bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors that influence the results of salvage surgery in patients with chemorefractory germ cell carcinomas with elevated tumor markers
Authors: Habuchi Tomonori , Kamoto Toshiyuki , Hara Isao , Kawai Koji , Nakao Masahiro , Nonomura Norio , Kobayashi Takashi , Ogawa Osamu , Kamidono Sadao , Akaza Hideyuki , Okuyama Akihiko , Kato Tetsuro , Miki Tsuneharu 
Published: October 2003

AbstractBACKGROUNDA standard concept for the integration of surgery into the chemotherapy‐based treatment of patients with advanced germ cell carcinoma has been that surgery should be avoided in patients with serum tumor markers (α‐fetoprotein [AFP] and human chorionic gonadotropin [HCG]) that remain elevated. However, some patients may benefit from resection under such chemorefractory conditions. The objective of this retrospective study was to clarify the outcome and clinical prognostic variables of salvage surgery in patients with disseminated (AJCC Stage II or III) testicular germ cell carcinoma or extragonadal germ cell carcinoma who had elevated serum markers.METHODSThe authors reviewed the clinical records of 24 patients who underwent salvage surgery with elevated serum AFP and/or HCG levels after at least 3 courses of cisplatin‐based, systemic chemotherapy between January, 1985 and December, 2000. The survival rates were compared between the subgroups with regard to preoperative and postoperative clinical parameters using the Kaplan–Meier method and a Cox proportional hazards model.RESULTSTen of 24 patients (41.7%) were rendered free of disease and alive without disease after the surgery with or without adjuvant therapy at a median follow‐up of 74 months (range, 24–207 months). Among the preoperative parameters, high HCG levels were associated with significantly poorer survival (hazard ratio [HR], 8.321; 95% confidence interval [95% CI], 1.0753–64.553; P = 0.043 and P = 0.016, respectively; log‐rank test). In addition, patients who had visceral lesions at resection had a significantly poorer prognosis compared with patients who had retroperitoneal and/or mediastinal lymph node lesions (P = 0.038; log‐rank test). Among postoperative parameters, incomplete resection and persistently high HCG levels were associated significantly with poor survival, with a risk of death from disease of 12.516‐fold (95% CI, 1.786–87.781) and 9.311‐fold (95% CI, 1.796–48.256), respectively.CONCLUSIONSSalvage surgery in patients with high serum tumors markers resulted in long‐term disease free status in approximately 40% of patients in a small subset with advanced germ cell carcinoma. Patients with elevated AFP levels alone (i.e., normal HCG levels) or with lymph node lesions alone seem to be good candidates for such surgery. Complete resection of target lesions and normalization of HCG levels after surgery are mandatory to achieve long‐term disease free status. Cancer 2003. © 2003 American Cancer Society.DOI 10.1002/cncr.11711
Response assessment classification in patients with advanced renal cell carcinoma treated on clinical trials
Authors: Schwartz Lawrence H. , Mazumdar Madhu , Wang Liang , Smith Alex , Marion Stephanie , Panicek David M. , Motzer Robert J. 
Published: October 2003

AbstractBACKGROUNDThe objective of the current study was to evaluate the effect on response assessment classification in patients with metastatic renal cell carcinoma (RCC) using unidimensional (Response Evaluation Criteria in Solid Tumors) and bidimensional (World Health Organization) criteria, including or excluding measurements of the primary renal tumor and using a new index to compensate for the disproportionate effect of large renal tumors relative to their metastases.METHODSFifty‐three imaging studies involving a total of 44 patients with metastatic RCC who were treated on clinical trials of interferon‐α analogue and/or thalidomide were reviewed retrospectively. The best overall response assessment and progression free survival were calculated with both unidimensional and bidimensional tumor measurements. Patients were then stratified into two groups: patients with primary renal tumors in situ and patients who underwent resection of their primary renal tumors. The best overall response and the time to disease progression were calculated based on the sum of measurements (conventional methodology), both including and excluding the primary tumor. A new method of response assessment, the ‘normalized lesion index’, which equalizes the differences in tumor size for an individual patient, was evaluated and compared with the conventional response assessment.RESULTSThere was an 11% disagreement rate in the best overall response assessment between unidimensional and bidimensional measurements. The time to progression was 9.2 months measured unidimensionally, compared with 6.4 months assessed bidimensionally. In the group of patients who had primary renal tumors in situ, using the conventional sum of measurements method, the apparent time to progression was an average of 4.2 months longer compared with measurements that did not include the primary renal tumor. The use of the normalized lesion index method resulted in an improved concordance in best overall response assessments and similar time to progression assessments when the primary renal tumor was included compared with patients who did not have primary renal tumors in situ.CONCLUSIONSThe use of unidimensional measurements in RCC therapy assessment results in significantly different time to progression classification compared with the use of bidimensional measurements. Response assessment classification in patients with RCC is affected by the exclusion or inclusion of measurements of the primary renal tumor. The normalized lesion index warrants further study in assessing response in patients with metastatic RCC and other solid tumor malignancies that often show substantial differences in sizes of measurable lesions. Cancer 2003. © 2003 American Cancer Society.DOI 10.1002/cncr.11712
Metronomic therapy with cyclophosphamide and dexamethasone for prostate carcinoma
Authors: Glode L. Michael , Barqawi Albaha , Crighton Frances , Crawford E. David , Kerbel Robert 
Published: October 2003

AbstractBACKGROUNDThe current study was designed to evaluate the efficacy and toxicity of the continuous oral administration of a combination of cyclophosphamide (50 mg/day given in the morning) and dexamethasone (1 mg/day given in the evening) in patients with prostate specific antigen (PSA) progression despite single or multiagent hormone therapy and antiandrogen withdrawal.METHODSThe authors retrospectively evaluated the medical records of all patients with prostate carcinoma who were treated with dexamethasone and cyclophosphamide and who were unable to participate in Phase II drug trials or had failed previous chemotherapy regimens.RESULTSUsing clinical response guidelines set forth by the Prostate Specific Antigen Working Group, 29% of patients were found to have a ≥ 80% reduction in PSA, 39% were found to have a 50–79% reduction in PSA, 6% were found to have a < 50% decrease in PSA, and 26% experienced disease progression while receiving treatment. The duration of response was 8 months (95% confidence interval [95% CI], 4–10 months). The duration of treatment was 9 months (95% CI, 6–14 months). The treatment was reported to be well tolerated with side effects being primarily bruising, Cushingoid facies, and gastrointestinal distress.CONCLUSIONSIn the current study, low‐dose dexamethasone and cyclophosphamide demonstrated efficacy as salvage therapy in the treatment of patients with hormone‐refractory prostate carcinoma. Cancer 2003. © 2003 American Cancer Society.DOI 10.1002/cncr.11713
Endometriosis‐associated ovarian carcinoma
Authors: del Carmen Marcela G. , Smith Sehdev Anne E. , Fader Amanda Nickles , Zahurak Marianna L. , Richardson Michael , Fruehauf John P. , Montz F. J. , Bristow Robert E. 
Published: October 2003

AbstractBACKGROUNDMultiple epidemiologic and histologic studies have suggested that ovarian endometriosis can give rise to malignant ovarian tumors, primarily those of epithelial origin. The progression of endometriosis to endometriosis‐associated ovarian carcinoma (EAOC) has not been investigated thoroughly and is poorly understood at best. Using immunohistochemical methods, we compared the differential expression patterns of various cytokines and growth factors in atypical endometriosis (AE) and EAOC.METHODSUsing the Johns Hopkins Pathology Data Bank, tissue blocks from patients diagnosed with EAOC or AE were identified. Tissue blocks were stained for 4 markers: vascular endothelial growth factor (VEGF), Ki‐67, estrogen receptor (ER), and progesterone receptor (PR).RESULTSSeventeen cases of EAOC and 8 cases of AE were identified. Staining for VEGF was documented in 16 of 17 (94%) EAOC tissue blocks and in only 1 of 8 (12.5%) AE tissue blocks (P < 0.0001). Only 4 of the 17 (23%) EAOC tissue blocks exhibited positive staining for ER, compared with 8 of 8 (100%) AE tissue blocks (P = 0.0005). Positive staining for PR was noted in only 6 of 17 (35%) EAOC samples but was present in 8 of 8 (100%) AE samples (P = 0.003). Seventy percent of EAOC samples exhibited positive staining for Ki‐67, compared with 37.5% of AE samples (P = 0.19).CONCLUSIONSEAOC appears to be associated with overexpression of VEGF and reduced expression of both ER and PR. Variations in VEGF expression may be associated with the malignant transformation of endometriosis and may present both diagnostic and therapeutic options for the treatment of ovarian malignancies. Cancer 2003. © 2003 American Cancer Society.DOI 10.1002/cncr.11714
National Cancer Data Base report on osteosarcoma of the head and neck
Authors: Smith Russell B. , Apostolakis Louis W. , Karnell Lucy H. , Koch Brenton B. , Robinson Robert A. , Zhen Weining , Menck Herman R. , Hoffman Henry T. 
Published: October 2003

AbstractBACKGROUNDOsteosarcoma is the most common primary bone malignancy overall but is encountered infrequently in the head and neck. Limited data are available on the significance of prognostics factors and results of therapy for patients with head and neck osteosarcoma (HNOS). It is known that surgical therapy is critical to successful outcome. The impact of adjuvant chemotherapy has not been defined well.METHODSThe National Cancer Data Base has collected data on cases of HNOS by voluntary accrual from participating hospitals. This database was used to assess patient demographics, tumor characteristics, treatment, and outcome for an 11‐year period extending from 1985 to 1996.RESULTSThe data set contained 496 cases of HNOS. Overall, the 5‐year disease‐specific survival rate was 59.7%. Factors associated with a poor prognosis were age older than 60 years; nonmandibular tumor location; tumor size > 6 cm; histologic type of osteoblastic, not otherwise specified (NOS); advanced disease stage; nonsurgical initial therapy; and positive margins of resection. Increased use of multimodality therapy was noted during the later years of the study. No substantial difference in the 5‐year survival rate was noted between treatment with surgery alone (74.7%) and surgery with adjuvant chemotherapy (71.3%), despite the greater prevalence of tumors with poor prognostic factors in the surgery and adjuvant chemotherapy group.CONCLUSIONSSurgery with clear margins is an important factor in successful therapy for patients with HNOS. Improved survival has been noted within the last 2 decades compared with historic controls. Multiple negative prognostic factors have been identified and should be considered in treatment planning. The role of chemotherapy has not been defined well, but its incorporation into treatment of patients with high‐risk tumors may improve survival. Cancer 2003. © 2003 American Cancer Society.DOI 10.1002/cncr.11716
Social networks and quality of life among female long‐term colorectal cancer survivors
Authors: Sapp Amy L. , Trentham‐Dietz Amy , Newcomb Polly A. , Hampton John M. , Moinpour Carol M. , Remington Patrick L. 
Published: October 2003

AbstractBACKGROUNDThe population of long‐term colorectal cancer survivors in the United States continues to increase, but little is known about how they fare—physically, mentally, or socially—in the years after diagnosis. The current study examines female long‐term colorectal cancer survivors' health‐related quality of life (HRQoL) in relation to social networks.METHODSA population‐based sample of female colorectal cancer survivors (n = 726) residing in Wisconsin was recontacted approximately 9 years after the initial diagnosis. Of 443 women who were alive in 1999, 307 women completed a follow‐up questionnaire. Analysis was conducted on 259 participants who completed the Medical Outcomes Study Short Form 36 Health Status Survey and a modified version of Berkman and Syme's Social Network Index. Using multivariate analyses, HRQoL summary scores were tested for associations with individual and composite measures of social networks, including marital/partner status; number of children, relatives, and friends; and the frequency of religious and community participation.RESULTSAfter adjusting for age, extent of disease at diagnosis, number of comorbidities, body mass, and education, HRQoL was similar to norms published for the general population. Individual social network measures (including the number of relatives and friends) and composite network measures (including network size, the number of ties seen at least once per month, and overall social connectedness) were associated positively with mental health.CONCLUSIONSSocial networks may have an important relation with HRQoL—particularly mental health—among female long‐term colorectal cancer survivors. The results of this study should be of interest to those seeking to understand or improve HRQoL among this growing population. Cancer 2003. © 2003 American Cancer Society.DOI 10.1002/cncr.11717
Reirradiation and hyperthermia in rectal carcinoma
Authors: Juffermans Jorine H. M. , Hanssens Patrick E. J. , van Putten Wim L. J. , van Rhoon Gerard C. , van der Zee Jacoba 
Published: October 2003

AbstractBACKGROUNDThe objective of this study was to evaluate the palliative effect of reirradiation and hyperthermia in patients with unresectable, recurrent colorectal carcinoma.METHODSThe medical records of 54 patients with unresectable, recurrent colorectal carcinoma that caused pain and who were treated with reirradiation and hyperthermia, were evaluated retrospectively. Previous radiotherapy was given up to a total dose ranging from 25–70 grays (Gy). The median interval between prior radiotherapy and reirradiation was 22 months (range, 4–97 months). The total reirradiation dose varied from 24 Gy to 32 Gy given in fractions of 4 Gy twice weekly. Three or four hyperthermia treatments were given once weekly. Toxicity was registered. The influence of World Health Organization (WHO) performance status, maximum tumor dimension, and time between first radiotherapy and reirradiation on therapeutic outcome was evaluated. The results of this study were compared with published results on patients who received radiotherapy with or without hyperthermia.RESULTSForty‐seven patients (87%) completed the planned treatment schedule. The maximum toxicity was Grade 2. All patients were evaluated for palliative effect. The median follow‐up was 10 months. A good or complete palliative effect was achieved in 72% of patients for a median duration of 6 months. Patients who had a better WHO performance status, smaller tumors, and a longer interval between first radiotherapy and reirradiation had slightly better outcomes, although none of those parameters reached statistical significance.CONCLUSIONSThe described combined treatment was feasible and well tolerated. Comparison of results from radiotherapy plus hyperthermia with results after radiotherapy alone suggested that additional hyperthermia prolonged the duration of palliation. Firm proof of the contribution of hyperthermia will require performing a Phase III study. Cancer 2003. © 2003 American Cancer Society.DOI 10.1002/cncr.11719
Internalization of interphotoreceptor retinoid‐binding protein by the Xenopus retinal pigment epithelium
Authors: Cunningham Lisa L. , Gonzalez‐Fernandez Federico 
Published: October 2003

AbstractXenopus rods and cones secrete into the interphotoreceptor matrix (IPM) a 124‐kDa glycoprotein termed interphotoreceptor retinoid‐binding protein (IRBP; Hessler et al. [1996] J. Comp. Neurol. 367:329–341). IRBP is confined to the IPM, being too large to diffuse through the zonulae adherentes between adjacent photoreceptor and Müller cells. Despite this physical entrapment within the subretinal space, IRBP is rapidly cleared from the IPM by an unknown mechanism. Immunohistochemistry and immunoelectron microscopy were used to localize IRBP in intact and detached retina‐retinal pigment epithelium (RPE) eyecups. The effects of light, dark, and time of day on the compartmentalization of IRBP were characterized by quantitative Western blot analysis and by immunoprecipitation of IRBP labeled in vivo by intraocular injection of [35S]methionine. Immunohistochemistry showed that the apparent intercellular IRBP in both the RPE and the photoreceptors is resistant to saline extraction, in contrast to that in the IPM. In the RPE, IRBP was associated with matrix material within phagosomes and endosomes. The IPM, RPE, and retina contained 75%, 18%, and 7% of the total IRBP in the eye, respectively. The IPM and RPE contain 130 ± 14 pmoles and 34 ± 4 pmoles of IRBP, respectively. The amounts of IRBP in the RPE at middark and midlight were the same. Furthermore, the in vivo uptake of [35S]methionine‐labeled IRBP was light independent. Our studies suggest that IRBP is not strictly confined to the subretinal space but rather that significant amounts are present intracellularly, particularly within the RPE, which does not synthesize IRBP. Furthermore, IRBP secreted by the photoreceptors is taken up from the IPM mainly through a light‐independent endocytic pathway separate from outer segment phagocytosis. The role of RPE endocytosis should be explored in relation to the function of IRBP. J. Comp. Neurol. 466:331–342, 2003. © 2003 Wiley‐Liss, Inc.
Synaptic connections of cholinergic antennal lobe relay neurons innervating the lateral horn neuropile in the brain of Drosophila melanogaster
Authors: Yasuyama Kouji , Meinertzhagen Ian A. , Schürmann Friedrich‐Wilhelm 
Published: October 2003

AbstractPresumed cholinergic projection neurons (PNs) in the brain of the fruit fly Drosophila melanogaster, immunoreactive to choline acetyltransferase (ChAT), convey olfactory information between the primary sensory antennal lobe neuropile and the mushroom body calyces, and finally terminate in the lateral horn (LH) neuropile. The texture and synaptic connections of ChAT PNs in the LH and, comparatively, in the smaller mushroom body calyces were investigated by immuno light and electron microscopy. The ChAT PN fibers of the massive inner antennocerebral tract (iACT) extend into all portions of the LH, distributing in a nonrandom fashion. Immunoreactive boutons accumulate in the lateral margins of the LH, whereas the more proximal LH exhibits less intense immunolabeling. Boutons with divergent presynaptic sites, unlabeled as well as ChAT‐immunoreactive, appear to be the preponderant mode of synaptic input throughout the LH. Synapses of ChAT‐labeled fibers appear predominantly as divergent synaptic boutons (diameters 1–3 μm), connected to unlabeled postsynaptic profiles, or alternatively as a minority of tiny postsynaptic spines (diameters 0.05–0.5 μm) among unlabeled profiles. Together these spines encircle unidentified presynaptic boutons of interneurons which occupy large areas of the LH. Thus, synaptic circuits in the LH differ profoundly from those of the PNs in the mushroom body calyx, where ChAT spines have not been encountered. Synaptic contacts between LH ChAT elements were not observed. The synaptic LH neuropile may serve as an output area for terminals of the ChAT PNs, their presynaptic boutons providing input to noncholinergic relay neurons. The significance of the postsynaptic neurites of the ChAT PNs is discussed; either local or other interneurons might connect the ChAT PNs within the LH, or PNs might receive inputs arising from outside the LH. J. Comp. Neurol. 466:299–315, 2003. © 2003 Wiley‐Liss, Inc.
Hodological characterization of the medial amygdala in anuran amphibians
Authors: Moreno Nerea , González Agustín 
Published: October 2003

AbstractEarly studies in anuran amphibians defined the amygdala as a single unit that only later could be subdivided into medial and lateral parts with the achievement of sensitive immunohistochemical and tracing techniques. However, the terminology used was often misleading when comparing with “homologous” amygdaloid nuclei in amniotes. Recently, the basal telencephalon of anurans has been demonstrated to be more complex than previously thought, and distinct amygdaloid nuclei were proposed on the basis of immunohistochemistry. Moreover, developmental data are increasing that support this notion. In the present study, we analyzed the patterns of afferent and efferent connections of the medial amygdala (MeA; formerly amygdala pars lateralis), considered as the main target of the vomeronasal information from the accessory olfactory bulb, as in other vertebrates. By means of axonal transport of dextran amines, the afferent and efferent connections of the MeA were traced in Rana perezi and Xenopus laevis under in vivo and in vitro conditions. Largely similar results were found in both species. The results showed abundant intratelencephalic and extratelencephalic connections that were readily comparable to those of other tetrapods. Most of these connections were reciprocal and, in particular, the strong relation of the MeA with the hypothalamus, via the stria terminalis, was demonstrated. Immunohistochemical techniques showed staining patterns that revealed abundant peptidergic afferents to the MeA, as well as minor inputs containing other neurotransmitters such as catecholamines. Double‐labeling experiments demonstrated that the peptidergic fibers that reach the MeA originate in the ventral hypothalamus, whereas the catecholaminergic innervation of the MeA arises in the caudal extent of the posterior tubercle. Taken together, the results about connectivity in our study support the comparison of the MeA in anurans with its counterparts (and similarly named) amygdaloid nuclei in amniotes. Most of the hodological features of the medial amygdala seem to be shared by those tetrapods with well‐developed vomeronasal systems. J. Comp. Neurol. 466:389–408, 2003. © 2003 Wiley‐Liss, Inc.