tbuckley/cabot-search huggingface dataset:
Downstaging capacity of neoadjuvant chemotherapy in distal versus proximal gastric carcinoma: Preliminary data from a regional tumor registry.
Authors: Benjamin Garlipp, Frank Meyer, Elke Burger, Daniela Adolf, Patrick Stuebs, Johannes Bernarding, Guenther F.E. Gademann, Hans Lippert
Journal: Journal of Clinical Oncology (2012)

120 Background: Following the results of 3 randomized controlled trials, neoadjuvant chemotherapy has become standard of care for locally advanced gastric cancer in Europe. All of these trials included patients with cancers located in the gastric corpus, antrum, and pylorus (distal gastric cancers, DGC) as well as cancers of the esophagogastric junction and fundus (proximal gastric cancers, PGC). However, data suggest that DGC and PGC may be two distinct tumor entities. The aim of our study was to investigate if the capacity of neoadjuvant chemotherapy to downstage gastric cancers is different for DGC and PGC. Methods: We used data from the clinical regional tumor registry of Magdeburg which covers the northern section of the federal district of Saxony-Anhalt, Germany, to compare pretherapeutic (clinical) and postoperative (histopathological) UICC tumor stages in patients with DGC and PGC treated with neoadjuvant chemotherapy followed by surgery. Results: Of 2,460 gastric cancer patients entered into the registry between January 1993 and September 2010, 189 (7.7%) received neoadjuvant chemotherapy. Of these, 149 underwent surgery with curative intent. Pretherapeutic and postoperative UICC stages were not available for 34 of these patients. A further 42 patients had UICC stage IV documented at laparotomy; since this was likely due to peritoneal carcinomatosis which may have gone unnoticed at the start of neoadjuvant chemotherapy and thus does not reliably indicate upstaging, these patients were excluded from analysis. Of the 73 evaluable patients, 33 (45.2%) had DGC and 40 (54.8%) had PGC. UICC tumor stage decreased during therapy in 55.1% and 75.0%, remained unchanged in 16.3% and 20.8%, and increased in 28.6% and 4.2% of DGC and PGC patients, respectively (p=0.039, Fisher’s exact test). Conclusions: Despite the limited statistical power, these preliminary data suggest that DGC and PGC may differ in their response to neoadjuvant chemotherapy. With more widespread use of neoadjuvant chemotherapy in gastric cancer in recent years, we expect a steep increase in evaluable patients in the tumor registry which will allow for future multivariate analyses regarding this issue.
Ability of urovysion FISH analysis to select patients with low- or intermediate-risk non-muscle-invasive bladder cancer (LI-NMIBC) for decreased surveillance.
Authors: H. M. Rosevear, A. J. Lightfoot, M. A. O'Donnell
Journal: Journal of Clinical Oncology (2011)

283 Background: Recurrent LI-NMIBC is difficult to detect cytologically, requiring frequent cystoscopies. Urovysion's (Abbot Laboratories, Downers Grove, IL) fluorescent in situ hybridization assay (FISH) detects genetic changes associated with LI-NMIBC and may be useful in identifying patients for extended screening intervals. Methods: Charts of 54 consecutive patients with LI-NMIBC who underwent cystoscopy, cytology, and FISH analysis every 3 months for the first year after resection since 2004 were retrospectively identified and reviewed. We analyzed the number of tumors or high-grade cytologies that would have been missed if surveillance cystoscopy, cytology, and FISH analysis had not been done between 3 and 12 months post-resection for patients with a normal cystoscopy, cytology, and FISH analysis at 3 months after initial resection and compared those results to patients with normal cystoscopy, cytology, and abnormal FISH analysis. Results: Mean age of the 54 patients was 67 (range 25–89) and 41 were males. Thirty-nine patients had normal cystoscopy, cytology, and FISH analysis at 3-months follow-up. If no further surveillance was done until 1 year post-resection, 2 low-grade tumors (3 and 7 mm at 7 months post-resection) and 2 incidents of high-grade cytology would have been missed (4 of 39, 10%). Fifteen patients had normal cystoscopy and cytology but abnormal FISH analysis results at 3 months. If no further surveillance had been done until 1 year after resection, 6 tumors (6 of 15, 40%) (5, 8, 3, 3, 9, 2 mm at 5, 6, 6, 7, 9, 10 months post-resection) and no high-grade cytology would have been missed. Overall, statistically fewer patients with normal compared to abnormal FISH analysis at first follow-up developed tumors before 1 year (4 of 39 vs. 6 of 15, p=0.033). Conclusions: FISH analysis can be used to significantly increase our ability to select patients suitable for extended screening intervals. It may be prudent to include FISH analysis at the first post-resection follow-up before selecting patients with LI-NMIBC for an extended screening interval. [Table: see text]
Robotic-assisted radical prostatectomy in a system of universal health care with limited access to high-tech resources.
Authors: A. Autran Gomez, A. Alzaharani, A. Williams, J. Chin
Journal: Journal of Clinical Oncology (2011)

116 Background: The goal of radical prostatectomy (RP) is to minimize the positive surgical margin (PSM) rate. Robotic- assisted radical prostatectomy (RALP) has the theoretical advantages of enhanced ability to identify surgical dissection planes to improve surgical outcome but is associated with a learning curve. The objective is to review the PSM rate and intra- and postoperative complications (Clavien grading) correlating with possible risk factors in a low-density RALP by a high-volume, open RP surgeon working in the Canadian Healthcare System. Methods: The data of 56 RALP from April 2004 to Dec 2009 by one surgeon contemporaneously performed 830 RP. PSM was analyzed and correlated with clinical variables. Univariable and multivariable analyses were used. Results: PSM 19 (34%) cases. At univariable analysis, no association was observed between PSM and age BMI, PSA, number positive cores, % positive cores, Gleason biopsy and clinical stage. Pathological Gleason (p=0.012), pathological stage (p= 0.003) and % tumor in surgical specimen (p=&lt;0.001) were associated with increased risk of PSM. At multivariable the % tumor in surgical specimen (p&lt;0.001) were only independent predictive factor for PSM. According to localization of PSM Apical 9 (48%), PLR 4 (21%), PLL 4 (21%) and bladder neck 1 (5%). Mean follow-up 23 months. In PSM, 12 (63%) showed an undetectable PSA (≤0.01ng/mL) at 3 months. Using Clavien grading, 9 surgical complication in 9(16%) patients: 6 (grade 1–2) and 3 (grade 3–4). 4 patients with PSM had complications, 2 (grade1-2) and 2 (grade 3–4). At multivariable analyses, BMI (p=0.008) was the only predictive factor for occurrence of complications. Conclusions: The pathological stage and tumor (%) in the surgical specimen were independent predictive factor for PMS. Applying the Clavien grading, most of the patients presented minor complications. The Canadian Universal Healthcare system with limited access to high-tech resources may not be ideal for introducing an expensive new surgical technique, especially for an ubiquitous procedure such as RP. However, results of our low-density series or sporadic cases were not inferior to reported initial experience series of RALP in the literature. No significant financial relationships to disclose.
The prostate cancer survivorship program: A new concept for holistic long-term support and follow-up.
Authors: Sanchia Shanika Goonewardene, Annie Young, Mary Symons, Anne Sullivan, Gary McCormack, Vanessa Milner, Adel Makar
Journal: Journal of Clinical Oncology (2012)

72 Background: Previously cancer follow-up was based in secondary care. Survivors were seen in overburdened clinics, receiving brief clinic appointments and limited holistic care. We have piloted a new community based model in prostate cancer survivors in order to reduce service load. Patients are discharged from clinic, and entered into a specially developed web based database. This reviews PSA results, triggers alerts, resulting in specialist nurses (CNS) bringing patients back to clinic. This is supplemented by an annual survivorship conference, where patients have access to heathcare professionals. Patients also have access to community based services including a newly built community centre for patients where they have access to a range of healthcare professionals, ranging from dieticians to psychologists. We present our results, and evaluate this model independently with Pickering Institute patient questionnaires distributed one month pre and post conference and focus groups to develop further recommendations for the programme. Methods: We have developed a team composed of a consultant urological lead, commissioners, a GP, a specialist nurse, patient representatives and an IT specialist. Patients were entered into this programme over the past 1 year (323 so far). Inclusion criteria specify patients must be: 2 years post radical prostatectomy (unrecordable PSA), 3 years post radical radiotherapy with/ without hormones or 3 years post brachytherapy (both with stable PSA) according to the Phoenix criteria. Results: Patients completed an outcome questionnaire before the conference and one month afterwards (55 in total). Perceived control pre-conference was 7.19, post conference 7.38. Concern pre-conference was 3.56, 3.46 post conference. Understanding pre-conference was 7.49, 7.85 post-conference. Focus Group Results: The advantages of community based follow up were having an approachable primary contact, speedy referral, saving time, money and stress over prolonged waits and brief hospital appointments. Conclusions: We discuss how the programme can be developed, including: PSA feedback, a buddying system, and how this can be put into use across other tumour sites and other specialities.
Differences in Electrocardiographic Findings Between Acute Isolated Right Ventricular Myocardial Infarction and Acute Anterior Myocardial Infarction
Authors: Masami Kosuge, Kazuo Kimura
Journal: JAMA Internal Medicine (2016)

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Temporal Profiles of Lymphocyte Subsets and the Correlation with Infectious Events in Idelalisib-Treated Patients
Authors: Jeffrey P. Sharman, Gilles A. Salles, Wojciech Jurczak, Jeffrey Jones, Carolyn J. Owen, Veerendra Munugalavadla, Lyndah K. Dreiling, Yuanyuan Xiao, Arati V. Rao, Ian W. Flinn, Susan M. O'Brien
Journal: Blood (2016)
Selective D-Dimer Testing for Diagnosis of a First Suspected Episode of Deep Venous Thrombosis
Authors: Lori-Ann Linkins, Shannon M. Bates, Eddy Lang, Susan R. Kahn, James D. Douketis, Jim Julian, Sameer Parpia, Peter Gross, Jeffrey I. Weitz, Frederick A. Spencer, Agnes Y.Y. Lee, Martin J. O'Donnell, Mark A. Crowther, Howard H. Chan, Wendy Lim, Sam Schulman, Jeffrey S. Ginsberg, Clive Kearon
Journal: Annals of Internal Medicine (2013)

D-Dimer testing is sensitive but not specific for diagnosing deep venous thrombosis (DVT). This trial compared D-dimer testing of all patients with testing based on clinical pretest probability amo...
A multicenter phase II study of S-1 combined with irinotecan (CPT-11) for patients with advanced/recurrent breast cancer.
Authors: U. Toh, N. Iwakuma, H. Otsuka, M. Takenaka, E. Ogo, T. Fujii, M. Tanaka, K. Shirouzu
Journal: Journal of Clinical Oncology (2011)

e11528 Background: Irinotecan (CPT-11) is an inhibitor of topoisomerase I, an enzyme necessary for DNA replication and S-1 has been developed as an oral drug consisting of the 5-FU prodrug tegafur combined with the two modulators of 5-FU activity. They have been shown to be effective in patients (pts) with advanced/recurrent breast cancer with a considerable single-agent activity, respectively. This study to evaluate the clinical effect of CPT-11 combined S-1 for advanced or recurrent breast cancer (BC). Methods: This is an open-label, multicenter, single-arm, phase II study. The primary objective is to evaluate the effect of S-1 plus CPT-11 regimen on clinical response, secondary objective included evaluating the safety, time to next progression and duration, the QOL during the treatment will also be evaluated. The planned sample size is 35-55. Patient eligibility criteria: All pts with histologically confirmed BC with unresectable or metastatic diseases, measurable lesions, PS 0-2, age between 18 and 80. Prior adjuvant chemotherapy finished at least 6 months before enrollment was allowed. Treatment schedule: S-1 80 mg/m2 p.o. twice daily on days 3 to 7, 10 to 14, and 17 to 21 and CPT-11 60 mg/m2 i.v. on day 1, 8, 15 with a 1-week interval until disease progression or unacceptable toxicities. Both recommended doses of S-1 and CPT-11 was based on our previous Phase I study. (Ogata et al. abstr 2535, ASCO 2008) Results: The enrollment have begun from January 2009, currently total 24 pts were enrolled in this study. The median age was 56.5 years (range, 38-73). Fourteen pts had recurrent disease after previous curative mastectomy and 10 had previous adjuvant chemotherapy. Conclusions: CPT-11+S1 is a promising regimen for the treatment of refractory BC pts. This trial will futher assess efficacy and safety using the standard response evaluation criteria in solid tumors (RECIST) and the National Cancer Institute Common Toxicity Criteria (version 3.0) in these pts.
Everolimus in metastatic renal cell carcinoma (mRCC): Subgroup analysis of patients (pts) with one versus two prior vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) therapies enrolled in the phase III RECORD-1 study.
Authors: R. A. Figlin, E. Calvo, R. J. Motzer, T. E. Hutson, S. Oudard, C. Porta, V. Grunwald, A. Ravaud, E. Kpamegan
Journal: Journal of Clinical Oncology (2011)

304 Background: The mammalian target of rapamycin (mTOR) inhibitor everolimus is the only medication to have shown efficacy in a randomized, controlled, phase III clinical trial (RECORD-1) in pts with mRCC after progression on VEGFR-TKIs. Everolimus more than doubled progression-free survival (PFS) vs. placebo (4.9 vs 1.9 months) and reduced the risk of disease progression by 67%. This analysis evaluated the effect of everolimus on survival in pts who had received 1 vs 2 prior VEGFR-TKIs. Methods: Pts with mRCC who progressed on sunitinib (SU) and/or sorafenib (SOR) were randomized (2:1) to receive everolimus 10 mg/day (n = 277) or placebo (n = 139) plus best supportive care in the double- blind, phase III RECORD-1 study (ClinicalTrials.gov: NCT00410124 ). Results: Before enrollment, the majority of pts received only 1 VEGFR- TKI (317 pts, 74%), with 317 pts receiving either SU or SOR (everolimus = 211; placebo = 106) and 99 pts receiving both SU and SOR (everolimus = 66; placebo = 33). Median PFS was 5.42 mo (95% confidence interval [CI]: 4.30, 5.82) in pts receiving everolimus who had received 1 prior VEGFR-TKI and 1.87 mo (95% CI: 1.84, 2.14) in those receiving placebo (hazard ratio [HR]: 0.31; 95% CI: 0.23, 0.42; p &lt; .001). Median PFS was 3.78 mo (95% CI: 3.25, 5.13) for the everolimus group in pts who received 2 prior VEGFR-TKIs, versus 1.87 mo (95% CI: 1.77, 3.06) for the placebo group (HR: 0.37; 95% CI: 0.22, 0.63; p &lt; 0.001). Conclusions: Pts in all stratified subgroups derived significant clinical benefit from everolimus treatment, including pts previously treated with either 1 or 2 VEGFR-TKIs. However, there was a trend toward a longer PFS in pts treated with 1 prior VEGFR-TKI compared with 2 VEGFR-TKIs. [Table: see text]
Association between smoking and the risk of acute mountain sickness: a meta-analysis of observational studies
Authors: Chen Xu, Hong-Xiang Lu, Yu-Xiao Wang, Yu Chen, Sheng-hong Yang, Yong-Jun Luo
Journal: Military Medical Research (2016)

People rapidly ascending to high altitudes (>2500 m) may suffer from acute mountain sickness (AMS). The association between smoking and AMS risk remains unclear. Therefore, we performed a meta-analysis to evaluate the association between smoking and AMS risk. The association between smoking and AMS risk was determined according to predefined criteria established by our team. Meta-analysis was conducted according to the PRISMA guidelines. We included all relevant studies listed in the PubMed and Embase databases as of September 2015 in this meta-analysis and performed systemic searches using the terms "smoking", "acute mountain sickness" and "risk factor". The included studies were required to provide clear explanations regarding their definitions of smoking, the final altitudes reached by their participants and the diagnostic criteria used to diagnose AMS. Odds ratios (ORs) were used to evaluate the association between smoking and AMS risk across the studies, and the Q statistic was used to test OR heterogeneity, which was considered significant when P < 0.05. We also computed 95% confidence intervals (CIs). Data extracted from the articles were analyzed with Review Manager 5.3 (Cochrane Collaboration, Oxford, UK). We used seven case-control studies including 694 smoking patients and 1986 non-smoking controls to analyze the association between smoking and AMS risk. We observed a significant association between AMS and smoking (OR = 0.71, 95% CI 0.52–0.96, P = 0.03). We determined that smoking may protect against AMS development. However, we do not advise smoking to prevent AMS. More studies are necessary to confirm the role of smoking in AMS risk.
Defibrotide (DF) for the Prevention of Hepatic Veno-Occlusive Disease (VOD) in Pediatric Stem Cell Transplantion: Results of a Prospective Phase II/III Randomized, Multicenter Study.
Authors: Selim Corbacioglu, Simone Cesaro, Maura Faraci, Dominique Valteau-Couanet, Bernd Gruhn, Jaap Jan Boelens, Cornelio Uderzo, Netty Hewitt, Johanna Schrum, Ingo Mueller, Ansgar S Schulz, Jerry Stein, Robert Wynn, Johann Greil, Susanne Matthes, Sykora Karl-Walter, Monika Fuehrer, Anne O'Meare, Klaus-Michael Debatin, Joseph Massaro, Ralph D'Agostino, Margeret Hoyle, Massimo Iacobelli, Christina Peters, Giorgio Dini
Journal: Blood (2009)
Diastolic Dysfunction Is an Independent Risk Factor for Death in Patients with Sickle Cell Disease.
Authors: Vandana Sachdev, Roberto F. Machado, Yukitaka Shizukudu, Yesoda Rao, Stanislav Sidenko, Inez Ernst, Marilyn St. Peter, Wynona A. Coles, Doug Rosing, William C. Blackwelder, Oswaldo Castro, Gregory J. Kato, Mark T. Gladwin
Journal: Blood (2005)
Prognosis and nonsentinel lymph node status of the patients with breast cancer with micrometastatic sentinel lymph nodes.
Authors: M. Takahashi, H. Jinno, T. Hayashida, M. Sakata, S. Hirose, M. Mukai, Y. Kitagawa
Journal: Journal of Clinical Oncology (2011)

e11503 Background: Sentinel lymph node biopsy (SLNB) is a more sensitive and accurate nodal staging procedure than axillary lymph node dissection (ALND). Because of detailed pathologic evaluation in SLNs, more nodal micrometastases have been identified. However, it remains controversial whether to perform ALND for patients with micrometastases in SLNs and their prognostic significance is also a matter of debate. The purpose of this study is to determine the non-sentinel lymph node (NSLN) status and prognosis of the patients with micrometastatic SLNs. Methods: A prospective database of 1,012 clinically node-negative, T1-T2 breast cancer patients, who underwent SLNB from January 2002 to Dec 2010 at Keio University Hospital was analyzed. SLNs were detected using a combined method of isosulfun blue dye and small-sized technetium-99m-labeled tin colloid. Intraoperative frozen examination was performed with hematoxylin and eosin (HE) staining. SLNs, fixed and embedded in paraffin, were additionally diagnosed with HE staining and immunohistochemical (IHC) analysis. Results: Micrometastases in SLNs were found in 69 (6.8%) of 1,012 patients. Thirty eight (55.1%) of 69 patients with micrometastatic SLNs underwent immediate or delayed ALND and revealed no NSLN metastasis. Among 31 (44.9%) patients with micrometastatic SLNs who omitted ALND and axillary radiation therapy, no axillary lymph node recurrence has been observed after a median follow-up of 50 months, although 29 patients (93.5%) in these 31 patients received adjuvant systemic therapy. There is no significant difference in recurrence free survival between the patients with micrometastatic and negative SLNs (98.0% vs. 95.7%, respectively). Conclusions: These date suggested that it may not be necessary to perform ALND for the patients with micrometastatic SLNs and the presence of micrometastases in SLNs may not worsen prognosis with proper systemic therapy.
Molecular markers for circulating tumor cells in breast cancer.
Authors: R. Zeillinger, E. Obermayr, A. Fink-Retter, G. Heinze, A. Reinthaller, R. Horvat, D. C. Castillo-Tong
Journal: Journal of Clinical Oncology (2011)

223 Background: Recently, we identified a six gene panel (CCNE2, DKFZp762E1312, EMP2, MAL2, PPIC, and SLC6A8) for the RT-qPCR based detection of circulating tumor cells (CTC) in breast cancer patients. The aim of the present study was to evaluate the gene panel in further blood samples. Methods: Blood samples were taken from breast cancer patients with metastatic disease (MBC, N=10) or with no evidence of disease (NED, N=30). Putative CTC were enriched by Oncoquick density gradient centrifugation. Total RNA was isolated with RNeasy Micro Kit (QIAgen). Template cDNA was generated with M-MLV Reverse Transcriptase, RNase H Minus (Promega) and random nonamers as primers. RT-qPCR was performed in duplicate reactions using TaqMan Assays (Applied Biosystems) with default thermal cycling parameters. Raw data were analyzed with the AB7900 Sequence Detection Software version 2.2.2 using automatic baseline correction and manual cycle threshold setting. Gene expression was normalized to GAPDH expression. A threshold value T X for each gene X was set at two standard deviations above the mean dCt X value in the healthy control group. A patient was defined as CTC-positive, if at least one gene marker was over-expressed compared to the defined threshold. Results: The gene panel consisting of CCNE2, DKFZp762E1312, EMP2, MAL2, PPIC, and SLC6A8 identified 4/11 MBC but only 5/27 NED patients as CTC positive (p=0.163). By adding known CTC markers (SCGB2A2, TFF1, FXYD3, AGR2, S100A18, and EPCAM) to the panel, 7/11 MBC but only 6/27 NED patients were CTC positive (p=0.018). The presence of CTC in NED patients correlated with pN staging (p=0.026). Only one out of the six CTC positive NED patients relapsed within the observation period (median 35 months, range 25-39 months from blood sampling). We observed no correlation of CTC positivity and recurrence in NED patients. Conclusions: The sensitivity of the RT-qPCR based CTC detection in breast cancer patients may be enhanced by adding known CTC markers (SCGB2A2, TFF1, FXYD3, AGR2, S100A18, and EPCAM) to the six gene panel (CCNE2, DKFZp762E1312, EMP2, MAL2, PPIC, and SLC6A8). Longer follow-up times are needed to evaluate the predictive value of the gene markers on survival.