bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of cell-free and concentrated ascites reinfusion therapy (CART) for intractable ascites associated with cancerous ascites.
Authors: Ueda Yuki , Katayama Kanji , Fujimoto Daisuke , Murakami Makoto , Hirono Yasuo , Goi Takanori , Yamaguchi Akio 
Published: February 2017

205 Background: Intractable ascites associated with cancerous ascites causes severe abdominal distention, loss of appetite, poor nutritional condition and reduce the quality of life. We treat patients suffering from cancerous ascites by Cell-free and Concentrated Ascites Reinfusion Therapy (CART). But, cancerous ascites contains a lot of cellular components, and it easily cause filter obstruction. So we applied new method of CART: KM-CART in cancerous ascites patients. This CART system has a filter cleaning function, so the system has less incidence of filter obstruction. We report on our experience on CART for patients with cancerous ascites. Methods: Since November 2009 to August 2014, we applied CART in 31 cases of cancerous ascites (gastric cancer, 13; colorectal cancer, 6; pancreatic cancer, 10; others, 2). Results: On average, 3.8kg (range 1.2-7.5kg) of ascites were filtrated and concentrated to 440g (70-1110g). In all cases abdominal distention disappeared and abdominal girth decreased. Side effect was only mild fever on 11 cases. Conclusions: CART is safe and effective treatment for patients with cancerous ascites. This treatment may be able to improve quality of life with peritoneal dissemination.
Optimal indications for palliative chemotherapy in elderly patients with metastatic or recurrent gastric cancer.
Authors: Hasegawa Hiroko , Fujitani Kazumasa , Sugimoto Aya , Nakazuru Shoichi , Hirao Motohiro , Tsujinaka Toshimasa , Mita Eiji 
Published: February 2017

207 Background: Gastric cancer is the second causes of cancer-related deaths in the world and its incidence of advanced gastric cancer (AGC) in the elderly is increasing as a result of increased life expectancy. However, elderly patients have been underrepresented in many kinds of chemotherapy clinical trials. Therefore it is difficult to evaluate the efficacy and safety of chemotherapy for elderly patients and select the appropriate patients aged 70 years or older who are likely to benefit from the chemotherapy. Methods: There were 265 patients with primary unresectable or recurrent gastric cancer treated at our institution between April 2007 and March 2014. Of all, 90 patients aged 70 years or older were retrospectively identified. We evaluated the efficacy of the chemotherapy and prognostic significance of clinico-pathologic factors to identify the optimal indications for chemotherapy. Univariate and multivariate analyses were perfomed on the base-line characteristics such as patient’s performance status (PS), gender, chemotherapy regimens, history of gastrectomy, presense of co-morbidity, serum LDH level, serum C reactive protein, and nutritional status, at the initiation of the first-line chemotherapy. Results: The median overall survival time (OS) was 343 days and the median TTF on first-line chemotherapy was 111 days. The toxicity was mild and tolerable. There were no significant difference in overall survival between patients receiving monotherapy and combination therapy. On multivariate analyses, PS 1 or 2 (hazard ratio (HR), 1.883; 95% confidence interval (CI), 1.047–3.390), presence of primary tumor (HR, 1.916; 95% CI, 1.063–3.448) at the initiation of the first- line chemotherapy were identified as significant independent poor prognostic factors for overall survival. Especially in patients aged 75 years or older, only PS was an independent prognostic factor for OS (HR, 3.703; 95% CI, 1.314–9.900). Conclusions: Analysis of our results shows that patients aged 70 years or older with good performance status and absence of primary tumor might achieve clinical benefit from chemotherapy.
Effect of neoadjuvant therapy on the risk for atrial fibrillation in patients undergoing esophagectomy.
Authors: Doepker Matthew , Abbott Andrea M. , Shridhar Ravi , Hoffe Sarah E. , Almhanna Khaldoun , Meredith Kenneth L. 
Published: February 2017

210 Background: Neoadjuvant chemoradiation (NT) has become the standard for patients with locally advanced esophageal cancer. Thirty percent of patients who undergo esophagectomy will develop atrial fibrillation (AF). NT may contribute to patients developing AF and this may be a surrogate for anastomotic dehiscence (AD). Methods: We queried a prospective esophageal database to identify patients who underwent esophagectomy with or without NT. Demographics and post-operative complications were all compared with fisher exact test and considered significant at p<0.05. Results: We identified 811 patients who underwent esophagectomy with a mean age of 68 +/- 12 years. Five-hundred and fifteen (63.5%) were treated with NT and 296 (36.5%) were not. Eighty-nine (11%) of patients developed AF, 59 (11.5%) in the NT group, and 30 (10.1%) in the non NT group. There was no significant differences noted in the incidence of AF in those that were treated with NT and those that were not (p=0.64). A total of 54 (6.7%) patients were identified as having AD, 27 (5.2%) in the NT cohort and 27 (9.1%) in the non NT cohort. The NT group had lower incidence of AD compared to their non NT counterparts (p=0.04). Of the 54 patients who experienced AD, 6 (11%) had concomitant AF, and 48 (89%) did not and the remaining 83 patients who developed AF did not develop AD (p=1). Conclusions: NT prior to esophagectomy does not increase patient’s risk for developing postoperative AF. Moreover, the presence of AF in the post esophagectomy patient, did not serve as a surrogate for identifying AD.
Clinical outcomes in 66 patients with advanced gastric cancer treated in phase I trials: The NCCHE experience.
Authors: Kawazoe Akihito , Shitara Kohei , Fukuoka Shota , Kuboki Yasutoshi , Bando Hideaki , Okamoto Wataru , Kojima Takashi , Yoshino Takayuki , Doi Toshihiko , Ohtsu Atsushi 
Published: February 2017

213 Background: Patients with advanced gastric cancer (AGC) have a poor prognosis once standard therapies fail. Phase I trial of investigational drugs might be one of the treatment options for patients with sufficient general status. But, the clinical outcome of patients with AGC treated in phase I trials has not yet been reported in detail. Methods: We retrospectively reviewed the clinical outcomes in 66 consecutive patients with AGC who were treated in phase I trials after standard chemotherapies between March 2008 and July 2014. Results: Median age was 66 years (range, 28-78 years) and all had performance status ECOG 0 or 1. The median number of previous systemic chemotherapy was 3 (range, 1-6) with the median interval from beginning of first-line chemotherapy to enrollment for phase I trials of 18 months. Twenty-three patients were enrolled for two or more phase I trials. Objective response was observed in 5 patients (8%) and additional 8 patients (12%) achieved stable disease >3 months. Although the median time to treatment failure (TTF) of the best phase I treatment was shorter than those of the last line of systemic chemotherapy (1.5 vs. 2.3 months; HR 1.80; P=0.002), the median TTF of best phase I trial was longer than the last line of systemic chemotherapy in 21 patients (32%). Severe adverse events and grade >3 toxicities were reported in 8 patients (12%) and 12 patients (18%), respectively. No treatment related death was observed. Median survival time after enrollment for phase I trials was 7.5 months and 4 death (6%) within 30 days after last administration was observed. Conclusions: The clinical outcome for patients with AGC treated in phase I trials was comparable to that of other malignancies previously reported. These results of our study suggest phase I trial might be one treatment option for patients with AGC after failure of standard chemotherapy.
Retrospective analysis of preoperative chemoradiation therapy for esophageal and gastroesophageal junction (GEJ) cancer: Lessons to be learned from expanding inclusion criteria in this patient population.
Authors: Iafolla Marco Adelmo James , Spratlin Jennifer L. , Ghosh Sunita , Mulder Karen E. 
Published: February 2017

214 Background: Preoperative chemoradiation therapy utilizing paclitaxel, carboplatin and radiation as per the CROSS Group increased survival rates among patients with potentially curable esophageal or GEJ cancer. A retrospective chart review was performed to determine: 1) the frequency of patients meeting the original trial inclusion/exclusion criteria 2) overall survival (OS), disease free survival (DFS), and pathological response rates (RR) of this patient population. Methods: Data was collected on 89 patients who received preoperative chemoradiation therapy (CROSS protocol) in Edmonton, Alberta between June 1, 2010 and April 11, 2014. Mean and standard deviation were calculated for continuous data and frequency (proportion) for categorical data. Time to event was presented using Kaplan-Meier estimates and log rank tests were used to compare the KM curves. Results: The median age of the entire patient population was 62 years with 77 (86.5%) of the patients being male. Twenty-three (26%) patients met inclusion criteria (MIC), whereas 66 (74%) patients failed to meet inclusion criteria (FMIC). Reasons for FMIC included: clinical stage (39.3%); weight loss > 10% (39.0%); previous cancer history (22.5%); tumor length (9.0%); and age (5.6%). Pathological complete response (CR) occurred in 24% of all patients with a trend to increased CR in MIC vs FMIC (35% vs 20%; p=0.18). Significant improvement in DFS was observed in the MIC group compared to FMIC (p=0.004). Although a trend to improvement was seen for OS in the MIC group, it is not yet significant at this early analysis (p=0.12). Conclusions: A significant proportion of patients treated with neoadjuvant chemoradiation therapy for esophageal and GEJ cancer at our center did not meet the inclusion/exclusion criteria utilized in the CROSS trial. This had a detrimental impact on FMIC patients questioning its benefit and utility in a broader patient population. [Table: see text]
Ethnicity and benefit of first-line chemotherapy in metastatic gastric adenocarcinoma (GC).
Authors: Vaezi Mariam , Rahman Jawaria , Yang Dongyun , Barzi Afsaneh 
Published: February 2017

218 Background: There is a significant difference in the incidence and mortality of GC across the world. Our group presented data on the differences in the outcome of GC based on ethnicity in patients in California Cancer Registry. Data from global trials have highlighted differences in the benefit from antiangiogenic therapy in different ethnic populations. We conducted a retrospective analysis of patients (pt) with stage IV GC, who received first line platinum based chemotherapy (CT) at Los Angeles County Hospital between 2003 - 2010. We explored the interaction between demographics and benefit from CT. Methods: We searched the administrative records for pt with diagnosis of GC and identified 308 pt of which 198 had metastatic GC with first line CT at our center. Time to progression (TTP), defined as time from start of chemotherapy to radiographic or clinical progression, was the primary end point of the study. Results: Of the 198 patients, 118 (60%) were male. 134(68%) Hispanics (H), 44 (22%) Asian (A), 6 (3%) African American (AA), 5(3%) white (W), and 9 (4%) other ethnicities. Primary site of the tumor was body (B) in 71(43%), antrum and pylorus (P) in 67(34%), and cardia/fundus or GEJ (GEJ) in 26 (16%). In 34 (17%) the primary site was unknown. The median TTP in the entire population was 17.7 months (M) (95%CI: 12.7 -125). TTP in H, A, and AA was 16.7(95%CI, 12.2 -125), 17.8 (95%CI, 8.2 - 79.2), and 10.2M(95%CI: 6.0 -106) respectively [p=0.75]. There was no difference in TTP between males and females or based on the location of the disease. Conclusions: In our small dataset, there was no difference in benefit from platinum based CT by ethnicity, demographics, or disease site. This suggests that CT benefit is similar across different ethnic populations, and observed differences in trials with antiangiogenic therapy are related to angiogenesis in different ethnic groups.
Treatment of nonresectable and metastatic gastrointestinal stromal tumors: Experience with the use of tyrosine kinase inhibitors in a third-level hospital in Mexico city.
Authors: Dip Borunda Abdel Karim , Silva Alejandro J. 
Published: February 2017

224 Background: Stromal tumors of the digestive tract are uncommon malignant diseases, and are subclassified as leiomyosarcomas and gastrointestinal stromal tumors (GIST) depending on the molecular expression of CD117 (KIT). GISTs represent 1% of malignant tumors affecting this anatomical site. Located diseases are reasonably well controlled by surgical resection and several criteria define the need for adjuvant therapy. In the case of metastatic disease a poor prognosis has been reported with systemic treatment based on chemotherapy. Recently, significant advances have been shown since Tyrosine – kinase inhibitors were introduced, with median overall survival close to 5 years. Unfortunately in Mexico, even though the therapy has been long used there are no published data of the experience in the treatment of these tumors. Methods: We used an electronic data base to obtain clinical, radiological and histological data of patients diagnosed with GIST and treated in the oncological center of the Mexican Institute of Social Security, patients were subclassified by stage, symptoms at diagnosis as well as the initial and subsequent systemic treatment. Finally we made an analysis for progression free survival and overall survival identifying prognostic factors. Results: We obtained information of 71 patients with metastatic, nonresectable or recurrent GIST, treated with a TKI, we observed a predominant relation for women (60.4%), with median age of 58 years. Stage at diagnosis was predominantly metastatic (46.5%) most frequently affected sites were lung, liver and retroperitoneum. Median progression free survival was 23.6m and overall survival was 81.3 months. All patients were initially treated with imatinib at a dose of 400mg per day. Treatment was well tolerated in most cases. Conclusions: Metastatic GIST evaluated in our center shows a different affection in gender and age, our population shows a different response to TKI’s, than reported in other series with superior overall survival, Poor prognosis is associated with lung affection. Biological studies will be started for the molecular evaluation of these tumors.
Prognosis model for overall survival in locally advanced unresecable pancreatic carcinoma: An ancillary study of the LAP 07 trial.
Authors: Vernerey Dewi , Hammel Pascal , Paget-Bailly Sophie , Huguet Florence , Van Laethem Jean Luc , Goldstein David , Glimelius Bengt , Artru Pascal , Moore Malcolm J. , André Thierry , Mineur Laurent , Chibaudel Benoist , Louvet Christophe , Bonnetain Franck 
Published: February 2017

235 Background: The management of locally advanced pancreatic cancer (LAPC) patients remains controversial and complex. Better discrimination for Overall Survival (OS) is needed to improve therapeutic decisions. We address this issue, with the largest Phase III cohort of LAPC, by establishing the first prognosis model for OS with the full spectrum of parameters currently available at diagnosis. Methods: We enrolled 442 LAPC patients recruited in LAP07, an international multicenter randomized phase III trial (NCT00634725). 30 baseline variables among demographic, cancer history, clinical, biological and radiological parameters were evaluated in univariate and multivariate analyses as prognostic factors for OS. The predictive value of the final model was evaluated with Harrell’s C index. This analysis was repeated 1,000 times with the use of bootstrap sample to derive 95%CI for the C. A prognostic score and nomogramm were then developed based on the identified prognostic factors in the final model. Results: Independent prognostic factors identified in multivariate analysis (n=370) for OS were: Age (HR= 1.01; 95%CI 1.00 - 1.03; p=0.0418), Pain (HR= 1.36 ; 95%CI 1.08 - 1.71; p=0.0094), Albumin (HR= 0.96; 95%CI 0.94 - 0.98; p=0.0001), and RECIST size (HR= 1.01; 95%CI 1.00 - 1.02; p=0.0033), Harrell’s C-statistic for the final model was 0.60 (95% bootstrap CI 0.56 0.63). A prognostic score between 0 and 4 was then calculated for each patient, based on the previous model. Three risk-groups for death could be identified: lower risk (n=17; median OS time = 18.8 months; group of reference); intermediate risk (n=166 ;median OS time = 13.4 months; HR=1.7); higher risk (n=187 ; median OS time = 11.8 months; HR=2.1); p = 0.0101 by the global log rank test. A score and nomogramm were also developped with the addition of CA19.9 information. Conclusions: Our results highlighted 4 OS’s independent pronostic factors among a broad spectrum of parameters at time of diagnosis. We identified 3 groups with different OS’s prognosis profile. The determination of this simple prognostic score allows risk stratification that may help guiding clinical management of patients and the design for future clinical trials.
Genetic and phenotypic characterization of families with familial pancreatic cancer and screening of high-risk individuals.
Authors: Guillen Carmen , Earl Julie , Mocci Evelina , Guerrero Carme , Montans Jose , Marquez Mirari , Vazquez Sequeiros Enrique , Gonzalez Gordaliza Cristina , Sanjuanbenito Alfonso , MuÃƒÂ‘oz Maria Jesus , Solera Jesus , Real Francisco X , Malats Nuria , Carrato Alfredo 
Published: February 2017

242 Background: The prognosis of patients diagnosed with Pancreatic Cancer (PC) is dismal with a 5-year survival rate of around 5%. Familial Pancreatic Cancer (FPC) is an autosomal dominant rare syndrome defined as families with two or more first-degree relatives with pancreatic cancer that do not fulfill the criteria of any other inherited tumor syndrome. The Spanish familial pancreatic cancer registry, Pan-Gen-FAM was established in 2009 in order to identify and manage families at high risk of developing PC. Methods: Information on the family history of cancer is collected in order to determine the phenotype of individual families and patients are offered genetic testing of known FPC associated genes pertinent to their familial syndrome. An individualized clinical screening program is devised for the early detection of a pancreatic tumor consisting of periodic monitoring by imaging techniques (EUS and MRI) and the evaluation of minimally-invasive tumor biomarkers approaches including Circulating Tumor Cells (CTC) and circulating free DNA in blood. Results: To date the registry includes 125 individuals representing some 41 families. Of 17 families tested so far BRCA2 germline mutations were detected in 5 families and a BRCA1 mutation in 1 family. 43 individuals underwent clinical screening. More pancreatic abnormalities were found by EUS (41%) than by MRI (31%). The most frequent abnormal findings were parenchymal changes associated with chronic pancreatitis. Eight cystic lesions were identified. One lesion was identified as a well differentiated neuroendocrine tumor and another was shown to have benign cytology and whilst carcinoma was found in a third patient, this patient underwent a subsequent partial pancreatectomy. The remaining patients with cystic lesions are undergoing close clinical observation. Seventy three patients underwent CTC determinations and all patients tested negative. Conclusions: Periodic screening of high risk individuals by EUS and RMI can detect small tumors and premalignant lesions. We hypothesize that these persons will have a higher probability of long-term survival than sporadic cases.
Comparison of four models for end-stage liver disease in predicting the survival rate of patients with advanced hepatocellular carcinoma (HCC).
Authors: Chen Zhan-Hong , Ma Xiao-kun , Li Xing , Hong Yingfen , Wu Dong-hao , Dong Min , Lin Qu , Wu Xiang-yuan 
Published: February 2017

251 Background: Prognosis of patients with advanced HCC is very poor, median overall survival varies from 3 to 6 months. Life expectancy more than 3 months is one inclusion criteria for molecular targeted drugs in clinical tirals. There exists four models for end-stage liver disease: 1.) MELD: The model for end-stage Liver disease; 2.) MELD-AS: MELD+4.53×c(Na)+4.46×Ascites [Serum Na: Na<135 mmol/L score 1, otherwise score 0; Ascites: persistent ascites score 1, otherwise score 0]; 3.) iMELD: MELD+(0.3×age)-0.7×c(Na)mmol/L+100; 4.) MESO:[MELD/c(Na)mmol/L]×10.Now we want to compare four models in predicting the survival rate of advanced HCC patients. Methods: From September 2008 to September 2010, a total of 183 patients with advanced HCC who were not amendable to locoregional therapy were analyzed. The median survival was 6.6 months. Data were collected to classify patients according to MELD, MELD-AS, iMELD and MESO at diagnosis.3-month survival and 6-month survival were the end points used in the analysis. Results: When predicting 3-month survival, ROC analysis shows AUC of MELD-AS, MESO, MELD and iMELD is 0.718, 0.691, 0.688 and 0.620. AUC of MELD-AS is significantly higher than that of the other three models (p<0.05 ).Cut-off point of MELD-AS is 9.54 with 76.9% sensitivity and 59.5% specificity.The cut-off point of MESO, MELD and iMELD is 0.44, 6.19 and 23.87. When predicting 6-month survival, ROC analysis shows AUC of MELD-AS, MESO, MELD and iMELD and is 0.574, 0.538, 0.533 and 0.507. AUC of MELD-AS is significantly higher than that of the other three models (p<0.05 ).Cut-off point of MELD-AS is 18.53 with 27.7% sensitivity and 89.1% specificity.The cut-off point of MESO, MELD and iMELD is 1.04, 13.83 and 40.76. MELD-AS, MESO, MELD and iMELD is dichotomized according to the cut-off point generated by ROC analysis when predicting 6-month survival.Log-Rank test shows P value of MELD-AS, MESO, MELD and iMELD is 0.001,0.008,0.02 and 0.0009 respectively. Conclusions: MELD-AS is the best model in prediction of 3-month survival and 6-month survival among the four models for end-stage liver disease analyzed for Chinese advanced HCC patients.
Can contrast-enhanced MRI using gadoxetate disodium (EOVIST) replace triphasic CT to derive future liver remnant?
Authors: Le Viet H. , Trocha Steven D. , Jones Wesley B. , Devane Michael A. , McKinley Brian 
Published: February 2017

263 Background: Calculating future liver remnant volume (FLRV) is important in planning treatment of hepatic neoplasm. CE-MRI gadoxetate disodium (Eovist) has been shown to yield more information than 3p-CT, often narrowing the differential of hepatic neoplasms. The purpose of this study is to compare FLRV calculated from CE-MRI to those from 3p-CT. Methods: We performed a retrospective review of 28 patients with liver tumors evaluated with both 3p-CT and CE-MRI prior to treatment. Three-dimensional reconstructions were computed by manual tracing technique. 3p-CT is considered the gold standard. Results: The calculated total hepatic mean volumes for 3p-CT was 1,588 cm3 and 1,916 cm3 for CE-MRI, with spearman correlation (ρ) of 0.91 (p <0.01). The total volume difference was 327 cm3 (p <0.01). The right hepatic lobe volume was 1,028 cm3 (3p-CT) and 1,283 cm for (CE-MRI) (ρ 0.83, p <0.01). The left hepatic volume was 525 cm3 (3p-CT) and 638 cm3 (CE-MRI), (ρ 0.79, p <0.01). The difference in calculated volume for the right liver is 254 cm3, p <0.01 (3.23%, p 0.008) and 94 cm3, p 0.07 (2.09%, p 0.045) for the left liver. Conclusions: Our data demonstrated a strong and positive correlation between 3p-CT and CE-MRI. When the 30% FLRV cutoff used, there is variability in 5 out of 28 patients (17.8%). Our data suggest that patients with FLRV calculated by CE-MRI that are near the resectability cutoff or those with abnormally large calculated FLRV should undergo 3p-CT for verification. Future studies are needed to further validate CE-MRI ability to calculate FLRV.