bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mammography screening among Chinese‐American women
Authors: Tu Shin‐Ping , Yasui Yutaka , Kuniyuki Alan A. , Schwartz Stephen M. , Jackson J. Carey , Hislop Thomas Gregory , Taylor Vicky 
Published: February 2003

AbstractBACKGROUNDBreast carcinoma is the most common major malignancy among several Asian‐American populations. This study surveyed mammography screening knowledge and practices among Chinese‐American women.METHODSIn 1999, the authors conducted a cross‐sectional, community‐based survey in Seattle, Washington. Bilingual and bicultural interviewers administered surveys in Mandarin, Cantonese, or English at participants' homes.RESULTSThe survey cooperation rate (responses among reachable and eligible households) was 72% with 350 eligible women (age ≥ 40 years with no prior history of breast carcinoma or double mastectomy). Seventy‐four percent of women reported prior mammography screening, and 61% of women reported screening in the last 2 years. In multivariate analysis, a strong association was found between mammography screening and recommendations by physicians and nurses (prior screening: odds ratio [OR], 16.0; 95% confidence interval [95% CI], 7.8–35.0; recent screening: OR, 7.0; 95% CI, 3.8–13.6). This finding applied to both recent immigrants (< 15 years in the U.S.) and earlier immigrants (≥ 15 years in the U.S.). Thirty‐two percent of women reported that the best way to detect breast carcinoma was a modality other than mammogram.CONCLUSIONSThe authors recommend a multifaceted approach to increase mammography screening by Chinese‐American women: recommendations from the provider plus targeted education to address the effectiveness of screening mammography compared with breast self examination and clinical breast examination. Cancer 2003;97:1293–302. © 2003 American Cancer Society.DOI 10.1002/cncr.11169
Refined measurement of outcome for adjuvant breast carcinoma therapy
Authors: Gamel John W. , Bonadonna Gianni , Valagussa Pinuccia , Edwards Michael J. 
Published: February 2003

AbstractBACKGROUNDTraditional nonparametric statistical methods do not provide a quantitative measure of the lifetime benefit from adjuvant therapy. This deficiency makes it difficult to determine the long‐term difference in impact between the two treatment arms of a clinical trial.METHODSTo assess the impact of breast carcinoma recurrence, parametric survival models were derived from two randomized, controlled clinical trials of adjuvant therapy for Stage II breast carcinoma. To assess time to death from causes other than breast carcinoma, actuarial models derived from 1980 Census data were used. These two models were then combined to estimate the mean time to event (MTE) as a function of patient age, with the event being either recurrence or death from other causes. The MTE was then used to measure the differential benefit between two arms of a clinical trial.RESULTSIn the first trial, differences in MTE between treatment groups varied from 2.7 years for 35‐year‐old patients to 1.4 years for 75‐year‐old patients. For this trial, the mechanism of survival benefit was an increase in time to recurrence. In the second trial, differences in MTE varied from 7.6 to 1.6 years over the same age ranges. For this trial, the mechanism of survival benefit was an increase in the likelihood of cure, i.e., an increase in the asymptote of the curve that represents proportion of patients without relapse.CONCLUSIONSWhen applied to data from controlled clinical trials, MTE offers a quantitative measure of long‐term outcome from adjuvant therapy. The greatest benefit is achieved when therapy that increases the likelihood of cure is provided to young patients. Cancer 2003;97:1139–46. © 2003 American Cancer Society.DOI 10.1002/cncr.11171
5‐Year mammography rates and associated factors for older women
Authors: Van Harrison R. , Janz Nancy K. , Wolfe Robert A. , Tedeschi Philip J. , Huang Xuelin , McMahon Laurence F. 
Published: February 2003

AbstractBACKGROUNDMajor national interventions occurred in the early and mid‐1990s to increase mammography screening rates among older women. The current study examined mammography utilization by older women during this period. Relation between mammography utilization and demographic measures and health care‐related factors also were examined.METHODSA cross‐sectional design examined variations in mammography during the 5 years between 1993 to 1997 in a representative sample of 10,000 female Medicare beneficiaries in Michigan age ≥ 65 years in 1993. Medicare and census data were used. Separate analyses were performed for having undergone any mammogram and, for the 5680 women who had undergone a mammogram, the number of mammograms. Relations were examined between mammography utilization and 15 demographic variables (e.g., age and African‐American race) and health care‐related variables (e.g., inpatient admissions and number of physicians involved in care).RESULTSIn the 5 years 43% of older women had no evidence of having undergone a mammogram. Those with any mammogram averaged 2.8 mammograms. Meaningful independent predictors of both having undergone a mammogram and having more than one mammogram were more physicians involved in care, fewer inpatient admissions, and younger age. Having undergone a mammogram also was found to be associated with seeing an obstetrician/gynecologist.CONCLUSIONSEven with screening mammography as a covered benefit and after several national informational campaigns, the current study found that in 5 years, 60% of older women either had not undergone a mammogram or had undergone only 1. Intervention efforts should emphasize screening based on functional status, not age. This message should be targeted to physicians as well as to older women without claims for recent mammograms and who are likely to be in good health. Cancer 2003;97:1147–55. © 2003 American Cancer Society.DOI 10.1002/cncr.11172
Is axillary lymph node dissection necessary in elderly patients with breast carcinoma who have a clinically uninvolved axilla?
Authors: Martelli Gabriele , Miceli Rosalba , De Palo Giuseppe , Coradini Danila , Salvadori Bruno , Zucali Roberto , Galante Emanuele , Marubini Ettore 
Published: February 2003

AbstractBACKGROUNDAxillary dissection in elderly patients with early‐stage breast carcinoma who do not have palpable axillary lymph nodes is controversial because of the associated morbidity of the surgery, reduced life expectancy of the patients, and efficacy of hormone therapy in preventing recurrences and axillary events.METHODSThe authors performed a retrospective analysis of 671 consecutive patients with breast carcinoma who were age ≥ 70 years and who underwent conservative breast surgery with axillary dissection (172 patients) or without axillary dissection (499 patients). Tamoxifen always was given. The effects of axillary dissection compared with no axillary dissection on breast carcinoma mortality and distant metastasis were analyzed using multiple proportional‐hazards regression models. Because the assignment to axillary treatment was nonrandom, covariate adjustments were made for baseline variables that influenced the decision to perform axillary dissection and for prognostic factors.RESULTSThe crude cumulative incidence curves for breast carcinoma mortality and distant metastasis did not appear to differ significantly between the two groups (P = 0.530 and P = 0.840, respectively). The crude cumulative incidences of axillary lymph node occurrence at 5 years and 10 years were 4.4% and 5.9%, respectively (3.1% and 4.1%, respectively, for patients with pT1 tumors).CONCLUSIONSElderly patients with breast carcinoma who have no evidence of axillary lymph node involvement may be treated effectively with conservative surgery and tamoxifen. Immediate axillary dissection is not necessary but should be performed in the small percentage of patients who later develop overt axillary lymph node involvement. Cancer 2003;97:1156–63. © 2003 American Cancer Society.DOI 10.1002/cncr.11173
Evaluation of an internet support group for women with primary breast cancer
Authors: Winzelberg Andrew J. , Classen Catherine , Alpers Georg W. , Roberts Heidi , Koopman Cheryl , Adams Robert E. , Ernst Heidemarie , Dev Parvati , Taylor C. Barr 
Published: February 2003

AbstractBACKGROUNDWomen with breast carcinoma commonly experience psychologic distress following their diagnosis. Women who participate in breast cancer support groups have reported significant reduction in their psychologic distress and pain and improvement in the quality of their lives. Web‐based breast cancer social support groups are widely used, but little is known of their effectiveness. Preliminary evidence suggests that women benefit from their participation in web‐based support groups.METHODSSeventy‐two women with primary breast carcinoma were assigned randomly to a 12‐week, web‐based, social support group (Bosom Buddies). The group was semistructured, moderated by a health care professional, and delivered in an asynchronous newsgroup format.RESULTSThe results indicate that a web‐based support group can be useful in reducing depression and cancer‐related trauma, as well as perceived stress, among women with primary breast carcinoma. The effect sizes ranged from 0.38 to 0.54. Participants perceived a variety of benefits and high satisfaction from their participation in the interventionCONCLUSIONSThis study demonstrated that the web‐based program, Bosom Buddies, was effective in reducing participants' scores on depression, perceived stress, and cancer‐related trauma measures. The effect size of the intervention was in the moderate range. Although web‐based social support groups offer many advantages, this delivery mechanism presents a number of ethical issues that need to be addressed. Cancer 2003;97:1164–73. © 2003 American Cancer Society.DOI 10.1002/cncr.11174
Pure versus follicular variant of papillary thyroid carcinoma
Authors: Zidan Jamal , Karen Drumea , Stein Moshe , Rosenblatt Edward , Basher Walid , Kuten Abraham 
Published: February 2003

AbstractBACKGROUNDThe follicular variant of papillary thyroid carcinoma (FVPTC) is a common subtype of papillary thyroid carcinoma. Few studies have compared the clinical behavior and treatment outcome of patients with FVPTC with the outcome of patients with pure papillary carcinoma (PTC). A retrospective study was performed to identify the influence of FVPTC compared with PTC on therapeutic variables, prognostic variables, and survival.METHODSA clinicopathologic analysis of 243 patients with papillary carcinoma was performed. One hundred forty‐three tumors were PTC, and 100 tumors were FVPTC. The following variables were evaluated: age at diagnosis, tumor size, stage of tumor, treatment, capsular invasion, and survival.RESULTSThe median follow‐up was 11.5 years. The median age was 43 years in the PTC group and 44 years in the FVPTC group. The median tumor size, disease stage, and type of initial surgery and iodine 131 ablation were similar. More patients had capsular invasion by the tumor and less metastases to cervical lymph nodes in the FVPTC group. The actuarial survival of patients age < 40 years was higher compared with the survival of patients age > 50 years in both groups. The 21‐year overall actuarial survival was 82% in patients with PTC and 86% in patients with FVPTC (P value not significant).CONCLUSIONSThe pathologic and clinical behaviors of PTC and FVPTC were comparable. Prognostic factors, treatment, and survival also were similar. Patients in both groups must be treated identically. Cancer 2003;97:1181–5. © 2003 American Cancer Society.DOI 10.1002/cncr.11175
Impact of a novel neoadjuvant and adjuvant hormone‐deprivation approach on quality of life, voiding function, and sexual function after prostate brachytherapy
Authors: Miller Nicole L. , Bissonette Eric A. , Bahnson Robert , Wilson John , Theodorescu Dan 
Published: February 2003

AbstractBACKGROUNDData demonstrate a benefit from neoadjuvant and adjuvant hormone‐deprivation therapy with luteinizing hormone‐releasing hormone agonists in patients who are treated with radiotherapy for localized prostate carcinoma; however, this approach has detrimental effects on quality of life (QOL). A cross‐sectional study was undertaken to evaluate the impact on QOL, voiding function, and sexual function of an alternative hormone‐deprivation approach.METHODSThree hundred fifty patients with clinical T1c–T2b prostate carcinoma were treated from March 1997 to August 2000 either with palladium 103 brachytherapy (BTM) without hormone therapy or with 8 months of adjuvant and neoadjuvant hormone‐deprivation therapy with an antiandrogen and finasteride (BTM+H), were mailed the Functional Assessment of Cancer Therapy (FACT) global well being QOL instrument (FACT‐G), the American Urological Association symptom score (AUASS), and specific items addressing urinary control and sexual function from validated instruments. Differences between treatment groups were assessed as a function of time since treatment.RESULTSSeventy‐two percent of patients responded to the questionnaire. No differences in overall FACT‐G scores, AUASS scores, or AUASS subscale scores between the BTM group and the BTM+H group were found. The BTM+H group initially had lower personal well being FACT‐G subscale scores, more urinary incontinence, and lower odds of attaining an erection sufficient for intercourse initially, although these differences disappeared with longer follow‐up.CONCLUSIONSThe use of neoadjuvant and adjuvant antiandrogen and finasteride with brachytherapy is associated with QOL equal to that of brachytherapy alone for the treatment of patients with localized prostate carcinoma, allowing the advantages of hormone manipulation in terms of tumor control without its downside. Cancer 2003;97:1203–10. © 2003 American Cancer Society.DOI 10.1002/cncr.11177
Elevation of cytokine levels in cachectic patients with prostate carcinoma
Authors: Pfitzenmaier Jesco , Vessella Robert , Higano Celestia S. , Noteboom Jennifer L. , Wallace David , Corey Eva 
Published: February 2003

AbstractBACKGROUNDApproximately 60–70% of patients with advanced prostate carcinoma (CaP) suffer from cachexia, one of the most devastating conditions associated with advanced malignant disease. The pathophysiology of cachexia is multifactorial, and several cytokines, such as tumor necrosis factor α (TNFα) and interleukin 1 (IL‐1), IL‐6, and IL‐8, may be involved. The objective of the current study was to determine whether cachexia associated with advanced CaP is accompanied by increased serum levels of TNFα, IL‐1β, IL‐6, and IL‐8.METHODSThe levels of TNFα, IL‐1β, IL‐6, IL‐8, and prostate specific antigen (PSA) were examined in serum samples from normal donors (n = 10 donors), from patients with organ‐confined CaP (n = 19 patients), from patients with advanced CaP without cachexia (n = 17 patients), and from patients with cachectic CaP (n = 26 patients). DPC Immulite and Abbott IMx Total‐PSA assays were used to determine cytokine and PSA levels, respectively.RESULTSLevels of TNFα, IL‐6, and IL‐8 were elevated significantly in the group of patients with advanced, cachectic CaP compared with patients who were without cachexia. In the cachectic patients, levels of TNFα were correlated positively with IL‐8, and there was no correlation between PSA levels and any of the cytokine levels. IL‐1β levels were below the limit of detection in all samples.CONCLUSIONSThe current results show that levels of TNFα, IL‐6, and IL‐8 were increased in CaP patients with cachexia. Increased levels of these cytokines were not correlated with PSA levels, suggesting that they are regulated by a mechanism that is independent of PSA synthesis. Additional fundamental research is needed to determine the mechanisms involved and to identify potential therapeutic targets in patients with cachexia. Cancer 2003;97:1211–6. © 2003 American Cancer Society.DOI 10.1002/cncr.11178
High‐dose weekly oral calcitriol in patients with a rising PSA after prostatectomy or radiation for prostate carcinoma
Authors: Beer Tomasz M. , Lemmon Dianne , Lowe Bruce A. , Henner W. David 
Published: February 2003

AbstractBACKGROUNDIn preclinical systems, calcitriol, the natural vitamin D receptor (VDR) ligand, has been found to demonstrate antiproliferative effects, although concentrations > 1 nM are required. Unlike daily dosing, weekly administration of oral calcitriol can safely achieve such blood calcitriol concentrations. This study sought to define the long‐term toxicity of this regimen and measure its effect on serum prostate specific antigen (PSA) levels in patients with hormone‐naïve prostate carcinoma.METHODSPatients with a rising serum PSA after prostatectomy and/or radiation and no prior systemic therapy for prostate carcinoma recurrence maintained a reduced calcium diet and received calcitriol 0.5 μg/kg orally once each week until a maximum of a four‐fold increase in the PSA.RESULTSTwenty‐two patients received treatment for a median of 10 months (range, 2–25+ months). Treatment was well tolerated with no Grade ≥ 3 toxicity and no hypercalcemia or renal calculi. No patient had a PSA response (50% reduction confirmed 4 weeks later). Three patients (14%, 95% CI 0–28%) had confirmed reductions in the PSA ranging from 10% to 47%. Statistically significant increases in the PSA doubling time (PSADT) were seen in three additional patients and no patient had a shorter PSADT after starting treatment. For the entire study population, the median PSADT increased from 7.8 months to 10.3 months (P = 0.03 by Wilcoxon signed rank test).CONCLUSIONSWeekly high‐dose calcitriol was found to be safe. The primary efficacy endpoint of 50% reduction in the serum PSA was not achieved with this therapy. Randomized studies are needed to further examine the impact of this therapy on prostate carcinoma progression. Cancer 2003;97:1217–24. © 2003 American Cancer Society.DOI 10.1002/cncr.11179
A randomized trial of liposomal daunorubicin and cytarabine versus liposomal daunorubicin and topotecan with or without thalidomide as initial therapy for patients with poor prognosis acute myelogenous leukemia or myelodysplastic syndrome
Authors: Cortes Jorge , Kantarjian Hagop , Albitar Maher , Thomas Deborah , Faderl Stefan , Koller Charles , Garcia‐Manero Guillermo , Giles Francis , Andreeff Michael , O'Brien Susan , Keating Michael , Estey Elihu 
Published: February 2003

AbstractBACKGROUNDBecause angiogenesis may play a role in the pathogenesis of acute myeloid leukemia (AML) and high‐risk myelodysplastic syndrome (MDS), and thalidomide (Th) has shown significant anti‐angiogenic activity, this study was designed to investigate the potential role of Th in the treatment of patients with AML and MDS and the possible role of a non–ara‐C‐containing regimen.METHODSAdults with AML or high‐risk MDS and cytogenetic abnormalities other than inv (16), t(8;21), ‐Y or ‐X were randomized to receive liposomal daunorubicin (DNX) and ara‐C (DA) or DNX and topotecan (DT). Within each arm, patients were randomized to receive chemotherapy alone (DA or DT) or with thalidomide (DATh or DTTh). Vascular endothelial growth factor (VEGF) plasma levels and microvascular density was measured before and after therapy. Eighty‐four patients (median age, 65 years; range, 27–84 years) were treated.RESULTSNone of 11 patients treated with DT or DTTh responded and these arms were closed. Seventeen of 37 patients treated with DA and 15 of 36 treated with DATh achieved an early complete remission. Median complete response duration was 38 and 34 weeks (P = 0.57) and median survival 35 and 28 weeks (P = 0.15), respectively. Patients with high pretreatment VEGF levels had an inferior survival. There was no significant difference in the changes in VEGF levels or microvascular density after treatment in patients who did versus those who did not receive thalidomide.CONCLUSIONSThe authors concluded that thalidomide in combination with chemotherapy does not result in clinical benefit in patients with AML or high‐risk MDS. Cancer 2003;97:1234–41. © 2003 American Cancer Society.DOI 10.1002/cncr.11180
Chromosomal aberrations of primary lung adenocarcinomas in nonsmokers
Authors: Wong Maria P. , Fung Lai‐Fan , Wang Elaine , Chow Wing‐Shun , Chiu Shui‐Wah , Lam Wah‐Kit , Ho Kwok‐Keung , Ma Edmond S. K. , Wan Thomas S. K. , Chung Lap‐Ping 
Published: February 2003

AbstractBACKGROUNDLung carcinoma is a common malignancy, and tobacco carcinogenesis is the major cause. Studies on individual genes or loci have suggested, that in tumors from nonsmokers, different genetic alterations are present compared with tumors from smokers. It is possible that distinct genetic pathways may be involved. However, the targets remain largely unknown; and, to the authors' knowledge, molecular cytogenetics studies on lung carcinomas from nonsmokers have not been reported.METHODSComparative genomic hybridization (CGH) analysis was performed on primary lung adenocarcinoma samples from 32 patients who never smoked to identify loci of frequent aberrations.RESULTSDifferent extents of aberration were found in 31 of the 32 samples studied. The most frequently altered locus was gain of 16p (59% of samples) followed by gain of 20q (44% of samples), with the minimal overlapping regions at 16p13.1‐p13.2 and 20q13.2, respectively. Other over‐represented loci with > 30% frequency were observed at 5p (34% of samples), 7p (41% of samples), 8q (31% of samples), 17q (34% of samples), and 19q (34% of samples); and high‐level DNA amplifications were detected at 1q, 7p, 12q, 19q, and 20q. DNA under‐representation was observed less commonly and included 8p (28% of samples), 9p (22% of samples), 13q (28% of samples), and 18q (38% of samples).CONCLUSIONSThe current study identified targets of frequent genetic aberration in primary adenocarcinomas from nonsmokers. Compared with reported CGH findings in the literature, the current findings suggest that DNA gain at 16p is the distinct aberration involved in these tumors. Other frequently altered loci involve commonly reported oncogenic and tumor suppressor loci, suggesting an overlap with the genetic pathways of tobacco‐induced lung carcinogenesis. Cancer 2003;97:1263–70. © 2003 American Cancer Society.DOI 10.1002/cncr.11183