bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do we need HER‐2/neu testing for all patients with primary breast carcinoma?
Authors: Taucher Susanne , Rudas Margaretha , Mader Robert M. , Gnant Michael , Dubsky Peter , Bachleitner Thomas , Roka Sebastian , Fitzal Florian , Kandioler Daniela , Sporn Emanuel , Friedl Josef , Mittlböck Martina , Jakesz Raimund 
Published: December 2003

AbstractBACKGROUNDHER‐2/neu is a valuable prognostic marker in primary breast carcinoma. Controversy surrounds the correlation between HER‐2/neu expression and other prognostic markers, as has been discussed in preclinical and clinical studies. The objective of the current study was to investigate the probability, calculated using parameters that are assessed routinely in clinical practice, that patients with breast carcinoma had positive HER‐2/neu status.METHODSThe authors evaluated HER‐2/neu status in 923 consecutive patients with breast carcinoma by immunohistochemical methods. Correlations involving HER‐2/neu status, estrogen receptor (ER) and progesterone receptor (PR) status, tumor grade, patient age, lymph node involvement, and tumor size were evaluated using the Mantel–Haenszel chi‐square test and the Spearman correlation. The authors created a simple scoring system (i.e., the diagnostic instrument for validation of HER‐2/neu score) to define subgroups of patients with breast carcinoma and to determine the likelihood of HER‐2/neu positivity.RESULTSHER‐2/neu overexpression was correlated significantly with negative ER (P = 0.0001) and PR status (P = 0.0001), Grade 3 (G3) lesions (P = 0.0001), and young age (P = 0.006). The likelihood of HER‐2/neu positivity in a patient with positive ER and PR status and G1/G2 disease was approximately 6.1%.CONCLUSIONSThe authors demonstrated in a large patient series that HER‐2/neu overexpression was associated with negative hormone receptor status, G3, and young age. In a subgroup of patients presenting with hormone‐responsive and G1/G2 tumors, the likelihood of HER‐2/neu overexpression was very small. Therefore, the assessment of HER‐2/neu status in this subgroup of patients with breast carcinoma may be considered unnecessary, unless the role of HER‐2/neu status in adjuvant treatment has been proven. Cancer 2003;98:2547–53. © 2003 American Cancer Society.
A Phase II study of estramustine, docetaxel, and carboplatin with granulocyte–colony‐stimulating factor support in patients with hormone‐refractory prostate carcinoma
Authors: Oh William K. , Halabi Susan , Kelly W. Kevin , Werner Cary , Godley Paul A. , Vogelzang Nicholas J. , Small Eric J. ,   for the Cancer and Leukemia Group B
Published: December 2003

AbstractBACKGROUNDThe authors determined the safety and efficacy of estramustine, docetaxel, and carboplatin with granulocyte–colony‐stimulating factor (G‐CSF) support in patients with hormone‐refractory prostate carcinoma.METHODSIn the current multicenter, cooperative group study, patients with advanced prostate carcinoma whose disease progressed despite androgen deprivation therapy were treated with a combination of oral estramustine(240 mg three times per day for 5 days), 70 mg/m2 of docetaxel, and carboplatin at a dose of (area under the curve) 5. G‐CSF was used to minimize the neutropenia associated with this regimen. Each cycle was repeated every 21 days.RESULTSForty patients were treated with a median of 7 cycles of therapy. Of the 34 evaluable patients with elevated pretreatment prostate‐specific antigen (PSA) levels, 23 (68%) had a ≥ 50% decline in PSA and 20 (59%) had a ≥ 75% decline. Twenty‐one patients had measurable disease, with 1 complete response (5%) and 10 partial responses (47%), for an overall measurable response rate of 52% (95% confidence interval [95% CI], 30–74%). The most common Grade 3 or Grade 4 toxicities (according to the National Cancer Institute Common Toxicity Criteria) included neutropenia in 23% of patients, thrombocytopenia in 13%, and fatigue in 13%. Febrile neutropenia occurred in 1 patient (3%). The overall median time to disease progression was 8.1 months (95% CI, 6–10 months) and the overall survival period was 19 months (95% CI, 13–26 months).CONCLUSIONSThe combination of estramustine, docetaxel, and carboplatin with G‐CSF support was found to have significant clinical activity with an acceptable toxicity profile in patients with progressive hormone‐refractory prostate carcinoma. Cancer 2003;98:2592–8. © 2003 American Cancer Society.
Imatinib mesylate therapy improves survival in patients with newly diagnosed Philadelphia chromosome‐positive chronic myelogenous leukemia in the chronic phase
Authors: Kantarjian Hagop M. , O'Brien Susan , Cortes Jorge , Giles Francis J. , Rios Mary Beth , Shan Jianqin , Faderl Stefan , Garcia‐Manero Guillermo , Ferrajoli Alessandra , Verstovsek Srdan , Wierda William , Keating Michael , Talpaz Moshe 
Published: December 2003

AbstractBACKGROUNDTheInternationalRandomized study ofInterferon‐alpha plus cytarabine (IFN‐α plus ara‐C) versusSTI571 (imatinib mesylate) [IRIS trial] in patients with newly diagnosed Philadelphia chromosome (Ph)‐positive, chronic‐phase chronic myelogenous leukemia (CML) has not shown (to date) a survival advantage for imatinib. This was most likely because approximately 90% of patients receiving IFN‐α plus ara‐C changed to imatinib therapy after a median of 8 months into therapy.METHODSThe authors analyzed the results with imatinib therapy in patients with newly diagnosed Ph‐positive CML in chronic phase and compared their outcome with patients who received IFN‐α regimens. A total of 187 patients with Ph‐positive CML in early chronic phase treated with imatinib were compared with a historic group of 650 similar patients treated with IFN‐α regimens from 1982 until 1997.RESULTSPatients who received imatinib were significantly older and had significantly more bone marrow basophilia and less leukocytosis. The complete cytogenetic response (Ph 0%) rates were better with imatinib (81% vs. 32%;P< 0.001), as were the survival rates (30‐month estimated survival rates 98% vs. 88%;P= 0.01). A multivariate analysis of the total study group of 837 patients identified imatinib therapy to be a significant independent favorable prognostic factor for survival (P= 0.01).CONCLUSIONSThe current study is the first to indicate the survival advantage of imatinib compared with IFN‐α, the previous standard of care, in patients with early chronic‐phase CML. Cancer 2003;98:2636–42. © 2003 American Cancer Society.
Short‐term biologic response to withdrawal of hormone replacement therapy in patients with invasive breast carcinoma
Authors: Prasad Ramachandran , Boland Gary P. , Cramer Angela , Anderson Elizabeth , Knox W. Fiona , Bundred Nigel J. 
Published: December 2003

AbstractBACKGROUNDThe biologic effect of continuing hormone replacement therapy (HRT) after a diagnosis of breast carcinoma is unclear. The goal of rhe current study was to determine the short‐term effect of HRT withdrawal on invasive breast carcinoma using biologic surrogate markers of tumor response.METHODSThe study was performed between 1996 and 2000 and comprised 140 women who had been using HRT at the time of breast carcinoma diagnosis by core needle biopsy. The breast tumors were removed a median of 17 days later (range, 2–31 days). Of these women, 125 women stopped HRT at the time of core needle biopsy and 15 continued to receive HRT until surgery. In addition, 55 women with breast carcinoma from the same time period, who were not receiving HRT at diagnosis, were studied. Changes in expression of Ki‐67 (a measure of epithelial cell proliferation), progesterone receptor (PR), p27KIP‐1 (a cyclin‐dependent kinase inhibitor), and cyclin D1 (a cell cycle‐related protein) were determined by immunohistochemistry on paired sections of the core needle biopsy and surgical specimens from each patient.RESULTSIn women who stopped HRT, a significant decrease in Ki‐67 expression was observed between core needle biopsy and surgery in estrogen receptor (ER)‐positive (n = 106; P < 0.001), but not in ER‐negative tumors (n = 19; P = 0.58), with an associated reduction in PR (P < 0.001) and cyclin D1 expression (P < 0.001) and an increase in p27KIP‐1 (P = 0.03). These changes in Ki‐67 and PR expression occurred irrespective of c‐erb‐B2 status. No change was observed in any parameter in the other groups of patients.CONCLUSIONSER‐positive invasive breast carcinomas demonstrated a favorable biologic response to withdrawal of HRT. Therefore, HRT should be stopped at the time of diagnosis and was subsequently contraindicated. Cancer 2003;98:2539–46. © 2003 American Cancer Society.
The value of routine follow‐up in patients treated for carcinoma of the vulva
Authors: Oonk Maaike H. M. , de Hullu Joanne A. , Hollema Harry , Mourits Marian J. E. , Pras Elisabeth , Wymenga Anke N. M. , van der Zee Ate G. J. 
Published: December 2003

AbstractBACKGROUNDVulvar carcinoma patients traditionally are offered follow‐up after their primary treatment because earlier diagnosis of recurrent disease is believed to improve chances for curative treatment. The objective of the current study was to determine the value of a strict routine follow‐up protocol for the detection of recurrences in a large series of patients who were treated for carcinoma of the vulva.METHODSClinicopathologic data for patients with primary squamous cell carcinoma of the vulva who were treated between January 1990 and July 2000 were prospectively stored in a database. After treatment, patients visited the outpatient clinic at the study institution at gradually increasing intervals. When a recurrence was diagnosed, it was indicated whether the recurrence was local, occurred in the skin bridge, occurred in the inguinal region, or was distant, and this information was registered. Moreover, it was noted whether the diagnosis was made at a routinely scheduled or at an interval follow‐up meeting and whether symptoms as noted by the patient herself led to the diagnosis.RESULTSData from 238 patients with International Federation of Gynecology and Obstetrics (FIGO) Stage I–IV vulvar carcinoma were analyzed with a mean follow‐up of 63 months (median, 58 months; range, 6–149 months). Sixty‐five of 238 patients (27%) developed recurrent disease; 49 were local recurrences, 2 recurrences were found in the skin bridge, 6 were found in the inguinal region, and 8 were distant recurrences. Forty‐two of these 65 recurrences (65%) were detected at a routinely scheduled follow‐up meeting, at which time 21 of the 42 patients with recurrent disease (50%) reported symptoms or signs. Local recurrences diagnosed at a routinely scheduled follow‐up meeting were found to have a smaller greater dimension (mean, 2.1 cm and median, 1.6 cm; range, 0.3–8.0 cm) compared with recurrences detected at an interval meeting (mean, 3.1 cm and median, 3.0 cm; range, 0.4–7.0 cm) (P = 0.04).CONCLUSIONSThe data from the current study indicated that routinely scheduled follow‐up meetings with patients with carcinoma of the vulva result in the detection of smaller recurrences in a substantial proportion of patients compared with self‐reported recurrences, without a measurable effect on morbidity or mortality. Cancer 2003;98:2624–9. © 2003 American Cancer Society.
Long‐term follow‐up of autologous stem cell transplantation in patients with diffuse mantle cell lymphoma in first disease remission
Authors: Khouri Issa F. , Saliba Rima M. , Okoroji Grace‐Julia , Acholonu Sandra A. , Champlin Richard E. 
Published: December 2003

AbstractBACKGROUNDThe current study was conducted to analyze the long‐term results of autologous stem cell transplantation (ASCT) in patients with diffuse mantle cell lymphoma (MCL) in first disease remission.METHODSThirty‐three patients were treated. Thirty‐one patients had Ann Arbor Stage III or Stage IV disease. The hyper‐CVAD regimen (hyperfractionated intense‐dose cyclophosphamide, vincristine, continuous intravenous infusion of doxorubicin, and dexamethasone, alternating with high doses of cytarabine and methotrexate plus leucovorin rescue) was used for cytoreduction before ASCT. Patients were consolidated with high‐dose cyclophosphamide (120 mg/kg), total body irradiation, and ASCT.RESULTSAt a median follow‐up of 49 months, the overall survival and disease‐free‐survival rates at 5 years were estimated to be 77% and 43%, respectively. Patients whose M. D. Anderson Lymphoma Tumor Score (TS) was ≤ 1 at the time of diagnosis or transplantation experienced longer disease‐free survival compared with those whose TS was > 1 (P = 0.02). A β2‐microglobulin (β2m)level ≤ 3 mg/L at the time of diagnosis or transplantation was also found to be strongly predictive of longer survival (5‐year survival rate of 100% vs. 22% in patients with a β2m level > 3 mg/L) (P = 0.0001).CONCLUSIONSASCT may prolong the overall survival in a subset of patients with MCL. This improvement has been observed for the most part in patients with low β2m levels (≤ 3 mg/L) and TS (≤ 1). Randomized trials are required to fully assess the benefits of this strategy. Cancer 2003;98:2630–5. © 2003 American Cancer Society.
The des‐γ‐carboxy prothrombin index is a new prognostic indicator for hepatocellular carcinoma
Authors: Nagaoka Sakae , Yatsuhashi Hiroshi , Hamada Hisayuki , Yano Koji , Matsumoto Takehiro , Daikoku Manabu , Arisawa Kokichi , Ishibashi Hiromi , Koga Michiaki , Sata Michio , Yano Michitami 
Published: December 2003

AbstractBACKGROUNDDes‐γ‐carboxy prothrombin (DCP) has been reported to be an important prognostic factor in patients with hepatocellular carcinoma (HCC). Recently, a monoclonal antibody, 19B7, which recognizes the Gla domain of DCP, has been identified. The 19B7 antibody recognizes an epitope different from that recognized by MU‐3, which is another antibody against DCP. In this study, the authors investigated the measurement of DCP using the antibodies MU‐3 and 19B7, respectively, as a prognostic factor for patients with HCC who had solitary, small tumors and or Child Stage A HCC.METHODSOne hundred four patients with HCC who had solitary, small tumors or Child Stage A tumors were enrolled in the study between 1991 and 2001. All patients were treated and were followed for a mean of 3.2 years. The authors analyzed the correlation between the DCP Index (DCP measured by MU‐3 and DCP measured by 19B7) and patient prognosis. The patients were classified into 3 groups based on their DCP Index: 1) DCP negative (DCP < 40 milli arbitrary unit (mAU)/mL)); 2) low DCP Index (DCP ≥ 40 mAU/mL; MU‐3:19B7 ratio, < 3.0; and 3) high DCP Index (DCP ≥ 40 mAU/mL; MU‐3:19B7 ratio, ≥ 3.0).RESULTSThe survival rate for patients in the high DCP Index group was lower compared with the survival rate for patients in the DCP‐negative group and was significantly lower compared with the survival rate for patients in the low DCP Index group. In a univariate Cox proportional hazards model, the positive factors were high DCP Index and low DCP Index. Among the positive predictive factors that were analyzed using a multivariate Cox proportional hazards model were age (hazard ratio, 3.27; P = 0.006), low DCP Index (hazard ratio, 2.87; P = 0.012), and high DCP Index (hazard ratio, 12.3; P < 0.0001).CONCLUSIONSThe prognosis of patients who had a high DCP Index score was poorer compared with patients who had a low DCP Index score and patients who were classified as DCP negative. The authors concluded that the DCP Index is a prognostic indicator for patients with HCC. Cancer 2003;98:2671–7. © 2003 American Cancer Society.
Should molecular testing be required for diagnosing synovial sarcoma?
Authors: Coindre Jean‐Michel , Pelmus Manuela , Hostein Isabelle , Lussan Catherine , Bui Binh N. , Guillou Louis 
Published: December 2003

AbstractBACKGROUNDThe t(X;18) translocation is a specific marker of synovial sarcomas (SS). Detection of SYT‐SSX transcripts by polymerase chain reaction (PCR) was tested on preselected specimens of well‐established histologic types, but to our knowledge, the diagnostic utility of molecular assays on a series of potential SS in comparison with conventional tools has never been reported.METHODSTwo hundred four consecutive cases of potential SS submitted for a second opinion were studied prospectively. On the basis of clinical context, histologic aspect, and immunohistochemical profile, the tumors were divided into three categories: 1) diagnosis of SS certain, when the only possible diagnosis was SS; 2) diagnosis of SS probable, when SS was the first diagnosis contemplated, but a differential diagnostic issue was raised by other tumors; 3) diagnosis of SS possible, when the diagnosis of SS was not the first diagnosis considered. Detection of SYT‐SSX transcripts was performed using real‐time PCR from fixed, embedded tissue as a systematic test.RESULTSSufficient RNA samples were recovered for PCR from 177 specimens (87%). One hundred four specimens (51%) were positive for SYT‐SSX transcripts. Tumor sites of SS included the extremities (n = 57), lung (n = 13), trunk wall (n = 12), head and neck (n = 6), and other sites (n = 16). There were 61 monophasic, 22 poorly differentiated, 17 biphasic, and 4 predominantly epithelial SS. For 58 tumor specimens (29%), diagnosis of SS was certain before molecular testing; 49 (84.5%) of these 58 contained SYT‐SSX transcripts. For 39 tumor specimens (19%), diagnosis of SS was probable; 29 (74.4%) of these 39 contained SYT‐SSX transcripts. For 107 tumor specimens (52%), diagnosis of SS was only possible and strongly challenged by another histologic type. The issue consisted mainly of making the distinction between an SS and a poorly differentiated spindle cell sarcoma (n = 49), a poorly differentiated round cell sarcoma (n = 34), a carcinoma (n = 11), a myoepithelioma (n = 8), or an epithelioid fibrosarcoma (n = 5).Twenty‐six tumor specimens (24.3%) contained SYT‐SSX transcripts—10, 7, 5, 3, and 1 in the spindle cell tumor, round cell tumor, carcinomalike tumor, myoepitheliomalike tumor, and epithelioid‐fibrosarcoma‐like tumor categories, respectively.CONCLUSIONSMolecular testing was not required if the diagnosis of SS was certain or probable on the basis of clinical, histologic, and immunohistochemical evaluation. However, it proved to be very helpful or necessary when the diagnosis of SS was only possible and was challenged by other tumor types, mainly other spindle cell sarcomas, round cell sarcomas, carcinomas, myoepitheliomas, and epithelioid fibrosarcomas. Cancer 2003;98:2700–7. © 2003 American Cancer Society.
Reassessment of the prognostic significance of hypodiploidy in pediatric patients with acute lymphoblastic leukemia
Authors: Raimondi Susana C. , Zhou Yinmei , Mathew Susan , Shurtleff Sheila A. , Sandlund John T. , Rivera Gaston K. , Behm Frederick G. , Pui Ching‐Hon 
Published: December 2003

AbstractBACKGROUNDThe purpose of the current study was to evaluate the cytogenetic features of the hypodiploid leukemic cells of pediatric patients with this rare subgroup of acute lymphoblastic leukemia (ALL). In addition, the authors determined whether subdivision of the hypodiploid category served a prognostic purpose for these patients.METHODSThe authors evaluated the cytogenetic records of 979 patients with ALL admitted to St. Jude Children's Research Hospital (Memphis, TN) between 1984 and 1999.RESULTSOf 67 patients (6.8%) whose leukemic cells contained a modal number (MN) of chromosomes less than or equal to 45 (i.e., hypodiploid leukemic cells), 57 had an MN of 45 and 10 had an MN of less than 45. In 19 patients, cells with an MN of 45 had a whole chromosome missing (42%), which was a sex chromosome in 12 patients (63%). Leukemic cells with an MN of 45 contained dicentric chromosomes (n = 33) formed from chromosome 9p (55%), 12p (18%), or both (21%). The ETV6‐CBFA2 fusion was present in 39% of 28 evaluable B‐lineage cases with an MN of 45. The event‐free survival rate (EFS) for patients with hypodiploid leukemic cells of MN less than 45 (5‐year EFS = 20.0% ± 10.3%) was significantly (P < 0.001) lower than that for patients with leukemic cells of MN greater than or equal to 45 (5‐year EFS = 74.9% ± 1.6%).CONCLUSIONSLow hypodiploidy (MN < 45) should be recognized as a high‐risk feature in pediatric ALL. Only two hypodiploid groups (MN < 45 and MN = 45) may be necessary in prognostic assessments. Cancer 2003;98:2715–22. © 2003 American Cancer Society.
Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation
Authors: Cassileth Barrie R. , Vickers Andrew J. , Magill Lucanne A. 
Published: December 2003

AbstractBACKGROUNDHigh‐dose therapy with autologous stem cell transplantation (HDT/ASCT) is a commonly used treatment for hematologic malignancies. The procedure causes significant psychological distress and no interventions have been demonstrated to improve mood in these patients. Music therapy has been shown to improve anxiety in a variety of acute medical settings. In the current study, the authors determined the effects of music therapy compared with standard care on mood during inpatient stays for HDT/ASCT.METHODSPatients with hematologic malignancy admitted for HDT/ASCT at two sites (Memorial Sloan‐Kettering Cancer Center and Ireland Cancer Center in Cleveland, Ohio) were randomized to receive music therapy given by trained music therapists or standard care. Outcome was assessed at baseline and every 3 days after randomization using the Profile of Mood States.RESULTSOf 69 patients registered in the study, follow‐up data were available for 62 (90%). During their inpatient stay, patients in the music therapy group scored 28% lower on the combined Anxiety/Depression scale (P = 0.065) and 37% lower (P = 0.01) on the total mood disturbance score compared with controls.CONCLUSIONSMusic therapy is a noninvasive and inexpensive intervention that appears to reduce mood disturbance in patients undergoing HDT/ASCT. Cancer 2003;98:2723–9. © 2003 American Cancer Society.
Salvage therapy in patients with glioblastoma
Authors: Hau Peter , Baumgart Ulrike , Pfeifer Katharina , Bock Anne , Jauch Tanya , Dietrich Jörg , Fabel Klaus , Grauer Oliver , Wismeth Caecilia , Klinkhammer‐Schalke Monika , Allgäuer Michael , Schuierer Gerhard , Koch Horst , Schlaier Juergen , Ulrich Winfried , Brawanski Alexander , Bogdahn Ulrich , Steinbrecher Andreas 
Published: December 2003

AbstractBACKGROUNDSurvival after first‐line therapy is poor for patients with glioblastoma. The role of second‐line treatment for recurrent disease is controversial. The authors studied the outcome in a subset of patients with glioblastoma who were selected for an aggressive reintervention strategy at the time of progression. Their objectives were to improve patients' overall survival with sustained quality of life and to make comparisons with overall survival in unselected patients.METHODSOverall, 168 patients were eligible for retrospective analysis. Ninety patients received specific therapy for disease recurrence (reintervention group) by specific criteria.RESULTSIn the reintervention group, promising median overall survival (mOS) results after diagnosis (61.5 weeks) and progression (33 weeks) were obtained. The progression‐free survival (PFS) rate at 12 months and the overall survival rate were superior in the reintervention group (71% at 12 months and 32% at 24 months) compared with the total cohort (45% and 20%, respectively) and the standard group (15% and 5%, respectively). A matched‐pair analysis (n = 46 in each group), with an mOS period of 65.5 versus 28.5 weeks, confirmed these data. Quality of life was stable or slightly improved during reinterventions in a subset of patients treated within clinical studies.CONCLUSIONSThe majority of patients in the current series were treated with a reintervention strategy, which had an impact on PFS and mOS. A second resection, focal radiotherapy (in selected cases), and additional chemotherapeutic regimens should be considered for patients with recurrent glioblastoma. Cancer 2003;98:2678–86. © 2003 American Cancer Society.