bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical evaluation of the different staging systems for hepatocellular carcinoma
Authors: Wildi S , Pestalozzi B C , McCormack L , Clavien P-A 
Published: March 2004

Abstract

Background
Diagnostic and therapeutic options for hepatocellular carcinoma (HCC) have improved substantially in recent years. A number of new palliative and potentially curative treatment strategies are now available. However, evaluation of the therapeutic modalities and assessment of the prognosis of HCC remain difficult owing to the lack of consensus on a single staging system and the availability of a number of new staging systems, each claiming to be the most appropriate.

Methods
The most frequently used staging systems for HCC are presented here. Their ability to stratify patients into different treatment groups and to define prognosis are discussed. In addition, the advantages and disadvantages of each system are analysed.

Results and conclusion
None of the currently used staging systems fulfils all the requirements for stratification of patients with HCC into groups of different prognosis and therapeutic recommendations. An international agreement on a single staging system is urgently needed in order to permit comparable randomized clinical trials. Only in this way will the outcome for those with HCC be improved.
Surgical site infection after groin hernia repair (Br J Surg 2004; 91: 105–111)
Authors: Gaunt A , McKain E S , Feroz A , Stephenson B M 
Published: March 2004

Abstract
The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses can be sent electronically via the BJS website (www.bjs.co.uk) or by post. All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Letters submitted by post should be typed on A4-sized paper in double spacing and should be accompanied by a disk.
Multiple arterial variations in the upper limb of a South Indian female cadaver
Authors: Kumar M.R. 
Published: March 2004

AbstractIn a routine dissection of a female cadaver, a variation in the course of the radial artery in the cubital fossa and a communication between the brachial artery and radial artery were observed. A rare origin and course of the median artery was also found. These anomalies are discussed in detail and their clinical relevance is highlighted. Clin. Anat. 17:233–235, 2004. © 2004 Wiley‐Liss, Inc.
Vascular pedicles of infrahyoid muscles: An anatomical study
Authors: Görmüs Gökhan , Bayramoğlu Alp , Aldur M. Mustafa , Çelik H. Hamdi , Maral Tugrul , Sargon Mustafa F. , Demiryürek Deniz , Aksit M. Dogan 
Published: March 2004

AbstractThis study was designed to determine the entering sites of vascular pedicles of the infrahyoid muscles. The neck regions of 12 cadavers were investigated bilaterally. The vascular pedicles of the infrahyoid muscles (except the thyrohyoid and inferior belly of the omohyoid muscle) were dissected and measurements taken with a caliper in reference to the attachments of the muscles. For the sternothyroid muscle, two vascular pedicles were found bilaterally in all cadavers. Two vascular pedicles were found bilaterally for the sternohyoid muscle in 11 cadavers; in one cadaver the inferior vascular pedicle was absent bilaterally. One vascular pedicle was found bilaterally for the superior belly of the omohyoid muscle in all cadavers. These data regarding the vascular pedicles of the infrahyoid muscles might be useful for preserving the vascular supply of the infrahyoid muscles during flap preparation. Clin. Anat. 17:214–217, 2004. © 2004 Wiley‐Liss, Inc.
Unilateral occurrence of a chondroepitrochlearis muscle
Authors: Sarikcioglu Levent , Yildirim Fatos Belgin , Chiba Shoji 
Published: March 2004

AbstractAn abnormal muscle slip was encountered during routine dissection studies of a male cadaver. According to its origin, attachment and innervation, the abnormal slip was identified a chondroepitrochlearis muscle. Arterial and nervous supply were from the lateral thoracic artery and the medial pectoral nerve, respectively. Furthermore, no axillary arch muscle was observed. In addition, an abnormality in the attachment of the pectoralis major muscle was observed. Clin. Anat. 17:272–275, 2004. © 2004 Wiley‐Liss, Inc.
Histological changes in radial forearm skin flaps in the oral cavity
Authors: Sinclair A. , Johnston E. , Badran D.H. , Neilson M. , Soutar D.S. , Robertson A.G. , McDonald S.W. 
Published: March 2004

AbstractWe reported previously that skin flaps transplanted to the oral cavity in reconstructive surgery for oral cancer frequently acquired the gross appearance of buccal mucosa. The changes were shown to be reactive in nature. The “changed” flaps generally had a heavier infiltration of leukocytes in the dermis and appeared to have thicker epithelium. The present study quantifies these parameters, as well as the numbers of intraepithelial leukocytes. The flaps that had acquired the gross appearance of oral mucosa had significantly thicker epithelium, larger numbers of dermal leukocytes, and more intraepidermal inflammatory cells per unit length than flaps that retained the gross appearance of thin skin. No correlation was found between these changes and radiotherapy. Clin. Anat. 17:227–232, 2004. © 2004 Wiley‐Liss, Inc.
Biochemotherapy in patients with metastatic anorectal mucosal melanoma
Authors: Kim Kevin B. , Sanguino Angela M. , Hodges Cynthia , Papadopoulos Nicholas E. , Eton Omar , Camacho Luis H. , Broemeling Lyle D. , Johnson Marcella M. , Ballo Matthew T. , Ross Merrick I. , Gershenwald Jeffrey E. , Lee Jeffrey E. , Mansfield Paul F. , Prieto Victor G. , Bedikian Agop Y. 
Published: March 2004

AbstractBACKGROUNDPatients with metastatic anorectal melanoma generally have an unfavorable prognosis, but no effective systemic therapy has been reported.METHODSThe authors retrospectively evaluated the medical records of all patients with metastatic anorectal melanoma treated with biochemotherapy between January 1991 and December 2001 at the University of Texas M. D. Anderson Cancer Center (Houston, TX).RESULTSThe search yielded 18 patients. Of these patients, 14 had undergone treatment with cisplatin (CDDP), vinblastine (VB), dacarbazine (DTIC), interferon alpha‐2b (IFN), and interleukin 2 (IL‐2); 2 had undergone treatment with CDDP, VB, DTIC, and IFN; 1 had undergone treatment with CDDP, IFN, and IL‐2; and 1 had undergone treatment with CDDP, VB, temozolomide, IFN, and IL‐2. All IL‐2 treatments were administered intravenously. The median follow‐up time was 12.2 months (range, 3.5–43.7 months). Eight patients (44%) had major responses, including two (11%) complete responses (CRs). Three patients were lost to follow‐up evaluation after the completion of treatment. The median time to progression among the 15 remaining patients was 6.2 months. Four patients, including 1 with a CR, were alive at their last documented follow‐up visits (survival: 14.0, 20.7, 31.3, and 43.7 months, respectively). The median overall survival was 12.2 months. Among 13 patients who received biochemotherapy as first‐line systemic therapy, 6 patients (46%) had major responses, including two (15%) CRs. The median time to progression for this group was 6.2 months, and the median overall survival was 12.9 months.CONCLUSIONSBiochemotherapy had substantial activity against metastatic anorectal melanoma and should be considered for use in the treatment of metastatic disease from primary anorectal melanoma. Cancer 2004;100:1478–83. © 2004 American Cancer Society.
5‐fluorouracil‐induced oligodendrocyte death and inhibitory effect of cycloheximide, trolox, and Z‐VAD‐FMK in murine cortical culture
Authors: Cho Ki‐Hyun , Choi Sung‐Min , Kim Byeong‐Chae , Lee Seung‐Han , Park Man‐Seok , Kim Myeong‐Kyu , Kim Jong‐Keun 
Published: March 2004

AbstractBACKGROUND5‐fluorouracil (5‐FU) is a widely used anticancer drug. One of the adverse effects of this drug is selective cerebral white matter injury, but to the authors' knowledge its mechanism has not been well documented. The current study was performed to investigate the mechanism of cerebral white matter injury caused by 5‐FU and to develop the intervention to attenuate its injury in vitro.METHODSMixed oligodendrocyte/astrocyte cells were dissociated from specimens taken from approximately 2‐day‐old postnatal mouse cortex and cultured for 3–4 weeks. The culture cells were exposed to 5‐FU, cycloheximide, emetine, Z‐VAD‐fmk, 2,3‐dihydroxy‐6‐nitro‐7‐sulfamoyl‐benzo(F)‐quinoxaline (NBQX), Trolox, and epigallocatechin gallate. Oligodendrocyte cell death was assessed by counting the number of viable galactocerebroside‐positive cells per × 100 field.RESULTSMixed oligodendrocyte/astrocyte culture cells that were exposed to 5‐FU (at doses of 10 μM, 30 μM, and 100 μM) for 24 hours ensued concentration‐dependent oligodendrocyte death. The majority of oligodendrocytes, but few astrocytes, were injured by 100 μM 5‐FU. Trolox, a vitamin E analog antioxidant, as well as cycloheximide (a protein synthesis inhibitor) and Z‐VAD‐fmk (a caspase inhibitor), significantly attenuated the 5‐FU–induced oligodendrocyte death. However, NBQX, an alpha‐amino‐2,3‐dihydro‐5‐methyl‐3‐oxo‐4‐isoxazolepropionic acid (AMPA) receptor antagonist, did not appear to effect the 5‐FU–induced oligodentrocyte death.CONCLUSIONSThe findings of the current study suggested that 5‐FU led to oligodendrocyte death rather than astrocyte death by way of the apoptotic process, whereas antioxidants may prevent the 5‐FU–induced oligodendrocyte cell death in vitro. Cancer 2004;100:1484–90. © 2004 American Cancer Society.
Sequential dose‐dense doxorubicin and ifosfamide for advanced soft tissue sarcomas
Authors: Maurel Joan , Fra Joaquín , López‐Pousa Antonio , García del Muro Xavier , Balañá Carmen , Casado Antonio , Martín Javier , Martínez‐Trufero Javier , de las Peñas Ramón , Buesa José M. 
Published: March 2004

AbstractBACKGROUNDCombinations of high‐dose ifosfamide (IF; 10–12 g/m2) plus doxorubicin (DX; 50–90 mg/m2) have been administered to patients with advanced soft tissue sarcoma (ASTS) in an attempt to improve therapeutic efficacy. Although these combination regimens appear to yield higher response rates than do standard‐dose regimens, they also are associated with significant hematologic toxicity, despite the administration of hematopoietic growth factor support. As a potentially less toxic alternative, the authors designed a sequential, dose‐dense schedule of DX and IF and explored its feasibility and toxicity, as well as patient compliance with the schedule, in a Phase II trial.METHODSChemotherapy‐naive patients with unresectable locally advanced or metastatic ASTS were to receive DX at 30 mg/m2 per day for 3 consecutive days once every 2 weeks for 3 cycles followed by IF at 12.5 g/m2 delivered by continuous infusion over 5 days once every 3 weeks for 3 cycles. Granulocyte–colony‐stimulating factor was administered subcutaneously for 7 days beginning 24 hours after the completion of each DX or IF cycle. Additional IF cycles were allowed if an objective response was achieved.RESULTSSixty patients were enrolled in the trial. Three were ineligible, 9 had locally advanced disease, and 48 had metastatic disease. At the completion of therapy, the mean dose intensities for DX and IF were 40 mg/m2 per week and 3.87 g/m2 per week, respectively. Sixty‐six percent of patients completed the regimen projected by the protocol. Grade 3 or 4 granulocytopenia, febrile neutropenia, and stomatitis occurred in 46%, 24%, and 27% of patients, respectively. Twenty of 53 assessable patients (38%; 95% confidence interval [CI], 25–51%) achieved objective responses, with a median time to progression of 24 weeks (95% CI, 18–30 weeks).CONCLUSIONSSequential administration of dose‐dense DX and high‐dose IF is feasible and exhibits an acceptable hematologic toxicity profile and a level of activity that is within the range described for schedules that combine high‐dose IF with an anthracycline. Cancer 2004;100:1498–506. © 2004 American Cancer Society.
Results of a randomized, population‐based study of biennial screening using serum prostate‐specific antigen measurement to detect prostate carcinoma
Authors: Hugosson Jonas , Aus Gunnar , Lilja Hans , Lodding Pär , Pihl Carl‐Gustav 
Published: March 2004

AbstractBACKGROUNDThe purpose of the current study was to evaluate the effectiveness of a prostate carcinoma screening program in which serum prostate‐specific antigen (PSA) levels were measured.METHODSFrom a group of 20,000 men born between January 1, 1930, and December 31, 1944, 10,000 men were randomized into a screening group and 10,000 were randomized into a control group. Patients in the screening group were invited to undergo initial PSA testing between 1995 and 1996 and then were invited to receive testing every second year thereafter for 8 years (for a total of 4 PSA tests). Men with PSA levels ≥ 3 ng/mL (or ≥ 2.54 ng/mL, in the third and fourth screening rounds) were invited to undergo clinical investigation, which included sextant biopsy of the prostate. By linking to the regional cancer registry, the authors were able to obtain the true and expected incidence rates for the screening and control groups.RESULTSThe screening participation rate was high (73%). A total of 884 malignancies have been detected to date, with 640 having been detected in the screening group. There was an early and marked shift toward more favorable disease stage and grade for malignancies detected on repeat screening. In the fourth screening round, only 2 of 82 detected malignancies were classified as advanced disease. Of the 227 screen‐detected tumors on which surgery was performed, only 20 (8.8%) had small volume (< 0.2 cm3). Forty‐three interval malignancies were detected, but only five were accompanied by symptoms. At 8 years, the cumulative disease incidence rate among screening participants was 7.3%, compared with 2.4% in the control arm. The incidence rate observed in the screening population corresponds to the cumulative incidence rate observed in the Swedish male population at age 72 years.CONCLUSIONSBiennial PSA screening was very successful in diagnosing prostate carcinoma at an early stage, when curative treatment typically is effective. In addition, the results regarding interval malignancies were favorable. Thus, decreased mortality should be observed on long‐term follow‐up. The lead time associated with screening appears to fall within the range described in earlier studies involving frozen sera (i.e., 5–9 years). Cancer 2004;100:1397–405. © 2004 American Cancer Society.
Neoadjuvant therapy changes the lymphocyte composition of tumor‐draining lymph nodes in cervical carcinoma
Authors: Fattorossi Andrea , Battaglia Alessandra , Ferrandina Gabriella , Coronetta Ferdinando , Legge Francesco , Salutari Vanda , Scambia Giovanni 
Published: March 2004

AbstractBACKGROUNDThe objective of the current study was to illustrate the influence of neoadjuvant therapy on the local immune response in patients with cervical carcinoma.METHODSUninvolved tumor‐draining lymph nodes (TDLN) (n = 158 lymph nodes), including internal, external, and common iliac lymph nodes as well as obturator, presacral, and aortic lymph nodes from 15 nontreated (NT) patients, 4 chemotherapy (CT)‐treated patients, and 19 chemoradiation (CR)‐treated patients, were analyzed for lymphocyte subset distribution and for the proliferative response of T cells to polyclonal activation and interferon‐γ (IFN‐γ) production. Lymphocyte subsets in peripheral blood also were assessed.RESULTSTDLNs from CR‐treated patients contained higher proportions of CD8+ cells and natural killer cells than NT and CT‐treated patients (P values ranged from < 0.05 to < 0.01). TDLNs from CR‐treated patients were enriched in activated‐type CD4+ cells (HLA‐DR+, CD134+, CD62L−, and CD25+ at an intermediate expression level; P values ranged from < 0.05 to < 0.01) and activated‐type CD8+ cells (CD62L−, P <0.001) compared with NT patients. Concomitantly, there was a reduction in the proportion of naïve‐type CD4+ and CD8+ cells (CD45RA+/CD62L+) (P< 0.01 and < 0.05, respectively). CR treatment increased the proportion of both CD4+ and CD8+ cells prone to produce IFN‐γ. All TDLNs contained suppressive CD4+ T regulatory (Treg) cells (CD25+ and CD152+ at a high expression level) whose frequency and suppressive activity was not influenced by the treatment. Therapy‐induced changes in TDLN were mirrored only in part by respective alterations in peripheral blood.CONCLUSIONSTo our knowledge, the current study is the first to show that neoadjuvant therapy produces an enhancing effect on the immune competency of TDLNs from patients with cervical carcinoma. Cancer 2004;100:1418–28. © 2004 American Cancer Society.
DNA repair and breast carcinoma susceptibility in women
Authors: Ramos Juan M. , Ruiz Abigail , Colen Rivka , Lopez Ivette D. , Grossman Lawrence , Matta Jaime L. 
Published: March 2004

AbstractBACKGROUNDBreast carcinoma is the most common cancer and the second leading cause of cancer‐related deaths among women. The disease represents approximately 31% of all cancers in Puerto Rican women. Several DNA repair pathways are involved in preventing carcinogenesis. The current study evaluated the hypothesis that a reduced DNA repair capacity (DRC) is a susceptibility factor for breast carcinoma.METHODSA retrospective case–control clinical study was performed to compare age‐matched DRC in 33 women with histopathologically confirmed breast carcinoma (cases) and 47 cancer‐free women (controls). DRC was measured using a host cell reactivation assay with a luciferase reporter gene and then transfected into human peripheral lymphocytes. A questionnaire was used to solicit breast carcinoma risk factors.RESULTSWomen with breast carcinoma had a mean DRC of 5.6% ± 0.5 standard error of the mean (SEM). Cancer cases had a 36% reduction (P < 0.001) in DRC when compared with the control group (DRC = 8.7% ± 0.7 SEM). Younger participants with breast carcinoma were found to have a more significant reduction in DRC when compared with age‐matched controls. Family (odds ratio [OR] = 4.1), maternal lineage (OR = 5.5), and maternal (OR = 12.4) history of breast carcinoma were found to be the only statistically significant (P < 0.05) risk factors associated with the disease.CONCLUSIONSThe findings supported the hypothesis that a low DRC is a susceptibility factor for breast carcinoma. A 1% decrease in DRC corresponded to a 22% increase in breast carcinoma risk. To the authors' knowledge, the current study was the first to directly determine the DRC of women with breast carcinoma. Because DRC is an independent risk factor for breast carcinoma, the DRC of women may be a useful marker in predicting susceptibility. Cancer 2004;100:1352–7. © 2004 American Cancer Society.
A prospective study of concurrent cyclophosphamide/methotrexate/5‐fluorouracil and reduced‐dose radiotherapy in patients with early‐stage breast carcinoma
Authors: Bellon Jennifer R. , Shulman Lawrence N. , Come Steven E. , Li Xiaochun , Gelman Rebecca S. , Silver Barbara J. , Harris Jay R. , Recht Abram 
Published: March 2004

AbstractBACKGROUNDConcurrent administration of chemotherapy and radiotherapy has the potential advantage of delaying neither treatment and providing radiation sensitization. However, the optimal approach to concurrent treatment in women with early‐stage breast carcinoma remains undefined. We present updated results of a prospective protocol of concurrent cyclophosphamide/methotrexate/5‐fluorouracil (CMF) and reduced‐dose radiotherapy, focusing on tumor control and patient tolerance.METHODSOne hundred twelve women with AJCC Stage I or Stage II breast carcinoma with 0–3 positive axillary lymph nodes were enrolled in a prospective single‐arm study of concurrent CMF and reduced‐dose radiotherapy (39.6 gray [Gy] to the whole breast, 16‐Gy boost). A high proportion of women had risk factors associated with an increased risk of local disease recurrence, including age < 40 (32%), close or positive margins (37%), or lymphatic/vascular invasion (51%). The median follow‐up period was 94 months.RESULTSThe 5‐year overall survival rate was 94%. By 60 months, 5 patients (4%) experienced local disease recurrence and 19 patients (17%) experienced distant metastasis. There were no isolated regional lymph node recurrences. Local disease recurrence occurred in 1 of 25 patients (4%), 1 of 16 patients (6%), and 3 of 70 patients (4%) with positive, close (< 1 mm), and negative margins, respectively. One patient developed acute myelogenous leukemia. An additional patient developed Grade 2 pneumonitis. Cosmetic results were not recorded uniformly for all patients and therefore could not be reliably analyzed.CONCLUSIONSConcurrent CMF and reduced‐dose radiotherapy resulted in a low level of late toxicity and excellent local tumor control, despite the large proportion of patients with substantial risk factors for local disease recurrence. Future studies of concurrent regimens, particularly in patients at high risk of local disease recurrence, are warranted. Cancer 2004;100:1358–64. © 2004 American Cancer Society.
Familial association of specific histologic types of ovarian malignancy with other malignancies
Authors: Bermejo Justo Lorenzo , Rawal Rajesh , Hemminki Kari 
Published: March 2004

AbstractBACKGROUNDPopulation‐based data on the familial association of specific histologic types of ovarian malignancy with other malignancies are limited. Such data may help to elucidate etiologic differences among histologic types of ovarian malignancy.METHODSThe nationwide Swedish Family‐Cancer Database, which includes 10.3 million individuals and 20,974 ovarian carcinomas, was used to calculate standardized incidence ratios and 95% confidence intervals for age‐ and histology‐specific ovarian malignancies in women whose parents or siblings were affected with malignancies at the most common disease sites.RESULTSOvarian malignancy was found to be associated with ovarian, laryngeal, breast, endometrial, liver, and colon carcinoma, as well as myeloma; epithelial ovarian malignancy was found to be associated with ovarian, endometrial, and skin malignancies and with melanoma and myeloma; papillary serous cystadenocarcinoma was found to be associated with ovarian and skin malignancies and with myeloma; and endometrioid carcinoma was found to be associated with endometrial, ovarian, and prostate malignancies and with melanoma. For younger women (ages 40–45 years) whose mothers were affected with endometrial malignancies, the risk of developing endometrioid carcinoma was slightly greater than the risk of developing papillary serous cystadenocarcinoma.CONCLUSIONSSpecific types of ovarian malignancy may be associated with specific familial disease sites, with such associations depending on age at diagnosis; the strength of the observed associations varied according to histology. Associations were found between endometrioid carcinoma and endometrial malignancy and between serous carcinoma and Hodgkin disease. Cancer 2004;100:1507–14. © 2004 American Cancer Society.