bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of a low‐fat, high fiber, fruit and vegetable intervention on rectal mucosal proliferation
Authors: Pfeiffer Ruth , McShane Lisa , Wargovich Michael , Burt Randall , Kikendall Walter , Lawson Michael , Lanza Elaine , Schatzkin Arthur 
Published: September 2003

AbstractBACKGROUNDBecause studies of diet and colorectal carcinoma tend to be large and complex, researchers have long been interested in the investigation of dietary exposures in relation to putative intermediate markers of large bowel malignancy, such as colorectal epithelial cell proliferation. The basic hypothesis underlying these investigations is that specific dietary components may reduce or increase the rate of cell proliferation, which, in turn, may reduce or increase neoplastic changes in the large bowel.METHODSThe authors assessed the effects of a 4‐year, low‐fat, high‐fiber, fruit and vegetable‐enriched dietary intervention on colorectal epithelial cell proliferation among 399 participants from the Polyp Prevention Trial, a randomized multicenter trial with adenoma recurrence as the primary endpoint. Rectal biopsies were taken from flat, normal appearing mucosa on patients at baseline, after 1 year, and after 4 years. Two assays, bromodeoxyuridine (Brd U) and proliferating cell nuclear antigen (PCNA), were used to evaluate two summary measures of proliferation: the labeling index (LI) and the proliferative height (PH).RESULTSThere were no significant differences between changes in LI and PH over the 4‐year period for the intervention and control groups. This finding parallels the finding in the larger primary study, in which the dietary intervention did not alter adenoma recurrence rates.CONCLUSIONSA low‐fat, high‐fiber, fruit and vegetable‐enriched dietary intervention did not alter rectal mucosal cell proliferation rates. Cancer 2003;98:1161–8. Published 2003 by the American Cancer Society.DOI 10.1002/cncr.11608
Non‐Hodgkin lymphoma in elderly patients
Authors: Bai Li‐Yuan , Yang Muh‐Hwa , Chiou Tzeon‐Jye , Liu Jin‐Hwang , Yen Chueh‐Chuan , Wang Wei‐Shu , Hsiao Liang‐Tsai , Chao Ta‐Chung , Chen Po‐Min 
Published: September 2003

AbstractBACKGROUNDThe annual incidence of non‐Hodgkin lymphoma (NHL) has increased over the past two decades in all age groups, including the elderly. Establishing guidelines for proper care for this segment of the population requires further information.METHODSBetween January 1993 and April 2002, 187 consecutive patients with NHL who were age 70 years or older were examined as part of the current study. Potential factors implicated in prognosis were analyzed for indolent lymphoma group and aggressive lymphoma group separately.RESULTSThe median patient age was 75 years (range, 70–90 years), and 83% of the patients examined were male. Fifty‐two patients (28%) had indolent lymphoma, and 135 patients (72%) had aggressive lymphoma. The complete remission rate was 33.3% for patients with indolent lymphoma and 35.9% for patients with aggressive lymphoma. Median overall survival was 41.5 months and 23.7 months for the indolent and aggressive lymphoma groups, respectively. The 1‐year and 5‐year survival rates were 76% and 32%, respectively, for patients with indolent lymphoma and 62% and 29%, respectively, for patients with aggressive lymphoma. Among patients with indolent lymphoma, poor prognosis was correlated with poor performance status (P = 0.0107), advanced disease stage (P = 0.0222), initial bone marrow involvement (P = 0.0069), and age greater than 80 years (P = 0.0486); however, none of these variables remained statistically significant after multivariate Cox regression. Among patients with aggressive lymphoma, the only prognostic factors that remained after multivariate analysis were performance status (P = 0.018) and age greater than 80 years (P = 0.029). For patients who received at least 2 courses of systemic chemotherapy, an anthracycline‐containing regimen did not affect the survival rate in either the indolent lymphoma group (P = 0.81) or the aggressive lymphoma group (P = 0.34). After stratification, it was found that patients with aggressive lymphoma who were in the high‐intermediate‐risk group (as determined by International Prognostic Index [IPI] score) benefited most from the anthracycline‐containing regimen (P = 0.0148).CONCLUSIONSPerformance status was identified as the major prognostic determinant for elderly patients with aggressive NHL. In addition, it was found that an anthracycline‐containing treatment regimen may be especially beneficial for patients in the high‐intermediate‐risk category as determined by IPI score. Cancer 2003;98:1188–95. © 2003 American Cancer Society.DOI 10.1002/cncr.11609
Lymphoblastic lymphoma of childhood and the LSA2‐L2 protocol
Authors: Mora Jaume , Filippa Daniel A. , Qin Jing , Wollner Norma 
Published: September 2003

AbstractBACKGROUNDUntil the 1970s, diffuse lymphoblastic lymphoma (DLBL) was considered incurable. With intensive multidrug regimens, the majority of patients can now be cured. In the current study, the authors present what to their knowledge is the longest follow‐up presented to date (median, 20 years for survivors) of the largest group of DLBL patients treated with a single protocol at a single institution.METHODSBetween 1971–1990, a total of 95 consecutive patients (age < 21 years) with DLBL were treated with the LSA2‐L2 protocol at the Memorial Sloan‐Kettering Cancer Center (MSKCC). Patients with Stage I‐II disease were treated for 2 years. In 1980, the protocol was modified and patients with Stage III and IV disease were treated for 3 years. In addition, before the modification, patients with Stage IV disease received a cumulative dose of 15,600 mg/m2 of cyclophosphamide for 3 years; after 1980, these patients received the same dosage as the other patients (i.e., 8400 mg/m2 for 2 years). Radiation therapy initially was administered to all patients with bulky disease in the primary tumor site. Until 1977, the dose of radiation was 20–55 grays (Gy); from 1977 to 1989, the dose was 20 Gy. After the fifth year of completion of treatment, all patients were evaluated comprehensively every 2 years.RESULTSThe overall survival (OS) of the patients was 79% with a median follow‐up of 20 years. The overall event‐free survival (EFS) was 75% (71 of 95 patients). Seventeen patients developed a disease recurrence and 15 died of disease. The OS and EFS rates for patients with Stages I‐II disease (n = 8) were 87% and 87%, respectively, and the OS and EFS rates for patients with Stage III disease (n = 41) were 90% and 85%, respectively. The OS and EFS for patients with Stage IVA disease (with bone marrow [BM] involvement of < 25%) (n = 19) were 79% and 73%, respectively, whereas the OS and EFS for patients with Stage IVB disease (BM involvement of > 25%) (n = 27) were 74% and 70%. Of the 29 patients with Stage IV disease who were treated with the original protocol, 7 died of disease (1 of 8 patients with Stage IVA disease and 6 of 21 patients with Stage IVB disease). Of the 17 patients with Stage IV disease who were treated with the modified protocol, 3 died of disease (2 of 11 patients with Stage IVA disease and 1of 6 patients with Stage IVB disease). Six patients developed secondary malignancies, four of whom died.CONCLUSIONSLong‐term EFS can be achieved in the majority of patients with widely disseminated pediatric DLBL. Chemotherapy alone appears to be sufficient prophylaxis against disease recurrence in the central nervous system. No disease‐related or treatment‐related deaths were reported to occur > 4.5 years after diagnosis in the current study. Cancer 2003;98:1283–91. © 2003 American Cancer Society.DOI 10.1002/cncr.11615
Genetic alterations in poorly differentiated endocrine carcinomas of the gastrointestinal tract
Authors: Pizzi Silvia , Azzoni Cinzia , Bassi Daniela , Bottarelli Lorena , Milione Massimo , Bordi Cesare 
Published: September 2003

AbstractBACKGROUNDThe molecular pathogenesis of poorly differentiated endocrine carcinomas of the gastrointestinal tract (GI PDECs) remains unclear. It has been suggested that these lesions either originate from multipotent stem cells that also can serve as the origin of nonendocrine adenocarcinomas or arise due to the dedifferentiation of well‐differentiated endocrine carcinomas (WDECs).METHODSTen gastric and 9 colorectal PDECs, 9 gastric WDECs, and 12 colorectal carcinomas (CRCs) were analyzed for loss of heterozygosity (LOH) at 11q13 (MEN1), 17p13.1 (p53), 3p14.2 (FHIT), 3p21.3 (RASSF1A), and 18q23 (DCC/DPC4/Smad2), and for immunohistochemical expression of p53, FHIT, Rb, and p16.RESULTSPDECs exhibited high fractional allelic loss (FAL; 0.49), with frequent (> 40%) alterations in p53, Rb, MEN1, FHIT, and 18q. No significant differences were found between gastric and colorectal PDECs. Gastric WDECs also exhibited high FAL (0.44), with frequent alterations in Rb and/or p16, MEN1, and 3p21. CRCs exhibited a low level of FAL (0.23), with frequent (> 50%) p16 and p53 alterations. When gastric PDECs and WDECs were compared, substantial similarities were found with respect to FAL (0.42 vs. 0.44) and with respect to individual gene alterations, except in p53, which was consistently altered only in PDECs. CRCs, which were characterized by a lower FAL (0.56 vs. 0.23) and which lacked alterations in both 3p and Rb, were found to be significantly different from colorectal PDECs.CONCLUSIONSGI PDECs demonstrated a high level of chromosomal instability; consistent inactivation of both the p53 and p16/Rb pathways; and frequent LOH at 3p (possibly involving FHIT), the MEN1 locus, and 18q. The profile of genetic alterations in PDECs was more consistent with the profile in WDECs than with the profile in CRCs. Cancer 2003;98:1273–82. © 2003 American Cancer Society.DOI 10.1002/cncr.11621
Choroid metastases: Clinical features and treatments in 123 patients
Authors: d'Abbadie Isabelle , Arriagada Rodrigo , Spielmann Marc , Lê Monique G. 
Published: September 2003

AbstractBACKGROUNDThe current study was performed to analyze the effects of radiotherapy and chemotherapy on visual improvement in patients with choroid metastases (CM), and to determine the clinical factors potentially related to the risk of death.METHODSOne hundred twenty‐three consecutive patients were diagnosed with CM at the Institut Gustave‐Roussy between 1966 and 1992. Treatment failure was defined as the absence of tumor regression or choroid tumor progression documented at the time of last ophthalmologic examination. The Cox proportional hazards model was used to estimate the risk of treatment failure associated with analyzed covariates.RESULTSApproximately 81% of the patients were women. The most frequent primary tumors were breast carcinoma (71%) and lung carcinoma (9%). Bilateral CM were found in 25% of patients. Sequential vinca alkaloid‐based chemoradiotherapy was reported to be significantly associated with a decreased rate of treatment failure compared with radiotherapy alone (relative risk [RR] = 0.3; 95% confidence interval [95% CI], 0.03–2.2). However, when considered separately, each type of treatment also decreased the risk of treatment failure (RR = 0.5 [95% CI, 0.3–0.8] for radiotherapy and RR = 0.4 [95% CI, 0.3–0.7] for chemotherapy). The total dose of radiotherapy (< 30 grays [Gy] vs. ≥ 30 Gy) was not found to modify treatment results. The 2‐year overall survival rate was 25% (95% CI, 17–34%). The risk of death was found to be correlated with the presence of metastases in the liver (P= 0.02) or lung pleura (P= 0.04) at the time of the diagnosis of CM.CONCLUSIONSSequential combination radiotherapy and vinca alkaloid‐based chemotherapy appear to be the most beneficial treatment modality. However, because treatments were not prescribed randomly, the results of the current study should be interpreted with caution. Cancer 2003;98:1232–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11622
High incidence of thromboembolism in patients with central nervous system lymphoma
Authors: Goldschmidt Neta , Linetsky Eduard , Shalom Edna , Varon David , Siegal Tali 
Published: September 2003

AbstractBACKGROUNDVenous thromboembolism (VTE) is a frequent complication in patients with cancer throughout the course of the disease. Patients with brain tumors are at particularly high risk for VTE, and several risk factors were found in patients with malignant glioma. To the authors' knowledge, the incidence of VTE in patients with central nervous system (CNS) lymphoma is not known, and possible risk factors have not been identified to date. The objective of this study was to evaluate the frequency and risk factors of VTE in patients with CNS lymphoma.METHODSThe authors retrospectively evaluated the medical records of 42 patients with CNS lymphoma who were treated at their center between 1992 and 2001.RESULTSIt was found that 25 patients (59.5%) had VTE, and, in 3 patients (7%), the VTE was fatal. The authors could not demonstrate that age or ambulatory status could predict VTE in this group of patients, but almost all VTE events occurred during the early period of intensive therapy.CONCLUSIONSThe high incidence of VTE found in this study indicates that anticoagulant prophylaxis with low‐molecular‐weight heparin probably outweighs the risk and cost of such therapy. A prospective evaluation of newly diagnosed patients with CNS lymphoma is underway at the authors' center. Cancer 2003;98:1239–42. © 2003 American Cancer Society.DOI 10.1002/cncr.11623
Prognosis for patients with thin cutaneous melanoma
Authors: McKinnon J. Gregory , Yu Xue Qin , McCarthy William H. , Thompson John F. 
Published: September 2003

AbstractBACKGROUNDEstimates of long‐term survival for patients with thin (≤ 1 mm) primary cutaneous melanomas vary widely. Two separate methods were used to study the survival of patients with melanoma from New South Wales (NSW), Australia, and from the Sydney Melanoma Unit (SMU).METHODSThe NSW Central Cancer Registry (NSWCCR) provided data on all patients who were diagnosed with cutaneous melanomas that measured ≤ 1 mm thick between 1983 and 1998, inclusive. Patients with metastases at the time of diagnosis were not included, leaving 18,088 patients for analysis. The SMU data base was analyzed to extract data for all patients with thin melanomas who met the same criteria from 1979 to 1998, inclusive. All patients who had their primary tumors treated definitively elsewhere were excluded, leaving 2746 patients for analysis. Ten‐year Kaplan–Meier survival rates were calculated, and significant differences were determined using log‐rank analysis. Prognostic factors were evaluated with Cox proportional hazards analysis.RESULTSThe NSWCCR analysis revealed a 10‐year survival rate of 96.4%. The 10‐year survival rate for patients at SMU was 92.7%. Among the patients at SMU who died, the median time to recurrence was 49.8 months, and the median time to death was 65.9 months. The 10‐year survival for patients at SMU who had lesions that measured ≤ 0.75 mm was 96.9% compared with 84.3% for patients who had lesions that measured 0.76–1.0 mm. For patients who had ulcerated melanomas measuring ≤ 1 mm thick, the 10‐year survival rate was 83%, compared with 92.3% for patients who had nonulcerated melanomas.CONCLUSIONSThe results of the current study confirmed the excellent survival rate for patients with thin melanomas. Higher‐risk subsets of patients who may warrant consideration for aggressive investigation and treatment are identifiable. Cancer 2003;98:1223–31. © 2003 American Cancer Society.DOI 10.1002/cncr.11624
The risk of multiple primary breast and thyroid carcinomas
Authors: Adjadj Élisabeth , Rubino Carole , Shamsaldim Akhtar , Lê Monique G. , Schlumberger Martin , de Vathaire Florent 
Published: September 2003

AbstractBACKGROUNDSome studies have suggested that there is an association between breast carcinoma and thyroid carcinoma. Because ionizing radiation is a well known risk factor for breast and thyroid carcinomas, the authors studied the effect of the radiation dose delivered for the treatment of each of these two malignancies on the risk of subsequently developing the other malignancy.METHODSThe risk of developing thyroid carcinoma subsequent to treatment for breast carcinoma was analyzed in 8 patients (cases) and 192 matched control patients (controls) nested in a cohort of 7711 women who were treated at Institut Gustave Roussy between 1954 and 1983. The risk of developing breast carcinoma after treatment for thyroid carcinoma was studied in a cohort of 2365 women who were treated in 3 French cancer centers between 1934 and 1995.RESULTSSix of 8 patients with breast carcinoma (75%) who developed thyroid carcinoma and 71% of patients in the control group received radiation therapy during their treatment. The median dose to the thyroid was 6.6 grays (Gy) in the case group and 9.4 Gy in the control group. The overall relative risk of thyroid carcinoma associated with radiation therapy was 1.2 (95% confidence interval, 0.2–6.2). No relation was observed between the radiation dose and the risk of thyroid carcinoma (P = 0.8). Among 2365 women who were treated for thyroid carcinoma, 48 women developed a subsequent breast carcinoma. A significant excess of breast carcinoma was observed among women younger than 59 years at the time of diagnosis of breast carcinoma compared with women in the same age group in the general population. The mean absorbed dose delivered to the breasts by 131I and external radiation therapy was 0.7 Gy. No relation was found between the radiation dose and the risk of breast carcinoma (P = 0.8).CONCLUSIONSThe previously reported excess incidence of breast carcinoma after thyroid carcinoma was not related to radiation treatment with 131I and/or external radiation therapy. Radiation therapy for breast carcinoma did not increase the risk of subsequent thyroid carcinoma. Cancer 2003;98:1309–17. © 2003 American Cancer Society.DOI 10.1002/cncr.11626
Intensive chemotherapy with cyclophosphamide, doxorubicin, high‐dose methotrexate/ifosfamide, etoposide, and high‐dose cytarabine (CODOX‐M/IVAC) for human immunodeficiency virus–associated Burkitt lymphoma
Authors: Wang Eunice S. , Straus David J. , Teruya‐Feldstein Julie , Qin Jing , Portlock Carol , Moskowitz Craig , Goy Andre , Hedrick Eric , Zelenetz Andrew D. , Noy Ariela 
Published: September 2003

AbstractBACKGROUNDIn the era of highly active antiretroviral therapy (HAART), standard‐dose chemotherapy for human immunodeficiency virus (HIV)‐associated diffuse large B‐cell lymphoma is becoming the standard of care. In contrast, the safety and efficacy of intensive regimens have not been established for Burkitt lymphoma (BL), a highly aggressive lymphoma for which moderate‐dose chemotherapy is substandard in the HIV‐negative population.METHODSTo evaluate the feasibility of intensive chemotherapy in HIV‐associated BL, the authors retrospectively reviewed 14 HIV‐positive adults with BL treated at their center between 1988 and 2000. Eight patients were treated between 1996 and 2000 with cyclophosphamide, doxorubicin, high‐dose methotrexate/ifosfamide, etoposide, and high‐dose cytarabine (CODOX‐M/IVAC), one of the currently preferred intensive‐dose chemotherapy regimens for BL. Six received other chemotherapy. Outcomes were compared with those of 24 HIV‐negative adult patients with BL who had similar patient characteristics and were treated concomitantly (13 with CODOX‐M/IVAC; 11 with other regimens).RESULTSOf the 14 HIV‐positive patients, 63% had a complete response after CODOX‐M/IVAC treatment, compared with 67% of patients receiving other chemotherapy. The 2‐year event‐free survival (EFS) rates were 60% and 60% after CODOX‐M/IVAC or other regimens, respectively. Similar outcomes were seen despite the fact that 88% of CODOX‐M/IVAC‐treated HIV‐positive patients had Stage IV disease, compared with one‐third of HIV‐positive patients treated with other chemotherapy. HIV status did not adversely affect long‐term EFS independent of the treatment regimen (P = 0.88). When EFS was evaluated according to chemotherapy regimen independent of HIV status, CODOX‐M/IVAC was found to be associated with improved EFS (P = 0.05) in all patients, and particularly those at high risk. HIV‐positive patients treated with CODOX‐M/IVAC tolerated chemotherapy well with similar rates of myelosuppression and infectious complications as HIV‐negative patients.CONCLUSIONSThe current nonrandomized retrospective study suggested that intensive chemotherapy with CODOX‐M/IVAC is feasible and well tolerated in HIV‐positive adults with BL. In the post‐HAART era, intensive chemotherapy such as CODOX‐M/IVAC may be appropriate in all adult patients with BL, and especially those with poor prognostic factors, regardless of HIV status. Cancer 2003;98:1196–205. © 2003 American Cancer Society.DOI 10.1002/cncr.11628
Craniofacial surgery for malignant skull base tumors
Authors: Patel Snehal G. , Singh Bhuvanesh , Polluri Ashok , Bridger Patrick G. , Cantu Giulio , Cheesman Anthony D. , deSa Geraldo M. , Donald Paul , Fliss Dan , Gullane Patrick , Janecka Ivo , Kamata Shin‐etsu , Kowalski Luiz P. , Kraus Dennis H. , Levine Paul A. , dos Santos Luiz R. M. , Pradhan Sultan , Schramm Victor , Snyderman Carl , Wei William I. , Shah Jatin P. 
Published: September 2003

AbstractBACKGROUNDMalignant tumors of the skull base are rare. Therefore, no single center treats enough patients to accumulate significant numbers for meaningful analysis of outcomes after craniofacial surgery (CFS). The current report was based on a large cohort that was analyzed retrospectively by an International Collaborative Study Group.METHODSOne thousand three hundred seven patients who underwent CFS in 17 institutions were analyzable for outcome. The median age was 54 years (range, 1–98 years). Definitive treatment prior to CFS had been administered in 59% of patients and included radiotherapy in 367 patients (28%), chemotherapy in 151 patients (12%), and surgery in 523 patients (40%). The majority of tumors (87%) involved the anterior cranial fossa. Squamous cell carcinoma (29%) and adenocarcinoma (16%) were the most common histologic types. The margins of surgical resection were reported close/positive in 412 patients (32%). Adjuvant postoperative radiotherapy was received by 510 patients (39%), and chemotherapy was received by 57 patients (4%).RESULTSPostoperative complications were reported in 433 patients (33%), with local wound complications the most common (18%). The postoperative mortality rate was 4%. With a median follow‐up of 25 months, the 5‐year overall, disease‐specific, and recurrence‐free survival rates were 54%, 60%, and 53%, respectively. The histology of the primary tumor, its intracranial extent, and the status of surgical margins were independent predictors of overall, disease‐specific, and recurrence‐free survival on multivariate analysis.CONCLUSIONSCFS is a safe and effective treatment option for patients with malignant tumors of the skull base. The histology of the primary tumor, its intracranial extent, and the status of surgical margins are independent determinants of outcome. Cancer 2003;98:1179–87. © 2003 American Cancer Society.DOI 10.1002/cncr.11630