bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytoreductive nephron‐sparing surgery does not appear to undermine disease‐specific survival in patients with metastatic renal cell carcinoma
Authors: Hutterer Georg C. , Patard Jean‐Jacques , Colombel Marc , Belldegrun Arie S. , Pfister Christian , Guille Francois , Artibani Walter , Montorsi Francesco , Pantuck Allan J. , Karakiewicz Pierre I. 
Published: October 2007

AbstractBACKGROUND.The role of nephron‐sparing surgery (NSS) showed promise in patients with metastatic renal cell carcinoma (MRCC). The disease‐specific survival of patients with MRCC was compared according to the type of surgery, NSS (N = 45) versus radical nephrectomy (RN) (N = 732), in unmatched and matched analyses.METHODS.Kaplan‐Meier, life tables, log‐rank test, and univariate as well as multivariate Cox regression analyses addressed disease‐specific survival of NSS versus RN patients. Subsequently, up to 4 RN cases were matched with each NSS case for TNM stage, Fuhrman grade, and histology. Then, disease‐specific survival differences were tested with the log‐rank statistic. Finally, the sample size necessary to achieve 80% power in survival analyses between the 2 groups (NSS vs RN) was calculated.RESULTS.Of 45 NSS cases, 38 were matched with 99 of 732 RN cases. First, in multivariate unmatched analyses RN predisposes to 1.7‐fold higher RCC‐specific mortality rate; second, in matched analyses RN predisposes to 1.5‐fold higher RCC‐specific mortality rate; and third, both analyses failed to demonstrate statistically significant differences. Based on these findings it could be postulated that until further data become available, NSS does not appear to undermine RCC‐specific survival in carefully selected patients with MRCC. The power analyses demonstrated that at least 146, 48, and 76 observations per arm are necessary at 1, 2, and 3 years, respectively, to confirm survival equivalence.CONCLUSIONS.Although the data were limited in size and completeness, they may indicate that RCC‐specific survival may not be undermined if NSS is performed in properly selected cases. Cancer 2007. © 2007 American Cancer Society.
Computed tomography screening for lung cancer: Review of screening principles and update on current status
Authors: Black William C. 
Published: October 2007

AbstractScreening for lung cancer with low‐dose computed tomography (CT) is controversial. In favor of screening, lung cancer is the leading cause of cancer death in the United States, and those at greatest risk are identified readily on the basis of age and smoking history. In addition, it is well established that CT is far more sensitive than chest radiography in detecting lung cancer when it is small and asymptomatic. Furthermore, very high rates of survival were reported recently for screen‐detected lung cancers in a large, multinational, single‐arm observational study. However, a reduction in lung cancer mortality has not been demonstrated to date, and a recent longitudinal study with a simulated control group suggested little or no mortality reduction. In addition, there are important harms from CT screening, including false‐positive test results and overdiagnosis. Furthermore, healthcare resources are finite. Therefore, even if the benefits do outweigh the harms, the cost‐effectiveness of CT screening for lung cancer still will need to be considered in the context of competing healthcare alternatives. The objectives of this article were 3‐fold: 1) to review the basic principles of screening and study designs related to cancer screening, 2) to summarize the results of the observational and analytical studies of CT screening that have been reported to date, and 3) to describe the design of the 2 ongoing, randomized controlled trials of CT screening and what may be learned from these studies in the near future. Cancer 2007. © 2007 American Cancer Society.
Placement of radiopaque clips for tumor localization in patients undergoing neoadjuvant chemotherapy and breast conservation therapy
Authors: Oh Julia L. , Nguyen Giang , Whitman Gary J. , Hunt Kelly K. , Yu Tse‐Kuan , Woodward Wendy A. , Tereffe Welela , Strom Eric A. , Perkins George H. , Buchholz Thomas A. 
Published: October 2007

AbstractBACKGROUND.The objective of this study was to determine whether patients with breast cancer who received breast‐conservation therapy after neoadjuvant chemotherapy had improved outcomes if radiopaque clips were placed to mark the primary tumor.METHODS.The authors retrospectively reviewed the records of 410 patients with nonmetastatic breast cancer who received doxorubicin‐based neoadjuvant chemotherapy and breast‐conservation therapy from January 1990 to September 2005. Thirty‐seven of those patients were omitted because of the inability to verify radiopaque clip placement in the primary tumor.RESULTS.Of the 373 patients who were analyzed, 145 patients had radiopaque clips placed to mark the primary tumor before or during neoadjuvant chemotherapy, and 228 patients did not. The distribution of clinical T classification, nuclear grade, estrogen receptor status, final margin status, and extent of residual primary disease was similar between the 2 groups. After a median follow‐up of 49 months (range, 20‐177 months), 21 patients developed a local recurrence in the treated breast. The 5‐year rate of local control was 98.6% in patients who had radiopaque clips placed versus 91.7% in patients who did not have tumor marker clips placed (P = .02; log‐rank test). On multivariate analysis, the omission of tumor bed clips was associated with a hazard ratio of 3.69 for increased local recurrence compared with patients who did have radiopaque clip placement (P = .083; 95% confidence interval, 0.84‐16.16).CONCLUSIONS.The placement of radiopaque clips in patients who were receiving neoadjuvant chemotherapy and breast‐conservation therapy was associated with better local control independent of stage and other clinicopathologic findings. The authors concluded that the placement of tumor‐marker clips should be an integral part of the multidisciplinary approach in appropriate patients. Cancer 2007. © 2007 American Cancer Society.
Is resection of periampullary or pancreatic adenocarcinoma with synchronous hepatic metastasis justified?
Authors: Gleisner Ana Luiza , Assumpcao Lia , Cameron John L. , Wolfgang Christopher L. , Choti Michael A. , Herman Joseph M. , Schulick Richard D. , Pawlik Timothy M. 
Published: October 2007

AbstractBACKGROUND.To date, no consensus has been reached regarding which primary tumor subtypes are managed appropriately with hepatic metastectomy. Specifically, the role of hepatic resection for metastatic periampullary or pancreatic adenocarcinoma remains controversial.METHODS.Between 1995 and 2005, 1563 patients underwent surgical resection for periampullary carcinoma (n = 608 patients) or pancreatic adenocarcinoma (head, n = 905 patients; tail, n = 50 patients). Data on demographics, operative details, primary tumor status, and—when indicated—extent of hepatic metastasis were collected.RESULTS.Of the 1563 patients who underwent resection of periampullary or pancreatic adenocarcinoma, 22 patients (1.4%) underwent simultaneous hepatic resection for synchronous liver metastasis. The primary tumor site was ampullary (n = 1 patient ), duodenal (n = 2 patients), distal bile duct (n = 2 patients), or pancreas (head, n = 10 patients; tail, n = 7 patients). The majority of patients (86.4%) had a solitary hepatic metastasis, and the median size of the largest lesion was 0.6 cm. Hepatic metastectomy included wedge resection (n = 20 patients), segmentectomy (n = 1 patient), and hemihepatectomy (n = 1 patient). After matching patients on primary tumor histology and location, the median survival of patients who underwent hepatic resection of synchronous metastasis was 5.9 months compared with 5.6 months for patients who underwent palliative bypass alone (P = .46) and 14.2 months for patients with no metastatic disease who underwent primary tumor resection only (P < .001). Pancreatic (median, 5.9 months) versus nonpancreatic (median, 9.9 months) primary tumor histology was not associated with a difference in survival in patients who underwent resection of synchronous liver metastasis (P = .43).CONCLUSIONS.Even in well selected patients with low‐volume metastatic liver disease, simultaneous resection of periampullary or pancreatic carcinoma with synchronous liver metastases did not result in long‐term survival in the overwhelming majority of patients. Cancer 2007. © 2007 American Cancer Society.
Biopsy or debulking surgery as initial surgery for locally advanced rhabdomyosarcomas in children?
Authors: Cecchetto Giovanni , Bisogno Gianni , De Corti Federica , Dall'Igna Patrizia , Inserra Alessandro , Ferrari Andrea , Garaventa Alberto , Scagnellato Angela , Carli Modesto 
Published: October 2007

AbstractBACKGROUND.The purpose of the current study was to analyze the influence of the initial surgical approach (biopsy vs resection with macroscopic residual tumors) on the outcome of patients with localized Intergroup Rhabdomyosarcoma Study (IRS) Group III rhabdomyosarcoma (RMS) enrolled in the Italian studies between 1979 and 2003.METHODS.Among the 394 patients evaluated, 323 underwent biopsy, as recommended by the protocols, and 71 patients underwent surgical resection with macroscopic residual tumors (debulking operation [DO]), although this procedure was discouraged. All these patients were classified at the same risk group and received the same treatment. The different characteristics (patient age, tumor site, T classification and size, histology) and outcome in the 2 groups were considered.RESULTS.The estimated 5‐year overall survival (OS) rates were 68.4% and 72.6%, respectively, after biopsy and DO(P = .38), and the rates of progression‐free survival (PFS) were 56.5% and 61.7%, respectively, after biopsy and DO (P = .41). The outcome did not differ significantly when considering other variables such as tumor site, size, and histology. Age > 10 years appeared to have little benefit in patients with DO; the OS was 62% after biopsy and 83.1% after DO (P = .06); the PFS was 49.7% and 72.8%, respectively after biopsy and DO (P = .04). No surgical complications due to the 2 procedures were reported, but in 2 cases the initial DO resulted in a mutilation.CONCLUSIONS.No significant advantages of DO versus biopsy were detected with regard to patient outcome. Biopsy, which is less aggressive, appears to be thebest option for patients with IRS Group III RMS. Cancer 2007. © 2007 American Cancer Society.
Individualized estimates of second cancer risks after contemporary radiation therapy for Hodgkin lymphoma
Authors: Hodgson David C. , Koh Eng‐Siew , Tran Tu Huan , Heydarian Mostafa , Tsang Richard , Pintilie Melania , Xu Tony , Huang Lei , Sachs Rainer K. , Brenner David J. 
Published: October 2007

AbstractBACKGROUND.Estimates of radiation‐related second cancer risk among Hodgkin lymphoma survivors are largely based on radiation therapy (RT) fields and doses no longer in use, and these estimates do not account for differences in normal tissue dose among individual patients. This study gives individualized estimates for the risks of lung and female breast cancer expected with contemporary involved‐field RT and low‐dose (20 Gy) RT for mediastinal Hodgkin lymphoma.METHODS.Three RT plans were constructed for 37 consecutive patients with mediastinal Hodgkin lymphoma: 35 Gy mantle RT, 35 Gy involved‐field RT (IFRT), and 20 Gy IFRT. For each of the 111 RT plans, individual‐level dosimetry data were incorporated into a cell initiation/inactivation/proliferation model to estimate the excess relative risk (ERR) and cumulative incidence of radiation‐induced second cancer.RESULTS.ERR estimates were compatible with results of epidemiological studies. Compared with 35 Gy mantle radiation therapy, 35 Gy IFRT was predicted to reduce the 20‐year ERRs of breast and lung cancer by 63% and 21%, respectively, primarily because of lower normal tissue doses with the omission of axillary RT. Low‐dose (20 Gy) IFRT was associated with a 77% and 57% decrease in these ERRs. Patient‐specific differences in normal tissue dose with IFRT led to 11‐fold and 3.6‐fold variations among individual's estimates of breast and lung cancer ERR, respectively.CONCLUSIONS.Contemporary IFRT is predicted to substantially reduce risk of secondary breast and lung cancer compared with mantle RT, with considerable variation in risk among individuals. Individualized prospective risk estimates could facilitate patient‐specific counseling and the development of more effective RT techniques. Cancer 2007. © 2007 American Cancer Society.
Preoperative chemotherapy treatment of breast cancer—A review
Authors: Buzdar Aman U. 
Published: October 2007

AbstractDespite proven benefits of neoadjuvant chemotherapy in patients with locally advanced, invasive breast cancer, no regimen is recommended as the treatment of choice. Neoadjuvant chemotherapy regimens encompass single‐agent and combination therapy and sequential treatment. For this report, the author reviewed the literature to determine which regimen, if any, was most beneficial. The results indicated that studies have yielded a wide range of response rates, but no single regimen has emerged as a clear leader. The literature is compounded further by lack of standardized criteria to determine pathologic complete response (which is predictive of survival benefits) and between‐study variation in the stringency by which this endpoint is defined. Given the lack of a preferred treatment regimen in the neoadjuvant setting, identifying patients who are likely to respond to specific agents could inform treatment decisions, improve treatment outcomes, and aid in avoiding unnecessary exposure to potential toxicities. The development of novel agents for use alone or in combination with existing agents may improve response rates further in the neoadjuvant setting, especially because a significant proportion of breast tumors can be resistant to many current antineoplastic agents. Particularly noteworthy are the epothilones and their analogs because of their low susceptibility to common tumor‐resistance mechanisms. Initial data have indicated that ixabepilone, which is an epothilone analog, has activity in the neoadjuvant setting, and predictive factors for response have been identified. The future of neoadjuvant therapy lies in tailoring treatment to individual patients by identifying response predictors and developing novel agents. This ultimately may lead to improved outcomes for women with breast cancer. Cancer 2007. © 2007 American Cancer Society.
Retracted: Response to dual blockade of epidermal growth factor receptor (EGFR) and cycloxygenase‐2 in nonsmall cell lung cancer may be dependent on the EGFR mutational status of the tumor
Authors: Gadgeel Shirish M. , Ali Shadan , Philip Philip A. , Ahmed Fakhara , Wozniak Antoinette , Sarkar Fazlul H. 
Published: October 2007

AbstractBACKGROUND.Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) have demonstrated clinical benefit in patients with nonsmall cell lung cancer (NSCLC), particularly those with tumors that have EGFR‐TK domain mutations. Moreover, the EGFR and cyclooxygenase (COX)‐2 pathways are known to enhance the procarcinogenic effects of each other in different tumor types. Therefore, it was hypothesized that tumor EGFR mutation status may influence the effectiveness of simultaneous EGFR and COX‐2 inhibition in patients with NSCLC.METHODS.Three NSCLC cell lines with varying EGFR mutation status and sensitivities to EGFR‐TKIs were selected: H3255 (L858R), H1650 (del E746‐A750), and H1781 (wild‐type EGFR). Cells were treated with erlotinib, gefitinib, or celecoxib alone, and the combination of both EGFR‐TKI inhibitors with celecoxib. Cell survival and apoptosis was assessed and correlated with the expression of COX‐2, EGFR, pEGFR, Akt, pAkt, expression, and derived prostaglandin E2 (PGE2).RESULTS.Celecoxib by itself was found to have no effects on cell growth or apoptosis in any of the cell lines. Erlotinib and gefitinib inhibited cell growth and induced apoptosis in both mutant cell lines and did so in H1781 cells at 10‐fold higher concentrations. Celecoxib when added to erlotinib or gefitinib significantly enhanced the antiproliferative and proapoptotic effects in both mutant cell lines but had no additional effects in H1781 cells. Greater down‐regulation of COX‐2, EGFR, pEGFR, Akt, pAkt, and PGE2 was found when H3255 cells were treated with the combination compared with any of the single agents alone.CONCLUSIONS.The results of the current study demonstrate that the effectiveness of the addition of celecoxib to an EGFR‐TKI is significantly greater in NSCLC cells with EGFR mutations, which is likely due to more complete inhibition of both pathways. Cancer 2007. © 2007 American Cancer Society.
Serum carcinoembryonic antigen level is associated with epidermal growth factor receptor mutations in recurrent lung adenocarcinomas
Authors: Shoji Fumihiro , Yoshino Ichiro , Yano Tokujiro , Kometani Takuro , Ohba Taro , Kouso Hidenori , Takenaka Tomoyoshi , Miura Naoko , Okazaki Hiroshi , Maehara Yoshihiko 
Published: October 2007

AbstractBACKGROUND.The presence of epidermal growth factor receptor (EGFR) gene mutations is a good indicator of the clinical efficacy of gefitinib in patients with nonsmall cell lung cancer. It was recently reported that the serum carcinoembryonic antigen (CEA) level could be a predictive factor for the efficacy of gefitinib treatment; therefore, it is suggested that the EGFR gene mutation is associated with the serum CEA level. The current study analyzed the association between EGFR gene mutations and clinical features, including the serum CEA level, in patients with recurrent lung adenocarcinomas.METHODS.A total of 48 lung adenocarcinoma patients with postoperative disease recurrence who underwent chemotherapy were investigated. EGFR gene mutations at exons 18, 19, and 21 were measured using surgical specimens taken from the primary tumor.RESULTS.Mutations of the EGFR gene were detected in 25 of the 48 patients and the abnormal serum CEA concentration at the time of disease recurrence was found to be significantly associated with the incidence of EGFR gene mutations (P = .045). The rate of EGFR gene mutations significantly increased as the serum CEA level increased (serum CEA level; <5 vs ≥5 <20 vs ≥20 = 35% vs 55% vs 87.5%, respectively, P = .040). A multivariate analysis revealed that a higher serum CEA level at the time of disease recurrence is independently associated with EGFR gene mutations (P = .036) with an odds ratio of 4.70 (95% confidence interval, 1.1–21.1).CONCLUSIONS.The serum CEA level appears to be closely associated with the presence of EGFR gene mutations in patients with pulmonary adenocarcinomas. Cancer 2007. © 2007 American Cancer Society.
Liposomal amphotericin B in combination with caspofungin for invasive aspergillosis in patients with hematologic malignancies
Authors: Caillot Denis , Thiébaut Anne , Herbrecht Raoul , de Botton Stéphane , Pigneux Arnaud , Bernard Frédéric , Larché Jérôme , Monchecourt Françoise , Alfandari Serge , Mahi Lamine 
Published: October 2007

AbstractBACKGROUND.Invasive aspergillosis (IA) has a poor prognosis in immunocompromised patients. Combinations of drugs that act on different targets are expected to improve the clinical efficacy of separate compounds.METHODS.Patients with proven or probable IA were randomized in a prospective, open pilot study to receive either a combination of liposomal amphotericin B (AmB) at the standard dose (3 mg/kg daily) and caspofungin at the standard dose or monotherapy with a high‐dose AmB regimen (10 mg/kg daily).RESULTS.Thirty patients (21 men and 9 women) with hematologic malignancies were analyzed, and there were 15 patients in each arm. The median duration of treatment was 18 days for the combination group and 17 days for the high‐dose monotherapy group. At the end of treatment, there were significantly more favorable overall responses (partial or complete responses; P = .028) in the combination group (10 of 15 patients; 67%) compared with the high‐dose monotherapy group (4 of 15 patients; 27%). Survival rates at 12 weeks after inclusion were 100% and 80%, respectively. Infusion‐related reactions occurred in 3 patients in the high‐dose monotherapy group. A 2‐fold increase in serum creatinine occurred in 4 of 17 patients (23%) who received high‐dose monotherapy and 1 of 15 patient (7%) who received combination therapy; hypokalemia <3 mmol/L occurred in 3 patients and 2 patients, respectively.CONCLUSIONS.The combination of liposomal AmB and caspofungin was promising as therapy for IA compared with monotherapy. A trial that includes more patients will be required next to confirm the results of this pilot study. Cancer 2007. © 2007 American Cancer Society.
R6/2 neurons with intranuclear inclusions survive for prolonged periods in the brains of chimeric mice
Authors: Reiner Anton , Del Mar Nobel , Deng Yun‐Ping , Meade Christopher A. , Sun Zhiqiang , Goldowitz Daniel 
Published: October 2007

AbstractThe R6/2 mouse possesses mutant exon 1 of human Hdh, and R6/2 mice with 150 CAG repeats show neurological abnormalities by 10 weeks and die by 15 weeks. Few brain abnormalities, however, are evident at death, other than widespread ubiquitinated neuronal intranuclear inclusions (NIIs). We constructed R6/2t+/t− ↔ wildtype (WT) chimeric mice to prolong survival of R6/2 cells and determine if neuronal death and/or neuronal injury become evident with longer survival. ROSA26 mice (which bear a lacZ transgene) were used as WT to distinguish between R6/2 and WT neurons. Chimeric mice consisting partly of R6/2 cells lived longer than pure R6/2 mice (up to 10 months), with the survival proportional to the R6/2 contribution. Genotypically R6/2 cells formed NIIs in the chimeras, and these NIIs grew only slightly larger than in 12‐week pure R6/2 mice, even after 10 months. Additionally, neuropil aggregates formed near R6/2 neurons in chimeric mice older than 15 weeks. Thus, R6/2 neurons could survive well beyond 15 weeks in chimeras. Moreover, little neuronal degeneration was evident in either cortex or striatum by routine histological stains. Nonetheless, striatal shrinkage and ventricular enlargement occurred, and striatal projection neuron markers characteristically reduced in Huntington's disease were diminished. Consistent with such abnormalities, cortex and striatum in chimeras showed increased astrocytic glial fibrillary acidic protein. These results suggest that while cortical and striatal neurons can survive nearly a year with nuclear and extranuclear aggregates of mutant huntingtin, such lengthy survival does reveal cortical and striatal abnormality brought on by the truncated mutant protein. J. Comp. Neurol. 505:603–629, 2007. © 2007 Wiley‐Liss, Inc.