bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carcinoid heart disease
Authors: Zuetenhorst Johanna M. , Bonfrer Johannes M. G. M. , Korse Catharina M. , Bakker Rob , van Tinteren Harm , Taal Babs G. 
Published: March 2003

AbstractBACKGROUNDSerotonin excretion plays a role in the development of carcinoid heart disease (CHD), but the exact pathogenesis is not known. In the current study, the authors evaluated 24‐hour urinary 5‐hydroxyindoleacetic acid (5‐HIAA) excretion, as well as plasma levels of transforming growth factor‐β (TGF‐β), fibroblast growth factor (FGF), and atrial natriuretic peptide (ANP) in patients with and without CHD determined by ultrasound examination.METHODSUrine and plasma samples were obtained for 37 patients and cardiac ultrasound was performed during follow‐up in 1999 and 2000. Median 5‐HIAA excretion was calculated for the period between diagnosis and ultrasound examination. CHD was defined as the thickening of the tricuspid valve with additional III–IV/IV tricuspid valve regurgitation.RESULTSCHD was found in 9 of 37 patients (24%). No significant differences were found for age, gender, presence, and duration of liver metastases. All CHD patients had symptoms of the carcinoid syndrome compared with 71% of the non‐CHD patients (P = 0.159). Median 5‐HIAA excretion was significantly higher in the CHD group compared with the non‐CHD group: 576 μmol/24 hours versus 233 μmol/24 hours (P = 0.02). No difference in TGF‐β and FGF plasma levels was observed between both groups (P = 0.139 and P = 0.985, respectively), nor was there a correlation with morphology of the tricuspid valve or degree of dilatation of the right atrium/ventricle. However, the CHD group had higher median ANP levels than the non‐CHD group: 48 ng/L and 25 ng/L, respectively (P = 0.026).CONCLUSIONSHigh levels of 5‐HIAA excretion and plasma ANP were found to be associated with CHD. No significant relation with TGF‐β or FGF was been found. Cancer 2003;97:1609–15. © 2003 American Cancer Society.DOI 10.1002/cncr.11226
Physical activity levels before and after a diagnosis of breast carcinoma
Authors: Irwin Melinda L. , Crumley Diane , McTiernan Anne , Bernstein Leslie , Baumgartner Richard , Gilliland Frank D. , Kriska Andrea , Ballard‐Barbash Rachel 
Published: March 2003

AbstractBACKGROUNDIncreased body weight at the time patients are diagnosed with breast carcinoma has been associated with an increased risk of recurrence and reduced survival. Weight gain also is common after diagnosis. Increasing physical activity (PA) after diagnosis may minimize these adverse outcomes. In this population‐based study, the authors investigated whether PA levels after diagnosis declined from prediagnosis levels and whether any changes in PA varied by disease stage, adjuvant treatment, patient age, or body mass index (BMI) in 812 patients with incident breast carcinoma (from in situ to Stage IIIa).METHODSTypes of sports and household activities and their frequency and duration for the year prior to diagnosis and for the month prior to the interview (i.e., 4–12 months postdiagnosis) were assessed during a baseline interview.RESULTSPatients decreased their total PA by an estimated 2.0 hours per week from prediagnosis to postdiagnosis, an 11% decrease (P < 0.05). Greater decreases in sports PA were observed among women who were treated with radiation and chemotherapy (50% decrease) compared with women who underwent surgery only (24% decrease) or who were treated with radiation only (23%; (P < 0.05). Greater decreases in sports PA were observed among obese patients (41% decrease) compared with patients of normal weight (24% decrease; P < 0.05).CONCLUSIONSPA levels were reduced significantly after patients were diagnosed with breast carcinoma. Greater decreases in PA observed among heavier patients implied a potential for greater weight gain among women who already were overweight. Randomized, controlled trials are needed to evaluate how PA may improve the prognosis for patients with breast carcinoma. Cancer 2003;97:1746–57. © 2003 American Cancer Society.DOI 10.1002/cncr.11227
Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease
Authors: Mariette Christophe , Balon Jean‐Michel , Piessen Guillaune , Fabre Sylvain , Van Seuningen Isabelle , Triboulet Jean‐Pierre 
Published: March 2003

AbstractBACKGROUNDDespite increasingly radical surgery for esophageal carcinoma, a large number of patients still experience recurrent disease soon after operation. The current study was undertaken to evaluate the pattern of recurrence after curative esophagectomy for cancer of the thoracic esophagus and to identify factors predictive of recurrent disease.METHODSA total of 439 consecutive patients discharged from the authors' institution following R0 resection between January 1982 and July 2002 were followed for evidence of recurrence over a mean interval of 37.3 (range, 1–207) months.RESULTSOverall 1‐, 3‐ and 5‐years survival rates were 91%, 54%, and 41%, respectively. Some 230 patients (52.4%) developed proven recurrence, of whom 24 were alive and 206 were dead at the time of writing. The median time to recurrence was 12.0 (range, 6–96) months, with a median survival thereafter of 7.0 (range, 0–83) months. The pattern of recurrence was local in 12.1%, regional in 20.5% (cervical 3.6%, mediastinal 14.8%, and abdominal 2.1%), and distant in 19.8%, respectively. The overall pattern of dissemination was significantly different according to the histologic subtype (P = 0.021). One hundred five (45.7%) of all recurrences occurred within 12 months of surgery, with local, regional, and distant recurrence occurring at a median of 14.0 (range, 6–77), 13.5 (range, 6–73), and 11.0 (range, 6–96) months, respectively; A factor predictive of recurrent disease was histologic tumor depth invasion (P = 0.001).CONCLUSIONSDepth of tumor invasion should be used to identify patients who will have recurrence within 12 months of operation, so that these patients may be either entered into trials of multimodality treatment or offered nonsurgical palliation. Cancer 2003;97:1616–23. © 2003 American Cancer Society.DOI 10.1002/cncr.11228
Sperm banking and rate of assisted reproduction treatment
Authors: Ragni Guido , Somigliana Edgardo , Restelli Liliana , Salvi Roberta , Arnoldi Mariangela , Paffoni Alessio 
Published: March 2003

AbstractBACKGROUNDSemen cryostorage remains the only proven method to preserve fertility in men with cancer. However, the necessity and the justification of banking spermatozoa have been questioned because it has been reported that only a small percentage of patients are referred for assisted reproductive technologies using frozen semen.METHODSA 15‐year cryopreservation program involving 776 men with malignant diseases who were referred to the study institution for semen cryopreservation before proceeding with chemotherapy and/or radiotherapy was reviewed. Data regarding cancer diagnosis, age, semen quality, and use of frozen semen were analyzed.RESULTSSperm banking was not performed for 90 of the 776 subjects (11.6%) because of azoospermia. Sperm quality was reduced in men with testicular carcinoma. To date, 36 of the 686 patients who had banked spermatozoa (5.2%) have attended the clinic for assisted conception treatments using frozen spermatozoa. Cumulative rates related to the use of frozen semen at 4, 8, and 12 years were 4.5%, 8.7%, and 11.8%, respectively. Relevant factors demonstrated to be significantly associated with a lower probability of using frozen material were a younger age at the time of cryostorage and a diagnosis of testicular carcinoma.CONCLUSIONSThe rate of referral for assisted reproductive techniques in patients who have banked their semen is low but tends to rapidly increase extending the length of follow‐up. The cumulative percentage of use is at least above 10% but a longer follow‐up is required to draw definitive conclusions. A diagnosis of testicular carcinoma is associated with a lower rate of use when compared with other cancers. Cancer 2003;97:1624–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11229
Molecular markers of outcome after radiotherapy in patients with prostate carcinoma
Authors: Pollack Alan , Cowen Didier , Troncoso Patricia , Zagars Gunar K. , von Eschenbach Andrew C. , Meistrich Marvin L. , McDonnell Timothy 
Published: March 2003

AbstractBACKGROUNDAbnormal expression of key proteins of the apoptotic pathway has been associated with poor prognosis, although there have been few studies of these correlations in patients with prostate carcinoma who are treated with radiotherapy. The current study examined the association between expression levels of Ki‐67, bcl‐2, bax, and bcl‐x in pretreatment biopsy specimens and patient outcome after definitive radiotherapy alone.METHODSArchival pretreatment prostate biopsy tumor tissue was retrieved from 106 patients with Stage T1–T3 prostate carcinoma who were treated at the University of Texas M. D. Anderson Cancer Center with external beam radiotherapy between 1987 and 1993. Expression levels of Ki‐67 (MIB‐1 staining; n = 106 patients), bcl‐2 (n = 77 patients), bax (n = 70 patients), and bcl‐x (both long and short splice variants; n = 72 patients) were determined by immunohistochemical staining. The Ki‐67 labeling index (Ki67‐LI) was available for all patients and was derived from the percentage of Ki‐67 positive cells. Biochemical failure after radiotherapy was defined as three consecutive rises in prostate specific antigen level on follow‐up. The median follow‐up was 62 months.RESULTSHigh Ki67‐LI (> 3.5%) expression was observed in 33% of patients, overexpression of bcl‐2 was observed in 16% of patients, altered bax expression was observed in 23% of patients, and altered bcl‐x expression was observed in 53% of patients. There was no correlation found between the biomarkers. Kaplan–Meier survival estimates of freedom from biochemical failure (bNED) and the log‐rank test revealed significantly lower rates in association with high Ki67‐LI, positive bcl‐2, and altered bax staining. No correlation was observed between bcl‐x staining and bNED. Cox proportional hazards multivariate analysis confirmed that bcl‐2 and bax were independent of pretreatment PSA level, Gleason score, disease stage, and Ki67‐LI in predicting bNED.CONCLUSIONSAbnormalities in the expression levels of bcl‐2 and bax were associated with increased failure after patients were treated for prostate carcinoma with external beam radiotherapy. These biomarkers appeared to be useful in categorizing patient risk further, beyond Ki‐67 staining and conventional clinical prognostic factors. Cancer 2003;97:1630–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11230
Anatomic distribution of periprostatic adipose tissue
Authors: Hong Heng , Koch Michael O. , Foster Richard S. , Bihrle Richard , Gardner Thomas A. , Fyffe Joanne , Ulbright Thomas M. , Eble John N. , Cheng Liang 
Published: March 2003

AbstractBACKGROUNDBecause the prostatic capsule is often indistinct, recognition of extraprostatic extension by carcinoma depends heavily on the identification of carcinoma cells in the periprostatic adipose tissue. However, the distribution of adipose tissue along the prostatic surfaces has not been studied extensively.METHODSThe authors analyzed the periprostatic adipose tissue in specimens from 100 patients treated with radical retropubic prostatectomy and bilateral pelvic lymphadenectomy for prostatecarcinoma. Each specimen was totally embedded and examined by the whole mount method. The presence or absence of adipose tissue on the anterior, posterior, right, and left surfaces of the prostate was determined and analyzed.RESULTSPeriprostatic adipose tissue was present on 48% of all prostatic surfaces examined. The distribution of periprostatic adipose tissue varied among the different surfaces of the prostate, with the anterior, posterior, right, and left surfaces showing 44%, 36%, 59%, and 57% adipose tissue, respectively. The amount of periprostatic adipose tissue was similar among specimens from operations performed by different surgeons (P = 0.72). However, nerve‐sparing procedures resulted in less adipose tissue (46%) than non‐nerve‐sparing procedures (54%) (P = 0.01).CONCLUSIONSLess than half of the prostatic surfaces examined were covered by adipose tissue. The absence of adipose tissue over large areas of the prostatic surface, especially the posterior surface, makes the evaluation of extraprostatic extension difficult and unreliable. Further refinement of the prostate carcinoma staging system is needed. Cancer 2003;97:1639–43. © 2003 American Cancer Society.DOI 10.1002/cncr.11231
Prediction of progression after radical nephrectomy for patients with clear cell renal cell carcinoma
Authors: Leibovich Bradley C. , Blute Michael L. , Cheville John C. , Lohse Christine M. , Frank Igor , Kwon Eugene D. , Weaver Amy L. , Parker Alexander S. , Zincke Horst 
Published: March 2003

AbstractBACKGROUNDThe objective of the current study was to develop an algorithm to predict progression to metastases after radical nephrectomy for patients with clinically localized renal cell carcinoma (RCC) to allow stratification of patients for potential adjuvant therapy trials.METHODSThe authors identified 1671 sporadic patients with clinically localized, unilateral clear cell RCC who underwent radical nephrectomy between 1970 and 2000. The clinical features examined included age, gender, smoking history, recent onset hypertension, performance status, and presenting symptoms. The pathologic features examined included surgical margins, tumor stage, regional lymph node status, tumor size, nuclear grade, histologic tumor necrosis, sarcomatoid component, cystic architecture, and multifocality. Metastases free survival was estimated using the Kaplan–Meier method. A multivariate Cox proportional hazards regression model was fit to determine associations between the clinical and pathologic features and distant metastases.RESULTSThe median follow‐up was 5.4 years (range, 0–31 years). Metastases occurred in 479 patients at a median of 1.3 years (range, 0–25 years) after nephrectomy. The estimated metastases free survival rates were 86.9% at 1 year, 77.8% at 3 years, 74.1% at 5 years, 70.8% at 7 years, and 67.1% at 10 years. Multivariate analysis showed that the following features were associated with progression to metastases: tumor stage, regional lymph node status, tumor size, nuclear grade, and histologic tumor necrosis (P < 0.001 for all).CONCLUSIONSIn patients with clear cell RCC, tumor stage, regional lymph node status, tumor size, nuclear grade, and histologic tumor necrosis showed statistically significant associations with progression to metastatic RCC. The authors present a scoring algorithm based on these features that can be used to predict disease progression after patients undergo radical nephrectomy for clinically localized clear cell RCC. Cancer 2003;97:1663–71. © 2003 American Cancer Society.DOI 10.1002/cncr.11234
Defects in the opioid growth factor receptor in human squamous cell carcinoma of the head and neck
Authors: McLaughlin Patricia J. , Stack Brendan C. , Levin Roger J. , Fedok Fred , Zagon Ian S. 
Published: March 2003

AbstractBACKGROUNDThe endogenous opioid peptide, [Met5]‐enkephalin, termed opioid growth factor (OGF), interacts with its receptor (OGFr) to play a role as a constitutively expressed inhibitory growth factor in the proliferation of epithelial cells. This study compared protein and gene expression of OGFr in surgical specimens of human squamous cell carcinoma of the head and neck (SCCHN) with normal epithelium.METHODSTissues from 64 patients with SCCHN and from 49 patients undergoing uvulapalatoplasty or tonsillectomy were utilized. Binding affinity and capacity were assessed by receptor binding assays and the levels of OGFr protein were determined by quantitative Western blot analysis. Immunohistochemistry assessed the presence and distribution of OGFr. Levels of OGFr mRNA were quantitated by Northern blot analysis. Protein and gene expressions of OGFr also were evaluated in the margins of SCCHN.RESULTSBinding analyses indicated nearly ninefold fewer OGFr binding sites in tumor tissue in comparison with normal samples. The OGFr protein levels were reduced fivefold in tumor tissues relative to normal epithelium. Values of OGFr mRNA were comparable in tumors and normal epithelium. Tumor margins had intermediate levels of protein and binding, but OGFr mRNA values were similar to those of normal specimens.CONCLUSIONSThese data demonstrate that OGFr is defective in SCCHN and that translation/posttranslation of OGFr protein, but not transcriptional levels of the OGFr gene, is involved. In addition, the attenuated levels of OGFr binding capacity may serve as a marker for SCCHN. These subnormal levels of OGFr may be responsible in part for tumor progression, diminishing the interaction of OGF with OGFr that aids in stabilizing cell replication by an inhibitory mechanism. Gene therapy to reinstate OGFr and/or function could provide a useful treatment for inhibiting tumor progression. Cancer 2003;97:1701–10. © 2003 American Cancer Society.DOI 10.1002/cncr.11237
Fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone plus rituximab and granulocyte‐macrophage–colony stimulating factor (GM‐CSF) alternating with methotrexate and cytarabine plus rituximab and GM‐CSF in patients with Richter syndrome or fludarabine‐refractory chronic lymphocytic leukemia
Authors: Tsimberidou Apostolia M. , Kantarjian Hagop M. , Cortes Jorge , Thomas Deborah A. , Faderl Stefan , Garcia‐Manero Guillermo , Verstovsek Srdan , Ferrajoli Alessandra , Wierda William , Alvarado Yesid , O'Brien Susan M. , Albitar Maher , Keating Michael J. , Giles Francis J. 
Published: March 2003

AbstractBACKGROUNDTherapy for patients with Richter syndrome (RS) or fludarabine‐refractory chronic lymphocytic leukemia (CLL) is unsatisfactory. A Phase II study was conducted to evaluate an alternating combination cytotoxic regimen given with rituximab and granulocyte‐macrophage–colony stimulating factor (GM‐CSF) in these patients.METHODSFludarabine‐refractory CLL was defined as failure to respond to most recent prior fludarabine‐containing regimen. Patients received up to six cycles of fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone (hyper‐CVXD) plus rituximab and GM‐CSF alternating with methotrexate and cytarabine plus rituximab and GM‐CSF. Response, toxicity, and survival data were compared with data from prior therapy with hyper‐CVXD alone in this patient group.RESULTSForty‐nine patients with RS (n = 30 patients) or refractory CLL (n = 19 patients) were treated on study. Nine patients (18%) achieved a complete remission, and 11 patients achieved a partial remission (22%), for an overall objective response (OR) rate of 41%. With a median follow‐up of 7.5 months and a maximum follow‐up of 15.2 months, the 12‐month failure free survival (FFS) rate was 27%, and the overall survival (OS) rate was 39%. Nine patients (18%) died during the first cycle of therapy, and two patients (4%) died during the second cycle. There were no significant differences between the rates of OR, OS, and FFS in the current study and those obtained with hyper‐CVXD alone on a prior study.CONCLUSIONSThe study regimen had activity and significant toxicity in patients with RS or fludarabine‐refractory CLL. It was not clearly better compared with hyper‐CVXD alone in this patient population. Cancer 2003;97:1711–20. © 2003 American Cancer Society.DOI 10.1002/cncr.11238
Comparison of allogeneic stem cell transplantation, high‐dose cytarabine, and autologous peripheral stem cell transplantation as postremission treatment in patients with de novo acute myelogenous leukemia
Authors: Tsimberidou Apostolia‐Maria , Stavroyianni Niki , Viniou Nora , Papaioannou Maria , Tiniakou Maria , Marinakis Theodoros , Skandali Anastasia , Sakellari Ioanna , Yataganas Xenophon 
Published: March 2003

AbstractBACKGROUNDPostremission therapy is critical in maintaining complete remission (CR) in patients with de novo acute myelogenous leukemia (AML). The aim of this trial was to compare allogeneic stem cell transplantation (SCT), high‐dose cytarabine (ara‐C; HiDAC), and autologous SCT as postremission therapy in patients with de novo AML.METHODSOne hundred twenty patients age ≤ 60 years with previously untreated AML (non‐M3) and a performance status score of ≤ 2 received induction therapy with 3 days of idarubicin and 7 days of ara‐C (IA). Patients in CR received one course of HiDAC. Subsequently, patients age ≤ 50 years with available HLA‐compatible donors were assigned to receive allogeneic SCT; patients with “favorable” cytogenetics received a second course of HiDAC; and all others were randomized to a second course of HiDAC or autologous SCT.RESULTSThe IA combination induced CR in 99 patients (82.5%). With a median follow‐up of 43 months (range, 18–64 years), the 3‐year survival and failure‐free survival (FFS) rates were 47% and 45%, respectively. The factors associated with longer survival were those identified for CR (i.e., age and cytogenetics). Forty‐nine patients (49%) received the assigned postremission therapy. Fifteen patients underwent allogeneic SCT. Nineteen patients underwent autologous SCT and 15 patients received a second course of HiDAC, after randomization. In the allogeneic SCT group, both the 3‐year survival and the FFS rates were 73%. In the autologous SCT and HiDAC groups, the 3‐year survival rates were 58% and 46%, respectively (P = 0.80), and the 3‐year FFS rates were 42% and 33%, respectively (P = 0.83).CONCLUSIONSThe three postremission treatment groups had comparable survival. Allogeneic SCT is associated with a prolonged FFS. Cancer 2003;97:1721–31. © 2003 American Cancer Society.DOI 10.1002/cncr.11240
Adjuvant irradiation for cervical lymph node metastases from melanoma
Authors: Ballo Matthew T. , Bonnen Mark D. , Garden Adam S. , Myers Jeffrey N. , Gershenwald Jeffrey E. , Zagars Gunar K. , Schechter Naomi R. , Morrison William H. , Ross Merrick I. , Kian Ang K. 
Published: March 2003

AbstractBACKGROUNDThe risk of regional disease recurrence after surgery alone for lymph node metastases from melanoma is well documented. The role of adjuvant irradiation remains controversial.METHODSThe medical records of 160 patients with cervical lymph node metastases from melanoma were reviewed retrospectively. Of these, 148 (93%) presented with clinically palpable lymph node metastases. All patients underwent surgery and radiation to a median dose of 30 grays (Gy) at 6 Gy per fraction delivered twice weekly. Surgical resection was either a selective neck dissection in 90 patients or local excision of the lymph node metastasis in 35 patients. Only 35 patients underwent a radical, modified radical, or functional neck dissection.RESULTSAt a median follow‐up of 78 months, the actuarial local, regional, and locoregional control rates at 10 years were 94%, 94%, and 91%, respectively. Univariate analysis of patient, tumor, and treatment characteristics failed to reveal any association with the subsequent rate of local or regional control. The actuarial disease‐specific (DSS), disease‐free, and distant metastasis‐free survival (DMFS) rates at 10 years were 48%, 42%, and 43%, respectively. Univariate and multivariate analyses revealed that patients with four or more involved lymph nodes had a significantly worse DSS and DMFS. Nine patients developed a treatment‐related complication requiring medical management, resulting in a 5‐year actuarial complication‐free survival rate of 90%.CONCLUSIONSAdjuvant radiotherapy resulted in a 10‐year regional control rate of 94%. Complications for all patients were rare and manageable when they did occur. The authors recommend adjuvant irradiation for patients with extracapsular extension, lymph nodes measuring 3 cm in size or larger, the involvement of multiple lymph nodes, recurrent disease, or any patient having undergone a selective therapeutic neck dissection. Cancer 2003;97:1789–96. © 2003 American Cancer Society.DOI 10.1002/cncr.11243