tbuckley/cabot-search huggingface dataset:
Timing of re-excision surgery (S2) for positive margins (PM) and initiation of adjuvant systemic treatment (aRx) in early breast cancer patients (BC pts).
Authors: L. De Mattos-Arruda, I. Rubio, L. Garcia-Aceituno, J. Cortes, G. Sanchez-Olle, V. Peg, C. Serrano, P. Gomez, J. Baselga, S. Di Cosimo
Journal: Journal of Clinical Oncology (2010)

e11065 Background: Breast-conserving surgery (BCS) aims to obtain pathologically negative resection margins. Pts with PM may require S2. According to different series, the timing of aRx is related to BC pt prognosis. This study evaluated the impact of re-excision for PM on initiation of aRx and its correlation with pt prognosis. Methods: BCS patients with PM treated between 2000 and 2009 at Vall d'Hebron Hospital were identified. Clinical and pathological characteristics were collected; the time of S2 and aRx calculated from initial surgery (S1), and univariate analysis performed. Results: Of 53 pts, median age 53 yrs (range 29-87), 6 pts (11%) had immediate re-excision; 47 pts underwent S2: 18 (38%) had wider re-excision and 29 (62%) mastectomy. The median time from S1 to S2 was 3.13 weeks (range 0–18) and 8.83 weeks (range 2–24) from S1 to aRx. The median time to aRx for the 23 pts with early-S2 (≤ 3 weeks) versus the 30 pts with delayed-S2 (>3 weeks) was 6.98 weeks (range 2-17) and 8.98 weeks (range 3-24 weeks), respectively. The Table shows pt distribution according to different S2 and aRx timing. Nodal and hormone receptor status did not differ between early-S2 versus delayed-S2 groups. However, delayed-S2 pts more often had grade 3 (21% vs.13%) and HER2-positive (19% vs.12%) BC. No differences were detected in local/systemic relapse rates for early- S2 (3 pts) and delayed-S2 (4 pts) or with respect to initiation of aRx. Conclusions: S2 timing for PM appears to unfavorably influence initiation of adjuvant systemic treatment. The timing of re-excision, however, does not compromise patient prognosis and both early and delayed re-excision are acceptable options. Initiation of aRx from S1(weeks) Timing of S2 from S1 ≤ 3 weeks > 3 weeks Pts (recurrent pts) < 4 4 (0) 1 (0) 4-7 12 (1) 4 (0) 8-12 6 (2) 22 (3) >12 1 (0) 3 (1) Total pts (recurrent pts) 23 (3) 30 (4) No significant financial relationships to disclose.
Routine PET and PET-CT scans in melanoma patients with positive sentinel node biopsy is of limited benefit
Authors: A. Constantinidou, M. Hofman, M. O'Doherty, K. Acland, C. Healy, M. Harries
Journal: Journal of Clinical Oncology (2007)

8582 Background: Positron emission tomography (PET) scanning is increasingly used for the staging and management of malignant melanoma. The role of PET as a routine procedure in patients with positive sentinel node biopsy (SNB) is not yet established. We report in the series with longest follow up outcomes of PET scans performed in patients with subclinical lymph node disease. Methods: Case notes of 29 sequential patients with melanoma of Breslow thickness greater than 1mm who had PET scans within 130 days after a positive SNB were reviewed. Four patients had a PET after the lymph node dissection (LND). Results: 2 patients (6%) had a positive PET scan neither of which was melanoma related. The first patient had a thyroid tumour confirmed with fine needle aspiration biopsy and the second patient had increased uptake in the chest wall which on verification with bone scan proved to be old trauma. 28 patients (96%) had a LND and this was positive in 5 cases (17%). With a median follow up of 23 months 21 patients remained disease free. Out of the 8 patients (27%) who presented with recurrence 2 (25%) were successfully treated with further surgery and remained in remission, 4 (50%) died, 1 (12.5%) was lost from follow-up and 1 (12.5%) is followed up in another hospital. In none of the 29 cases did the early PET scan after a positive SNB alter subsequent melanoma management. Conclusions: The role of PET scanning soon after a positive sentinel node biopsy appears to be of uncertain benefit. It is questionable whether any imaging is beneficial at this stage. The results of this review suggest that PET scanning might not be indicated for this group of patients but larger prospective studies are required to confirm this. Patients Characteristics No % Male 15 (51) Female 14 (49) Melanoma Type: Nodular 8 (27) Superficial spreading 15 (51) Other 2 (6) Unknown 4 (13) Breslow thickness: 1.0–1.9 13 (44) 2.00–3.9 14 (49) ○= 4.0 2 (6) Ulceration: Yes 3 (10) No 25 (86) Unknown 1 (3) Age Median 56 No significant financial relationships to disclose.
Biweekly paclitaxel as second-line treatment in advanced non-small cell lung-cancer (NSCLC). A phase II study of the Lung Cancer Galician Group
Authors: S. Vazquez-Estevez, J. Fírvida, G. Huidobro, L. León, M. Lázaro, M. Salgado, J. Mel, C. Grande, E. Pérez, B. Campos
Journal: Journal of Clinical Oncology (2007)

18120 Background: Paclitaxel is an active drug for NSCLC. Our purpose was to evaluate the efficacy and toxicity of biweekly administration of this drug in previously treated patients with advanced NSCLC. Methods: Patients with stage IIIB and IV NSCLC, which progressed after or during first-line chemotherapy, measurable disease, ECOG PS=0–1 and adequate organ function were included. Paclitaxel was administered at 150 mg/m 2 iv, days 1 and 14, every 28 days, for a maximum of six cycles. Both, toxicity and efficacy analyses, were performed on the intent-to-treat (ITT) population. Results: Between September 2004 and November 2006, 42 patients (M/F, 39/3) were included, with median age 64 years (39–79). Tumor histology mainly included epidermoid (40.5%) and adenocarcinoma (35.7%). Tumor stage was IIIB (23.8%) and IV (76.2%). Median number of metastatic lesions was 1 (55%), located mainly in lymph nodes (30%), lung (25%), adrenal glands (16%) and bone (11%). Previous chemotherapy included platinum (76.1%), docetaxel (66.6%) and gemcitabine (52.4%). A total of 167 cycles (median 4, range 1–6) were administered. Median relative dose intensity was 94%. Toxicity: Grade III/IV hematologic toxicities per patient were neutropenia (2.5%) and anemia (2.5%). Grade III/IV non-hematologic toxicities were asthenia (2.5%), arthralgias/myalgias (2.5%) and peripheral neuropathy (2.5%). Efficacy: Of 39 ITT patients (3 patients have just begun chemotherapy), 7 achieved PR, 11 SD and 16 progressed, resulting in an ORR of 17.95% (95% CI: 5.9–30%). Five patients could not be evaluated for response due to early withdrawal (4 tumor-related exitus and 1 PS deterioration). Median TTP and OS were 174 days (95% CI: 115.52–232.48) and 332 days (95% CI: 261.18–402.82), respectively. Conclusions: Biweekly paclitaxel is an active and very well tolerated regimen in previously treated patients with advanced NSCLC. No significant financial relationships to disclose.
Quasispecies analysis of HCV in liver, peripheral blood mononuclear cells and plasma: Evidence for alternative sites of HCV replication?
Authors: F. Maggi, C. Fornai, M.L. Vatteroni, M. Giorgi, A. Morrica, M. Pistello, G. Cammarota, S Marchi, P. Ciccorossi, A. Ricchiuti, A. Bionda, M. Bendinelli
Journal: Hepatology (1997)
Effective salvage therapy of liver-only colorectal cancer metastases with chronomodulated irinotecan-fluorouracil-oxaliplatin via hepatic artery infusion
Authors: M. Bouchahda, R. Adam, S. Giacchetti, X. M. Li, D. Castaing, D. Gholam, F. Kunstlinger, C. Jasmin, D. Machover, F. Lévi
Journal: Journal of Clinical Oncology (2006)

3585 Background: Cell cycle and pharmacology genes are controlled by the molecular clock in normal liver but not in tumors (Filipski et al. JNCI 2005). As a result, circadian-based hepatic artery infusions of 3 main active drugs (ChronoHAI) could improve both tolerability and efficacy in patients (pts) with liver metastases from colorectal cancer. Methods: The therapeutic potential of 3-drug chronoHAI was evaluated in 28 heavily pretreated non hospitalized pts with metastatic colorectal cancer (MCC). They received 5-day (d) q21 d courses (c) with d1 irinotecan (160 mg/m 2 from 2 to 8 am, peak at 5 am) and d2–5 oxaliplatin (20 mg/m 2 /d from 10 am to 10 pm, peak at 4 pm) and 5-fluorouracil (600 mg/m 2 /d from 10 pm to 10 am, peak at 4 am). 149 courses (c) were given (median, 5 ; 1–15) using a multichannel pump (Mélodie, Aguettant, F). Toxicity was assessed q21 d and response q3 c with CT scan. Results: Pt characteristics: prior chemotherapy lines 1/2/3/4+: 3/4/8/13 pts; WHO Performance Status 0/1/2/3 : 12/9/6/1 pts; median age: 63 years (32–73); liver only: 21 pts; liver and lung: 7 pts. Treatment was withdrawn for thrombosis (6 pts) and/or Grade (gr) 3 abdominal pain (3 pts). Grade 3–4 diarrhea and vomiting respectively occurred in 6 pts (21%) and 4 pts (14%) and were the main toxicities. Leucopenia, anemia and thrombocytopenia were respectively encountered in 5, 2 and 1 pt (&lt; 18%). NCIC gr 3 sensory neuropathy occurred in 4 pts and alopecia in 3 pts. Of 25 pts with measurable lesions, disease progressed in 11 pts (exclusively outside the liver for 3 pts) and was controlled in 14 pts (56%), including 8 objective responses - 32% [95% C.L. 13.4 to 50.6]. Partial hepatectomy was performed in 3 pts with measurable disease (12%): R0 (2 PR) and R1 (1 SD). Median Progression free survival is 5 months [2.5 to 7.5] and median survival is 18.4 mo [10.5 to 26.3]. Five pts are alive at 2 to 51 mo. Conclusions: 3-drug chronoHAI is safe in heavily pretreated pts and achieves consistent activity against colorectal cancer liver metastases despite prior failure to oxaliplatin, irinotecan and fluorouracil. The addition of systemic molecular targeted therapy could be useful for preventing extra hepatic dissemination. Supported by ARTBC, Hôpital P. Brousse, Villejuif, France No significant financial relationships to disclose.
Authors’ reply to Smith and colleagues
Authors: James L Mills, Aggeliki Dimopoulos
Journal: BMJ (2016)

Some of Smith and colleagues’ statements about our editorial require clarification.1 2 They interpret our statement that: “No important adverse effects have been identified to date, probably because a modest level of fortification has proved very effective in preventing these devastating birth defects” as a claim that fortification is safe because it is effective for one condition. This interpretation is incorrect. Food fortification in the US has resulted in an average exposure to about 200 µg of folic acid per day.3 This is half the recommended dietary allowance (RDA). We were indicating that it is not surprising that no adverse effects have been seen from such a modest dose. As Smith and colleagues point out, WHO states that even high folic acid exposure, in contrast to the small amount fortification delivers, “has not reliably been shown to be associated with negative effects.”4 Thus, the postulated adverse effects, if any, have not been proved.

The reduction in neural tube defect rates produced by fortification is proportional to the underlying rate,5 and reported reductions vary depending on the completeness of ascertainment.6 Many …
Correlation of high CD49d expression with disease progression and need for therapy in chronic lymphocytic leukemia (CLL) patients
Authors: V. Gattei, P. Bulian, M. I. Del Principe, A. Zucchetto, P. Niscola, R. Bomben, M. Dal Bo, F. Buccisano, S. Amadori, G. Del Poeta
Journal: Journal of Clinical Oncology (2007)

7091 Background: CD49d mediates interaction of lymphocytes with microenvironmental components. We and others reported the correlated expression of CD49d and CD38 by CLL cells, and the complementary value of these molecules in predicting overall survival for CLL patients. However, nothing is known on the relationship of CD49d with other prognosticators and its impact in predicting disease progression and need for therapy in CLL. Methods: The study includes 232 CLLs (median age 64 yrs), all characterized for Rai stages, lymphocyte doubling time (LDT), CD49d, CD38 and ZAP-70 expression, serum levels for sCD23 and beta2-microglobulin (beta2-m), IgVH mutations (139/232), cytogenetics (151/232; FISH for 17p, 11q, 13q, 12). CD49d was measured in CD19/CD5 cells by three-color flow cytometry, choosing a 30% cut-off to discriminate CD49d-low vs. CD49d-high CLLs. NCI-working group criteria were used for CLL diagnosis, progression and therapy need. Results: Median time-to-progression (TTP) was 136 and 56 months in CD49d-low and CD49d-high CLL patients (p=0.00008), respectively; similarly, median time-to-treatment (TTT) was 108 and 46 months for the same patient groups (p=0.000008). Correlations were also observed among CD49d and CD38 (p=2.2x10exp-16) or ZAP-70 (p=0.00009) expression, sCD23 serum level (p=0.0017), LDT (p=0.0037), Rai stages (p=0.019), cytogenetics (p=0.011), IgVH mutations (p=0.00008). TTT and TTP were significantly shorter in CLLs in advanced Rai stages, or with high CD38 and ZAP-70 or low IgVH mutations. Within these cases, significantly longer TTP/TTT were observed in subsets expressing low CD49d. Serum levels of sCD23 and beta2-m, LDT, and FISH analyses had also predictive value for progression and treatment in our series. Within the better prognosis groups (i.e. &lt;70 U/ml sCD23, 12 months, or a normal karyotype), high CD49d expression identified a subset of patients with significantly shorter TTP/TTT. Overall, the capability of CD49d to predict disease progression and need for therapy was statistically significant in younger patients (&lt;64 y.o.; 115 cases; p=0.0001), but not in those older than 64 yrs (117 cases; p=0.09). Conclusions: We propone to include evaluation of CD49d expression in the prognostic assessment of CLL patients. No significant financial relationships to disclose.
Autopsy Room
Authors: D Ofri
Journal: JAMA (1998)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Local Tumor Inflammation, Lymph Node Metastasis, and Survival of Operated Bronchus Carcinoma Patients
Authors: K Kayser, H Bülzebruck, W Ebert, N M Merkle, I Vogt-Moykopf
Journal: JNCI Journal of the National Cancer Institute (1986)

Three hundred and fifty-three resection specimens with primary lung carcinomas were cut into serial sections, and the tumor volume was computed. Resected lymph nodes were cut into 0.3-mm serial sections and analyzed for metastasis. The inflammatory reaction of lung tissue was analyzed by grading the amount of inflammatory infiltrations of a complete tumor cross section. Survival of patients was evaluated by consulting the house physician every 3 months after surgical treatment. Percentage of specimens with severe inflammatory reaction of host tissue increased remarkably in tumors with a volume of 35-60 cm3. Percentage of patients with detectable lymph node metastasis increased with tumor volume but decreased at the tumor volume of 35-45 cm3. Mean tumor volume in patients with no detectable lymph node metastasis was increased if severe inflammatory response of host tissue existed. Survival of patients with severe inflammatory infiltrations was superior to survival of patients with no inflammatory infiltrations if grouped for tumor volume. Data indicated that inflammatory infiltrations in primary lung carcinoma may partly be related to the immunologic response of host tissue to tumor growth. Inflammatory infiltrations may delay tumor cell propagation into lymph nodes or may be even able to destroy small tumor cell agglutinations.
Susceptibility to Urethan-Induced Pulmonary Adenomas Between A/J and C57BL/6J Mice: Use of AXB and BXA Recombinant Inbred Lines Indicating a Three-Locus Genetic Model234
Authors: Alvin M. Malkinson, Muriel N. Nesbitt, Emil Skamene
Journal: JNCI Journal of the National Cancer Institute (1985)

For insight into the number of genes governing differential susceptibility such as in mice of the inbred strain A/J (A) highly susceptible to the induction of pulmonary adenomas by urethan in comparison to resistant strain C57BL/6J (B6) mice, tumor induction was studied in the AXB and BXA series of recombinant inbred (RI) strains derived respectively from A♀ × B6♂ and B6♀ × A♂ ancestral lines. Mice from 46 of these lines were given injections with 1 mg urethan/g (body wt), and the tumor number was assessed 4 months later. Lung tumor multiplicity for several RI lines was independently characterized in the Boulder, CO, and Montreal laboratories, and very similar numbers were obtained. Most lines had multiplicities intermediate to those of the progenitor strains, clearly indicating that more than a single gene accounted for the differences in lung tumor susceptibility between A and B6. The tumor incidence and multiplicity data fit very closely to what would be expected under a three-locus model, and we designated these genes “Pas” for pulmonary adenoma susceptibility. One locus called “Pas-1” had an effect on tumor multiplicity greater than that of the other loci.
Abstract 17621: PI3K? Inhibition Protects From in Diabetic Cardiomyopathy in Mice
Authors: Daniela Carnevale, Giuseppe Cifelli, Roberta Iacobucci, Fabio Pallante, Giuseppe Lembo
Journal: Circulation (2013)

Cardiovascular complications, including cardiomyopathy, are the major causes of fatalities in diabetes. The cardiac abnormalities observed, including apoptosis, hypertrophy, [[Unable to Display Cha...
Erratum to: NLK functions to maintain proliferation and stemness of NSCLC and is a target of metformin
Authors: Dong Suwei, Zeng Liang, Liu Zhimin, Li Ruilei, Zou Yingying, Li Zhen, Ge Chunlei, Lai Zhangchao, Xue Yuanbo, Yang Jinyan, Li Gaofeng, Song Xin
Journal: Journal of Hematology & Oncology (2016)

The online version of the original article can be found under doi: 10.1186/s13045-015-0203-8  .
Stillbirths: economic and psychosocial consequences
Authors: Alexander E P Heazell, Dimitrios Siassakos, Hannah Blencowe, Christy Burden, Zulfiqar A Bhutta, Joanne Cacciatore, Nghia Dang, Jai Das, Vicki Flenady, Katherine J Gold, Olivia K Mensah, Joseph Millum, Daniel Nuzum, Keelin O'Donoghue, Maggie Redshaw, Arjumand Rizvi, Tracy Roberts, H E Toyin Saraki, Claire Storey, Aleena M Wojcieszek, Soo Downe, Vicki Flenady, J Frederik Frøen, Mary V Kinney, Luc de Bernis, Joy E Lawn, Hannah Blencowe, Alexander E P Heazell, Susannah Hopkins Leisher, Ingela Radestad, Louise Jackson, Chidubem Ogwulu, Alison Hills, Stephanie Bradley, Wendy Taylor, Jayne Budd
Journal: The Lancet (2016)
Which better predicts mortality, a prostate cancer (PCa) history or vulnerability on the Vulnerable Elders Survey (VES-13)? A prospective cohort study.
Authors: S. G. Mohile, H. Hopkins, J. Hemmerich, L. Fan, W. Dale
Journal: Journal of Clinical Oncology (2010)

e19589 Background: Older PCa pts face competing mortality risks. We compared the utility of the VES-13 for predicting mortality in older PCa pts (n = 59) with controls (n = 318). Methods: Men from an urban geriatrics clinic completed the VES-13 from 2003-2008. Additional data obtained included sociodemographics, comorbidities, and PCa characteristics. PCa pts were matched by age to 5 controls. Date of death was obtained from the Social Security database. Logistic regression and Cox-proportional hazard analyses compared groups by cancer status and VES-13 score. Optimal VES-13 “cut-points” were determined by ROC curves. Results: The PCa pts were well-matched with controls in terms of underlying characteristics. There was a high prevalence of African Americans (94.7% in PCa survivors versus 82.2% in controls, p = 0.053). Of the PCa group, 7 of the 59 subjects had metastatic disease, all except one had stable disease on hormonal therapy. The prevalence of vulnerability as measured by the conventional score of ≥ 3 was high (45.8% of PCa pts versus 54.7% of controls, p = .26). By the end of the follow-up period, 33.9% of PCa pts had died compared to 30.8% of controls (p = 0.639). Regression analysis revealed that increasing VES-13 score was independently associated with mortality (OR = 1.16, p <.0.01), while having PCa was not (p = 0.62). Controlling for other factors, the hazard ratio for dying during the follow-up period associated with increasing VES-13 score was 1.14, p<0.01. Being a PCa survivor trends toward being “protective” (HR = 0.21, p = .06), although metastatic disease was associated with higher risk for death (HR = 3.0, p = .02). With an area under the ROC curve of 0.80, the optimal VES-13 screening cutoff is ≥ 6 rather than the conventional 3. Conclusions: The VES-13 is a more valuable predictor of mortality than PCa status for older men in an urban geriatrics clinic. For this population, the optimal screening cutoff value is 6. Clinics caring for older men with PCa should consider using the VES-13 to screen for vulnerability. No significant financial relationships to disclose.
Esophagitis and pneumonitis in patients treated with concurrent chemo-radiation for stage IIIA/B non-small cell lung cancer
Authors: G. Hare, N. Reddy, J. Gomez, N. Ramnath
Journal: Journal of Clinical Oncology (2004)

7354 Background: Concurrent rather than sequential chemotherapy and radiotherapy (XRT) is the standard of care for patients (pts) with Stage IIIA/B non- small cell lung cancer (NSCLC). Esophagitis and pneumonitis complicate this modality and may be under-reported. Our objective was to evaluate these toxicities in patients who received concurrent chemo-radiation in our institution. Methods: Retrospective study of 100 stage IIIA/IIIB NSCLC pts. from 1998–2003 who received concurrent chemo-radiation. The chemotherapy used was carboplatin and paclitaxel (on a weekly schedule × 6 weeks) in 85/100 pts. The primary site was treated at 200cGy per fraction to 60–66Gy and the regional lymph nodes from 36–44 Gy. XRT was intended daily as a single fraction for 6 weeks. Results: There were 52 female and 48 males with a median age of 67 years. The pathology was squamous (n=46), adeno (n=31), large cell (n=12) and other (n=11). The performance status was 0–1 in 97/100 pts. Smokers constituted 97/100 pts. Seven patients had a history of asbestos exposure. Twenty- five pts had a clinical diagnosis of COPD. Esophagitis was seen in 53 pts; gr 1 (n=9), gr II (n=35) gr III (n=7) and gr IV (n=2). Treatment was discontinued abruptly in the 2 patients with grade IV esophagitis. Pneumonitis gr 1(n=19), gr II (n=18), gr III (n=2) and gr IV (n=1) was noted in 40 patients. The median time to onset of pneumonitis was 7 months (range 2–12). Hematological toxicity was less common, gr I (n=11), gr II (n=5) and gr III (n=1). Conclusions: Esophagitis and pneumonitis in pts treated with concurrent chemoradiation for stage IIIA/IIIB NSCLC is underreported. A significant number of pts experience lung and esophageal toxicity. Novel XRT techniques, such as the use of intensity modulated radiation therapy (IMRT) and incorporation of chemo and radio-protectants are needed to decrease morbidity to normal lung and the esophagus. No significant financial relationships to disclose.