bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic management of upper urinary tract transitional cell carcinoma
Authors: Daneshmand Siamak , Quek Marcus L. , Huffman Jeffry L. 
Published: June 2003

AbstractBACKGROUNDThe efficacy and long‐term results of endoscopic management of upper tract transitional cell carcinoma (TCC) were examined. The authors evaluated the accuracy of endoscopic biopsy in determining tumor grade in the subset of patients who underwent open surgical excision.METHODSBetween 1987 and 2001, 50 patients (17 with a solitary kidney) underwent ureteroscopy and biopsy of upper tract TCC. Eleven patients underwent ureterectomy or nephroureterectomy shortly after endoscopic biopsy. There was no follow‐up for nine patients. Thirty patients underwent endoscopic ablation of their primary tumor with laser or electrofulguration at the time of the initial biopsy and were followed with close endoscopic surveillance at 3–4‐month intervals.RESULTSFor the 30 patients who underwent endoscopic ablation, mean follow‐up was 38 months (range, 4–106 months). There was an average of 3.4 recurrences, with an average time to first recurrence of 7 months. Ten of the 30 patients underwent open resection during follow‐up. Six patients exhibited tumor progression at follow‐up. During the follow‐up period, one patient died of recurrent disease, and six died of other causes. Endoscopic biopsy accurately predicted the tumor grade for 8 of the 9 patients who had open tumor resection within 2 months of their last biopsy and for 10 of the 11 patients who had open resection shortly after their initial endoscopic biopsy (overall accuracy, 18 of 20 [90%]).CONCLUSIONSEndoscopic treatment of focal low‐grade TCC of the upper urinary tract is feasible and safe, provided that vigilant follow‐up and endoscopic surveillance are performed. Endoscopic biopsy provides accurate information regarding tumor grade. Cancer 2003;98:55–60. © 2003 American Cancer Society.DOI 10.1002/cncr.11446
Central nervous system metastases in neuroblastoma
Authors: Matthay Katherine K. , Brisse Hervé , Couanet Dominique , Couturier Jerome , Bénard Jean , Mosseri Veronique , Edeline Véronique , Lumbroso Jean , Valteau‐Couanet Dominique , Michon Jean 
Published: June 2003

AbstractBACKGROUNDCentral nervous system (CNS) metastases rarely occur in patients with neuroblastoma, although recent reports suggest an increase in the rate. CNS recurrence may represent a different mechanism of spread than bone and bone marrow metastases and may be associated with unique genetic determinants. Further definition of the radiologic, clinical, and biologic features may provide clues to the predisposing factors and mechanisms of CNS dissemination.METHODSA retrospective analysis of all children ages 0–21 years with Stage IV neuroblastoma who were diagnosed at the Institut Curie and the Institut Gustave‐Roussy between 1985 and 2000 was performed with direct review of medical records and magnetic resonance images, computed tomography scans, and iodine‐123 or iodine‐131 metaiodobenzylguanidine scintiscans (MIBG scans). When tumor tissue was available, genetic analysis was performed using comparative genomic hybridization (CGH).RESULTSOf 434 patients with Stage 4 disease, 23 children had the CNS as their site of first recurrence. The estimated risk of CNS recurrence was 8.0% at 3 years, with no significant change in risk over the 15‐year period. Eleven patients had isolated CNS recurrences, and the remaining patients developed recurrences concomitantly in other sites. The sites of recurrences were parenchymal (n = 8 patients), parenchymal with meningeal (n = 7 patients), and meningeal alone (n = 8 patients). MIBG scans detected CNS lesions in only 43% of patients. Significant risk factors for CNS recurrence included lumbar puncture at diagnosis, ages 2–3 years, and MYCN gene amplification. Abnormalities that were identified using CGH, in addition to 2p24 amplification in 5/7, included gains of 17q and 18q and losses of 1p, 3p, 10q25‐26, and 11q.CONCLUSIONSThe risk of CNS recurrence in patients with neuroblastoma is 8% at 3 years after diagnosis and has not increased in the last 15 years. Because the CNS often is the sole site of recurrence, either it may be a sanctuary site, or the biologic determinants of CNS metastasis may be unique. Elucidation of risk factors and pathogenesis may allow prevention of this fatal event. Cancer 2003;98:155–65. © 2003 American Cancer Society.DOI 10.1002/cncr.11448
Detecting the expression of human endogenous retrovirus E envelope transcripts in human prostate adenocarcinoma
Authors: Wang‐Johanning Feng , Frost Andra R. , Jian Bixi , Azerou Ricardo , Lu Danielle W. , Chen Dung‐Tsa , Johanning Gary L. 
Published: June 2003

AbstractBACKGROUNDThe expression of human endogenous retrovirus (HERV) mRNA and proteins was associated recently with diseases that include human malignancies. The authors report that, in the current study, transcripts encoding the envelope region of an HERV family, HERV‐E, were expressed in human prostate carcinoma.METHODSRNA was isolated from various prostate tissues and was tested for the expression of various HERV envelope (env) genes by reverse transcriptase–polymerase chain reaction (RT‐PCR) analysis, RNA in situ hybridization (ISH), and Northern blot analysis. Variants of HERV that appeared in prostate carcinoma tissues were sequenced, and HERV‐E was expressed in prokaryotic and eukaryotic systems.RESULTSIn the current study, the authors found that the mRNA of the env gene of one particular family of HERVs, HERV‐E, was expressed in some prostate carcinoma tissues (38.8% positive; n = 49 specimens) but not in normal prostate tissues using RT‐PCR, RNA ISH, and Northern blot assays. The expression of HERV‐E transcripts in prostate tumor epithelial cells was confirmed further by ISH using an HERV‐E specific antisense probe. Approximately 50% of the cDNA of HERV‐E obtained from prostate carcinoma specimens contained no stop codon and expressed proteins in prokaryotic or eukaryotic expression systems. Furthermore, the expression of both HERV‐E and ERV3 (another class of HERV) was detected in the same prostate carcinoma tissues.CONCLUSIONSThe expression and distribution of multiple HERV‐E endogenous retroviral elements in prostate carcinoma, but not in normal control specimens, suggests that they may serve as novel tumor markers for the early diagnosis and immunotherapy of patients with prostate carcinoma. Cancer 2003;98:187–97. © 2003 American Cancer Society.DOI 10.1002/cncr.11451
Gemcitabine and cisplatin as induction chemotherapy for patients with unresectable Stage IIIA‐bulky N2 and Stage IIIB nonsmall cell lung carcinoma
Authors: Cappuzzo Federico , Selvaggi Giovanni , Gregorc Vanesa , Mazzoni Francesca , Betti Maura , Rita Migliorino Maria , Novello Silvia , Maestri Antonio , De Marinis Filippo , Darwish Samir , De Angelis Verena , Nelli Fabrizio , Bartolini Stefania , Scagliotti Giorgio V. , Tonato Maurizio , Crinò Lucio 
Published: June 2003

AbstractBACKGROUNDThe objective of this trial was to evaluate the activity and safety of one of the newer platinum‐based doublets as a neoadjuvant regimen in patients with unresectable Stage IIIA‐bulky N2 and Stage IIIB nonsmall cell lung carcinoma (NSCLC).METHODSFrom June 1996 to April 2000, 129 consecutive patients with locally advanced NSCLC were treated with gemcitabine, 1000 mg/m2 on Days 1 and 8 and cisplatin, 70 mg/m2 on Day 2 (GC) of a 21‐day treatment cycle, for 4 cycles, as part of a combined‐modality approach.RESULTSAfter induction chemotherapy, 80 patients (62%; 95% confidence interval, 53.6–70.4%) achieved a partial response, 43 patients (33%) had stable disease, and 6 patients (5%) had disease progression during chemotherapy. Forty patients (31%), were considered resectable and underwent thoracotomy. Complete resectability was obtained in 38 patients (29%), with 2% of patients achieving a pathologic complete response. After surgery, 9 patients with Mountain Classification Stage IIIA NSCLC and 9 patients with Stage IIIB NSCLC received definitive adjuvant radiotherapy. Forty‐six of 52 patients with Stage IIIB disease and 24 of 37 patients with Stage IIIA disease who were not considered suitable for surgery received definitive radiotherapy. The median time to disease progression was 11.4 months, the median survival was 19.4 months (range, 1.2–55.2 + months), and the 1‐year survival rate was 74%. The lungs (33%) and the brain (21%) were the main sites of recurrence. Major toxicity was comprised of Grade 3–4 thrombocytopenia, which occurred in 34 patients (27%).CONCLUSIONSGC administered according to a 3‐week schedule was a highly active and safe regimen in patients with primary, unresectable, locally advanced NSCLC. Cancer 2003;98:128–34. © 2003 American Cancer Society.DOI 10.1002/cncr.11460
Expression ofbcl‐2 protein is associated with shorter survival in nonsmall cell lung carcinoma
Authors: Huang Chris I. , Neuberg Donna , Johnson Bruce E. , Wei Jeanne Y. , Christiani David C. 
Published: June 2003

AbstractBACKGROUNDThe aim of this study was to assess the relationship between the expression of the 27‐kilodalton (kD)bcl‐2 protein and survival among nonsmall cell lung carcinoma (NSCLC) patients.METHODSPaired tissue samples of histologically confirmed tumor and uninvolved lung of 91 randomly selected NSCLC patients were used in this study. The expression of 27‐kDbcl‐2 proteins in uninvolved lung and tumor tissue specimens was analyzed using Western blot analysis. Overall survival was estimated using the Kaplan–Meier method. The relation between patient survival and expression of the 27‐kDbcl‐2 protein in uninvolved lung, tumor, and in uninvolved lung and/or tumor tissue specimens was assessed using log‐rank tests and Cox proportional hazards multiple regression.RESULTSThe 27‐kDbcl‐2 protein was expressed in 54% of the uninvolved lung tissue specimens, in 53% of the tumor tissue specimens, and in 70% of the uninvolved lung and/or tumor tissue specimens. When NSCLC patient survival was considered with respect to the expression of the 27‐kDbcl‐2 protein, a statistically significant shorter survival was observed for patients whose tissue samples expressed the 27‐kDbcl‐2 protein in the uninvolved lung and in the uninvolved lung and/or tumor (log‐rank test,P= 0.008 andP= 0.001, respectively). Cox proportional hazards multiple regression models also showed statistically significant associations between shorter survival and positive 27‐kD protein expression in the uninvolved lung (hazard ratio of 2.27;P= 0.05) and in the uninvolved lung and/or tumor (hazard ratio of 5.58,P= 0.008) after controlling for tumor size, stage, the type of surgery received, smoking status, age, and cell type.CONCLUSIONSIn the current study, patients with nonsmall cell lung carcinoma with positive expression of the 27‐kD proteinbcl‐2, either in the uninvolved lung or in uninvolved lung and/or tumor, were found to have significantly poorer postresection survival. Cancer 2003;98:135–43. © 2003 American Cancer Society.DOI 10.1002/cncr.11461
Phase I study of intranodal delivery of a plasmid DNA vaccine for patients with Stage IV melanoma
Authors: Tagawa Scott T. , Lee Peter , Snively Jolie , Boswell William , Ounpraseuth Song , Lee Sandra , Hickingbottom Barbara , Smith John , Johnson Denise , Weber Jeffrey S. 
Published: June 2003

AbstractBACKGROUNDBased on the likelihood of transfecting large numbers of local antigen‐presenting cells, a Phase I study in patients with Stage IV melanoma was conducted to determine the practicality, toxicity of, and immune responses to repeated infusions into a groin lymph node of escalating doses of a DNA plasmid encoding tyrosinase epitopes.METHODSCohorts of 8 patients each received 200 μg, 400 μg, or 800 μg of DNA intranodally by pump over 96 hours every 14 days for 4 cycles. Blood was collected for immunologic assays and to measure plasmid in serum prior to treatment, 4 weeks later, and 8 weeks later. Scans and X‐rays were performed at baseline and after 8 weeks.RESULTSTreatment was tolerated well, with only five patients demonstrating Grade 1–2 toxicity. Vaccine delivery by 96‐hour infusions of plasmid into a groin lymph node resulted in only 1 episode of catheter leakage in 107 cannulations. Detection of plasmid in serum was rare and transient in two patients. Immune responses by peptide‐tetramer assay to tyrosinase 207–216 were detected in 11 of 26 patients. No clinical responses were seen. Survival of the heavily pretreated patients on this trial was unexpectedly long, with 16 of 26 patients alive at a median follow‐up of 12 months.CONCLUSIONSInfusion of a DNA plasmid vaccine into a groin lymph node was practical and well tolerated. Immune responses to a novel tyrosinase epitope were noted. Overall survival in this trial of heavily pretreated patients was unexpectedly long, with 16 of 26 patients alive after a follow‐up of 12 months, favoring immune responders. Cancer 2003;98:144–54. © 2003 American Cancer Society.
The relationship between psychologic distress and cancer‐related fatigue
Authors: Tchekmedyian N. Simon , Kallich Joel , McDermott Anne , Fayers Peter , Erder M. Haim 
Published: June 2003

AbstractBACKGROUNDThe authors examined the relationship between changes in depression and anxiety levels with changes in fatigue levels among anemic patients with lung cancer who participated in a randomized, double‐blind, placebo‐controlled clinical trial of darbepoetin alfa for the treatment of anemia.METHODSPatients completed the Brief Symptom Inventory (BSI) Depression and Anxiety subscales and the Functional Assessment of Cancer Therapy (FACT) Fatigue subscale during the trial. Pearson correlation coefficients were used to compare changes in the BSI scores with changes in the FACT Fatigue scores. Multiple regression models were used to explore sociodemographic and clinical explanatory variables.RESULTSAt baseline, 25% and 35% of 250 patients reported high levels (normed BSI scores ≥ 65) of anxiety and depression, respectively. Correlations of changes in normed BSI Anxiety and Depression subscale scores with changes in FACT Fatigue scores had coefficients of −0.45 (P< 0.001) and −0.44 (P< 0.001), respectively. In the multiple regression models, change in the FACT Fatigue score was the only significant explanatory variable (P< 0.001). For every unit improvement in FACT Fatigue score, there was a corresponding improvement of 0.7 points and 0.8 points in anxiety and depression levels, respectively.CONCLUSIONSImprovements in fatigue were associated significantly with reductions in anxiety and depression. For patients with anemia, fatigue can be improved or reversed with darbepoetin alfa therapy. Thus, less fatigued patients also may benefit from reduced levels of anxiety and depression. Cancer 2003;98:198–203. © 2003 American Cancer Society.DOI 10.1002/cncr.11463
Favorable cardiac risk among elderly breast carcinoma survivors
Authors: Lamont Elizabeth B. , Christakis Nicholas A. , Lauderdale Diane S. 
Published: June 2003

AbstractBACKGROUNDThere are two reasons why women who survive breast carcinoma may be at a lower risk of developing coronary heart disease (CHD) compared with women without a history of breast carcinoma. First, estrogens may be etiologic in the development of breast carcinoma and protective of CHD. Second, a common therapy for breast carcinoma (tamoxifen) may be associated with cardiac protection.METHODSIn this population‐level cohort study, the authors analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)‐Medicare program to study the cardiac risk of elderly female Medicare beneficiaries with and without a history of breast carcinoma. Using the SEER file, the authors identified elderly women survivors of Stage 0, I, or II breast carcinoma (n = 5980) diagnosed between the ages of 55 and 64. Using the Medicare 5% noncancer file, the authors also identified elderly women without a history of cancer (n = 23,165). They followed women from age 67 for up to 5 years for hospitalization for acute myocardial infarction (AMI) through a review of Medicare claims. The authors controlled the analyses for race, socioeconomic status, geographic location, cohort entry year, and medical comorbidity.RESULTSThe hazard of hospitalization for AMI for breast carcinoma survivors relative to comparison patients was 0.66 (95% confidence interval, 0.49–0.88). This apparent cardioprotective effect of breast carcinoma survivorship was stronger in breast carcinoma survivors with documented cardiac risk factors.CONCLUSIONSSurvivors of early‐stage postmenopausal breast carcinoma are at a significantly lower risk of hospitalization for AMI than women who do not have a history of breast carcinoma. That survivors' risk varies with previous cardiac risk factors may be consistent with effects of selective estrogen receptor modulators. This phenomenon should be evaluated further with individual‐level data containing information on patient cardiac risk factors and tamoxifen use to help clarify the mechanism behind the risk reduction. Cancer 2003;98:2–10. © 2003 American Cancer Society.DOI 10.1002/cncr.11467
Detection, treatment, and outcome of isolated supraclavicular recurrence in 42 patients with invasive breast carcinoma
Authors: van der Sangen Maurice J.C. , Coebergh Jan‐Willem W. , Roumen Rudi M.H. , Rutten Harm J.T. , Vreugdenhil Gerard , Voogd Adri C. 
Published: June 2003

AbstractBACKGROUNDThere still is debate as to whether breast carcinoma patients with isolated supraclavicular recurrence should be considered to be patients with disseminated disease or patients for whom aggressive treatment with curative intent is justified.METHODSIn the period 1984–1994, 4669 patients with invasive breast carcinoma underwent axillary dissection in 1 of 8 community hospitals in the southeastern part of the Netherlands. During follow‐up, 42 patients with isolated supraclavicular recurrence, without other sites of distant disease, were identified.RESULTSThe median interval between treatment of the primary tumor and diagnosis of the supraclavicular recurrence was 2.5 years (range, 0.2–11.5 years). Radiotherapy was administered to 25 patients (60%), 5 of whom also underwent surgery and 16 of whom also received chemotherapy or hormonal therapy. Eleven patients received hormonal therapy only, and four received chemotherapy only. One patient received surgical treatment only, and one patient remained untreated. Complete remission was achieved in 35 patients (83%), but a second supraclavicular recurrence occurred in 12 (34% of patients who achieved complete remission). Overall, 6 patients (14%) were alive without evidence of disease after a follow‐up period of 4.4–8.3 years. The 5‐year actuarial overall survival and distant disease–free survival rates, based on the date of diagnosis of supraclavicular recurrence, were 38% (95% confidence interval [CI], 23–53%) and 22% (95% CI, 8–35%), respectively. The distant disease–free survival rate was somewhat better for the 25 patients who underwent radiotherapy as part of the treatment for supraclavicular recurrence than it was for the 17 patients who did not receive radiotherapy (P = 0.06); the difference became more pronounced after the exclusion of 8 patients who had received axillary and supraclavicular radiotherapy as part of treatment for the primary tumor (P = 0.002).CONCLUSIONSAlthough complete remission can be obtained in most patients with isolated supraclavicular recurrence, the prognosis for these patients is poor. Involved field radiotherapy appears to play an important role in the treatment of supraclavicular recurrence and may improve the distant recurrence–free survival rate. Cancer 2003;98:11–7. © 2003 American Cancer Society.DOI 10.1002/cncr.11469
Candidemia in women with breast carcinoma treated with high‐dose chemotherapy and autologous bone marrow transplantation
Authors: Gottfredsson Magnús , Vredenburgh James J. , Xu Jianping , Schell Wiley A. , Perfect John R. 
Published: June 2003

AbstractBACKGROUNDInvasive fungal infections, including candidemia, pose a major threat to patients with impaired immune defenses, including bone marrow transplantation (BMT) recipients. During 1992–1997, 845 women with multiple lymph node positive or metastatic breast carcinoma underwent high‐dose chemotherapy (HDC) and subsequent autologous BMT at Duke University Medical Center. No systemic antifungal prophylaxis was administered. The purpose of the current study was to evaluate the risk and long‐term outcome of candidemia in this patient population.METHODSClinical data were collected on patients with candidemia, and a group of age‐matched control patients were identified who underwent HDC and BMT for breast carcinoma in the same time period. The difference in crude mortality between these two groups was used to calculate the attributable mortality of candidemia. The genetic relatedness of the fungal blood stream isolates was investigated by DNA fingerprinting. Antifungal susceptibility testing was performed using serial microdilution.RESULTSTwenty‐nine of 845 women developed candidemia (3.4%). The crude mortality of women with candidemia was 35% at 90 days after transplantation but 11% among women in the matched control group who were without infection (P = 0.01), for an attributable mortality rate of 24%. The most common pathogen was Candida tropicalis (50%), followed by Candida albicans (23%). The mortality was highest for women who were infected with C. albicans, followed by C. tropicalis, and other Candida species (P = 0.037). DNA fingerprinting of the yeasts revealed genetic heterogeneity in all species. However, 9 of 15 C. tropicalis isolates had identical DNA fingerprint profiles, suggesting spread of this genotype from a common source. All yeast isolates were susceptible to amphotericin B, and 20 of 30 isolates were susceptible to ≤ 8 μg/mL of fluconazole.CONCLUSIONSCandidemia was relatively infrequent after HDC and autologous BMT in women with for multiple lymph node positive or metastatic breast carcinoma. This was true even in the absence of systemic antifungal prophylaxis. The mortality attributable to candidemia in this patient population was 24% and was higher among patients who were infected by C. albicans compared with patients who were infected by other Candida, non‐albicans species. Cancer 2003;98:24–30. © 2003 American Cancer Society.DOI 10.1002/cncr.11470