bluuebunny/crossref_metadata_2025_split huggingface dataset:
Platinum‐free combination chemotherapy in patients with advanced or metastatic transitional cell carcinoma
Authors: Lara Primo N. , Meyers Frederick J. , Law Lisa Y. , Dawson Nancy A. , Houston Joan , Lauder Ignacio , Edelman Martin J. 
Published: December 2003

AbstractBACKGROUNDPlatinum‐based regimens have improved response rates and survival in patients with advanced transitional cell carcinoma (TCC) of the urothelial tract. However, the toxicities of platinum‐based chemotherapy are considerable. Regimens with reduced toxicity that are applicable to a broader group of TCC patients without sacrificing activity therefore are of interest.METHODSBecause gemcitabine, paclitaxel, and methotrexate have each been reported to possess single‐agent activity in this disease, the authors evaluated the tolerability and efficacy of fixed doses of paclitaxel (100 mg/m2 over 3 hours) and methotrexate (30 mg/m2) with escalating doses of gemcitabine (800–1000 mg/m2), all given on Days 1 and 8 every 21 days, in patients with previously untreated unresectable or metastatic TCC.RESULTSTwenty‐five patients were enrolled. Two patients were ineligible and were excluded from analysis. Because no dose‐limiting toxicity occurred in the first 4 patients who were given gemcitabine at a dose of 800 mg/m2, the gemcitabine dose was escalated to 1000 mg/m2 in the next 21 patients. Of the 21 patients assessable for response, 6 had achieved a complete response (CR) and 6 had achieved a partial response, for an overall response rate of 57%. An additional patient was converted to a CR surgically. The median overall and progression‐free survival times were 18 months and 9.2 months, respectively. Toxicity was predominantly neutropenia: Grade 3 in 9 patients (39%) and Grade 4 in 4 patients (17%) (according to the Southwest Oncology Group Toxicity Criteria, version 12/1994). One patient died of septic shock associated with febrile neutropenia after three cycles.CONCLUSIONSThe regimen of gemcitabine, paclitaxel, and methotrexate at this dose and schedule was found to possess activity in patients with locally advanced or metastatic TCC. Further studies of this regimen are warranted. Cancer 2004;100:82–8. © 2003 American Cancer Society.
Surgical treatment of recurrent endometrial carcinoma
Authors: Campagnutta Elio , Giorda Giorgio , De Piero Giovanni , Sopracordevole Francesco , Visentin M. Caterina , Martella Luca , Scarabelli Carlo 
Published: December 2003

AbstractBACKGROUNDSurgery does not have a definite role in the treatment of patients with recurrent endometrial carcinoma, except for those with central pelvic recurrences. The authors describe their experience with surgery in patients with abdominal endometrial recurrences.METHODSBetween 1988 and 2000, 75 patients with abdominal and pelvic endometrial recurrences underwent secondary rescue surgery. Patients were classified according to the presence or absence of residual tumor after surgery. Therapy after rescue surgery was undertaken at the discretion of the medical oncologist. The progression‐free interval and overall survival were defined as the time from secondary rescue surgery to the specific event and were evaluated by the Kaplan–Meier method and the log‐rank test. A Cox proportional hazards regression model was used to compare survival with covariates.RESULTSFifty‐six patients (74.7%) underwent optimal debulking. Major surgical complications were observed in 23 patients (30.7%). Only 1 postoperative death was observed, although the mortality rate for surgical complications after the postoperative period was 8%. Patients who underwent optimal debulking had a significantly better cumulative survival rate compared with patients who had residual disease (36% vs. 0% at 60 months; P < 0.05). Residual disease, chemotherapy after rescue surgery, and central pelvis–vagina as the only site of recurrence were associated significantly with survival.CONCLUSIONSThe authors found that this approach was very challenging in terms of the procedures involved, the incidence of major surgical complications, and the high mortality rate. It was useful in increasing overall survival, provided that patients were free of macroscopic disease. Careful selection of patients is needed to minimize mortality. Cancer 2004;100:89–96. © 2003 American Cancer Society.
Antiangiogenic activity of genistein in pancreatic carcinoma cells is mediated by the inhibition of hypoxia‐inducible factor‐1 and the down‐regulation of VEGF gene expression
Authors: Büchler Peter , Reber Howard A. , Büchler Markus W. , Friess Helmut , Lavey Robert S. , Hines Oscar J. 
Published: December 2003

AbstractBACKGROUNDPrevious reports indicate that Genistein, a naturally occurring isoflavonoid, exhibits strong antiangiogenic activity. The underlying mechanism of inhibition, however, remains unclear. Among the biologic effects of Genistein are the inhibition of tyrosine kinases and the inhibition of hypoxic activation of hypoxia‐inducible factor‐1 (HIF‐1), one of the main regulators of VEGF gene expression.METHODSHypoxic cell culture was performed in a modular incubator chamber. Vascular endothelial growth factor (VEGF) protein secretion was measured using the enzyme‐linked immunosorbent assay, binding of DNA by HIF‐1 was measured using the electrophoretic mobility shift assay, and mRNA quantification was performed using Northern blot analysis. Pancreatic carcinoma was studied in an orthotopic murine model. Angiogenesis in vivo was quantified by staining xenograft tumors for endothelial cell markers.RESULTSVEGF protein secretion was dose‐dependently suppressed with increasing doses of Genistein. Furthermore, treatment of pancreatic carcinoma cells with Genistein led to impaired activation of HIF‐1 under hypoxic culture conditions. Northern blot analysis indicated that VEGF mRNA expression decreased upon treatment with Genistein, both under normoxic and hypoxic culture conditions. In vivo, Genistein inhibited tumor growth for xenograft pancreatic carcinoma cells, whereas extensive hypoxia was observed in xenograft tumors and was not influenced by Genistein therapy. Similarly, decreased VEGF mRNA levels were observed in Genistein‐treated Capan‐1 xenograft tumors.CONCLUSIONSThe current study indicates that the previously reported antiangiogenic activity of Genistein probably is mediated by the inhibition of HIF‐1, an important regulator of VEGF gene homeostasis, particularly under low‐oxygen conditions. Therefore, this bioactive compound may well be beneficial to patients with pancreatic carcinoma. Cancer 2004;100:201–10. © 2003 American Cancer Society.
Early‐stage cervical carcinoma, radical hysterectomy, and sexual function
Authors: Jensen Pernille T. , Groenvold Mogens , Klee Marianne C. , Thranov Ingrid , Petersen Morten Aa. , Machin David 
Published: December 2003

AbstractBACKGROUNDLimited knowledge exists concerning the impact of radical hysterectomy (RH) alone on the sexual function of patients with early‐stage cervical carcinoma. The authors investigated the longitudinal course of self‐reported sexual function after RH.METHODSThe current study was comprised of 173 patients with lymph node‐negative, early‐stage cervical carcinoma who had undergone RH and pelvic lymphadenectomy. They were assessed prospectively using a validated self‐assessment questionnaire 5 weeks and 3 months, 6 months, 12 months, 18 months, and 24 months after RH. Results were compared with an age‐matched control group from the general population.RESULTSCompared with control women, patients experienced severe orgasmic problems and uncomfortable sexual intercourse due to a reduced vaginal size during the first 6 months after RH, severe dyspareunia during the first 3 months, and sexual dissatisfaction during the 5 weeks after RH. A persistent lack of sexual interest and lubrication were reported throughout the first 2 years after RH. Long‐term lack of sexual interest and insufficient vaginal lubrication were confirmed by the patient's self‐reported changes 12 months after RH compared with before the cancer diagnosis and by a pre‐post comparison within patients. However, most of the patients who were sexually active before their cancer diagnosis were sexually active again 12 months after surgery (91%), although with a decrease in sexual frequency reported.CONCLUSIONSRH had a persistent and negative impact on patients' sexual interest and vaginal lubrication whereas the majority of other sexual and vaginal problems disappeared over time. Sexual and vaginal problems in the short‐term and long‐term after RH should be discussed with the patient before and after surgery. Cancer 2004;100:97–106. © 2003 American Cancer Society.
Screening mammography performance and cancer detection among black women and white women in community practice
Authors: Gill Karminder S. , Yankaskas Bonnie C. 
Published: December 2003

AbstractBACKGROUNDDespite improvement in mammography screening attendance, black women continue to have poorer prognosis at diagnosis than white woman. Data from the Carolina Mammography Registry were used to evaluate whether there may be differences in mammography performance or detected cancers when comparing black women with white women who are screened by mammography.METHODSProspectively collected data from community‐based mammography facilities on 468,484 screening mammograms (79,397 in black women and 389,087 in white women) were included for study. Mammograms were linked to a pathology data base for identification of cancers. Sensitivity, specificity, positive predictive value, and cancer detection rates were compared between black women and white women. Logistic regression methods were used to control for covariates associated with performance characteristics. Differences in cancer characteristics were compared between black women and white women using chi‐square statistics.RESULTSScreening mammography performance results for black women compared with white women were as follows: sensitivity, odds ratio (OR) = 1.07 (95% confidence interval [95% CI], 0.83–1.39); specificity, OR = 1.02 (95% CI, 0.98–1.06); and positive predictive value, OR = 1.07 (95% CI, 0.94–1.23). Among women with no previous screening, black women had a larger proportion of invasive tumors that measured ≥ 2 cm (38% vs. 26%; P = 0.04). The cancer detection rate was highest among black women who reported symptoms at screening (13.9 per 1000 black women vs. 7.9 per 1000 white women). Invasive cancers in black women were poorer grade (P = 0.001), and more often had negative estrogen receptor status and progesterone receptor status (P < 0.001).CONCLUSIONSOverall, screening mammography performed equally well in black women and white women controlling for age, breast density, and time since previous mammogram. Black women who reported symptoms had larger and higher grade tumors compared with white women. Educational efforts need to be strengthened to encourage black women to react sooner to symptoms, so that the tumors detected will be smaller and black women will have a better prognosis when they appear for mammography. Cancer 2004;100:139–48. © 2003 American Cancer Society.
STK15/Aurora‐A expression in primary breast tumors is correlated with nuclear grade but not with prognosis
Authors: Royce Melanie E. , Xia Weiya , Sahin Aysegul A. , Katayama Hiroshi , Johnston Dennis A. , Hortobagyi Gabriel , Sen Subrata , Hung Mien‐Chie 
Published: December 2003

AbstractBACKGROUNDDNA amplification on chromosome 20q13 is commonly detected in breast carcinoma and is correlated with poor prognosis. STK15 maps to this amplicon. The objective of the current study was to use immunohistochemistry to determine STK15 expression in primary breast tumors. The authors also explored whether STK15 was a prognostic factor for breast carcinoma by comparing the level of STK15 gene expression with clinical parameters that are known prognostic factors for the disease.METHODSArchival mastectomy and lumpectomy specimens, randomly selected, were immunohistochemically stained to determine the STK15 gene expression level. The clinical parameters of these same patients were reviewed retrospectively and analyzed for correlations with STK15 expression level, based on a positive‐versus‐negative scoring system.RESULTSOf the 112 human breast tumor specimens analyzed, 26% stained positively for STK15 by immunohistochemistry. Of the tumors, that stained positively 62.1% had a well‐to‐moderately differentiated nuclear grade. The correlation between STK15 staining and nuclear grade was nearly statistically significant (P = 0.05). No association was found between STK15 staining and tumor size, lymph node status, or hormone receptor status. Analysis of recurrence‐free survival and overall survival rates also failed to reveal a statistically significant difference between the two groups.CONCLUSIONSSTK15 expression by immunohistochemistry was noted in approximately one‐fourth of primary breast tumors. STK15 expression was associated with nuclear grade, but no correlation was found between the other clinical parameters evaluated. Furthermore, no differences were found in survival rates when they were analyzed by level of STK15 staining. Cancer 2004;100:12–9. © 2003 American Cancer Society.
Is there age bias in the treatment of localized prostate carcinoma?
Authors: Alibhai Shabbir M. H. , Krahn Murray D. , Cohen Marsha M. , Fleshner Neil E. , Tomlinson George A. , Naglie Gary 
Published: December 2003

AbstractBACKGROUNDTreatment recommendations for localized prostate carcinoma are based on the patient's remaining life expectancy (RLE), which is influenced by age, comorbidity, and tumor grade. Previous studies have evaluated the influence of age and comorbidity, but to the authors' knowledge not RLE, on actual treatment decisions.METHODSAn age‐stratified random sample of 347 patients was generated from a cohort of all patients with newly diagnosed prostate carcinoma in the Ontario Cancer Registry between May 1, 1995 and April 30, 1996 (n = 5192). Chart review was performed to obtain detailed tumor, comorbidity, and treatment information. RLE was estimated from a published model derived from a cohort of 451 men with untreated prostate carcinoma who were followed for 15 years. Multivariable logistic regression was performed to evaluate predictors of treatment, such as radical prostatectomy (RP), radiotherapy (RT), or potentially curative therapy (RP or RT), in relation to patient age, comorbidity, tumor characteristics, and RLE.RESULTSRP was provided within 6 months of diagnosis to 58.7%, 32.1%, 2.6%, and 0% of patients of ages < 60 years, 60–69 years, 70–79 years, and 80+ years, respectively. The results for RT were 6.4%, 30.9%, 23.4%, and 3.3%, respectively. Increasing comorbidity decreased rates of RP but did not affect use of RT. After controlling for comorbidity and tumor characteristics, older men were found to be treated with RP less often than younger men with similar RLE, whereas RLE did not appear to influence receipt of RT.CONCLUSIONSAlthough different mechanisms may account for these results, an age bias may be present among urologists and radiation oncologists treating men with localized prostate carcinoma. Cancer 2004;100:72–81. © 2003 American Cancer Society.
Suicidality in terminally ill Japanese patients with cancer
Authors: Akechi Tatsuo , Okuyama Toru , Sugawara Yuriko , Nakano Tomohito , Shima Yasuo , Uchitomi Yosuke 
Published: December 2003

AbstractBACKGROUNDThe risk of suicide is higher in patients with cancer than in the general population, making end‐of‐life care of suicidal terminal patients with cancer critical. To identify factors and longitudinal changes associated with suicidality among terminally ill Japanese patients with cancer, a prospective cohort study was performed.METHODSConsecutive outpatients with cancer who registered with a palliative care unit participated. Structured interviews (e.g., Structured Clinical Interview for DSM‐ III‐R [SCID]) were conducted to assess patient suicidal ideation (Ideation) and interest in requesting euthanasia (Interest) as main outcome measures of suicidality. Possible correlated factors also were investigated. The authors analyzed the data from 140 terminally ill patients with cancer at initial study participation (baseline) whose subsequent survival time was < 6 months. Of these 140 patients, 57 (40.7%) completed the follow‐up assessment after admission to the unit.RESULTSAt baseline, 8.6% of the patients had Ideation and 5.0% had Interest. Self‐reported anxiety and depression was significantly associated with Ideation (P= 0.003). Changes in Ideation and Interest occurred in 38.6% and 15.8% of the patients, respectively. Ideation was more likely to change than Interest (P = 0.006). The current study did not identify factors that predict changes and occurrences of suicidal ideation and interest in requesting euthanasia.CONCLUSIONSSuicidality can change even in terminally ill patients. End‐of‐life care that focuses on the psychologic distress of dying individuals may be a way of preventing suicide. Cancer 2004;100:183–91. © 2003 American Cancer Society.
Zoledronic acid is superior to pamidronate for the treatment of bone metastases in breast carcinoma patients with at least one osteolytic lesion
Authors: Rosen Lee S. , Gordon David H. , Dugan William , Major Pierre , Eisenberg Peter D. , Provencher Louise , Kaminski Mary , Simeone Joe , Seaman John , Chen Bee‐Lian , Coleman Robert E. 
Published: December 2003

AbstractBACKGROUNDTreatment with zoledronic acid (Zol) was compared with a dose of 90 mg of pamidronate (Pam) in breast carcinoma (BC) patients with at least 1 osteolytic lesion based on data from a Phase III, randomized trial.METHODSOverall, 1130 patients with breast carcinoma who had all types of bone metastases (osteolytic, mixed, or osteoblastic by radiology) were randomized to receive treatment with either 4 mg of Zol or 8 mg of Zol as a 15‐minute infusion or 90 mg of Pam as a 2‐hour infusion every 3–4 weeks for 12 months. A skeletal‐related event (SRE) was defined as a pathologic fracture, spinal cord compression, radiotherapy, or surgery to bone.RESULTSAmong all patients with BC, the proportion of those who had an SRE (primary endpoint) was comparable between treatment groups (43% of patients who received 4 mg of Zol vs. 45% of patients who received Pam). Among patients who had breast carcinoma with at least 1 osteolytic lesion (n = 528 patients), the proportion with an SRE was lower in the 4‐mg Zol group compared with the Pam group (48% vs. 58%), but this did not reach statistical significance (P = 0.058). The time to first SRE was significantly longer in the 4‐mg Zol group compared with the Pam group (median, 310 vs. 174 days; P = 0.013). Moreover, multiple‐event analysis demonstrated significant further reductions in the risk of developing SREs over the reduction achieved with Pam (30% in the osteolytic subset [P = 0.010] and 20% for all patients with BC [P = 0.037]).CONCLUSIONSThe current data indicate that treatment with 4 mg of Zol was more effective than 90 mg of Pam in reducing skeletal complications in a subset of patients with breast carcinoma who had at least 1 osteolytic lesion at study entry. Cancer 2004;100:36–43. © 2003 American Cancer Society.
Cognitive‐behavioral stress management improves stress‐management skills and quality of life in men recovering from treatment of prostate carcinoma
Authors: Penedo Frank J. , Dahn Jason R. , Molton Ivan , Gonzalez Jeffrey S. , Kinsinger David , Roos Bernard A. , Carver Charles S. , Schneiderman Neil , Antoni Michael H. 
Published: December 2003

AbstractBACKGROUNDThe current study evaluated the efficacy of a 10‐week, group‐based, cognitive‐behavioral stress management (CBSM) intervention relative to a half‐day seminar in improving quality of life (QoL) among men who were treated for localized prostate carcinoma (PC) with either radical prostatectomy (RP) or radiation therapy.METHODSNinety‐two men were assigned randomly to either the 10‐week CBSM group intervention or a 1‐day seminar (control group). The intervention was designed to improve QoL by helping participants to identify and effectively manage stressful experiences and was focused on the treatment‐related sequelae of PC.RESULTSA hierarchical regression model was used to predict postintervention QoL. The final model, including all predictors and relevant covariates (i.e., income, baseline QoL, ethnicity, and group condition), explained 62.1% of the variance in QoL scores. Group assignment was a significant predictor (β = − 0.14; P = 0.03) of QoL after the 10‐week intervention period, even after controlling for ethnicity, income, and baseline QoL. Post‐hoc analyses revealed that individuals in the CBSM intervention condition showed significant improvements in QoL relative to men in the 1‐day control seminar. Improved QoL was mediated by greater perceived stress‐management skill.CONCLUSIONSA 10‐week cognitive‐behavioral group intervention was effective in improving the QoL in men treated for PC, and these changes were associated significantly with intervention‐associated increases in perceived stress‐management skills. Cancer 2004;100:192–200. © 2003 American Cancer Society.
Ethnic/racial influences on the physiologic health of cancer survivors
Authors: Schultz Pamela N. , Stava Charles , Beck Martha L. , Vassilopoulou‐Sellin Rena 
Published: December 2003

AbstractBACKGROUNDImprovements in early detection, treatment, and general supportive care allow more people to survive cancer. Information regarding the long‐term health impact of cancer and cancer treatments on these survivors of adult‐onset malignancies is gradually accumulating. Although information is limited overall, it is apparent that the cancer experience differs across ethnically/racially diverse populations.METHODSIn the current report, the authors characterized and compared health profiles among ethnic/racial groups within a large cohort (n > 6000) of long‐term survivors of cancer. In addition, the authors focused on survivors of cervical carcinoma, because they constitute a substantial and relatively homogeneous portion of the overall cohort.RESULTSThe authors observed significant differences among African American, Hispanic American, and Caucasian American cancer survivors in terms of age at diagnosis, time since diagnosis, family dynamics, education, type of malignancy, and perceived influences of cancer on specific physiologic health problems. Among survivors of cervical carcinoma, there were significant ethnic/racial differences in terms of disease histology as well as the impact of the disease on overall health.CONCLUSIONSThe current study reveals significant ethnic/racial differences among cancer survivors and highlights the need for further investigation of the relation between cancer survivorship and ethnicity/race. Cancer 2004;100:156–64. © 2003 American Cancer Society.