bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma
Authors: Wu Anna H. , Tseng Chiu‐Chen , Bernstein Leslie 
Published: August 2003

AbstractBACKGROUNDSince the 1970s, incidence rates of esophageal and gastric cardia adenocarcinoma have risen substantially. Reasons for the increasing trends are not well understood.METHODSA population‐based, case–control study that included esophageal adenocarcinomas (n = 222), gastric cardia adenocarcinomas (n = 277), distal gastric adenocarcinomas (n = 443), and 1356 controls was conducted in Los Angeles County. Unconditional logistic regression was used to calculate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the 3 tumor types.RESULTSAfter adjustment for demographic factors, smoking, and body size, both hiatal hernia and reflux symptoms emerged as significant independent risk factors. Risk of esophageal adenocarcinoma was increased 3‐fold (adjusted OR, 3.61; 95% CI, 2.49–5.25) among those who had reflux symptoms but did not have hiatal hernia, 6‐fold (adjusted OR, 5.85; 95% CI, 3.18–10.75) among those who had hiatal hernia but did not have reflux symptoms, and 8‐fold (adjusted OR, 8.11; 95% CI, 4.75–13.87) among those who had both reflux symptoms and hiatal hernia. A similar risk pattern was found in relation to history of hiatal hernia and other reflux conditions. A more modest but still significant risk pattern was observed for gastric cardia adenocarcinoma. Among control subjects, there was a significant and positive association between increasing body mass index and history of hiatal hernia and/or reflux symptoms.CONCLUSIONSHiatal hernia, in combination with other reflux conditions and symptoms, was associated strongly with the risk of esophageal adenocarcinoma. These associations were more modest for gastric cardia adenocarcinomas. A significant and positive association between body size and history of hiatal hernia/reflux symptoms also was observed. Cancer 2003;98:940–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11568
Natural history of surgically treated bladder carcinoma with extravesical tumor extension
Authors: Quek Marcus L. , Stein John P. , Clark Peter E. , Daneshmand Siamak , Miranda Gus , Cai Jie , Groshen Susan , Lieskovsky Gary , Quinn David I. , Raghavan Derek , Skinner Donald G. 
Published: August 2003

AbstractBACKGROUNDThe current TNM classification for bladder carcinoma stratifies extravesical extension into microscopic (pT3a) and macroscopic (pT3b) tumor involvement. The authors evaluated the outcomes of patients with pT3a and pT3b disease after radical cystectomy.METHODSPatients (n = 129) with transitional cell carcinoma of the bladder treated with radical cystectomy alone demonstrated pathologic extravesical tumor extension: 37 (29%) had pT3a disease and 92 (71%) had pT3b disease. No patient received any adjuvant therapy. With a median follow‐up of 13.6 years, the presence of lymph node involvement, margin positivity, local (pelvic) and distant disease recurrence, and clinical outcomes were determined.RESULTSOf the 129 patients, 43 (33%) had lymph node tumor involvement: 13 of 37 patients with pT3a disease (35%) and 30 of 92 patients with pT3b disease (33%). The 10‐year recurrence‐free and overall survival for the entire group was 54% and 20%, respectively. No statistical difference between pT3a and pT3b disease was observed with regard to recurrence‐free (P = 0.54) and overall (P = 0.66) survival. Lymph node involvement was predictive of a significantly worse 10‐year recurrence‐free survival (32%) compared with lymph node‐negative disease (60%; P = 0.003). Local disease recurrence was reported to occur in 12 patients (9%), whereas 37 patients (29%) were reported to develop distant metastases. Among those who had disease recurrence, the type of disease recurrence (local or distant) was not found to be associated with tumor stage (pT3a vs, pT3b, P = 0.47).CONCLUSIONSThis cohort of surgically managed patients provided insight into the long‐term natural history of pathologically confirmed extravesical bladder carcinoma after radical cystectomy. There was no important difference in the incidence of lymph node involvement, survival rates, and disease recurrence rates between patients with microscopic and macroscopic extravesical extension. Adjuvant protocols should be undertaken for these high‐risk patients to further improve on these clinical outcomes. Cancer 2003;98:955–61. © 2003 American Cancer Society.DOI 10.1002/cncr.11569
Zoledronic acid delays the onset of skeletal‐related events and progression of skeletal disease in patients with advanced renal cell carcinoma
Authors: Lipton Allan , Zheng Ming , Seaman John 
Published: August 2003

AbstractBACKGROUNDThe objective of this study was to assess the efficacy and safety of zoledronic acid in patients with bone metastases secondary to renal cell carcinoma (RCC).METHODSA retrospective subset analysis of patients with RCC enrolled in a multicenter, randomized, placebo‐controlled study of zoledronic acid was performed. Patients were randomized to receive zoledronic acid (4 or 8 mg as a 15‐minute infusion) or placebo with concomitant antineoplastic therapy every 3 weeks for 9 months. The primary efficacy analysis was the proportion of patients with one or more skeletal‐related events (SREs), which were defined as pathologic fracture, spinal cord compression, radiation therapy, or surgery to bone. Secondary analyses included time to first SRE, skeletal morbidity rate (events per year), disease progression, and multiple event analysis.RESULTSIn this subset of 74 patients with RCC, zoledronic acid (4 mg) was found to significantly reduce the proportion of patients with an SRE (37% vs. 74% for placebo; P = 0.015). Similarly, zoledronic acid significantly reduced the mean skeletal morbidity rate (2.68 vs. 3.38 for placebo; P = 0.014) and extended the time to the first event (median not reached vs. 72 days for placebo; P = 0.006). A multiple event analysis demonstrated that the risk of developing an SRE was reduced by 61% compared with placebo (hazard ratio of 0.394; P = 0.008). The median time to progression of bone lesions was significantly longer for patients who were treated with zoledronic acid (P = 0.014 vs. placebo). Zoledronic acid appeared to be well tolerated; the most common adverse events in all treatment groups included bone pain, nausea, anemia, and emesis.CONCLUSIONSZoledronic acid (4 mg as a 15‐minute infusion) demonstrated significant clinical benefit in patients with bone metastases from RCC, suggesting that further investigation of zoledronic acid in this patient population is warranted. Cancer 2003;98:962–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11571
Gemcitabine added to doxorubicin, bleomycin, and vinblastine for the treatment of de novo Hodgkin disease
Authors: Friedberg Jonathan W. , Neuberg Donna , Kim Helen , Miyata Sarah , McCauley Mary , Fisher David C. , Takvorian Tak , Canellos George P. 
Published: August 2003

AbstractBACKGROUNDGemcitabine is an effective treatment for recurrent Hodgkin disease (HD), with relatively minimal associated toxicity. The authors conducted a trial substituting this drug for dacarbazine in the standard regimen to form ABVG (doxorubicin, bleomycin, vinblastine, gemcitabine) for patients with newly diagnosed, high‐risk HD.METHODSTwelve patients (median age, 34 years) with advanced‐stage de novo HD were enrolled. Standard doses of doxorubicin, bleomycin, and vinblastine were given for six cycles. Cohorts of three patients were enrolled and the dose of gemcitabine was escalated to identify the maximally tolerated dose in this combination.RESULTSThe maximally tolerated dose of gemcitabine was determined to be 800 mg/m2 in this combination. Five patients developed clinically significant pulmonary toxicity. Three required hospitalization during the final two cycles of treatment. Pneumonitis could not be predicted with serial diffusion capacity for carbon monoxide (DECO) evaluations, and reversed after discontinuation of bleomycin in three patients and steroid therapy in two patients. All 12 patients are alive to date, and 4 patients have experienced disease progression.CONCLUSIONSThe bleomycin/gemcitabine combination should not be pursued for de novo HD due to significant pulmonary toxicity. Cancer 2003;98:978–82. © 2003 American Cancer Society.DOI 10.1002/cncr.11582
Differential gene expression in leiomyosarcoma
Authors: Skubitz Keith M. , Skubitz Amy P. N. 
Published: August 2003

AbstractBACKGROUNDLeiomyosarcomas (LMS) are a common subtype of soft tissue sarcoma. The molecular causes of the disease remain unclear.METHODSIn the current study, gene expression in LMS, leiomyomas, and normal myometrium was examined. RNA was prepared and gene expression was determined using microarray analysis arrays containing approximately 12,000 known genes and 48,000 expressed squence tags (ESTs).RESULTSA number of genes were found to be differentially expressed in these sample sets, and six genes including cyclin‐dependent kinase inhibitor 2A, diaphanous (Drosophila homolog) 3, doublecortin, calpain 6, interleukin‐17B, and proteolipid 1 were found to be overexpressed in LMS compared with normal myometrium and 18 other tissues. Sets of genes were identified whose expression could be used to cluster samples with either LMS, leiomyomas, or normal myometrium.CONCLUSIONSThe authors concluded that differences in gene expression can be detected between LMS and leiomyomas, normal myometrium, and other tissues, and that these changes in gene expression may yield clues with regard to the pathophysiology of leiomyosarcoma. Cancer 2003;98:1029–38. © 2003 American Cancer Society.DOI 10.1002/cncr.11586
Multicenter study of pegylated liposomal doxorubicin in patients with cutaneous T‐cell lymphoma
Authors: Wollina Uwe , Dummer Reinhard , Brockmeyer Norbert H. , Konrad Helga , Busch J.‐O. , Kaatz Martin , Knopf Burkhard , Koch Hans‐Jürgen , Hauschild Axel 
Published: August 2003

AbstractBACKGROUNDIn single center studies and case reports, it was shown that pegylated liposomal doxorubicin (PEG‐DOXO) was effective as second‐line therapy for patients with cutaneous T‐cell lymphoma (CTCL). The objective of this study was to evaluate the efficacy and toxicity of single‐agent PEG‐DOXO as second‐line chemotherapy in patients with CTCL.METHODSA retrospective, multicenter study was performed evaluating 34 patients (31 male patients and 3 female patients). Twenty‐seven patients received PEG‐DOXO 20 mg/m2, 5 patients received PEG‐DOXO 20–30 mg/m2, and 2 patients received PEG‐DOXO 40 mg/m2. PEG‐DOXO was administered intravenously every 2 weeks in 6 patients, every 2–3 weeks in 4 patients, and every 4 weeks in 23 patients. One patient received only a single course of PEG‐DOXO. Outcomes were evaluated, and adverse effects were recorded.RESULTSThirty‐four patients received at least 1 cycle of PEG‐DOXO. Disease was classified as mycosis fungoides in 28 patients, mycosis fungoides with follicular mucinosis in 2 patients, small or medium‐sized pleomorphic CTCL in 2 patients, Sèzary syndrome in 1 patient, and CD30 positive CTCL in 1 patient. Fifteen patients achieved a complete response (CR), including patients who achieved a CR and patients who achieved a CR defined by clinical criteria only with no biopsy (CRu), and 15 patients achieved a partial response (PR), resulting in a response rate (CRs, CRus, and PRs) of 88.2%. Two patients dropped out: one patient after a single PEG‐DOXO infusion because of Grade 3 capillary leakage syndrome and one patient after two cycles because of a suicide attempt that was not related to treatment or to CTCL. All other patients received at least four cycles of PEG‐DOXO. Overall survival was 17.8 months ± 10.5 months (n = 33 patients), event‐free survival was 12.0 months ± 9.5 months, and disease‐free survival was 13.3 ± 10.5 months (n = 16 patients). Adverse effects were seen in 14 of 34 patients (41.2%); they were temporary and generally mild. Only 6 patients had Grade 3 or 4 adverse effects.CONCLUSIONSThis multicenter study provided evidence of high efficacy of PEG‐DOXO monotherapy with a low rate of severe adverse effects compared with other chemotherapy protocols in patients with CTCL. Cancer 2003;98:993–1001. © 2003 American Cancer Society.DOI 10.1002/cncr.11593
Heat shock proteins HSP27, HSP60, HSP70, and HSP90
Authors: Lebret Thierry , Watson R. William G. , Molinié Vincent , O'Neill Amanda , Gabriel Christophe , Fitzpatrick John M. , Botto Henry 
Published: August 2003

AbstractBACKGROUNDHeat shock proteins (HSPs) are synthesized by cells in response to various stress conditions, including carcinogenesis. The expression of HSPs in neoplasia has been implicated in the regulation of apoptosis, and HSPs also can act by increasing immunity. In the current study, the authors attempted to clarify the significance of HSPs in bladder carcinoma and their effect on tumor behavior.METHODSExpression levels of the 27‐kilodalton HSP (HSP27), HSP60, HSP70, and HSP90 were studied using immunohistochemistry on tissue sections from 42 transitional cell carcinomas of the bladder (14 Grade 1 tumors; 13 Grade 2 tumors; 15 Grade 3 tumors, including 3 tumors associated with carcinoma in situ; 30 Stage Ta tumors; 7 Stage T1 tumors; and 5 Stage T2 tumors). Bladder specimens from 10 healthy patients were used as controls in the study. The selected patients had a mean follow‐up of 52 months (range, 24–78 months). Among the 37 patients with superficial bladder carcinoma, 17 patients did not have any recurrence after undergoing primary resection, and 20 patients developed recurrent disease, including 4 recurrences with muscle invasion. HSP expression was evaluated according to the percentage of positively stained cells, and loss of expression was defined as < 80% of stained cells.RESULTSIn normal bladder specimens, all four HSPs (HSP27, HSP60, HSP70, and HSP90) were expressed strongly in the cytoplasm and membrane from the basal cell layer to the superficial cell layer. Loss of expression was detected in tumors: respectively, 45.2%, 38.1%, 69.0% and 23.8% of tumors showed a loss of immunostaining for HSP27, HSP60, HSP70, and HSP90. No correlation between HSP expression and grade was found. Low expression levels of HSP27 and HSP60 were correlated with higher tumor stage (87% vs. 6% [P < 0.001] and 78% vs. 9% [P < 0.01], respectively). HSP60 and HSP90 expression levels were correlated with final outcome for patients with superficial bladder carcinoma: loss of expression was associated with the risk of developing an infiltrating recurrence (97% vs. 6.0% [P < 0.001] and 88.2% vs. 52.5% [P = 0.02] for HSP60 and HSP90, respectively).CONCLUSIONSHSPs were expressed in normal urothelium, and the current results indicated that loss of HSP60 and HSP90 expression may have prognostic relevance in patients with bladder carcinoma. The authors believe that HSP60 may be a very useful marker for patients with superficial bladder carcinoma and may be used for predicting disease progression. If these data are confirmed, low HSP60 expression levels may be usable as a prognostic marker to identify patients for whom local treatment would be insufficient. Cancer 2003;98:970–7. © 2003 American Cancer Society.DOI 10.1002/cncr.11594
Late genitourinary and gastrointestinal toxicity after magnetic resonance image‐guided prostate brachytherapy with or without neoadjuvant external beam radiation therapy
Authors: Albert Michele , Tempany Clare M. , Schultz Delray , Chen Ming‐Hui , Cormack Robert A. , Kumar Sanjaya , Hurwitz Mark D. , Beard Clair , Tuncali Kemal , O'Leary Michael , Topulos George P. , Valentine Kristin , Lopes Lynn , Kanan Angela , Kacher Daniel , Rosato James , Kooy Hanne , Jolesz Ferenc , Carr‐Locke David L. , Richie Jerome P. , D'Amico Anthony V. 
Published: August 2003

AbstractBACKGROUNDThis study was designed to estimate the rates of late genitourinary (GU) and rectal toxicity after magnetic resonance image (MRI)‐guided prostate brachytherapy exclusively or in conjunction with external beam radiation therapy (EBRT).METHODSBetween November 1997 and April 2002, 201 patients with category T1C prostate carcinoma (according to the 2002 American Joint Committee on Cancer staging criteria), prostate specific antigen levels < 10 ng/mL, and biopsy Gleason score 3 + 4 disease were treated with MRI‐guided brachytherapy exclusively or in conjunction with EBRT. The MRI‐guided technique was designed to spare the urethra based on delivery of the prescription dose to the peripheral zone exclusively. The Kaplan–Meier method was used to estimate rates of freedom from late GU and rectal toxicity. Comparisons were made using a log‐rank test.RESULTSAt a median follow‐up of 2.8 years (range, 0.5–5.0 years), the 4‐year estimates of rectal bleeding requiring coagulation for patients who underwent implantation therapy, compared with patients who received combined‐modality therapy, were 8% versus 30%, respectively (log‐rank P value = 0.0001). Although erectile dysfunction was common (range, 82–93%), with the use of sildenafil citrate (Viagra®), it was estimated that at least two‐thirds of patients had erectile function comparable to or superior to baseline function, independent of whether they received monotherapy or combined‐modality therapy (P = 0.46). The 4‐year estimate of freedom from radiation cystitis was 100% versus 95% (P = 0.01) for patients who received monotherapy and patients who received combined‐modality therapy, respectively. No urethral strictures were observed, and no patients underwent postimplantation transurethral resection of the prostate.CONCLUSIONSIn the current study, rectal bleeding after MRI‐guided prostate brachymonotherapy was infrequent, and urethral and bladder toxicity is reported to be rare and may be attributed to the urethral‐sparing technique of the MRI‐guided approach. Cancer 2003;98:949–54. © 2003 American Cancer Society.DOI 10.1002/cncr.11595
Evaluation of dietetic intervention in children with medulloblastoma or supratentorial primitive neuroectodermal tumors
Authors: Bakish Jaimie , Hargrave Darren , Tariq Nauman , Laperriere Normand , Rutka James T. , Bouffet Eric 
Published: August 2003

AbstractBACKGROUNDMalnutrition is a common complication of cancer treatment; it can affect energy levels and, as a consequence, quality of life. The goal of the current study was to evaluate the effect of dietetic intervention in a cohort of children treated for medulloblastoma and supratentorial primitive neuroectodermal tumors (PNET) over a 10‐year period.METHODSA retrospective chart review (1992–2002) of newly diagnosed cases of medulloblastoma/supratentorial PNET was performed. Hospital records were reviewed for data, including demographic characteristics, patient heights and weights, and information on treatment modalities and the use of dietetic intervention. Percent changes in body weight were calculated at time points associated with particular stages of treatment or dietetic intervention.RESULTSOne hundred three of 112 cases were evaluable. Treatment methods included surgery only (7.8%), surgery + radiotherapy (16.5%), surgery + chemotherapy (14.5%), and surgery + radiotherapy + chemotherapy (61.2%). There was no significant change in patient weight due to surgery (median change in body weight [MCBW], −0.35%) or radiotherapy (MCBW, −0.78%). In contrast, children experienced significant weight loss (MCBW, −4.35%; P < 0.0001) 3 months after starting chemotherapy. A dietician saw 53 of the 103 children in the study cohort. There were 84 dietetic interventions (oral, 36%; parenteral, 27%; enteral, 37%) among these 53 patients. Oral diets did not result in weight gain. Parenteral nutrition was associated with significant weight gain at 1 month (MCBW, +2.7%; P = 0.03), but not at 3 months. The use of enteral feeds resulted in significant weight gain at 1 month (MCBW, +4.8%; P = 0.006) and at 3 months (MCBW, +11.8%; P < 0.0001).CONCLUSIONSCurrent multimodality treatment of intracranial PNET results in significant nutritional morbidity, primarily due to the use of intensive chemotherapy regimens. Dietetic input for pediatric patients with medulloblastoma/PNET is essential, and the implementation of enteral feeding in these children can help to reverse their nutritional morbidity. Cancer 2003;98:1014–20. © 2003 American Cancer Society.DOI 10.1002/cncr.11598
Clinical implication and prognostic significance of the tumor suppressor TSLC1 gene detected in adenocarcinoma of the lung
Authors: Uchino Kazuya , Ito Akihiko , Wakayama Tomohiko , Koma Yu‐ichiro , Okada Tomoyo , Ohbayashi Chiho , Iseki Shoichi , Kitamura Yukihiko , Tsubota Noriaki , Okita Yutaka , Okada Morihito 
Published: August 2003

AbstractBACKGROUNDRecently, the TSLC1 (tumor suppressor in lung cancer 1) gene has been identified as a novel tumor suppressor in human nonsmall cell lung carcinoma. To the authors' knowledge, the clinical relevance of TSLC1 gene expression has not been studied using patient data and surgical samples. The current study was designed to evaluate whether the TSLC1 gene can serve as a target for the prognostic determination of patients with pulmonary adenocarcinoma.METHODSA total of 38 patients who were surgically treated for proven primary lung adenocarcinoma were enrolled in the current study. Surgical specimens were examined for TSLC1 protein expression immunohistochemically and by Western blot analysis. The correlation between levels of TSLC1 expression and pathologic characteristics, as well as prognosis, was investigated.RESULTSAll patients underwent a potentially curative resection of their tumor. TSLC1 antigen expression as evaluated by immunohistochemistry was confirmed by immunoblotting. The expression of TSLC1 protein was found to be inversely correlated with advanced disease stage, lymph node involvement, lymphatic permeation, and vascular invasion. The 4‐year overall survival rates of patients with a tumor demonstrating high (> 70% positive cells [n = 14 patients]), intermediate (20–70% positive cells [n = 10 patients]), and low (< 20% positive cells [n = 14 patients]) expression of the TSLC1 antigen were 84%, 28%, and 7%, respectively. In addition, the disease‐free survival of patients with a tumor that demonstrated a high percentage of TSLC1 protein‐positive cells was reported to be significantly better than that of patients with a tumor that showed a low percentage of TSLC1 protein‐positive cells.CONCLUSIONSThe loss or reduction of TSLC1 expression in resected lung adenocarcinoma cases was associated with a poor prognosis, indicating that TSLC1 represents a central effector gene for controlling the biologic aggressiveness of the tumor and that it is an essential biomarker for predicting patient prognosis. These data may help to detect those patients at high risk for recurrence who might benefit from additional therapeutic strategies such as adjuvant therapy. Cancer 2003;98:1002–7. © 2003 American Cancer Society.DOI 10.1002/cncr.11599