bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loss of YAP Protein in Prostate Cancer is Associated with Gleason Score Increase
Authors: Hu Xiaoyong , Jia Yingying , Yu Jianjun , Chen Jie , Fu Qiang 
Published: April 2015

Aims and Background To investigate the expression of YAP protein by immunohistochemistry in prostate cancer tissues and hyperplasia or normal prostate tissues adjacent to cancer, and establish the correlation of YAP expression with Gleason score. Methods and Study Design The expression of YAP protein was evaluated in tissue microarray by immunohistochemistry. The samples included 66 radical prostatectomy specimens with clinically detected prostate cancer and 54 hyperplasia or normal prostate tissues adjacent to cancer. Results YAP expression was present mainly in the nuclei of basal cells in both prostate cancer tissues and normal prostate or hyperplasia tissues adjacent to cancer. Cytoplasmic expression of YAP was weaker than nuclear expression in both malignant and nonmalignant luminal epithelial cells. YAP expression was decreased or lost in prostate cancer tissues; hyperplasia or normal prostate tissues adjacent to cancer exhibited stronger nuclear and cytoplasmic expression of YAP (p = 0.0001). Downregulation of YAP expression in prostate cancer samples correlated with Gleason score increase (p = 0.002). Conclusions This immunohistochemical study expands our knowledge of the expression and localization of YAP in prostate cancer tissue and nonmalignant prostate tissue adjacent to cancer. YAP might function as a tumor suppressor in prostate cancer. Such information may provide the foundation for the treatment of preneoplastic and neoplastic lesions of the prostate.
Ampulla of Vater Carcinoma in Real-World Clinical Practice: A Case Series
Authors: Giuliani Jacopo , Piacentini Paolo , Bonetti Andrea 
Published: April 2015

Aims and Background The aim of this report was to describe the way in which a rare and niche disease like ampulla of Vater carcinoma (AVC) was treated in real-world clinical practice. Methods and Study Design A retrospective analysis of consecutive patients with a diagnosis of AVC treated at our medical oncology unit between August 2004 and August 2013 was performed. Results We evaluated 8 consecutive patients with a median age of 60 years (range 56–84). At the last follow-up, 4 patients were alive without evidence of disease and 4 patients had died. The median follow-up time was 21.51 months (range 1–100.43), the median overall survival 23.19 months (range 7.07–102.2), and the median disease-free survival 18.26 months (range 0–102.2). Six patients underwent surgery, which consisted of pylorus-preserving pancreaticoduodenectomy, R0 in all cases. Tumor histology was adenocarcinoma in all patients. Two patients presented with locally advanced disease. Only 1 patient presented with metastases while 3 patients subsequently developed metastases. Two patients received chemotherapy for metastatic disease; in both cases disease progression was observed at the first disease evaluation. Conclusions We can consider AVC as a pathology niche and pancreaticoduodenectomy as the effective treatment for these patients.
Comparison of Stereotactic Body Radiation Therapy for Biopsy-Proven versus Radiographically Diagnosed Early-Stage Non-Small Lung Cancer: A Single-Institution Experience
Authors: Fischer-Valuck Benjamin W. , Boggs Hunter , Katz Sanford , Durci Michael , Acharya Sahaja , Rosen Lane R. 
Published: April 2015

Introduction Histological confirmation of non-small cell lung cancer (NSCLC) is often required before patients are offered stereotactic body radiation therapy (SBRT) as a treatment option. Many patients, however, are unsuitable to undergo a biopsy procedure because of comorbidity. Our objective is to compare the outcomes of patients with biopsy-proven (BxPr) or clinically/radiographically diagnosed (RadDx) early-stage NSCLC treated with SBRT. Methods Records of 88 patients treated with SBRT at a single institution were reviewed. Sixty-five patients had BxPr early-stage NSCLC. Twenty-three patients were RadDx with early-stage NSCLC based on an FDG-avid chest nodule on PET scan, serial sequential CT-findings compatible with NSCLC, and consensus of a multidisciplinary team. Outcomes of patients with BxPr and RadDx NSCLC were evaluated in regard to local control, regional lymph node metastasis-free and distant metastasis-free rates, and overall survival using Kaplan-Meier survival curves. Results Median follow-up for all patients was 29 months (range, 4–82 months). Cumulative local progression-free rate after 3 years for the BxPr group was 93.1% (95% confidence interval [CI], 85.2%-97.6%) and 94.10% (95% CI, 73.2%-97.6%) for the RadDx group (p = 0.98). No differences regarding regional lymph node metastasis-free and distant metastasis-free rates by subgroup were observed. The overall 3-year survival rate for the BxPr group was 59.9% (95% CI, 44.8%-68.2%) and 58.9% (95% CI, 40.1%-77.8%) for the RadDx group (p = 0.46). Conclusions SBRT is a practical treatment modality for patients with RadDx early-stage NSCLC. Outcomes of patients RadDx with NSCLC mirror the results of patients treated with BxPr disease.
Stereotactic Body Radiotherapy with Cyberknife for Cardiac Malignancies
Authors: Bonomo Pierluigi , Cipressi Samantha , Desideri Isacco , Masi Laura , Doro Raffaela , Iermano Carmine , Greto Daniela , Simontacchi Gabriele , Mangoni Monica , Paiar Fabiola , Meattini Icro , Scoccianti Silvia , Santoro Gennaro , Valente Serafina , Gensini Gian Franco , Livi Lorenzo 
Published: April 2015

Aims and Background Radiobiological and technical considerations have traditionally limited the role of radiation therapy in the context of primary and secondary cardiac malignancies. Stereotactic body radiotherapy (SBRT) is a promising modality for the delivery of focused high-dose radiation with ablative potential to complex targets such as small, deep-seated, moving lesions, allowing also for re-irradiation. Methods Between January 2013 and October 2013, 3 patients underwent SBRT for cardiac lesions: 2 patients had recurrent, previously irradiated cardiac angiosarcomas (PCA) and 1 patient had a cardiac metastasis from melanoma. They were treated with fiducial-guided robotic radiotherapy with CyberKnife. As for dose prescription, 24 Gy in 3 fractions (80% isodose) and 30 Gy in 5 fractions (80% isodose) were administered to the recurrent PCAs and cardiac metastasis, respectively. Results At 2 months after SBRT, cardiac MRI showed a partial response in the patients treated for recurrent PCA while the cardiac metastasis remained stable. In all cases, absence of local progression was subsequently confirmed by contrast-enhanced cardiac MRI after 6 months, without any evidence of treatment-related side effects. Conclusions Fiducial-guided SBRT proved to be feasible and effective in preventing local disease progression in selected patients with cardiac malignancies.
Management of Oropharyngeal Mycosis in Head and Neck Cancer Occurring during (Chemo) Radiotherapy: An Italian Radio-Oncologist Survey
Authors: Belgioia Liliana , Bacigalupo Almalina , Alterio Daniela , Russi Elvio , Corvò Renzo 
Published: April 2015

Aims and Background Oropharyngeal candidiasis is a common disorder in head and neck cancer patients (HNCPs) who underwent (chemo)-radiotherapy. An Italian survey was conducted in order to investigate radiation oncologists' behavior in regard to diagnosis, prevention, and treatment of oral candidiasis. Methods and Study Design Between April and May 2013, a national online 18-question survey was sent to major Italian radiotherapy centers. Results All Italian regions were represented and 86 radiation oncologists were involved. Eighty-three percent of responders estimated that oropharyngeal candidiasis occurred in 30%-40% of their HNCPs. The majority of responders were able to recognize oral mycosis when it occurred in a localized pseudomembranous form and all responders agreed with the fact that oral candidiasis was always associated with mucositis. A prophylactic therapy was prescribed occasionally by 35% and routinely by 20% of responders. Forty percent prescribed an antifungal drug in the case of suspected mycotic infection and 20% waited for symptomatic clinical evidence before prescribing a therapy. In the presence of candidiasis, mainly topical fluconazole (59%) and itraconazole (36%) were prescribed. Concomitant chemo-radiotherapy was first identified as a risk factor for mycosis occurrence and development. Ninety-nine percent of responders believed that oral mycosis was associated with increased toxicity and 44% of them interrupted treatment due to candidiasis. Conclusions A variety of approaches to oropharyngeal candidiasis emerges from this survey; further clinical trials are necessary to identify the best approach for oral mycosis prevention and treatment and to establish specific international guidelines for HNCPs.
Risk Patterns of Subsequent Primary Cancers following Esophagectomy in Early-Stage Thoracic Esophageal Squamous Cell Cancer Patients
Authors: Hu Wen-Si , Liu Zeng-Jun , Zhang Jian-Bo , Wang Zeng-Liang , Yang Ning , Xu Liang , Tian Hui , Zhang Pin-Liang 
Published: April 2015

Aims and Background Subsequent primary cancers (SPCs) have been demonstrated to be the major causes of death among patients with thoracic esophageal squamous cell cancer (ESCC) negative for lymph node involvement. We designed this study to investigate clinical characteristics and risk patterns of SPCs following esophagectomy in patients with early-stage thoracic ESCC. Methods We retrospectively analyzed clinical factors in 512 patients with early-stage thoracic ESCC collected from 3 independent hospitals over a 10-year interval. Results The overall standard incidence rate (SIR) of SPCs was 3.84 (95% confidence interval 2.98–4.95). The most common SPCs were head and neck cancers, lung cancer, and stomach cancer. The risk patterns of SPCs varied across organs. A 3-phase risk pattern with a U-shaped curve between 2 rising phases was seen for head and neck cancers, while for the other cancers, the risk patterns all displayed as an approximately linear upward trend. It was further noted that sex, smoking habits, and cancer histories among first-degree relatives were 3 significant independent risk factors in the development of SPCs. Conclusions We observed significant associations between early-stage ESCC and SPCs arising from anatomically adjacent sites. The different risk patterns of SPCs indicated that follow-up strategies should be established accordingly in different organs at different times, with particularly close follow-up for head and neck cancers in the first 5 years and beyond 15 years after diagnosis of ESCC.
Role of Multidetector Computed Tomography in Evaluating Incidentally Detected Breast Lesions
Authors: Moschetta Marco , Scardapane Arnaldo , Lorusso Valentina , Rella Leonarda , Telegrafo Michele , Serio Gabriella , Angelelli Giuseppe , Ianora Amato Antonio Stabile 
Published: April 2015

Aims and Background Computed tomography (CT) does not represent the primary method for the evaluation of breast lesions; however, it can detect breast abnormalities, even when performed for other reasons related to thoracic structures. The aim of this study is to evaluate the potential benefits of 320-row multidetector CT (MDCT) in evaluating and differentiating incidentally detected breast lesions by using vessel probe and 3D analysis software with net enhancement value. Methods and Study design Sixty-two breast lesions in 46 patients who underwent 320-row chest CT examination were retrospectively evaluated. CT scans were assessed searching for the presence, location, number, morphological features, and density of breast nodules. Net enhancement was calculated by subtracting precontrast density from the density obtained by postcontrast values. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CT were calculated for morphological features and net enhancement. Results Thirty of 62 lesions were found to be malignant at histological examination and 32 were found to be benign. When morphological features were considered, the sensitivity, specificity, accuracy, PPV, and NPV of CT were 87%, 100%, 88%, 100%, and 50%, respectively. Based on net enhancement, CT reached a sensitivity, specificity, accuracy, PPV, and NPV of 100%, 94%, 97%, 94%, and 100%, respectively. Conclusions MDCT allows to recognize and characterize breast lesions based on morphological features. Net enhancement can be proposed as an additional accurate feature of CT.
Knowledge, Opinions and Attitudes of Italian Mothers towards HPV Vaccination and Pap test
Authors: La Torre Giuseppe , De Vito Elisabetta , Ficarra Maria Giovanna , Firenze Alberto , Gregorio Pasquale , Miccoli Silvia , Giraldi Guglielmo , Unim Brigid , De Belvis Giulio , Boccia Antonio ,   HPV Collaborative Group, Saulle Rosella , Semyonov Leda , Ferrara Maria , Langiano Elisa , Capizzi Silvio , Nardella Rosaria , Marsala Maria Grazia Laura , Bonanno Valentina , Ferrara Clara , Guidi Enrica , Bergamini Mauro , Lupi Silvia 
Published: April 2015

Aim This study evaluated the knowledge and attitudes of Italian mothers – whose daughters had been vaccinated in 2012 – towards primary (anti-HPV vaccination) and secondary (Pap test screening) cervical cancer prevention, as well as sources of information and mother-daughter communication on health issues. Methods The survey – part of a multicenter study carried out in 4 Italian cities (Ferrara, Rome, Cassino and Palermo) – was conducted through self-administered questionnaires. The first univariate analysis evaluated differences between mothers of under-18s and over-18s relative to knowledge and attitudes on HPV vaccination and Pap test. The second univariate analysis evaluated differences between the 2 groups of mothers and possible geographical variations regarding the sources of information on HPV and Pap test. Results The sample proved knowledgeable about the correlation between HPV and cervical cancer (>85%) but less aware of other HPV-related diseases. HPV vaccination should be administered before first sexual intercourse according to mothers of over-18s, and to 14- to 17-year-olds according to mothers of under-18s. Up to 88% of mothers of under-18s and 80% of mothers of over-18s declared that the vaccine should be given free of charge. More mothers of under-18s consulted a general practitioner (GP) or gynecologist before deciding to vaccinate their daughters. Mothers of under-18s received information on HPV vaccination mainly from GPs and gynecologists, while mothers of over-18s were informed through TV and books/journals. Over 80% of the sample declared satisfaction with the information received from their gynecologist during the Pap test. Conclusions The findings provide useful information for the development of effective public health interventions that may help improve acceptance of HPV vaccination among mothers.
Image-Guided Radiotherapy for Prostate Cancer using 3 Different Techniques: Localization Data of 186 Patients
Authors: Garibaldi Cristina , Jereczek-Fossa Barbara Alicja , Zerini Dario , Cambria Raffaella , Ferrari Annamaria , Serafini Flavia , Cattani Federica , Tagaste Barbara , Fodor Cristiana , Luraschi Rosa , Orecchia Roberto 
Published: April 2015

Aims and Background This study evaluates 3 different imaging modalities—ultrasound (US), stereoscopic X-ray imaging of implanted markers (Visicoils) (X-ray), and kV cone-beam computed tomography (CBCT)—to assess interfraction and intrafraction localization error during conformal radiation therapy of prostate cancer. Methods and Study Design The study population consisted of 186 consecutive prostate cancer patients treated with an image-guided radiotherapy (IGRT) hypofractionated protocol using 3 techniques: 32 with X-ray, 30 with CBCT, and 124 with US. Treatment dose of 70.2 Gy was delivered in 26 fractions with a conformal dynamic arcs technique. Interfraction prostate localization errors were determined for the 3 techniques. Moreover, interfraction and intrafraction prostate motion in terms of translations and rotations, as well as residual errors, were determined with X-ray. Results The systematic and random components of the prostate localization errors were as follows: ( 1 ) with X-ray 3.0 ± 3.4, 2.3 ± 2.7, 1.8 ± 2.3 mm in anterior-posterior (AP), superior-inferior (SI), and left-right (LR) directions and 1.8° ± 1.2°, 2.3° ± 1.5°, 2.7° ± 3.1°, for the yaw, roll, and pitch rotations; ( 2 ) with CBCT3.5 ± 4.2, 3.3 ± 3.3, 2.5 ± 3.1 mm in AP, SI, and LR directions; ( 3 ) with US 3.7 ± 4.7, 3.4 ± 4.3, 2.3 ± 3.5 mm in AP, SI, and LR directions. Residual errors with X-ray were less than 1 mm in all directions. Intrafraction prostate motion of less than 0.5 mm in LR and of the order of 1 mm in AP and SI directions was found. This led to a significant reduction of the margins, potentially important for dose escalation studies. Conclusions Daily on-line IGRT with stereoscopic X-ray imaging allowed a consistent PTV margin reduction considering residual interfraction prostate localization error and intrafraction motion. X-ray offers the best compromise among accuracy, reliability, dose to the patient, and time investment for daily IGRT treatment of prostate.
Investigation of Prognostic Factors Affecting Efficacy in Carboplatin- and Paclitaxel-based First-line Chemotherapies for Advanced Non-small-cell Lung Cancer
Authors: Komuro Masato , Kaneko Masayuki , Narukawa Mamoru 
Published: April 2015

Aims and Background First-line chemotherapies for advanced non-small-cell lung cancer (NSCLC) are platinum-based regimens. An analysis of efficacy outcomes has not yet been systematically performed and fully evaluated using large patient cohorts in each of the platinum-based chemotherapies. The present meta-analysis aims to investigate prognostic factors affecting overall survival (OS), progression-free survival (PFS) or time to progression (TTP), and overall response rate (ORR) in carboplatin and paclitaxel-based first-line chemotherapies for advanced NSCLC. Methods We performed a literature search in PubMed for randomized phase II and III clinical trials in patients with NSCLC treated with carboplatin and paclitaxel as first-line chemotherapy published from January 2000 to December 2013 to investigate prognostic factors affecting OS, PFS or TTP, and ORR by linear regression analysis and logistic regression analysis. Results We identified 61 treatment arms in 53 phase II and III clinical trials for the analysis. Asian region was found to be a prognostic factor that affects longer OS in treatment with carboplatin and paclitaxel as first-line chemotherapy. In addition, we identified weekly administration schedule of paclitaxel, Asian region, and lower percentage of patients with adenocarcinoma as factors affecting higher ORR. Conclusions Our findings of prognostic factors affecting ORR and OS in carboplatin and paclitaxel-based chemotherapies as first-line therapy should be considered in the interpretation of efficacy results in global phase II and III clinical trials.
Neoadjuvant Chemotherapy in Locally Advanced Gastric Cancer: What to Avoid. Preliminary Analysis of a Consecutive Series of Patients
Authors: Rausei Stefano , Lianos Georgios D. , Proserpio Ilaria , Ruspi Laura , Galli Federica , Frattini Francesco , Mangano Alberto , Rovera Francesca , Boni Luigi , Roukos Dimitrios H. , Pinotti Graziella , Dionigi Gianlorenzo 
Published: April 2015

Aims and background The role of neoadjuvant (NAD) chemotherapy (CHT) in patients with locally advanced gastric cancer (LAGC) is validated. However, some important limitations emerged from the literature, including patient selection, quality of surgery, and pathologic response evaluation. Neoadjuvant CHT for LAGC has been evaluated with a focus on safety and efficacy of the preoperative approach in terms of patient compliance, surgical outcomes, and pathologic response. Methods and Study Design Ninety-one patients with gastric adenocarcinoma were prospectively observed. All patients received computed tomography scan and laparoscopy staging. Ten patients with LAGC (including 2 with LAGC suspected for cM+/lapM+) had been recruited in the preoperative ECF/EOX CHT protocol and were compared with 61 patients who underwent surgery alone. Results The overall compliance for the preoperative CHT group was higher than compliance for adjuvant CHT observed in both the NAD CHT group and the surgery alone group. There were 2 treatment shifts to FOLFOX in the preoperative regimen. In the preoperative CHT group, D2-gastrectomy was possible only in 6/10 of cases, with a R0 resection rate of 67% (versus 64% in the LAGC patients treated by surgery alone). The postoperative mortality and morbidity were 0% and 17% in the NAD CHT group versus 2% and 26% in the surgery alone group. The overall pathologic response rate after NAD CHT was 83% (5/6). Conclusions Staging and CHT management problems can negatively affect patient outcomes. In the LAGC setting, when well applied, NAD CHT could be considered a valuable treatment option.
Paul Auster’s Poland- Related Constructs of Death in Timbuktu and Oracle Night
Authors: Aleksandrowicz- Pędich Lucyna 
Published: April 2015

Abstract
Although the portrayal of Poland as a land of death is common in Jewish- American fiction, the theme is given subtle and restrained treatment in the fiction of Paul Auster, within the context of the emphasis on death that permeates his work. In Timbuktu and Oracle Night, Auster associated Poland with death in an indirect and symbolic fashion. His evocation of Poland is poetic and imaginative as well as highly effective as a literary device.