of DC(6×106) had more number of CTL than other patients and showed delayed-type hypersensitivity responses at injection sites and this patient stopped application of the analgetics. Another patient with relapsed pancreatic cancer who had finished the 4 times of vaccination and then followed 6 times of chemotherapy with Gemcitabine had a surprisingly long term of survival of 12 month. No evidence of significant treatment related toxicity or auto-immunity was observed. Conclusions: This study showed the safety and clinical response of MUC1 peptide-pulsed dendritic cell therapy for patients with advanced pancreatic cancer. It confirms the capability of this DC vaccine to stimulate an immune response in patients with pancreatic cancer even in the presence of a large tumor burden. Dendritic cell therapy is recommended for further clinical studies in pancreatic cancer patients. No significant financial relationships to disclose.
A comparison between treatment outcomes of stage III and stage IV esophageal squamous cell carcinoma without visceral or bone metastases
Authors: Wang Y. , Liu D. , Chang B. , Kao R. , Lai Y. , Hsu W. 
Published: August 2020

e15659 Background: Although classified as end-stage, patients of stage IV esophageal squamous cell carcinoma (SCC) without visceral or bone metastases (nodal stage IV) often have good performance status and are medically fit for curative treatment. The objective of this study was to compare the prognosis of patients of stage III and nodal stage IV. Methods: The retrospective study included patients who were diagnosed esophageal squamous cell carcinoma at Tzu Chi General Hospital from Jan, 2005 to Aug, 2008. Eligible patients must meet the following criteria: (1) stage III or nodal stage IV; (2) underwent esophagectomy or chemoradiation with curative intent; (3) Eastern Cooperative Oncology Group performance status ≤2. The standard order-set of chemotherapy was two monthly cycles of fluorouracil (1,000 mg/m2/24 hours for 4 days) and cisplatin (75 mg/m2 bolus day 1). Radiotherapy dose was 59.4 Gy for concurrent chemoradiation (CCRT) or 54 Gy for adjuvant setting after esophagectomy. Results: Patients characteristics were listed in Table . The median follow-up was 8 months (range: 1∼42 months). In 38 patients underwent definitive CCRT, ten achieved complete response (CR) and 13 achieved partial response. Two-year disease-free survival rate in 28 patients who achieved CR or underwent esophagectomy was 29.9%. Median survival of stage III and nodal IV were 11.5 and 8 months. Two-year overall survival (OS) rate of stage III and nodal IV were 23.9% and 33% (p=0.814). The only significant poor prognostic factor in both univariate and multivariate analyses was tumor length longer than 5 cm. Conclusions: In our study, medically fit patients of nodal stage IV esophageal SCC could achieve OS similar to those of stage III after intensive treatment. The result may indicate the necessity of developing a selection criterion in deciding which nodal stage IV patient should undergo curative treatment. [Table: see text] No significant financial relationships to disclose.
Diabetes mellitus (DM), serum glucose, and outcome in gastroesophageal (GE) cancer
Authors: Feilchenfeldt J. W. , Capanu M. , Farooki A. , Sully D. , Miron B. , Power D. G. , Jhawer M. , Ilson D. H. , Kelsen D. P. , Shah M. A. 
Published: August 2020

e15661 Background: Diabetes mellitus (DM) and impaired glucose tolerance (IGT) are frequent comorbidities in cancer patients. Their diagnosis is predictive of early recurrence following resection of colorectal cancer and of increased treatment related toxicity in localized breast cancer. Impaired glucose tolerance is a risk factor for the development of GE cancer. As nutrition and performance status are key determinants of outcome, we hypothesized that DM would influence treatment outcome in GE cancer. Our primary objective was to analyze the role of serum glucose, DM, serum albumin and BMI on treatment outcome and toxicity amongst a cohort of uniformly treated patients with GE cancer. Methods: 211 patients with GE cancer enrolled on 3 localized (2 esophagus, 1 gastric) and 4 metastatic consecutive prospective clinical trials (3 gastric, 1 esophagus) were examined. The studies involved treatment with chemotherapy combinations of taxanes, platinum, irinotecan, 5-fluorouracil, bevacizumab and cetuximab. Diagnosis of DM was based on clinical data, random glucose or fasting-glucose levels. Study parameters were tested for their association to time to treatment failure (TTF), overall survival (OS) and toxicity using the X2 test. Results: 132 metastatic pts were included: median age 57(range 32–76), M/F 96/36, median BMI 25.3 (16.2–40.1), 19 diabetic / 113 non-diabetic; overall survival was 10.8 months. 79 patients had localized disease: median age 61(32–80), M/F=53/26, median BMI 25.8 (range 16.1–38.5), 10 diabetic/69 non-diabetic; overall survival was 23.2 months. There was no statistically significant association of random glucose (p=0.06), DM (p=0.9), or BMI(p=0.2) with survival or with treatment related toxicity. Low serum albumin was associated with reduced survival, hazard ratio 2.12 (95% CI1.5–3.2), p<0.001. Conclusions: In GE cancer patients on protocol therapy, we confirm the negative prognostic significance of serum albumin on patient survival. This is remarkable considering all patients were protocol eligible with adequate organ function and performance score. We did not observe a clinically relevant impact of IGT or DM on treatment outcome or toxicity. No significant financial relationships to disclose.
A phase II clinical and biological study of lithium carbonate (Li) in patients with low-grade neuroendocrine tumors
Authors: Lubner S. J. , Chen H. , Holen K. , LoConte N. , Rikkers L. , Weber S. , Warner T. , Eickhoff J. , Fass T. , Schelman W. 
Published: August 2020

e15662 Background: Low-grade neuroendocrine tumors (NETs), such as carcinoid, islet cell tumors, and medullary thyroid carcinomas, respond poorly to chemotherapy, and effective, less toxic therapies are needed. Glycogen Synthase Kinase (GSK)-3β, a multifunctional protein kinase, has been shown to regulate growth and hormone production in NETs. Use of lithium carbonate (Li) in murine models suppressed carcinoid cell growth, reduced GSK-3β levels and reduced expression of chromogranin A. This study assessed the efficacy of Li in patients with NETs. Methods: Eligible pts had pathologically-proven, measurable low-grade NETs. Prior treatment was allowed if completed >4wks prior to registration. Standard eligibility criteria were used, and use of medications affecting Li metabolism or levels were prohibited. A single-arm, open-label, two-stage Phase II design was used. Li was dosed at 300mg orally TID with meals, titrated to a target serum level of 0.8–1.0mmol/L. The primary endpoint was objective tumor response by RECIST. Secondary endpoints included overall survival, progression-free survival, decrease of serum tumor markers, toxicity, and quality of life. Results: 15 pts were enrolled between 10/3/07and 7/17/08; 6 men, 9 women. The median age was 58 (range 47–74). Patients’ diagnoses were carcinoid tumor for 8 subjects, islet cell tumor for 5 subjects, and 2 unknown primary sites. ECOG PS was 0 (6 patients) or 1 (9 patients). Two pts came off study due to side effects (tremor, dizziness/abdominal pain). There were no radiographic responses. Due to an early stopping rule requiring at least 1 objective response in the first 13 evaluable pts, the study was closed to further accrual. 13 patients had pre- and post-therapy biopsies. Evaluation of quality of life and GSK-3β levels in tumor tissue is ongoing. Conclusions: Li was ineffective at obtaining a radiographic response in our 13 evaluable patients who were treated as part of this study. We will determine from tumor biopsies whether Li was effective at phosphorylating GSK-3β in order to make conclusions about GSK-3β as a therapeutic target for future NET treatment strategies. Funded through NIH grant R21CA117117- 01A2 and CTRC grant 1ULRR025011. No significant financial relationships to disclose.
Gemcitabine in combination with intraperitoneal cisplatin in advanced hepatobiliary cancers
Authors: Liu W. , Zhang H. , Liu D. , Xue Y. , Huang Y. , Si X. 
Published: August 2020

e15666 Background: Standard chemotherapy for advanced hepatobiliary cancers remains undefined. This study was to observe the therapeutic effect of gemcitabine combined with intraperitoneal cisplatin for the treatment of advanced hepatobiliary cancers and analyze their toxicities. Methods: Patients with measurable hepatobiliary cancers were unrandomized into gemcitabine (GEM) + cisplatin (DDP) (GEM group) and epirubicin (EPI) + DDP (EPI group). GEM was used intravenously by infusion for 30 min with the dose to 1,000 mg/m2 on day 1 and 8; cisplatin was infused intraperitoneal with a dose of 25mg/m2 on day1, 3 and 5. Twenty-one days counted as one cycle. After 2 cycles, treatment efficacy and adverse events were evaluated according to WHO criteria. Results: A total of 76 patients were enrolled from May 2004 to May 2006, with 30 patients for EPI group and 46 patients for GEM group, and all the patients were eligible for effectiveness analysis. Among GEM group patients, there was no complete response. The partial response rate was 32.61% and clinical benefit response (CR+ PR +SD) was 67.39%. All those data mentioned above were significantly higher than that of EPI group. The main adverse re-ction was hematologic toxicity, while nonhematologic toxicity was mild. Conclusions: This study demonstrated that combination gemcitabine with intraperitoneal infusion of cisplatin was an effective and safety treatment for the patients with advanced hepatobiliary cancers. No significant financial relationships to disclose.
Retrospective study of the patients with unresectable gastric cancer (UNGC) who underwent a gastrectomy after receiving S-1 or S-1 combination chemotherapy (S-1+α)
Authors: Kobayashi K. , Tsuji A. , Hata Y. , Morita S. , Horimi T. 
Published: August 2020

e15668 Background: At the 2007 ASCO annual meeting, JCOG 9912 and the SPIRITS trial showed that S-1 (S) and CDDP/S-1 (S+P) therapy to now be an accepted standard chemotherapy for advanced and recurrent gastric cancer (ARGC). Today in Japan, S- 1+αincluding S+DTX, S+CPT-11 and S+PTX are the mainstay treatments for ARGC. There are some case reports of pts with UNGC who were operated on due to the good anti-tumor effect of S-1+α, however, no consensus for performing a gastrectomy after chemotherapy has yet been reached. This study aims to identify the factors which make it appropriate to perform a gastrectomy after S- 1+α and to examine the validity of this chemotherapeutic regimen in combination with surgery. Methods: Twenty-five chemo-naïve pts with UNGC who received S-1+α (excluding neo-adjuvant) between May 2005 and Dec. 2007 were retrospectively reviewed, using the RESIST, Kaplan-Meier method, and Japanese Classification of Gastric Carcinoma (Eng. ed.). Results: The characteristics were: mean age 62; sex: M/F=18/7; cancer status; locally advanced (L):11, distant metastasis (D):9, lymph node swelling ≥group 3 (N):12, and peritoneal dissemination (P):11. Treatment regimens; S:13, S+DTX:3, and S+P:9. The median number of courses was 5. RR was 56% (PR:14, SD:9, PD:2). MST was 780 days. Twelve pts underwent a gastrectomy. The reasons for performing an operation were downstaging (DOWN):8, and palliative (PAL):4 (anemia:2/passage disturbance:2). The features were DOWN (M/F=5/3/65 yrs/PR:8/L:6, D:0, N:4, P:3) and PAL (M/F=4/0/57 yrs/SD:4/L:1, D:3, N:1 P:1). The median PFS and mean OS were 445 days and 312 days, respectively. No significant difference was observed between DOWN and PAL regarding the PFS and OS. All PAL cases were free from painful symptoms. Three pts received a curative A resection. In addition, 8 pts experienced histological changes, in particular, one pt achieved Grade 3 (No viable tumor cells were found.). Ten pts received adjuvant chemotherapy. Nine pts are alive at this writing. Conclusions: The findings of this study suggest that the above described chemotherapeutic regimen combined with a second-look gastrectomy might therefore be a new potentially effective strategy for the treatment of UNGC. No significant financial relationships to disclose.