bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediagnostic Plasma 25-Hydroxyvitamin D and Pancreatic Cancer Survival
Authors: Yuan Chen , Qian Zhi Rong , Babic Ana , Morales-Oyarvide Vicente , Rubinson Douglas A. , Kraft Peter , Ng Kimmie , Bao Ying , Giovannucci Edward L. , Ogino Shuji , Stampfer Meir J. , Gaziano John Michael , Sesso Howard D. , Buring Julie E. , Cochrane Barbara B. , Chlebowski Rowan T. , Snetselaar Linda G. , Manson JoAnn E. , Fuchs Charles S. , Wolpin Brian M. 
Published: June 2016

Purpose Although vitamin D inhibits pancreatic cancer proliferation in laboratory models, the association of plasma 25-hydroxyvitamin D [25(OH)D] with patient survival is largely unexplored. Patients and Methods We analyzed survival among 493 patients from five prospective US cohorts who were diagnosed with pancreatic cancer from 1984 to 2008. We estimated hazard ratios (HRs) for death by plasma level of 25(OH)D (insufficient, < 20 ng/mL; relative insufficiency, 20 to < 30 ng/mL; sufficient ≥ 30 ng/mL) by using Cox proportional hazards regression models adjusted for age, cohort, race and ethnicity, smoking, diagnosis year, stage, and blood collection month. We also evaluated 30 tagging single-nucleotide polymorphisms in the vitamin D receptor gene, requiring P < .002 (0.05 divided by 30 genotyped variants) for statistical significance. Results Mean prediagnostic plasma level of 25(OH)D was 24.6 ng/mL, and 165 patients (33%) were vitamin D insufficient. Compared with patients with insufficient levels, multivariable-adjusted HRs for death were 0.79 (95% CI, 0.48 to 1.29) for patients with relative insufficiency and 0.66 (95% CI, 0.49 to 0.90) for patients with sufficient levels (P trend = .01). These results were unchanged after further adjustment for body mass index and history of diabetes (P trend = .02). The association was strongest among patients with blood collected within 5 years of diagnosis, with an HR of 0.58 (95% CI, 0.35 to 0.98) comparing patients with sufficient to patients with insufficient 25(OH)D levels. No single-nucleotide polymorphism at the vitamin D receptor gene met our corrected significance threshold of P < .002; rs7299460 was most strongly associated with survival (HR per minor allele, 0.80; 95% CI, 0.68 to 0.95; P = .01). Conclusion We observed longer overall survival in patients with pancreatic cancer who had sufficient prediagnostic plasma levels of 25(OH)D.
The Effects of Oncologist Implicit Racial Bias in Racially Discordant Oncology Interactions
Authors: Penner Louis A. , Dovidio John F. , Gonzalez Richard , Albrecht Terrance L. , Chapman Robert , Foster Tanina , Harper Felicity W.K. , Hagiwara Nao , Hamel Lauren M. , Shields Anthony F. , Gadgeel Shirish , Simon Michael S. , Griggs Jennifer J. , Eggly Susan 
Published: June 2016

PurposeHealth providers’ implicit racial bias negatively affects communication and patient reactions to many medical interactions. However, its effects on racially discordant oncology interactions are largely unknown. Thus, we examined whether oncologist implicit racial bias has similar effects in oncology interactions. We further investigated whether oncologist implicit bias negatively affects patients’ perceptions of recommended treatments (i.e., degree of confidence, expected difficulty). We predicted oncologist implicit bias would negatively affect communication, patient reactions to interactions, and, indirectly, patient perceptions of recommended treatments.MethodsParticipants were 18 non-black medical oncologists and 112 black patients. Oncologists completed an implicit racial bias measure several weeks before video-recorded treatment discussions with new patients. Observers rated oncologist communication and recorded interaction length of time and amount of time oncologists and patients spoke. Following interactions, patients answered questions about oncologists’ patient-centeredness and difficulty remembering contents of the interaction, distress, trust, and treatment perceptions.ResultsAs predicted, oncologists higher in implicit racial bias had shorter interactions, and patients and observers rated these oncologists’ communication as less patient-centered and supportive. Higher implicit bias also was associated with more patient difficulty remembering contents of the interaction. In addition, oncologist implicit bias indirectly predicted less patient confidence in recommended treatments, and greater perceived difficulty completing them, through its impact on oncologists’ communication (as rated by both patients and observers).ConclusionOncologist implicit racial bias is negatively associated with oncologist communication, patients’ reactions to racially discordant oncology interactions, and patient perceptions of recommended treatments. These perceptions could subsequently directly affect patient-treatment decisions. Thus, implicit racial bias is a likely source of racial treatment disparities and must be addressed in oncology training and practice.
Survival Analyses of Patients With Metastatic Renal Cancer Treated With Targeted Therapy With or Without Cytoreductive Nephrectomy: A National Cancer Data Base Study
Authors: Hanna Nawar , Sun Maxine , Meyer Christian P. , Nguyen Paul L. , Pal Sumanta K. , Chang Steven L. , de Velasco Guillermo , Trinh Quoc-Dien , Choueiri Toni K. 
Published: June 2016

Purpose The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) has become unclear since the introduction of targeted therapies (TT). We sought to evaluate contemporary utilization rates of CN and to examine the survival benefit of CN compared with non-CN patients treated with TT. Methods We used the National Cancer Data Base to identify patients with clinical mRCC treated with TT between 2006 and 2013. The intervention of interest was CN. Multivariable logistic regression predicting receipt of CN was performed. Overall survival (OS) was examined using Cox regression models and incremental survival analyses were performed. Sensitivity analyses using propensity scores were conducted. Results Of 15,390 patients treated with TT, 5,374 (35%) underwent CN between 2006 and 2013. Patients who were younger, privately insured, treated at an academic center, and had lower tumor stage and cN0 disease were more likely to undergo CN. The median OS of CN versus non-CN patients was 17.1 (95% CI, 16.3 to 18.0 months) versus 7.7 months (95% CI, 7.4 to 7.9 months; P < .001). In sensitivity analyses using propensity scores adjustment in addition to other available covariates, CN patients had a lower risk of any death (hazard ratio, 0.45; 95% CI, 0.40 to 0.50; P < .001). The survival benefit of CN was +0.7 and +3.6 months in patients who survived ≤ 6 and ≤ 24 months, respectively, versus no CN. Conclusion CN is performed in three of 10 patients with mRCC who are receiving TT. Several patient and sociodemographic characteristics were associated with receipt of CN. When feasible, CN may offer an OS benefit when combined with TT.
Ovarian Cancer Risk Factors by Histologic Subtype: An Analysis From the Ovarian Cancer Cohort Consortium
Authors: Wentzensen Nicolas , Poole Elizabeth M. , Trabert Britton , White Emily , Arslan Alan A. , Patel Alpa V. , Setiawan V. Wendy , Visvanathan Kala , Weiderpass Elisabete , Adami Hans-Olov , Black Amanda , Bernstein Leslie , Brinton Louise A. , Buring Julie , Butler Lesley M. , Chamosa Saioa , Clendenen Tess V. , Dossus Laure , Fortner Renee , Gapstur Susan M. , Gaudet Mia M. , Gram Inger T. , Hartge Patricia , Hoffman-Bolton Judith , Idahl Annika , Jones Michael , Kaaks Rudolf , Kirsh Victoria , Koh Woon-Puay , Lacey James V. , Lee I-Min , Lundin Eva , Merritt Melissa A. , Onland-Moret N. Charlotte , Peters Ulrike , Poynter Jenny N. , Rinaldi Sabina , Robien Kim , Rohan Thomas , Sandler Dale P. , Schairer Catherine , Schouten Leo J. , Sjöholm Louise K. , Sieri Sabina , Swerdlow Anthony , Tjonneland Anna , Travis Ruth , Trichopoulou Antonia , van den Brandt Piet A. , Wilkens Lynne , Wolk Alicja , Yang Hannah P. , Zeleniuch-Jacquotte Anne , Tworoger Shelley S. 
Published: June 2016

Purpose An understanding of the etiologic heterogeneity of ovarian cancer is important for improving prevention, early detection, and therapeutic approaches. We evaluated 14 hormonal, reproductive, and lifestyle factors by histologic subtype in the Ovarian Cancer Cohort Consortium (OC3). Patients and Methods Among 1.3 million women from 21 studies, 5,584 invasive epithelial ovarian cancers were identified (3,378 serous, 606 endometrioid, 331 mucinous, 269 clear cell, 1,000 other). By using competing-risks Cox proportional hazards regression stratified by study and birth year and adjusted for age, parity, and oral contraceptive use, we assessed associations for all invasive cancers by histology. Heterogeneity was evaluated by likelihood ratio test. Results Most risk factors exhibited significant heterogeneity by histology. Higher parity was most strongly associated with endometrioid (relative risk [RR] per birth, 0.78; 95% CI, 0.74 to 0.83) and clear cell (RR, 0.68; 95% CI, 0.61 to 0.76) carcinomas (P value for heterogeneity [P-het] < .001). Similarly, age at menopause, endometriosis, and tubal ligation were only associated with endometrioid and clear cell tumors (P-het ≤ .01). Family history of breast cancer (P-het = .008) had modest heterogeneity. Smoking was associated with an increased risk of mucinous (RR per 20 pack-years, 1.26; 95% CI, 1.08 to 1.46) but a decreased risk of clear cell (RR, 0.72; 95% CI, 0.55 to 0.94) tumors (P-het = .004). Unsupervised clustering by risk factors separated endometrioid, clear cell, and low-grade serous carcinomas from high-grade serous and mucinous carcinomas. Conclusion The heterogeneous associations of risk factors with ovarian cancer subtypes emphasize the importance of conducting etiologic studies by ovarian cancer subtypes. Most established risk factors were more strongly associated with nonserous carcinomas, which demonstrate challenges for risk prediction of serous cancers, the most fatal subtype.
12-Gene Recurrence Score Assay Stratifies the Recurrence Risk in Stage II/III Colon Cancer With Surgery Alone: The SUNRISE Study
Authors: Yamanaka Takeharu , Oki Eiji , Yamazaki Kentaro , Yamaguchi Kensei , Muro Kei , Uetake Hiroyuki , Sato Takeo , Nishina Tomohiro , Ikeda Masataka , Kato Takeshi , Kanazawa Akiyoshi , Kusumoto Tetsuya , Chao Calvin , Lopatin Margarita , Krishnakumar Jayadevi , Bailey Helen , Akagi Kiwamu , Ochiai Atsushi , Ohtsu Atsushi , Ohashi Yasuo , Yoshino Takayuki 
Published: June 2016

Purpose The 12-gene Recurrence Score assay has been validated in resected stage II colon cancer treated with or without chemotherapy and resected stage III disease treated with chemotherapy. This study evaluated the 12-gene Recurrence Score assay for stage II and III colon cancer without chemotherapy to reveal the natural course of recurrence risk in stage III disease. Methods A cohort-sampling design was used. From 1,487 consecutive patients with stage II to III disease who had surgery alone, 630 patients were sampled for inclusion with a 1:2 ratio of recurrence and nonrecurrence. Sampling was stratified by stage (II v III). The assay was performed on formalin-fixed, paraffin-embedded primary cancer tissue. Association of the Recurrence Score result with recurrence-free interval (RFI) was assessed by using weighted Cox proportional hazards regression. Results Overall, 597 of 630 patients were analyzable—247 patients had stage II, and 350 had stage III colon cancer. The continuous Recurrence Score was significantly associated with RFI after adjustment for disease stage (hazard ratio for a 25-unit increase in Recurrence Score, 2.05; 95% CI, 1.47 to 2.86; P < .001). With respect to prespecified subgroups, as defined by low (< 30), intermediate (30 to 40), and high (≥ 41) Recurrence Score risk groups, patients with stage II disease in the high-risk group had a 5-year risk of recurrence similar to patients with stage IIIA to IIIB disease in the low-risk group (19% v 20%), whereas patients with stage IIIA to IIIB disease in the high-risk group had a recurrence risk similar to that of patients with stage IIIC disease in the low-risk group (approximately 38%). Conclusion To our knowledge, this study provides the first validation of the 12-gene Recurrence Score assay in stage III colon cancer without chemotherapy and showed the heterogeneity of recurrence risks in stage III as well as in stage II colon cancer.
Phase II Study of Hemithoracic Intensity-Modulated Pleural Radiation Therapy (IMPRINT) As Part of Lung-Sparing Multimodality Therapy in Patients With Malignant Pleural Mesothelioma
Authors: Rimner Andreas , Zauderer Marjorie G. , Gomez Daniel R. , Adusumilli Prasad S. , Parhar Preeti K. , Wu Abraham J. , Woo Kaitlin M. , Shen Ronglai , Ginsberg Michelle S. , Yorke Ellen D. , Rice David C. , Tsao Anne S. , Rosenzweig Kenneth E. , Rusch Valerie W. , Krug Lee M. 
Published: June 2016

Purpose We conducted a two-center phase II study to determine the safety of hemithoracic intensity-modulated pleural radiation therapy (IMPRINT) after chemotherapy and pleurectomy-decortication (P/D) as part of a multimodality lung-sparing treatment. Patients and Methods Patients received up to four cycles of pemetrexed plus platinum. If feasible, P/D was performed. Hemithoracic IMPRINT was administered to a planned dose of 50.4 Gy in 28 fractions. The primary end point was the incidence of grade 3 or greater radiation pneumonitis (RP). Results A total of 45 patients were enrolled; 18 were not evaluable (because of disease progression before radiation therapy [RT], n = 9; refusal of surgery or RT, n = 5; extrapleural pneumonectomy at time of surgery, n = 2; or chemotherapy complications, n = 2). A total of 26 patients received pemetrexed plus cisplatin, 18 received pemetrexed plus carboplatin, and four received a combination. Thirteen patients (28.9%) had a partial response, 15 patients (33.3%) experienced disease progression, one patient died during chemotherapy, and all others had stable disease. Eight patients underwent P/D or an extended P/D, and 13 underwent a partial P/D. A total of 27 patients started IMPRINT (median dose, 46.8 Gy; range, 28.8 to 50.4 Gy) and were evaluable for the primary end point (median follow-up, 21.6 months). Six patients experienced grade 2 RP, and two patients experienced grade 3 RP; all recovered after corticosteroid initiation. No grade 4 or 5 radiation-related toxicities were observed. The median progression-free survival and overall survival (OS) were 12.4 and 23.7 months, respectively; the 2-year OS was 59% in patients with resectable tumors and was 25% in patients with unresectable tumors. Conclusions Hemithoracic IMPRINT for malignant pleural mesothelioma (MPM) is safe and has an acceptable rate of RP. Its incorporation with chemotherapy and P/D forms a new lung-sparing treatment paradigm for patients with locally advanced MPM.
Improved Survival With Prostate Radiation in Addition to Androgen Deprivation Therapy for Men With Newly Diagnosed Metastatic Prostate Cancer
Authors: Rusthoven Chad G. , Jones Bernard L. , Flaig Thomas W. , Crawford E. David , Koshy Matthew , Sher David J. , Mahmood Usama , Chen Ronald C. , Chapin Brian F. , Kavanagh Brian D. , Pugh Thomas J. 
Published: June 2016

Purpose There is growing interest in the role of local therapies, including external beam radiotherapy (RT), for men with metastatic prostate cancer (mPCa). We used the National Cancer Database (NCDB) to evaluate the overall survival (OS) of men with mPCa treated with androgen deprivation (ADT) with and without prostate RT. Methods The NCDB was queried for men with newly diagnosed mPCa, all treated with ADT, with complete datasets for RT, surgery, prostate-specific antigen (PSA) level, Gleason score, and Charlson-Deyo comorbidity score. OS was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses. Results From 2004 to 2012, 6,382 men with mPCa were identified, including 538 (8.4%) receiving prostate RT. At a median follow-up of 5.1 years, the addition of prostate RT to ADT was associated with improved OS on univariate (P < .001) and multivariate analysis (hazard ratio, 0.624; 95% CI, 0.551 to 0.706; P < .001) adjusted for age, year, race, comorbidity score, PSA level, Gleason score, T stage, N stage, chemotherapy administration, treating facility, and insurance status. Propensity score analysis with matched baseline characteristics demonstrated superior median (55 v 37 months) and 5-year OS (49% v 33%) with prostate RT plus ADT compared with ADT alone (P < .001). Landmark analyses limited to long-term survivors of ≥1, ≥3, and ≥5 years demonstrated improved OS with prostate RT in all subsets (all P < .05). Secondary analyses comparing the survival outcomes for patients treated with therapeutic dose RT plus ADT versus prostatectomy plus ADT during the same time interval demonstrated no significant differences in OS, whereas both therapies were superior to ADT alone. Conclusion In this large contemporary analysis, men with mPCa receiving prostate RT and ADT lived substantially longer than men treated with ADT alone. Prospective trials evaluating local therapies for mPCa are warranted.
Clinicopathologic Significance of Mismatch Repair Defects in Endometrial Cancer: An NRG Oncology/Gynecologic Oncology Group Study
Authors: McMeekin D. Scott , Tritchler David L. , Cohn David E. , Mutch David G. , Lankes Heather A. , Geller Melissa A. , Powell Matthew A. , Backes Floor J. , Landrum Lisa M. , Zaino Richard , Broaddus Russell D. , Ramirez Nilsa , Gao Feng , Ali Shamshad , Darcy Kathleen M. , Pearl Michael L. , DiSilvestro Paul A. , Lele Shashikant B. , Goodfellow Paul J. 
Published: June 2016

PurposeThe clinicopathologic significance of mismatch repair (MMR) defects in endometrioid endometrial cancer (EEC) has not been definitively established. We undertook tumor typing to classify MMR defects to determine if MMR status is prognostic or predictive.MethodsPrimary EECs from NRG/GOG0210 patients were assessed for microsatellite instability (MSI), MLH1 methylation, and MMR protein expression. Each tumor was assigned to one of four MMR classes: normal, epigenetic defect, probable mutation (MMR defect not attributable to MLH1 methylation), or MSI-low. The relationships between MMR classes and clinicopathologic variables were assessed using contingency table tests and Cox proportional hazard models.ResultsA total of 1,024 tumors were assigned to MMR classes. Epigenetic and probable mutations in MMR were significantly associated with higher grade and more frequent lymphovascular space invasion. Epigenetic defects were more common in patients with higher International Federation of Gynecology and Obstetrics stage. Overall, there were no differences in outcomes. Progression-free survival was, however, worse for women whose tumors had epigenetic MMR defects compared with the MMR normal group (hazard ratio, 1.37; P < .05; 95% CI, 1.00 to 1.86). An exploratory analysis of interaction between MMR status and adjuvant therapy showed a trend toward improved progression-free survival for probable MMR mutation cases.ConclusionMMR defects in EECs are associated with a number of well-established poor prognostic indicators. Women with tumors that had MMR defects were likely to have higher-grade cancers and more frequent lymphovascular space invasion. Surprisingly, outcomes in these patients were similar to patients with MMR normal tumors, suggesting that MMR defects may counteract the effects of negative prognostic factors. Altered immune surveillance of MMR-deficient tumors, and other host/tumor interactions, is likely to determine outcomes for patients with MMR-deficient tumors.
Σε ποιον ανήκει ο 21ος αιώνας; Patrimonial versus agency capitalism
Authors: Κατσούλης Ηλίας 
Published: June 2016

<p class="p1"><span class="s1">Ο </span><span class="s2">T. Piketty </span>υποστηρίζει ότι, εάν δεν ληϕθούν δραστικά δημοσιονομικά μέτρα ελέγχου της κληρονομικής μεταϕοράς πλούτου στα ανώτερα εκατοστημόρια και χιλιοστημόρια του πληθυσμού στις δυτικές χώρες, δημιουργείται ο κίνδυνος οι οικονομικές ανισότητες να οδηγήσουν σε καταστάσεις αντίστοιχες με εκείνες που κυριαρχούσαν στην Ευρώπη κατά τον <span class="s3">19</span>ο αιώνα. Από την πλευρά μου επιλέγω να παρακολουθήσω το πρόβλημα των ανισοτήτων από την οπτική γωνία της εταιρικής διακυβέρνησης και να εξετάσω μέσα στον χρόνο τη διανομή των εισοδημάτων μεταξύ των συντελεστών της εταιρικής σχέσης, δηλαδή μεταξύ <span class="s2">principals </span>και <span class="s2">agents</span>, στο πλαίσιο ενός εν εξελίξει τύπου καπιταλισμού ο οποίος στη βιβλιογραϕία ονομάζεται <span class="s2">agency capitalism</span>. Σε αυτόν οι <span class="s2">principals</span>, οι μέτοχοι, οι οποίοι στην πλειονότητά τους είναι εργαζόμενοι και οι πραγματικοί ‘ιδιοκτήτες’ της επιχείρησης, συγκλίνουν με τους <span class="s2">agents</span>, τους εντολοδόχους, στην επιδίωξη της μεγιστοποίησης της αξίας της επιχείρησης. Στους εντολοδόχους ανήκουν τα διευθυντικά στελέχη της επιχείρησης, οι εμπειρογνώμονες και διαχειριστές των ιδιωτικών κεϕαλαίων και μια νέα κατηγορία ειδικών διαχειριστών, οι γνωσιογνώστες, οι οποίοι στις συνθήκες της εν εξελίξει παγκοσμιοποίησης των οικονομικών και άλλων ανταλλαγών επιδιώκουν σε σύντομα χρονικά διαστήματα να μεγιστοποιούν τα οικονομικά οϕέλη για όλους τους εμπλεκόμενους. η έρευνα των σχέσεων δύναμης αλλά και συμϕερόντων στο πλαίσιο του <span class="s1">agency </span><span class="s1">capitalism </span>δείχνει σε μια κατεύθυνση στην οποία <span class="s1">principals </span>και <span class="s1">agents </span>θέτουν τις βάσεις μιας συμπόρευσης η οποία μπορεί να διανέμει πλούτο προς τα κάτω αποτρέποντας τη συγκέντρωσή του στα εκατοστημόρια και χιλιοστημόρια της εισοδηματικής πυραμίδας.</p>