bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative ultrasonographic identification of the sentinel lymph node in patients with malignant melanoma
Authors: Kahle Birgit , Hoffend Johannes , Wacker Jörg , Hartschuh Wolfgang 
Published: April 2003

AbstractBACKGROUNDDissection of the “sentinel lymph node” (SLN) as identified by lymphoscintigraphy is becoming increasingly important in the treatment of patients with malignant melanoma. The purpose of the current study was to determine whether the SLN also could be identified by ultrasound.METHODSSixty‐seven patients with malignant melanoma (40 females and 27 males, with an average age of 48.8 years) in whom extirpation of the SLN was indicated underwent ultrasonography of the regional lymph nodes prior to preoperative lymphoscintigraphy. The location of the melanoma was the legs in 30 patients, the arms in 14 patients, and the trunk in 23 patients. During regional ultrasonography, the location of the lymph nodes that differed in the cortex/medulla ratio from the surrounding lymph nodes was marked on the skin corresponding to the planes of insonation (M1) when the probe was held vertically to the skin surface. After lymphoscintigraphy using technetium‐99m, the position of a gamma probe at which the highest count rate vertical to the skin surface was recorded also was marked (M2).RESULTSIn the inguinal region, the agreement between M1 and M2 was found to be 100% (40 of 40 SLNs) and was 72.5% in the axilla (29 of 40 SLNs). In patients with melanomas located on the leg, the location of M1 and M2 agreed in 97% of cases (36 of 37 lymph nodes in 30 patients); in patients with melanomas located on the arms, the agreement was 76% (13 of 17 lymph nodes in 14 patients) and in patients with melanomas located on the trunk, the agreement was 75% (21 of 28 lymph nodes in 23 patients). The position documented by ultrasound relative to the neighboring structures of the SLN was confirmed intraoperatively in all cases.CONCLUSIONSThe results of the current study indicate that the SLN in patients with melanoma located on the limbs, especially the legs, are characterized by a specific sonomorphologic pattern. Preoperative sonography might constitute an important addition to lymphoscintigraphy in the planning of SLN biopsy. Cancer 2003;97:1947–54. © 2003 American Cancer Society.DOI 10.1002/cncr.11261
Empiric risk of prostate carcinoma for relatives of patients with prostate carcinoma
Authors: Zeegers Maurice P.A. , Jellema Annemarie , Ostrer Harry 
Published: April 2003

AbstractBACKGROUNDAlthough narrative reviews have concluded that there is strong support for familial clustering of prostate carcinoma, the association has never systematically been quantified in reviews. The purpose of this meta–analysis was to summarize and quantify the recurrence risk ratio with emphasis on the degree of relation, the specific relationship of the family member, the number of affected family members, and the age at diagnosis.METHODSPublications were identified through computerized database searches for epidemiologic studies published up to December 2002. In addition, references cited in original and review papers were examined. Three blinded reviewers extracted both qualitative and quantitative information from each paper. Using random effects meta–regression analyses, the authors calculated summary recurrence risk ratios (Sλ). The reviewers also evaluated changes in Sλ according to differences in study methodology.RESULTSThirty–three epidemiologic studies were included in the current review. Sλ was 2.53 (95% confidence interval, 2.24–2.85) for first–degree family members. Sλ appeared to be greater for men with an affected brother than for men with an affected father. Sλ for men who had second–degree relatives with prostate carcinoma was only slightly elevated. The nature of the familial clustering is such that Sλ increases with decreasing age of the patient and family members, with increasing genetic relatedness of the affected relative, and with increasing number of individuals affected within a family.CONCLUSIONSThe studies that were reviewed consistently demonstrate that family history is a significant risk factor for development of prostate carcinoma. Cancer 2003;97:1894–903. © 2003 American Cancer Society.DOI 10.1002/cncr.11262
Clinical relevance of the expression of the CD31 ligand for CD38 in patients with B‐cell chronic lymphocytic leukemia
Authors: Ibrahim Sherif , Jilani Iman , O'Brien Susan , Rogers Anna , Manshouri Taghi , Giles Francis , Faderl Stefan , Thomas Deborah , Kantarjian Hagop , Keating Michael , Albitar Maher 
Published: April 2003

AbstractBACKGROUNDCD31 (platelet endothelial cell adhesion molecule‐1 [PECAM‐1]) is the ligand for CD38, a transmembrane glycoprotein that is expressed on the surface of leukemic cells in many patients with B‐cell chronic lymphocytic leukemia (B‐CLL). In a previous study, the authors showed that CD38 expression was correlated with a poor prognosis in patients with B‐CLL. In the current study, blood samples from patients with B‐CLL were examined to identify CD31 surface marker expression, and CD31 expression was correlated with several other known prognostic variables, including CD38.METHODSUsing flow cytometry, peripheral blood samples from 120 patients with B‐CLL were analyzed for CD31 and CD38 expression on CD19 positive leukemic B cells.RESULTSThirteen of 120 patients (11%) had CD31 expression on < 20% of their B cells, and the remaining patients had various levels of CD31 expression. The median expression of CD31 was 76% of leukemic, CD19 positive cells. Levels of CD31 expression were not correlated with survival outcomes or with any of the known prognostic parameters when all patients were considered. Patients who had high CD38 expression (≥ 20%), as expected, had significantly shorter survival (P = 0.001) compared with patients who had low CD38 expression (< 20%). However, in patients with low CD38 expression, a subgroup with low CD31 expression (< 76%) had significantly longer survival compared with the survival for the entire group (P = 0.0001). Moreover, the survival pattern of patients with low CD38 expression and high CD31 expression was not significantly different from the survival pattern seen in patients with high CD38 expression.CONCLUSIONSCD31 expression further defined a subgroup of patients with B‐CLL who had a different survival outcome. Defining the interaction between CD31 expression and CD38 expression in patients with CLL will require further exploration. Cancer 2003;97:1914–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11264
Cytokeratin expression patterns in low‐grade papillary urothelial neoplasms of the urinary bladder
Authors: Ramos David , Navarro Samuel , Villamón Rafael , Gil‐Salom Manuel , Llombart‐Bosch Antonio 
Published: April 2003

AbstractBACKGROUNDThe differential expression patterns of cytokeratin 20 (CK20) and 34βE12 antigen in low‐grade papillary urothelial tumors of the bladder are discussed.METHODSA retrospective study of 120 patients with low‐grade papillary bladder tumors (45 neoplasms of low malignant potential and 75 low‐grade WHO G1 carcinomas) was performed. All tumors were graded in accordance with the 1998 World Health Organization/International Society of Urological Pathology (WHO/ISUP) and 1999 WHO classifications. The mean follow‐up was 76.6 months (range, 36–168 mos), considering for prognostic purposes the time to first recurrence, or relapse‐free interval (RFI), and the total number of recurrent patients. Immunohistochemically, normal or abnormal CK20 and 34βE12 antigen expression patterns were determined for each patient. CK20 (clone IT‐Ks) and a high‐molecular weight cytokeratin (clone 34βE12) were the monoclonal antibodies used in the immunohistochemical study.RESULTSSeventy‐seven of 120 patients (64.2%) experienced a recurrence during follow‐up. In recurrence prediction, the differential expression pattern of both cytokeratins showed a high sensitivity (76.6% for CK20 and 80.5% for 34βE12 antigen) and a high positive predictive value (85.5% for CK20 and 75.6% for 34βE12 antigen), although specificity was higher for CK20 (76.7%) than it was for 34βE12 antigen (53.4%). Independent of adjuvant intravesical chemotherapy, these 2 markers showed a strong statistical correlation (p < 0.001) in univariate studies with both the prediction of disease recurrences and RFI.CONCLUSIONSCK20 and 34βE12 antigen have proved to be strong predictive markers of disease recurrences when considering different topographic expression profiles, and, in the authors' opinion, these profiles could be incorporated into follow‐up clinicopathologic strategies. Cancer 2003;97:1876–83. © 2003 American Cancer Society.DOI 10.1002/cncr.11265
Expression and prognostic role of tumor suppressor gene PTEN/MMAC1/TEP1 in hepatocellular carcinoma
Authors: Hu Tsung‐Hui , Huang Chao‐Cheng , Lin Pey‐Ru , Chang Hsueh‐Wen , Ger Luo‐Ping , Lin Yu‐Wei , Changchien Chi‐Sin , Lee Chuan‐Mo , Tai Ming‐Hong 
Published: April 2003

AbstractBACKGROUNDInactivation of the tumor suppressor gene PTEN/MMAC1/TEP1, located on chromosome 10q23, is a common event in advanced stages of diverse human malignancies. However, the prognostic role of PTEN expression in patients with hepatocellular carcinoma (HCC) has not been characterized.METHODSOne hundred five resected specimens were collected from patients with HCC. Expression levels of PTEN and p53 in clinical samples were analyzed by immunohistochemistry.RESULTSImmunohistochemical analysis of 105 HCC tissue specimens revealed that decreased or absence of PTEN immunostaining was found in 43 specimens (40.9%). Reduced PTEN expression levels were correlated with increased tumor grade (P = 0.017), advanced disease stage (P = 0.016), and elevated serum α‐fetoprotein (αFP) levels (P = 0.001). Kaplan–Meier analysis indicated that patients with reduced PTEN levels had shorter overall survival (P = 0.001) and higher recurrence rates (P = 0.0007) compared with patients who had intact PTEN expression. Examining p53 expression unveiled an inverse correlation between p53 overexpression and reduced PTEN expression in patients with HCC (P = 0.004). In addition, patients with p53 overexpression had shorter overall survival compared with patients who were without p53 overexpression (P = 0.0014). Univariate and multivariate analyses revealed that reduced PTEN expression was an independent prognostic factor for survival in patients with HCC.CONCLUSIONSThe current study demonstrated that reduced PTEN expression levels are involved in the pathogenesis of HCC. Moreover, decreased PTEN expression was correlated with tumor progression, high αFP levels, p53 overexpression, and poor prognosis in patients with HCC. Cancer 2003;97:1929–40. © 2003 American Cancer Society.DOI 10.1002/cncr.11266
Analysis of the Na,K‐ATPase α‐ and β‐subunit expression profiles of bladder cancer using tissue microarrays
Authors: Espineda Cromwell , Seligson David B. , James Ball William , Rao JianYu , Palotie Aarno , Horvath Steve , Huang Yunda , Shi Tao , Rajasekaran Ayyappan K. 
Published: April 2003

AbstractBACKGROUNDThe purpose of this study was to determine the clinical significance of Na,K‐ATPase α‐ and β‐subunit expression in a histopathologically well‐characterized group of patients representing a wide spectrum of tumor grades and disease stages with transitional cell carcinomas (TCC).METHODSNa,K‐ATPase α‐ and β‐subunit protein expression patterns were analyzed using immunohistochemistry on urothelial cancer tissue microarrays (TMA) of 146 patients diagnosed with urothelial carcinoma. For each subunit, the maximum staining intensity and the percentage of positive cells staining at the maximal intensity were analyzed.RESULTSCompared with the benign fields, the mean protein expression for both Na,K‐ATPase α‐ and β‐subunits were found to be decreased overall in in situ and invasive tumors, as well as in tumor‐adjacent dysplastic fields. When Na,K‐ATPase α‐ and β‐subunit expression levels were dichotomized into distinct groups, they were both found to be significant predictors of recurrence risk in multivariate logistic regression analysis (P = 0.0062, odds ratio [OR] = 2.6 and P = 0.013, OR = 0.43, for Na,K‐ATPase α‐ and β‐subunits, respectively). The authors also found that patients with high α‐ and low β‐subunit expression had a high risk for early recurrence, whereas patients with a low α‐ and high β‐subunit expression had a significantly longer median recurrence‐free time (17 months and 125 months, respectively, log rank statistics P = 0.0005).CONCLUSIONSThe results suggested that Na,K‐ATPase α‐ and β‐subunit expression levels may be useful predictors of clinical outcomes such as recurrence‐free time of bladder cancer patients. Cancer 2003;97:1859–68. © 2003 American Cancer Society.DOI 10.1002/cncr.11267
Refined prognostic evaluation in colon carcinoma using immunohistochemical galectin fingerprinting
Authors: Nagy Nathalie , Legendre Hugues , Engels Olivier , André Sabine , Kaltner Herbert , Wasano Kojiro , Zick Yehiel , Pector Jean‐Claude , Decaestecker Christine , Gabius Hans‐Joachim , Salmon Isabelle , Kiss Robert 
Published: April 2003

AbstractBACKGROUNDKnowledge of the expression of the galectins in human colon carcinomas is mainly restricted to galectin‐3 and, to a lesser extent, galectin‐1. The current study analyzed the prognostic values contributed by galectin‐1, galectin‐3, galectin‐4, and galectin‐8 in cases of colon carcinoma.METHODSThe authors selected 55 colon carcinomas (including 10 Dukes A, 16 Dukes B, 15 Dukes C, and 14 metastatic tumors that the authors labeled “Stage D”). The immunohistochemical levels of expression of the four galectins were determined quantitatively by means of computer‐assisted microscopy.RESULTSThe data from the current study indicate that the four galectins under study are associated with significant and separate prognostic values that depend on the Dukes stage of the colon tumor. In particular, the authors observed a significant prognostic value associated with galectins‐1, ‐3, and ‐4 in Dukes A and B colon tumors. In addition, significant prognostic value also was associated with galectin‐8 in Dukes C and D colon tumors. The prognostic values associated with the levels of expression of galectin‐1 and galectin‐4 in Dukes A and B tumors appear to be independent of the Dukes stage. The same feature was observed when galectin‐4 and galectin‐8 were analyzed in the complete series.CONCLUSIONSThe data from the current study strongly suggest that galectins‐1, ‐3, and ‐4 may be involved in the early stages of human colon carcinoma development and that galectin‐8 is involved in the later stages. Cancer 2003;97:1849–58. © 2003 American Cancer Society.DOI 10.1002/cncr.11268
Histopathologic score predicts recurrence free survival after radical surgery in patients with stage IA2–IB1–2 cervical carcinoma
Authors: Grisaru Dan A. , Covens Allan , Franssen Edmee , Chapman William , Shaw Patricia , Colgan Terence , Murphy Joan , DePetrillo Denny , Lickrish Gordon , Laframboise Stefane , Rosen Barry 
Published: April 2003

AbstractBACKGROUNDThe authors evaluated clinical and pathologic factors that predicted for recurrence after patients underwent radical surgery for International Federation of Gynecology and Obstetrics (FIGO) Stage IA2–IB1–2 cervical carcinoma and developed a simple method of scoring those predictive factors to quantify outcome.METHODSAn analysis was conducted of a prospective radical surgery cervical carcinoma data base. A Cox proportional hazards regression analysis was done for each of the individual factors to estimate individual risk ratios using all available data for each factor. Stepwise and best‐model options were used to identify the best combinations as predictors and to calculate adjusted risk ratios. Based on the information obtained, each patient was assigned a categorical score to predict recurrence. The variables used for the score were dichotomized. The differences between the scores in time to recurrence were evaluated using the log‐rank test to compare the time to recurrence curves that were generated with the Kaplan–Meier method.RESULTSEight hundred seventy‐one patients were included in the study, and 66 patients who developed recurrent disease after a median follow‐up of 49 months. Tumor size, maximum depth of invasion, pelvic lymph node status, tumor grade, and capillary lymphatic space (CLS) were single predictors for recurrence, and the score, which was based on combinations of these factors, predicted the disease free survival. Maximum depth of invasion, pelvic lymph node status, and CLS were the best combined predictors for recurrence, and they were used to form a second, precise scoring system to predict disease free survival (P < 0.0001; log‐rank test).CONCLUSIONSThe scoring system based on maximal depth of invasion, CLS, and pelvic lymph node metastases identified four strata of patients with distinct recurrence free survival. The incremental presence of each factor decreased recurrence free survival after patients underwent radical surgery. Patients with the presence of all three factors had a 5‐year recurrence free survival rate of 65%. These patients would be suitable for studies of postoperative adjuvant therapy to improve outcome. Cancer 2003;97:1904–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11269
Surgical margins in cutaneous melanoma (2 cm versus 5 cm for lesions measuring less than 2.1‐mm thick)
Authors: Khayat David , Rixe Olivier , Martin Ginette , Soubrane Claude , Banzet Martine , Bazex Jacques‐André , Lauret Philippe , Vérola Olivier , Auclerc Gérard , Harper Peter , Banzet Pierre 
Published: April 2003

AbstractBACKGROUNDThis study addressed the question of whether limited surgery for primary malignant melanoma with a 2‐cm margin is as good as a 5‐cm margin. An update of a 16‐year follow‐up is provided.METHODSNine European Centers, over a period of 5 years, prospectively randomized 337 patients with melanoma measuring less than 2.1 mm in thickness to undergo a local excision with either a 2‐cm or a 5‐cm margin. Three hundred twenty‐six patients were eligible for statistical analysis. Excluded from the trial were patients older than 70 years; those with melanomas from the toe, nail, or finger; and those with acral‐lentiginous melanoma. A separate randomization was performed to independently test an adjuvant treatment with a nonspecific immunostimulant, isoprinosine, compared with observation. The median follow‐up time was 192 months (16 years) for the estimation of survival and disease recurrences.RESULTSThere were 22 tumor recurrences in the 2‐cm arm and 33 in the 5‐cm arm. The median time to disease recurrence was 43 months and 37.6 months, respectively. The 10‐year disease‐free survival rates were 85% for the group with a 2‐cm margin and 83% for the group with a 5‐cm margin. There was no difference in the 10‐year overall survival rates (87% vs. 86%). Isoprinosine did not demonstrate any activity in this setting.CONCLUSIONSThe authors concluded that for melanoma less than 2.1‐mm thick, a margin of excision of 2 cm is sufficient. A larger margin of 5 cm does not appear to have any impact on either the rate or the time to disease recurrence or on survival. Cancer 2003;97:1941–6. © 2003 American Cancer Society.DOI 10.1002/cncr.11272
Dose escalation study of tezacitabine in combination with cisplatin in patients with advanced cancer
Authors: Flaherty Keith T. , Stevenson James P. , Gallagher Maryann , Giantonio Bruce , Algazy Kenneth M. , Sun Weijing , Haller Daniel G. , O'Dwyer Peter J. 
Published: April 2003

AbstractBACKGROUNDThe authors performed a dose escalation study of cisplatin and the novel deoxycytidine analog, tezacitabine, to determine the maximum tolerated dose of the combination.METHODSTwenty‐three patients with advanced cancer and good performance status were accrued to 3 dose levels of tezacitabine (150–270 mg/m2) and cisplatin (50 mg/m2). Using a 28‐day treatment cycle, both drugs were administered on Days 1 and 15.RESULTSHematologic toxicity was the most frequently observed side effect and was dose limiting. Grade 3 or 4 neutropenia and thrombocytopenia complicated 75% and 31% of all cycles, respectively. Nonhematologic toxicities were mild. Among 18 evaluable patients, 2 with upper gastrointestinal tract tumors achieved partial responses and 4 had stable disease.CONCLUSIONSBased on dose‐limiting neutropenia and thrombocytopenia at the highest dose level, the recommended Phase II doses are 200 mg/m2 of tezacitabine and 50 mg/m2 of cisplatin. Cancer 2003;97:1985–90. © 2003 American Cancer Society.DOI 10.1002/cncr.11273
Late anthracycline cardiotoxicity after childhood cancer
Authors: Sorensen Keld , Levitt Gill A. , Bull Catherine , Dorup Inge , Sullivan Ian D. 
Published: April 2003

AbstractBACKGROUNDThe objective of the current study was to examine the risk factors for progression in severity of anthracycline‐induced cardiac dysfunction, thereby providing information that is useful in refining cancer treatment regimes and guiding follow‐up.METHODSSerial echocardiograms were performed on 101 acute lymphoblastic leukemia survivors and 83 Wilms tumor survivors after a mean interval of 6.2 years and 6.7 years since last anthracycline dose, respectively, at first study, and after 10.3 years and 11.1 years, respectively, at second study. The paired data were contrasted with data from 100 normal subjects, and potential correlations with follow‐up interval, cumulative dose, cancer diagnosis, gender, age at diagnosis, and growth were explored using univariate and multiple regression techniques.RESULTSThe most important predictor of worsening cardiac performance was total anthracycline dose. As a group, patients receiving < 240 mg/m2 showed no deterioration of left ventricular end systolic stress at > 10 years from the end of treatment.CONCLUSIONSSurvivors who have received low‐dose anthracycline require cardiac surveillance infrequently. In good prognosis tumors, cumulative anthracycline dose should be maintained at < 250 mg/m2. Cancer 2003;97:1991–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11274