bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence of patients with colorectal carcinoma under care in the U.S.
Authors: Mariotto Angela , Warren Joan L. , Knopf Kevin B. , Feuer Eric J. 
Published: September 2003

AbstractBACKGROUNDPrevalence usually is defined as the proportion of individuals alive who previously had a diagnosis of the disease, regardless of whether the individuals still are receiving treatment or are cured. The objective of this study was to estimate the proportion of elderly patients with colorectal carcinoma (CRC) in the U.S. that actually were receiving care for their disease as a better quantification of the burden of CRC.METHODSThe authors used data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program linked to Medicare claims. Four phases of CRC care were defined: initial diagnosis and treatment, postdiagnostic monitoring, treatment for recurrent/metastatic disease, and terminal care. CRC care prevalence measures by phase were extrapolated to the U.S. population age 65 years and older.RESULTSFor all patients with CRC who were diagnosed between 1975 and 1996, 62% received at least 1 service related to their CRC in 1996, and patients received an average of 2.1 months per person of CRC care. Among the U.S. population age 65 years and older, 1.81% had 1 diagnosis of CRC, and (1.81% × 0.62%) = 1.12% received at least 1 service related to their CRC. This translated to 380,783 individuals who received care and 1,210,121 person months of care during 1996.CONCLUSIONSTo the authors' knowledge, this is the first report in which care prevalence has been estimated directly. The classification of CRC care by phases of care provides a very detailed picture of the amount of care delivered in the U.S. population. Person‐month estimates can be used to estimate the cost of CRC. Cancer 2003;98:1253–61. Published 2003 by the American Cancer Society.DOI 10.1002/cncr.11631
Cancer rates among American Indians and Alaska Natives
Authors: Swan Judith , Edwards Brenda K. 
Published: September 2003

AbstractBACKGROUNDTwo important goals of cancer surveillance are to provide milestones in the effort to reduce the cancer burden and to generate observations that form the basis for cancer research and intervention for cancer prevention and control. Determination of the cancer burden among American Indians and Alaska Natives (AIAN) has been difficult largely due to lack of data collection efforts in many areas of the country and misclassification of racial data that results in undercounting of Native Americans. There is a revitalized commitment to improve data collection among the national agencies and organizations.METHODSData on cancer trends from 12 areas covered by the Surveillance, Epidemiology and End Results (SEER) Program were reviewed for incidence and death rates for 1992–2000. AIAN trends were examined and compared with trends among other racial/ethnic population groups. Reference was made to studies of disease‐specific survival for nine of the SEER areas for 1988–1997.RESULTSIn SEER areas, cancer incidence rates for AIAN populations appeared to be decreasing significantly for lung and breast cancers among women and for prostate cancer among men. However, death rates rose, although not significantly, over the same period, except for a significant decrease in prostate cancer. Among the cancers with rising death rates were lung cancer (AIAN women) and colorectal cancer (AIAN men). In addition, survival often was lower for AIAN populations.CONCLUSIONSAlthough the incidence was stable or decreased among AIAN populations, increased death rates and lower survival rates indicate the need for intensified application of cancer prevention and control measures, including screening and treatment. Difficulties in interpretation of data include small population size and substantial interregional differences in rates. Cancer 2003;98:1262–72. Published 2003 by the American Cancer Society.DOI 10.1002/cncr.11633
Childbearing and survival after breast carcinoma in young women
Authors: Mueller Beth A. , Simon Michael S. , Deapen Dennis , Kamineni Aruna , Malone Kathleen E. , Daling Janet R. 
Published: September 2003

AbstractBACKGROUNDMany young patients with breast carcinoma have not started, or completed, their desired families. How childbearing after a diagnosis of breast carcinoma affects survival is of importance to these women and their families. The authors measured relative mortality among young patients with breast carcinoma with and without births occurring after diagnosis.METHODSThe authors conducted a cohort study using data from three population‐based cancer registries in the U.S. (Seattle, Detroit, and Los Angeles), linked to birth certificate data in each state. Four hundred thirty‐eight women younger than 45 years of age with primary invasive breast carcinoma were identified as having births after diagnosis. In addition, 2775 comparison women, matched on the basis of age at the time of diagnosis, race/ethnicity, diagnosis year, disease stage, and presence of previous nonbreast primary tumors, were identified among those with breast carcinoma without births after diagnosis. Relative mortality was assessed using multivariable statistical methods.RESULTSAfter adjustment for stage of disease, age at diagnosis, study region, diagnosis year, and race/ethnicity, women with births occurring 10 months or more after diagnosis had a significantly decreased risk of dying (relative Risk [RR] = 0.54, 95% confidence interval [CI], 0.41–0.71) compared to women without subsequent births. Women pregnant at the time of diagnosis had a mortality rate similar to those who did not give birth (RR = 1.10, 95% CI, 0.80–1.60).CONCLUSIONSThe results of the current study, in light of growing evidence from other studies using various methods, may provide some reassurance to young women with breast carcinoma that subsequent childbearing is unlikely to increase their risk of mortality. Cancer 2003;98:1131–40. © 2003 American Cancer Society.DOI 10.1002/cncr.11634
Prostate carcinoma presentation, diagnosis, and staging
Authors: Miller David C. , Hafez Khaled S. , Stewart Andrew , Montie James E. , Wei John T. 
Published: September 2003

AbstractBACKGROUNDBased on the 1998 Patient Care Evaluation (PCE) from the American College of Surgeons National Cancer Data Base (NCDB), the authors described contemporary nationwide patterns of prostate carcinoma presentation, diagnosis, and staging.METHODSThe authors reviewed 54,212 cases from the 1998 PCE. Demographics, presenting signs and symptoms, tumor characteristics, prostate biopsy techniques, and use of staging modalities were evaluated.RESULTSThe mean age of patients in the sample was 68 years. Among patients with available data, 87.5% had a prostate specific antigen (PSA) level of 4 ng/mL or higher, 83.1% had American Joint Committee on Cancer (AJCC) Stage I–II lesions, 80.2% had well or moderately differentiated cancers, and 68.7% of newly diagnosed patients were asymptomatic. Compared with symptomatic patients, asymptomatic patients were more likely to have localized disease (84.6% vs. 78.2%, P < 0.01) and well or moderately differentiated tumors (82.2% vs. 74.6%, P < 0.01). Transrectal ultrasound‐guided prostate biopsy was the most common method of tissue confirmation (45.4%). Radionuclide bone scintigraphy was the most frequently employed staging modality (48.7%). Use of various staging evaluations was more frequent among patients at increased risk for disseminated disease (PSA > 10 ng/mL and/or high‐grade tumors) versus patients at lower risk (PSA ≤ 10 and low to moderate‐grade tumors) for metastatic disease (P < 0.005).CONCLUSIONSMost newly diagnosed patients with prostate carcinoma are asymptomatic and have moderately differentiated and organ‐confined disease. Compared with symptomatic patients, tumors in asymptomatic men are associated with lower pretreatment PSA levels, AJCC stage, and tumor grade. Selective use of staging evaluations, based on risk of metastatic disease, may be relatively uncommon. The NCDB remains a unique and rich source of novel patient care information and serves as a national point of reference for prostate carcinoma presentation, diagnosis, and staging. Cancer 2003;98:1169–78. © 2003 American Cancer Society.DOI 10.1002/cncr.11635
Internal tandem duplication and Asp835 mutations of the FMS‐like tyrosine kinase 3 (FLT3) gene in acute promyelocytic leukemia
Authors: Shih Lee‐Yung , Kuo Ming‐Chung , Liang Der‐Cherng , Huang Chein‐Fuang , Lin Tung‐Liang , Wu Jin‐Hou , Wang Po‐Nan , Dunn Po , Lai Chang‐Liang 
Published: September 2003

AbstractBACKGROUNDThe clinical relevance of mutations of the FMS‐like tyrosine kinase 3 (FLT3) gene in specific cytogenetic subgroups is not clear. The authors examined internal tandem duplication (ITD) and Asp835 mutations of FLT3 in patients with acute promyelocytic leukemia (APL) to determine the incidence of these mutations and to analyze the results for correlations with clinicohematologic features and outcome.METHODSBone marrow samples from 107 patients with APL were analyzed. Isoforms of PML‐RARα were identified using a reverse transcription–polymerase chain reaction assay. A standard polymerase chain reaction (PCR) assay was used to detect FLT3/ITD mutations. Asp835 mutations were analyzed by PCR amplification of exon 20 followed by EcoRV digestion. All aberrant PCR products subsequently were sequenced.RESULTSTwenty‐two patients had FLT3/ITD mutations: 9 of 63 patients with L‐type PML/RARα, 13 of 34 patients with S‐type PML/RARα, and 0 of 10 patients with V‐type PML/RARα (P = 0.005). The incidence of FLT3/ITD mutations was significantly higher in patients with S‐type PML/RARα than in patients with L‐type PML/RARα or V‐type PML/RARα. Twenty patients had Asp835 mutations (L‐type PML/RARα: n = 11; S‐type PML/RARα: n = 8; V‐type PML/RARα: n = 1). The frequency of Asp835 mutations was not significantly different among patients with different PML/RARα isoforms (P = 0.582). Three patients had both ITD and Asp835 mutations. The microgranular variant (M3v) form of leukemia was found to be associated with a higher frequency of ITD (P = 0.002) but not with a higher frequency of Asp835 mutations (P = 1.000); analysis of clinicohematologic variables revealed no significant differences in FLT3 mutation incidence among other patient subgroups. There was no significant difference in complete remission rate, overall survival, or event‐free survival between patients with ITDs and those without ITDs or between patients with Asp835 mutations and those without Asp835 mutations.CONCLUSIONSThe current study found that ITD or Asp835 mutations of the FLT3 gene were present in 36.4% of patients with APL; however, these mutations had no prognostic impact. FLT3/ITD frequently was associated with S‐type PML/RARα and with the M3v form of leukemia. Cancer 2003;98:1206–16. © 2003 American Cancer Society.DOI 10.1002/cncr.11636
Outcome of children with centrally reviewed low‐grade gliomas treated with chemotherapy with or without radiotherapy on Children's Cancer Group high‐grade glioma study CCG‐945
Authors: Fouladi Maryam , Hunt Daniel L. , Pollack Ian F. , Dueckers Gregor , Burger Peter C. , Becker Laurence E. , Yates Allen J. , Gilles Floyd H. , Davis Richard L. , Boyett James M. , Finlay Jonathan L. 
Published: September 2003

AbstractBACKGROUNDThe objectives of the current study were to determine the outcome of children who were treated with chemotherapy and radiotherapy on the Children's Cancer Group (CCG) high‐grade glioma protocol (CCG‐945) who were diagnosed with low‐grade gliomas on post hoc central pathologic review and to identify clinical and biologic features associated with prognosis.METHODSBetween 1985 and 1991, 250 children with institutionally classified high‐grade gliomas were enrolled on CCG‐945. Patients older than 24 months with intracranial lesions were assigned randomly to receive either lomustine, vincristine, and prednisone (control regimen) or the 8‐drugs‐in‐1‐day regimen (experimental regimen); younger patients and those with primary spinal cord tumors were assigned nonrandomly to the experimental regimen. Central independent review by 5 neuropathologists led to a reclassification of low‐grade glioma in 70 patients, who were the focus of the current study.RESULTSThe study involved 42 males and 28 females (median age, 7.7 years) with a median follow‐up of 10.4 years. At 5 years, the progression‐free survival (PFS) rate was 63% ± 6%, and the overall survival (OS) rate was 79% ± 5%, compared with a PFS rate of 19% ± 3% (P< 0.0001) and an OS rate of 22% ± 3% (P< 0.0001) in the remainder of the cohort. Significantly poorer 5‐year PFS was seen in children younger than 24 months, those with fibrillary astrocytoma, and those with posterior fossa tumors. Patients demonstrated a modest improvement in PFS but no improvement in OS compared with children with low‐grade gliomas who were treated with contemporary chemotherapy‐alone approaches.CONCLUSIONSThe current report calls attention to the importance of central pathologic review in large multiinstitutional trials of children with gliomas and suggests that aggressive front‐line combined chemoradiotherapy does not confer a survival advantage in this highly selected population of patients. Cancer 2003;98:1243–52. © 2003 American Cancer Society.DOI 10.1002/cncr.11637
Older women with breast carcinoma are less likely to receive adjuvant chemotherapy
Authors: Woodard Stacy , Nadella Padma C. , Kotur Linda , Wilson John , Burak William E. , Shapiro Charles L. 
Published: September 2003

AbstractBACKGROUNDOlder women with breast carcinoma are less likely than younger women to receive adjuvant chemotherapy. The authors hypothesized that after controlling for confounders (i.e., variables related to both age and chemotherapy use) and effect modifiers (i.e., variables that have a significant interaction with age), age would become a less significant factor for predicting adjuvant chemotherapy use.METHODSData on 480 women with localized breast carcinoma were entered into the National Comprehensive Cancer Network database at The Ohio State University Medical Center. Women were divided into 3 groups: women age < 50 years (n = 143 [30%]), women ages 50–65 years (n = 216 [45%]), and women age > 65 years (n = 121 [25%]). Chi‐square and Wilcoxon rank sum tests were used for univariate analyses of the variables of interest, and logistic regression was used for multivariate analyses.RESULTSAfter adjustment for confounders (stage, tumor size, progesterone receptor status, and lymph node involvement) and effect modifiers (namely, estrogen receptor [ER] status), the odds of not receiving chemotherapy for women ages 50–65 years and women age > 65 years with ER‐positive breast carcinoma were approximately 6 (odds ratio [OR], 6.4; 95% confidence interval [CI], 3.1–13.3; P < 0.001) and 62 (OR, 62.4; 95% CI, 21.8–178.7; P < 0.001) times greater, respectively, than the odds for women age < 50 years. Women ages 50–65 years with ER‐negative breast carcinoma were not significantly different from women age < 50 years with respect to chemotherapy use (OR, 1.9; 95% CI, 0.5–7.3; P = 0.374). However, the odds of not receiving chemotherapy for women age > 65 years with ER‐negative breast carcinoma were 7 times (OR, 6.7; 95% CI, 1.5–30.6; P = 0.013) greater than the odds for women age < 50 years.CONCLUSIONSThe results of the current study indicate that based on older age alone, women are less likely to receive adjuvant chemotherapy. In addition, the results suggest that age bias may contribute to undertreatment and lack of accrual of older women into clinical trials. Cancer 2003;98:1141–9. © 2003 American Cancer Society.DOI 10.1002/cncr.11640
Treatment of postmastectomy lymphedema with low‐level laser therapy
Authors: Carati Colin J. , Anderson Sandy N. , Gannon Bren J. , Piller Neil B. 
Published: September 2003

AbstractBACKGROUNDThe current study describes the results of a double blind, placebo‐controlled, randomized, single crossover trial of the treatment of patients with postmastectomy lymphedema (PML) with low‐level laser therapy (LLLT).METHODSParticipants received placebo or one cycle or two cycles of LLLT to the axillary region of their affected arm. They were monitored for reductions in affected limb volume, upper body extracellular tissue fluid distribution, dermal tonometry, and range of limb movement.RESULTSThere was no significant improvement reported immediately after any of the treatments. However, the mean affected limb volume was found to be significantly reduced at 1 month or 3 months of follow‐up after 2 cycles of active laser treatment. Approximately 31% of subjects had a clinically significant reduction in the volume of their PML‐affected arm (> 200 mLs) approximately 2–3 months after 2 cycles of treatment. There was no significant effect of placebo treatment, or one cycle of laser treatment, on affected limb volume. The extracellular fluid index of the affected and unaffected arms and torso were reported to be significantly reduced at 3 months after 2 cycles of laser therapy, and there was significant softening of the tissues in the affected upper arm. Treatment did not appear to improve range of movement of the affected arm.CONCLUSIONSTwo cycles of laser treatment were found to be effective in reducing the volume of the affected arm, extracellular fluid, and tissue hardness in approximately 33% of patients with postmastectomy lymphedema at 3 months after treatment. Cancer 2003;98:1114–22. © 2003 American Cancer Society.DOI 10.1002/cncr.11641
Combination of early bisphosphonate administration and irradiation leads to improved remineralization and restabilization of osteolytic bone metastases in an animal tumor model
Authors: Krempien Robert , Huber Peter E. , Harms Wolfgang , Treiber Martina , Wannenmacher Michael , Krempien Burkhardt 
Published: September 2003

AbstractBACKGROUNDThe goal of the current study was to analyze the combined effect of bisphosphonates (BPs) and irradiation on remineralization and restabilization of osteolytic bone metastases in an animal tumor model.METHODSBone metastases were induced in male Wistar rats via intraosseous injection of the Walker carcinosarcoma 256B cell line into both proximal tibia metaphyses on Day 1 of the study. Three treatment groups were analyzed. All animals received a single radiation dose of 17 grays (in the form of 6‐megaelectron‐volt electrons) on Day 7 and were sacrificed on Day 49. Group 1 (the control group) was treated with irradiation only. Groups 2 and 3 received additional BPs (clodronate; daily intraperitoneal injection dose, 20 mg/kg per day). In Group 2, BPs were given before irradiation, on Days 3–6; this schedule later was referred to as early BP treatment. In Group 3, BPs were administered simultaneously with irradiation, on Days 7–10; this schedule later was referred to as simultaneous BP treatment. The endpoints of the study were bone density and microstructural parameters of bone on Day 49. Bone density was measured using X‐ray absorption. Microstructural parameters of bone were assessed using histomorphometry. A total of thirty tibiae were analyzed in each group.RESULTSAfter irradiation, bone density was significantly higher among animals in the early BP treatment group compared with those in the control group and those in the simultaneous BP treatment group (P = 0.001). Histomorphometric analysis of bone showed significantly better‐preserved (P < 0.001) microstructural parameters (bone area, trabecular number, and trabecular separation) in the early BP treatment group compared with the control and simultaneous BP treatment groups.CONCLUSIONSEarly BP administration in combination with irradiation led to improved remineralization and restabilization of osteolytic bone metastases in an animal tumor model. Cancer 2003;98:1318–24. © 2003 American Cancer Society.DOI 10.1002/cncr.11646
Extraocular retinoblastoma: A 13‐year experience
Authors: Antoneli Célia Beatriz Gianotti , Steinhorst Flávio , de Cássia Braga Ribeiro Karina , Novaes Paulo Eduardo R. S. , Chojniak Martha M. M. , Arias Victor , de Camargo Beatriz 
Published: September 2003

AbstractBACKGROUNDThe current study was performed to evaluate two regimens of treatment and to describe clinical and epidemiologic characteristics in patients with extraocular retinoblastoma.METHODSEighty‐three patients with extraocular retinoblastoma according to Childrens Cancer Group (CCG) classification were admitted to the Pediatric Department of the A. C. Camargo between 1987–2000. The age, gender, race, lag time, first clinical presentation, staging, laterality, and treatment regimen were analyzed. Treatment was comprised of cisplatin, teniposide, vincristine, doxorubicin, and cyclophosphamide during the first treatment period (1987–1991) or cisplatin and teniposide with alternating courses of ifosfamide and etoposide during the second treatment period (1992–2000).RESULTSThe mean age of the patients was 32.9 months (range, 2–145 months). The mean lag time was 10.5 months. Forty‐three patients were treated in the first period and 40 patients were treated in the second period. Locally advanced tumors (Class I–III) were present in 83.1% of the patients. There was a positive correlation between lag time and age for unilateral tumors (correlation coefficient [r] = 0.35; P = 0.006), whereas the correlation was negative for bilateral tumors (r = −0.12; P = 0.63). The 5‐year overall survival was 55.1% in the first treatment period and 59.4% in the second treatment period (P = 0.69). No significant differences with regard to survival rates were noted for unilateral tumors between the two treatment periods (44.6 noted for unilateral tumors vs. 59.1 noted for unilateral tumors).CONCLUSIONSIn the current study, the addition of ifosfamide and etoposide to a treatment regimen comprised of cisplatin, teniposide, vincristine, doxorubicin, and cyclophosphamide did not appear to improve the survival of patients with extraocular retinoblastoma. Patients with dissemination to the central nervous system or metastatic disease remain incurable and die of progressive disease, despite the aggressive treatment. A multicenter trial should be considered to evaluate the best strategy for these situations. Cancer 2003;98:1292–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11647