bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palliative care in adolescents and young adults with cancer
Authors: Pritchard Sheila , Cuvelier Geoff , Harlos Mike , Barr Ronald 
Published: April 2011

AbstractAdolescents and young adults (AYA) with advanced or terminal cancer have distinctive medical and psychosocial needs that may not have been adequately provided by either pediatric or adult palliative care services. A discussion group, as part of a larger workshop on AYA with cancer, was held in Toronto on March 11‐13, 2010;117:–. Recommendations were as follows: Develop a specific AYA screening tool designed to detect increased anxiety or new symptoms and to initiate discussion about palliative or symptom care; Set Canadian standards for palliative care in AYA patients. These standards should be included in hospital accreditation; Involve the palliative/symptom care team early in the disease trajectory to help manage clinically important symptoms that may not be associated with imminent death; Establish specific AYA multidisciplinary palliative care teams throughout Canada that are flexible and can work in both pediatric and adult facilities, and are able to work in a “virtual” environment to support patients being cared for at home; Improve physical facilities in hospices and hospitals to meet the distinctive needs of terminally ill AYA patients; Enhance support for palliative care at home by: changing legislation to improve Compassionate Care Benefits and developing “virtual palliative care support teams”. Adequate provision of AYA palliative care and symptom management services will likely confer notable benefits to AYA patients and their families, and is likely to be cost saving to the tax payer by avoiding prolonged hospitalization and promoting easier return to work for the families and caregivers. Cancer 2011;117(10 suppl):2323–8. © 2011 American Cancer Society.
Cancer genome variation in children, adolescents, and young adults
Authors: Hudson Thomas J. 
Published: April 2011

AbstractThis mini‐review describes the rapid changes in genome technologies that are leading to comprehensive views of genetic alterations in cancer, and presents high‐level thoughts on ways to accelerate translation into clinical medicine. Issues that are more relevant to children, adolescents, and young adult patients with cancer are highlighted. Cancer 2011;117(10 suppl):2262–7. © 2011 American Cancer Society.
The cancer is over, now what?
Authors: Oeffinger Kevin C. , Tonorezos Emily S. 
Published: April 2011

AbstractAbout 26,000 adolescents and young adults ages 15 to 29 years are diagnosed with invasive cancer each year. Although >80% will survive beyond 5 years from their cancer diagnosis, many will develop serious morbidity or die prematurely secondary to health problems in part related to their cancer therapy. This article provides a brief overview of mortality, morbidity, and health status among long‐term survivors of adolescent and young adult (AYA) cancer. Four examples were used to illustrate the potential of risk‐reducing strategies: breast cancer after chest irradiation, coronary artery disease after chest irradiation, cardiovascular disease in testicular cancer survivors, and the multitude of health problems faced by survivors receiving an allogeneic hematopoietic stem cell transplant. A conceptual model for risk‐based health care was presented and future directions of the delivery of care for AYA cancer survivors discussed. Cancer 2011;117(10 suppl):2250–7. © 2011 American Cancer Society.
Adolescents, young adults, and cancer—the international challenge
Authors: Barr Ronald D. 
Published: April 2011

AbstractCancer in adolescents and young adults is an important public health issue, because there are approximately 1 million new cases annually. The distribution of diseases in this age group varies geographically, contributing to differences in survival rates. Although an overall survival rate exceeding 80 % has been reported in optimal circumstances, emerging knowledge about distinctions in tumor biology and enhanced clinical accrual to clinical trials should lead to further gains. The challenges of cancer survivorship demand further attention with a particular focus on the quality of life of survivors and amelioration of the long‐term complications of treatment. Programs in cancer screening and prevention provide potential for considerable benefits in this age group. A renewed perspective on the adolescent and young adult cohort is required; and, in all of these opportunities for change, there are important roles to be played by advocacy groups internationally. Cancer 2011;117(10 suppl):2245–9. © 2011 American Cancer Society.
Psychological, social, and behavioral issues for young adults with cancer
Authors: Zebrack Brad J. 
Published: April 2011

AbstractTheories of human development suggest that, although all cancer patients experience a common set of life disruptions, they experience them differently, focus on different issues, and attach different levels of importance to different aspects of the experience depending on the time in life at which they were diagnosed. During the critical developmental transition from childhood to adulthood, older adolescents and young adults in particular have typical concerns with establishing identity, developing a positive body image and sexual identity, separating from parents, increasing involvement with peers and dating, and beginning to make decisions about careers or employment, higher education, and/or family. Accordingly, cancer‐related issues such as premature confrontation with mortality, changes in physical appearance, increased dependence on parents, disruptions in social life and school/employment because of treatment, loss of reproductive capacity, and health‐related concerns about the future may be particularly distressing for adolescents and young adults. Psychosocial and behavioral interventions for young adult cancer patients and survivors often involve assisting these individuals in retaining or returning to function in significant social roles, such as spouse, parent, student, worker, or friend. Successful interventions will enable these young people to overcome the detrimental impact of a health crisis and strengthen the internal and external coping resources available to them. Cancer 2011;117(10 suppl):2289–94. © 2011 American Cancer Society.
Research challenges in adolescent and young adult cancer survivor research
Authors: Tonorezos Emily S. , Oeffinger Kevin C. 
Published: April 2011

AbstractEvery year in Canada and the United States, about 26,000 adolescent and young adults (AYA) between ages 15 and 29 years are diagnosed with cancer. Although the majority of AYA cancer patients will survive their primary cancer, many will develop serious health problems or die prematurely secondary to their curative cancer therapy. Much is known about the long‐term health outcomes after adolescent cancer. In contrast, there remain substantial gaps in our understanding of the long‐term outcomes after most young adult cancers. To optimize the health and quality of life of AYA cancer survivors and improve upon curative cancer therapy, it is essential to further investigate the long‐term outcomes of this population. Before embarking upon this endeavor, it is important for the investigator and the funding agency to be cognizant about some of the unique challenges in research of AYA cancer survivors. To this end, the authors present a brief overview of some of the key research challenges, discuss the strengths and limitations of using available AYA cohorts and databases, and highlight potential future directions. Cancer 2011;117(10 suppl):2295–300. © 2011 American Cancer Society.
CT‐guided percutaneous microwave ablation of adrenal malignant carcinoma
Authors: Li Xin , Fan Weijun , Zhang Liang , Zhao Ming , Huang Zilin , Li Wang , Gu Yangkui , Gao Fei , Huang Jinhua , Li Chuanxing , Zhang Fujun , Wu Peihong 
Published: April 2011

AbstractBACKGROUND:Microwave ablation has recently been developed as a safe and effective treatment for a variety of tumors. The authors evaluated the safety and efficacy of computed tomography (CT)‐guided percutaneous microwave ablation of adrenal malignant tumors.METHODS:Nine patients between 41 and 83 years of age (average age, 54 years) with adrenal carcinoma (a total of 10 lesions) received CT‐guided percutaneous water‐cooled microwave ablation. The 9 cases included 1 primary adrenocortical carcinoma and 8 metastatic carcinomas (4 from lung cancer, 2 from hepatocellular carcinoma, 1 from intrahepatic cholangiocarcinoma, and 1 from left tibial osteosarcoma). Of the 8 metastatic cases, 7 were unilateral, and 1 was bilateral. All cases were pathologically confirmed by aspiration biopsy or postsurgical biopsy. The tumor diameters ranged from 2.1 cm to 6.1 cm (average, 3.8 cm). The average number of ablation sites was 1.5 sites (1‐3 sites), and the average accumulated ablation time was 7.7 minutes (4‐15 minutes). The procedures were performed using a cooled‐shaft antenna.RESULTS:The patients were followed for 3‐37 months, with an average of 11.3 months. Nine of 10 lesions were completely necrotized after first treatment. The other lesion was completely necrotized after 2 treatments. One of the patients experienced hypertensive crisis during treatment. No patient experienced recurrent tumor at the treated site, and this lack of recurrence indicated effective local control. All patients had progression of metastatic disease at extra‐adrenal sites.CONCLUSIONS:CT‐guided percutaneous water‐cooled microwave ablation is a minimally invasive and effective method for the treatment of adrenal carcinoma. Cancer 2011;. © 2011 American Cancer Society.
Patterns of extralaryngeal spread of laryngeal cancer
Authors: Chen Susie A. , Muller Susan , Chen Amy Y. , Hudgins Patricia A. , Shin Dong M. , Khuri Fadlo , Saba Nabil F. , Beitler Jonathan J. 
Published: April 2011

AbstractBACKGROUND:Laryngeal preservation programs for patients with advanced laryngeal squamous cell carcinomas (SCC) have generally excluded patients with T4 disease. The accuracy of preoperative imaging in evaluating thyroid cartilage penetration and extralaryngeal spread (ELS) has previously been questioned. Clinically, SCC spread into noncartilaginous structures may have less of a functional impact when compared with thyroid cartilage penetration. The current study was designed to characterize and quantify the routes and frequency of ELS.METHODS:A total of 103 laryngectomy specimens with preoperative contrast‐enhanced neck computed tomography scans were coded according to the observed extent of disease by pathological and radiological data. Previously irradiated tumors or those of pyriform sinus origin were omitted. Routes of spread were categorized as anterior (thyroid cartilage penetration), posterior (arytenoid cartilage destruction and thyroarytenoid space widening), inferior (conus elasticus penetration), and superior (base of tongue, thyrohyoid membrane or thyroid notch penetration involvement).RESULTS:Sixty‐three cases of ELS were identified. Anterior spread by thyroid cartilage penetration occurred in 44% of all instances of ELS, followed by both inferior and posterior spread each representing 33% of ELS cases. Superior spread occurred with a frequency of 24%.CONCLUSIONS:Although thyroid cartilage penetration is a common route of ELS of glottic and supraglottic SCC, ELS into surrounding structures with thyroid cartilage penetration was found to occur in only 44% of the cases of ELS in the current study. As illustrated, advanced SCC spreads in a variety of pathways. Once these patterns are better understood and identified at the time of initial evaluation, subgroups of patients with ELS who may still be candidates for laryngeal preservation may be identified. Cancer 2011;. © 2011 American Cancer Society.
Colonoscopy screening rates among patients of colonoscopy‐trained African American primary care physicians
Authors: Xirasagar Sudha , Hurley Thomas G. , Burch James B. , Mansaray Ali , Hébert James R. 
Published: April 2011

AbstractBACKGROUND:When performed competently, colonoscopy screening can reduce colorectal cancer rates, especially in high‐risk groups such as African Americans. Training primary care physicians (PCPs) to perform colonoscopy may improve screening rates among underserved high‐risk populations.METHODS:The authors compared colonoscopy screening rates and computed adjusted odds ratios for colonoscopy‐eligible patients of trained African American PCPs (study group) versus untrained PCPs (comparison group), before and after initiating colonoscopy training. All colonoscopies were performed at a licensed ambulatory surgery center with specialist standby support. Retrospective chart review was conducted on 200 consecutive, established outpatients aged ≥50 years at each of 12 PCP offices (7 trained African American PCPs and 5 untrained PCPs, practicing in the same geographic region). There were a total of 1244 study group and 923 comparison group patients.RESULTS:Post‐training colonoscopy rates in both groups were higher than pretraining rates: 48.3% versus 9.3% in the study group, 29.6% versus 9.8% in the comparison group (both P < .001). African American patients in the study group showed a >5‐fold increase (8.9% pretraining vs 52.8% post‐training), with no change among whites (18.2% vs 25.0%). Corresponding pretraining and post‐training rates among comparison patients were 10.4%% and 38.7%, respectively, among African Americans (P < .001), and 13.3% versus 13.2%, respectively, among whites. After adjusting for demographics, duration since becoming the PCP's patient, and health insurance, the study group had a 66% higher likelihood of colonoscopy in the post‐training period (odds ratio, 1.66; 95% confidence interval, 1.30‐2.13), and African Americans had a 5‐fold increased likelihood of colonoscopy relative to whites.CONCLUSIONS:Colonoscopy‐trained PCPs may help reduce colorectal cancer disparities. Cancer 2011;. © 2011 American Cancer Society.
Retinoic acid induces REST degradation and neuronal differentiation by modulating the expression of SCFβ‐TRCP in neuroblastoma cells
Authors: Singh Akanksha , Rokes Christopher , Gireud Monica , Fletcher Stephen , Baumgartner James , Fuller Greg , Stewart John , Zage Peter , Gopalakrishnan Vidya 
Published: April 2011

AbstractBACKGROUND:The repressor element‐1 silencing transcription factor (REST) is a repressor of neuronal genes. Its expression is associated with poor neuronal differentiation in many neuroblastoma patient samples and cell lines. Because retinoic acid promotes neuronal differentiation, the authors postulated that it involves modulation of REST expression.METHODS:The expression of REST and of an S‐phase kinase‐associated protein 1/cullin 1/F‐box (SCF) protein complex that contains the F‐box protein β‐transducin repeat‐containing protein (β‐TRCP) (SCFβ‐TRCP) in neuroblastoma tumor samples and cell lines was analyzed by immunofluorescence and Western blot analysis. SK‐N‐SH and SK‐N‐AS cells were treated with retinoic acid and MG‐132 to measure proteasomal degradation of REST by Western blot and quantitative real‐time polymerase chain reaction analyses. Immunoprecipitation and coimmunoprecipitation assays were done in SK‐N‐AS cells that were transfected either with a control plasmid or with an enhanced green fluorescent protein‐SCFβ‐TRCP–expressing plasmid.RESULTS:Several neuroblastoma patient samples and cell lines displayed elevated REST expression. Although, REST transcription increased upon retinoic acid treatment in SK‐N‐SH and SK‐N‐AS cells, REST protein levels declined, concomitant with the induction of neuronal differentiation, in SK‐N‐SH cells but not in SK‐N‐AS cells. MG‐132 treatment countered the retinoic acid‐mediated decline in REST protein. SCFβ‐TRCP, a known REST‐specific E3‐ligase, was poorly expressed in many neuroblastoma samples, and its expression increased upon retinoic acid treatment in SK‐N‐SH cells but declined in SK‐N‐AS cells. Ectopic expression of SCFβ‐TRCP in SK‐N‐AS cells promoted REST ubiquitination and degradation and neuronal differentiation.CONCLUSIONS:The current results indicated that elevated transcription of REST compounded by its impaired degradation by SCFβ‐TRCP may contribute to the failure of these tumors to differentiate in response to retinoic acid. Cancer 2011;. © 2011 American Cancer Society.
Prognostic impact of deletions of derivative chromosome 9 in patients with chronic myelogenous leukemia treated with nilotinib or dasatinib
Authors: Quintás‐Cardama Alfonso , Kantarjian Hagop , Shan Jianqin , Jabbour Elias , Abruzzo Lynne V. , Verstovsek Srdan , Garcia‐Manero Guillermo , O'Brien Susan , Cortes Jorge 
Published: April 2011

AbstractBACKGROUND:Deletions of derivative chromosome 9 are a poor prognostic factor in patients with chronic myeloid leukemia (CML) treated with hydroxyurea, interferon, or stem cell transplantation. Imatinib may overcome the adverse prognostic impact of deletions of derivative chromosome 9.METHODS:A study was undertaken to investigate the prognostic impact of deletions of derivative chromosome 9 in 353 patients with CML receiving the second generation tyrosine kinase inhibitors (TKIs) nilotinib (n = 161) or dasatinib (n = 192).RESULTS:Deletion of derivative chromosome 9 status was determined in 245 (69%). Twenty‐eight (11%) patients, 22 in chronic phase, 4 in accelerated phase, and 2 in blast phase, carried deletions of derivative chromosome 9, including 17 receiving nilotinib and 11 receiving dasatinib (P = .47). Overall survival (OS) at 24 months was similar between patients with or without deletions of derivative chromosome 9 (70% vs 71%, P = .76). For patients in chronic phase, no significant differences in overall major cytogenetic response (77% vs 82%, P = .57) or complete cytogenetic response (77% vs 81%, P = .71) rates were observed between patients with or without deletions of derivative chromosome 9. At 24 months, patients with CML in chronic phase without deletions of derivative chromosome 9 had improved event‐free survival (EFS) (88% vs 66%, P = .07) and OS (96% vs 82%; P = .08) compared with those carrying deletions of derivative chromosome 9. However, multivariate analysis established second‐line versus frontline second generation TKI therapy as the only adverse prognostic factor for EFS and increased bone marrow blast burden and older age as independent adverse prognostic factors for OS.CONCLUSIONS:Deletions of derivative chromosome 9 do not appear to be an independent risk factor for survival among patients with CML in chronic phase receiving second generation TKIs. Cancer 2011;. © 2011 American Cancer Society.
Do multidisciplinary team meetings make a difference in the management of lung cancer?
Authors: Boxer Miriam M. , Vinod Shalini K. , Shafiq Jesmin , Duggan Kirsten J. 
Published: April 2011

AbstractBACKGROUND:There is limited evidence regarding the effectiveness of multidisciplinary team (MDT) meetings in lung cancer. The objective of this study was to compare the patterns of care for patients with newly diagnosed lung cancer who were presented at a lung cancer MDT meeting with the patterns of care for patients who were not presented.METHODS:All patients who had lung cancer newly diagnosed in South West Sydney (SWS) between December 1, 2005, and December 31, 2008, were identified from the local Clinical Cancer Registry. Patient and tumor characteristics and treatment receipt were compared between patients who were and were not presented at MDT meetings. A logistic regression model was constructed to determine predictors for receiving treatment and survival.RESULTS:In total, there were 988 patients, including 504 patients who were presented at MDT meetings and 484 who were not presented at MDT meetings. The median patient age was 69 years and 73 years in the MDT group and the non‐MDT group, respectively (P < .01). There was no pathologic diagnosis for 13% of non‐MDT patients compared with 4% of MDT patients (P < .01). Treatment receipt for MDT patients versus non‐MDT patients was 12% versus 13%, respectively, for surgery (P value nonsignificant); 66% versus 33%, respectively, for radiotherapy (P < .001); 46% versus 29%, respectively, for chemotherapy (P < .001); and 66% versus 53%, respectively, for palliative care (P < .001). In patients with good performance status, the MDT group had significantly better receipt of radiotherapy among patients with stage I through IV nonsmall cell lung cancer (NSCLC) and had significantly better receipt of chemotherapy among patients with stage IV NSCLC. MDT discussion was an independent predictor of receiving radiotherapy, chemotherapy, and referral to palliative care but did not influence survival.CONCLUSIONS:MDT discussion was associated with better treatment receipt, which potentially may improve quality of life for patients with lung cancer. However, it did not improve survival. Cancer 2011;. © 2011 American Cancer Society.
Expression and function role of DNA methyltransferase 1 in human bladder cancer
Authors: Wu Chun‐Te , Wu Ching‐Fang , Lu Chang‐Hsien , Lin Cheng‐Chia , Chen Wen‐Cheng , Lin Paul‐Yang , Chen Miao‐Fen 
Published: April 2011

AbstractBACKGROUND:The identification of potential tumor markers will help improve therapeutic planning and patient management. Therefore, the aim of this study was to highlight the role of DNA methyltransferase 1 (DNMT1) in bladder cancer.METHODS:A total of 50 samples of nonmalignant urothelium, 65 of muscle‐invasive bladder cancers, 15 of distant metastasis, and 50 of nonmuscle‐invasive bladder cancers were selected for immunohistochemical staining analysis. Furthermore, human bladder cancer cell lines HT1376 and HT1197 were selected for cell and animal experiments investigating changes in tumor behavior, treatment response, and related signaling in bladder cancer.RESULTS:The incidence of nuclear DNMT1 immunoreactivity in the bladder cancer specimens (45%) was significantly higher than in nonmalignant urothelium (15%, P = .0005), and the incidence in cancer was positively linked to clinical stage (24% in ≤T1 vs 55% in T2‐T4, P = .0007). The staining of DNMT1 was also significantly linked to lower complete response rates (P = .0014) and reduced survival rates (P = .000). By in vitro and in vivo experiments, DNMT1 silencing vector reduced tumor growth and attenuated treatment resistance in bladder cancer cells. Less epithelial‐mesenchymal transition, less invasion, and slower tumor growth were noted in cancer cells with inhibited DNMT1. Furthermore, the epidermal growth factor receptor‐mediated phosphatidylinositol 3′–kinase‐protein kinase B pathway might be the mechanism underlying the effects of DNMT1 on bladder cancer.CONCLUSIONS:DNMT1 could be a significant clinical predictor for stage and treatment response of bladder cancer. Moreover, targeting this enzyme could be a promising strategy for treating bladder cancer, as evidenced by inhibited tumor growth and enhanced radiosensitivity. Cancer 2011;. © 2011 American Cancer Society.