tbuckley/cabot-search huggingface dataset:
Colorectal liver metastases management in the Veterans Health Administration: Geographic disparity.
Authors: Dalia A. Mobarek, Brendan C. Visser, Steven Krasnow, Ji Won Chang, Patricia Nechodom, Scott L. DuVall
Journal: Journal of Clinical Oncology (2016)

694 Background: Multidisciplinary management including surgical resection of Colorectal Liver Metastases (CLM) offers the greatest chance of long-term survival. We aimed to study surgical intervention types, rates and factors affecting the decision making in the Veterans Health Administration. Methods: The Veterans Affairs Central Cancer Registry (VACCR) and VA Informatics &amp; Computing Infrastructure (VINCI) were queried and linked to retrospectively analyze stage IV CLM from 10/01/2004-12/31/2012. Cohort construction and statistical analyses were performed utilizing SQL Server, SAS software, version 9.4 (SAS Institute Inc., Cary, NC) and Microsoft Excel. Results: We identified 118 VA stations and 1245 subjects meeting the inclusion criteria. Hemicolectomy was identified in 79%, (637) and 21 % (168) liver metastatectomy. Open versus laparoscopic hemicolectomy was 87.96% and 12.04% respectively. Follow-up imaging post metastatic disease diagnosis was carried in 88.9% (1,108) subjects. Immense variation in the percentage of surgeries conducted and the sites of surgery when stratified by geographic location. The percentage of patients receiving surgery at the colon remained high across almost all the stations. In 53 stations, hemicolectomy and hepatectomy were attempted in at least 15% of subjects with stage IV colorectal cancer and isolated liver metastases. Of the high volume stations, only 52% had a 15% or higher percentage of hemicolectomy and hepatectomy. Subjects receiving hepatectomy only were the least frequent and occurred in only three stations. Age at diagnosis, gender, Charlson comorbidity scores and the performance status at diagnosis did not differ significantly among surgery versus no-surgery groups. Conclusions: Geographic disparity emerged as a factor affecting metastatectomy decisions. Ongoing analysis to identify and analyze the differences amongst various stations is underway. Additional characterization of the liver metastases including size, number, and specific hepatic lobe and the surgical expertise is underway.
Intensity-modulated radiation therapy versus 3D conformal radiation therapy for squamous cell carcinoma of the anal canal.
Authors: Michael Chuong, Jessica Freilich, Sarah Hoffe, William J. Fulp, Jill Weber, Khaldoun Almhanna, William R. Dinwoodie, Kenneth Meredith, Ravi Shridhar
Journal: Journal of Clinical Oncology (2013)

494 Background: The emergence of intensity-modulated radiation therapy (IMRT) in the treatment of anal cancer has dramatically lowered the incidence of severe toxicity while maintaining excellent long-term outcomes. We compared our institutional experience using 3D conformal radiation therapy (3DCRT) versus IMRT for anal cancer. Methods: We performed a single-institution retrospective review of all non-metastatic squamous cell carcinoma anal cancer patients treated between 2000-2011 using definitive chemoradiation with curative intent. Results: This study included 89 consecutive anal cancer patients (37 3DCRT, 52 IMRT). Median follow-up for all patients, IMRT patients alone, and CRT patients alone was 26.5 months (range, 3.5-133.6), 20 months (range, 3.5-125.5), and 61.9 months (range, 7.6-133.6), respectively. Three-year overall survival (OS), progression free survival (PFS), locoregional control (LRC), and colostomy free survival (CFS) were 91.1%, 82.3%, 90.8%, and 91.3% in the IMRT cohort and 86.1%, 72.5%, 91.9%, and 93.7% for the 3DCRT patients (all p&gt;0.1). More patients in the 3DCRT group required a treatment break (11 vs. 4; p=0.006), although the difference in median treatment break duration was not significant (12.2 vs. 8.0 days; p=0.35). Survival outcomes did not differ based on whether a treatment break was required (all p&gt;0.1). Acute grade ≥3 non-hematologic toxicity was significantly decreased in the IMRT cohort (21.1 vs. 59.5%; p&lt;0.0001). Acute grade ≥3 skin toxicity was significantly worse in the 3DCRT group (p&lt;0.0001) while an improvement in late grade ≥3 GI toxicity was observed in the IMRT patients (p=0.012). Conclusions: This is the largest retrospective review comparing 3DCRT and IMRT for definitive treatment of anal cancer. In contrast to previously published data, this study demonstrates that while long-term outcomes do not significantly differ based on RT technique, a marked decrease in adverse effects and the need for a treatment break can be achieved using IMRT.
Comorbidity as a predictor of survival in veterans with stage I and II non-small cell lung cancer (NSCLC).
Authors: I. Boholli, D. Hoover, W. M. Yang, C. Abanonu, M. Gonzalez, B. Kasimis, V. T. Chang
Journal: Journal of Clinical Oncology (2011)

e16605 Background: To examine comorbidity measures and survival in Veteran patients with stage I and II non small cell lung cancer. Methods: In an IRB approved protocol, we performed a retrospective review of all patients(pts) diagnosed with stage I & II NSCLC at the VA New Jersey HCS from July 1, 1998-June 30, 2007. Records were reviewed for demographic, clinical and pathological data, ECOG PS, treatments, relapse and survival. Five co morbidity indices were assessed; The Charlson Comorbidity Index (CCI), Kaplan Feinstein Index (KFI), Cumulative Illness Rating Scale (CIRS), Adult Comorbidity Evaluation-27 (ACE-27), and the Veterans Affairs co-morbidity index (VA comorbidity). Cox survival regression analysis, chi-square test and Spearman’s rank test were performed. Results: The charts of 77 pts were reviewed, (61 (79%) stage I, 16 (21%) stage II), all men, with a median age of 69 years (range 44-85), median survival of 824 days (range 6-4171); 67 pts (87%) had died. ECOG PS was available for 30 pts (12 pts PS 0, 16 pts PS 1, 1 pt PS 2, 1 pt PS 3). The medians (ranges) for each index are: CCI 4.67 (1- 17.4), KFI 3 (0-3), ACE27 3 (0-3), VA comorbidity 3.1 (0-9), CIRS16 6 (2-14), CIRS17 2.5 (1-10), CIRS18 0 (0-5). In univariate Cox analysis, for CIRS17 the Hazard Ratio (HR) was 1.36, (p<0.003), CCI HR 1.21 (p<0.0006), clinical stage HR 2.02( p< 0.02), ECOG PS HR 3.94, (p<0.001), surgery vs. non surgery HR 0.36, (p<0.001), albumin HR 0.62, (p <0.02), and creatinine HR 1.95, (p<0.001), were significant predictors of survival. In multivariate Cox analyses controlling for stage, creatinine and albumin, CCI (p <0.05), CIRS16 (p< 0.01), CIRS17 (p<0.0003), CIRS18 (p<0.01), forced expiratory volume in 1 second (FEV1) (p< 0.001), and surgery (p< 0.01) were significant predictors of survival. Comorbidity indices were associated with reduced likelihood of surgery: CIRS17 odds ratio (OR) 0.21 with 95% confidence interval (CI) 0.07-0.65 and ACE27 OR 0.27 (CI 0.09-0.81). Conclusions: The comorbidity indices CCI and CIRS subscales (CIRS16, CIRS17, CIRS18), surgery, stage, FEV1 can be predictive of survival in patients with stage I and II NSCLC. The feasibility of surgery is related to the CIRS subscales and ACE27 comorbidity index score.
Low dose involved field radiation (IFRT) or no further treatment following complete response to initial chemotherapy in young adult (YA) patients 16–21 years of age with Hodgkin’s disease (HD): The Children’s Cancer Group (CCG) Experience
Authors: J. Nachman, R. Sposto, P. Herzog, S. Wolden, M. Kadin
Journal: Journal of Clinical Oncology (2005)

8513 Background: There is scant data in the literature concerning the outcome of YA pts 16–21 years of age with HD. Methods: Newly diagnosed YA HD pts (N=227) were entered on the CCG 5942 study. Following clinical staging, YA pts received risk adapted chemotherapy. Group I patients had Stage I or IIA, no bulk disease, no hilar adenopathy and < 4 nodal regions involved. Group III patients had stage 4 disease. Initial therapy for Group I patients consisted of 4 cycles of the COPP/ABV Hybrid while Group 2 patients received 6 cycles of COPP/ABV. Group III patients received two cycles each of high dose ARA-C/VP-16. COPP/ABV, and CHOP. Patients who achieved a complete response to initial chemotherapy were randomized to receive no further treatment or IFRT (2100 RADS). Patients with partial response were nonrandomly assigned to IFRT. Results: Five year EFS for YA pts was 81% ± 2.8%; 5 year survival was 91.4% ± 2.1%. Events included 3 - progressive disease, 36 - relapse, and 1 second malignancy. Sixty and 56 YA pts were randomized to IFRT or no IFRT respectively. Five pts randomized to receive IFRT received no IFRT (1 relapse) and 5 patients assigned to no IFRT received IFRT (no relapse). In an as treated analysis, 5 year EFS was 94.6% for IFRT pts versus 74% for no IFRT pts (P = .002). IFRT improved EFS for group 2 and group 3 patients. At 5 years, there is a trend for better survival for the IFRT group compared to the no IFRT group, 100% vs. 90% (P = .06). Conclusion: The 5942 study showed a significant advantage for IFRT in preventing relapse but not for survival. This effect was consistent in all age groups, including YA. High dose radiation therapy is not necessary for the treatment of YA pts with HD. No significant financial relationships to disclose.
Pelvic side wall nodes in locally advanced rectal cancer as a prognostic indicator.
Authors: Kirsten Elizabeth Jean Laws, Christina Wilson, Stephen Harrow
Journal: Journal of Clinical Oncology (2014)

613 Background: Neoadjuvant long course chemoradiotherapy is a well recognised treatment in locally advanced rectal cancer. Patients with pelvic side wall nodes are often considered for neoadjuvant treatment. We investigated whether pelvic side wall nodes identified on pre-treatment imaging is a poor prognostic factor and whether there are different patterns of recurrence compared to patients without pelvic side wall node involvement. Methods: All patients treated with long course chemoradiotherapy between January 2008 and December 2009 were identified. Patients were excluded if treatment indication was for inoperable disease, postoperative, recurrence, or palliative intent. 231 patients were identified and a retrospective analysis performed investigating patterns of recurrence and survival for patients with pelvic side wall nodes identified on pre-treatment imaging. Results: Kaplan Meier curves are presented showing patients with pelvic side wall nodes identified on pre-treatment imaging appear to have poorer outcomes and overall survival compared with those with only mesorectal nodes or no nodes. Patterns of recurrence are presented, showing patients with pelvic side wall nodes identified on pre-treatment imaging have a non significant trend to increased rates of disease recurrence (local and distal recurrence combined, 45.7% versus 27.9% for pelvic side wall nodes versus no pelvic side wall nodes). Patients with pelvic side wall nodes identified on pre-treatment imaging appear to be more likely to develop distant metastases compared to those patients who have mesorectal nodes or no nodal involvement (37% versus 23%). Conclusions: Our study highlights that patients with pelvic side wall nodes identified on pre-treatment imaging appear to have a trend to poorer overall survival, are more likely to recur and develop distant metastases. These results were not statistically significant, due to the small number of patients, and the data is consequently limited. We intend to further investigate current management strategies for this subgroup of patients, with assessment of radiotherapy treatment plans, current use of integral boosts, and surgical procedures for this subgroup of patients.
A pooled analysis of long pentraxin for patients with advanced pancreatic cancer.
Authors: Mitsuhito Sasaki, Shunsuke Kondo, Hiroko Hosoi, Futa Koga, Yasunari Sakamoto, Chigusa Morizane, Hideki Ueno, Takuji Okusaka
Journal: Journal of Clinical Oncology (2016)

251 Background: Pancreatic carcinoma is one of the most lethal cancers and is the fourth leading cause of cancer-related death in Japan. Inflammatory responses play decisive roles at different stages of tumor development, including initiation, promotion, malignant conversion, invasion, and metastasis, affecting immune surveillance and response to therapy. We previously reported that pentraxin family members, especially long pentraxin (PTX3), are promising biomarkers for the prognosis of pancreatic carcinoma patients. The objective of the present study was to determine whether PTX3 levels could be a prognostic factor for patients with unresectable or recurrent pancreatic carcinoma. Methods: We analyzed data from two clinical trials (UMIN000002323 and UMIN000009474) using the Kaplan-Meier method and Cox proportional hazards model. We included data from patients who were chemo-naïve pancreatic invasive ductal carcinoma patients, had a 0–2 performance status score, and had adequate organ function. PTX3 levels and other laboratory and clinical data were assessed before initial treatment. Results: Overall, 181 patients with unresectable or recurrent pancreatic carcinoma were evaluated for the baseline plasma PTX3 level (median, mean, and range PTX3: 3.54 ng/mL, 4.34 ng/mL, and 0.9–17.7 ng/mL, respectively). In this study population, the median overall survival was 327 days (95% confidence interval, 281–372 days). The median overall survival was significantly shorter at high PTX3 levels( &gt; 4.34ng/mL) than at low PTX3 levels ( &lt; 4.34ng/mL)(223days vs 409 days; log rank test, P &lt; 0.0001). In a multivariate analysis, the PTX3, C-reaction protein (CRP), and cancer antigen (CA) 19-9 levels, and performance status were independent predictors of survival. High PTX3 levels were associated with high CA19-9 and high CRP levels. Conclusions: We confirmed that a high PTX3 level may be a useful prognostic marker for advanced pancreatic carcinoma. However, the mechanism of tumor inflammation and the exact nature of the role of PTX3 expression remain unclear, calling for investigation of the mechanisms underlying PTX3 activity in carcinoma cells and in the tumor environment. Clinical trial information: UMIN000002323 and UMIN000009474.
Impact of 24 months of androgen deprivation therapy (ADT) on physical function in men with nonmetastatic prostate cancer.
Authors: S. M. H. Alibhai, H. Breunis, N. Timilshina, S. Duff Canning, N. Fleshner, M. Krahn, I. Tannock, G. A. Tomlinson, P. R. Warde, G. Naglie
Journal: Journal of Clinical Oncology (2011)

4640 Background: Use of ADT has been shown to adversely affect self-reported and objective physical function within 3 months of initiation; declines persist at 12 months. Few studies have examined physical function with ongoing ADT use beyond 12 months. Methods: In this extension of our prior study, men age 50 or older with non-metastatic prostate cancer (PC) who were on continuous ADT were followed along with two control groups (PC, no ADT; healthy controls) matched on age, education, and baseline function. Physical function was assessed with the 6-minute walk test (6MWT), grip strength, and the Timed Up and Go (TUG) test, representing endurance, upper extremity strength, and lower extremity strength, respectively. Self-reported physical function was measured with the Medical Outcomes Study SF-36. Assessments were done at baseline and at 3, 6, 12, 18, and 24 months. Mixed effects regression models were used, adjusting for baseline function and other covariates. Results: 87 patients on ADT, 86 PC controls, and 86 healthy controls were enrolled (mean age 69.1 y, range 50-87). At baseline, all three groups were similar in age and physical function (all ANOVA p>0.05) and most patients reported excellent health and functional status. The decline in 6MWT in ADT users within the first 3 months compared to controls persisted up to 24 months (p=0.0046), and remained stable after initially improving in both control groups. Grip strength declined sharply in the ADT group by 3 months and remained stable up to 24 months (p<0.001), whereas both control groups were relatively stable or slightly improved over time. There was a slight worsening of TUG scores in the ADT group over 24 months compared to controls (p=0.0013), whereas TUG scores were unchanged in both control groups (p>0.10). Self-reported physical function continued to decline in ADT users (p=0.0003), remained stable in PC controls, and improved slightly in healthy controls over 24 months. Conclusions: Initial declines in both objective and self-reported physical function with continuous ADT use persist for at least 24 months. Greater use of exercise interventions should be considered in men starting ADT.
Patient-Reported Quality of Life before and after Stopping Treatment in the ENESTop Trial of Treatment-Free Remission for Patients with Chronic Myeloid Leukemia in Chronic Phase
Authors: François-Xavier Mahon, Carla Maria Boquimpani, Naoto Takahashi, Noam Benyamini, Nelma Cristina D Clementino, Vasily Shuvaev, Sikander Ailawadhi, Jeffrey H. Lipton, Anna G Turkina, Elena Beatriz Moiraghi, Franck-Emmanuel Nicolini, Jolanta Dengler, Tomasz Sacha, Dong-Wook Kim, Rafik Fellague-Chebra, Sandip Acharya, Patricia Brandt, Ari Gnanasakthy, Yu Jin, Timothy P. Hughes
Journal: Blood (2016)
Building evidence with flawed data? The importance of analysing valid data
Authors: Paolo Menaspà
Journal: British Journal of Sports Medicine (2017)

In replying to a PostScript on the use of rolling averages,1 Drew and colleagues failed to respond to the main point of the letter. In fact, the original commentary raised concern on the specific mathematical model used for quantifying acute and chronic training load (TL), not on how TL can be subsequently analysed and interpreted. This could be of …
EMR optimized oral chemotherapy monitoring program: Adherence and ADR outcomes.
Authors: George W. Carro, Thomas A. Hensing, Bruce Brockstein, Shannon Maureen Gavin, Abigail Harper, Cheryl Jee, Anna Palafox, Kathryn Schiavo, Wendy Hui, Amanda Blankenship, Brad Hughes, William J. Uhlig, Wayne Spath, Ashton Marie Hullett, Madelyn Marciniak, Jacqueline Filippini, Yousuf Azhar
Journal: Journal of Clinical Oncology (2014)

77 Background: Utilization of oral anticancer agents (OAA) has drastically increased over the past decade, accounting for more than 70% of new oncology agents approved in 2013. There are many challenges associated with OAA, including monitoring of adverse drug reactions (ADR) and adherence. While few studies estimate adherence of OAA, it is known that a multidisciplinary approach with intensive pharmacist counseling may improve outcomes. Currently, the electronic medical record (EMR) at our institution has many limitations on tracking OAA. In 2007, 1,872 OAA prescriptions were written. The 2014 annualized OAA prescriptions will surpass 5,510, demonstrating a growth of 194%. The purpose of this project is to establish an OAA monitoring program to allow consistent documentation, closer monitoring, and timely management of ADR. Methods: American Society of Clinical Oncology’s Quality Oncology Practice Initiative criteria were utilized to develop a unique monitoring tool, specific for OAA, which was employed via EMR. The monitoring tool assesses the current regimen, ADR, labs, adherence, and drug interactions. The initial analysis focused on testing the tools on two of the most commonly prescribed OAA agents within our institution. New start patients were identified through utilization of an OAA pharmacist verification queue. The pharmacist provided education, intensive follow up, and communicated treatment complications to other healthcare team members. Results: Follow-up calls were placed for 24 capecitabine patients and four erlotinib patients. Over half of the patients required an intervention. For capecitabine, there were seven patients with barriers to adherence. There were two patients who were non-adherent and one patient who was lost to follow-up; therefore, overall adherence rate was 91%. For erlotinib, adherence rate was 100% with no barriers to adherence. Symptom management and education were provided to 16 patients with grade 1 toxicities, and four drug interactions were identified. Conclusions: Oral chemotherapy should be treated with the same intensive monitoring as IV chemotherapy. A multidisciplinary pharmacist driven OAA monitoring program may improve adherence and allow more timely management of ADR.
The Role of Dasatinib in Patients with Philadelphia (Ph) Positive Acute Lymphocytic Leukemia (ALL) and Chronic Myeloid Leukemia (CML) Relapsing after Stem Cell Transplantation (SCT).
Authors: Ehab Atallah, Hagop Kantarjian, Marcos De Lima, Gautam Borthakur, William Wierda, Richard Champlin, Jorge Cortes
Journal: Blood (2006)
Long-term oncologic outcomes of neoadjuvant chemohormonal therapy followed by radical prostatectomy for patients with clinically localized, high-risk prostate cancer.
Authors: Jonathan L Silberstein, Stephen A Poon, Daniel Sjoberg, Andrew J. Vickers, Aaron Bernie, Badrinath R. Konety, William Kevin Kelly, James Andrew Eastham
Journal: Journal of Clinical Oncology (2014)

153 Background: To determine long-term oncologic outcomes of radical prostatectomy (RP) after neoadjuvant chemo-hormonal therapy for clinically localized, high-risk prostate cancer. Methods: In this phase II multicenter trial of patients with high-risk prostate cancer (prostate-specific antigen greater than 20ng/ml, Gleason greater than or equal to 8, or clinical stage greater than or equal to T3), androgen deprivation therapy (goserelin acetate depot) and paclitaxel, carboplatin and estramustine were administered prior to RP. We report the long-term oncologic outcomes of these patients and compared them to a contemporary cohort who met oncologic inclusion criteria but received RP only. Results: Thirty four patients were enrolled in this study and followed for a median of 13.1 years. Within 10 years most patients experienced biochemical recurrence (BCR-free probability= 22%; 95% CI 10%, 37%). However the probability of disease-specific survival at 10 years was 84% (95% CI 66%, 93%) and overall survival was 78% (95% CI 60%, 89%). The chemohormonal therapy group had higher-risk features than the comparison group (N=123 patients) with an almost doubled risk of calculated preoperative 5-year BCR (69% vs 36%, p&lt;0.0001). After adjusting for these imbalances the CHT group had trends toward improvement in BCR (0.76, 95% CI 0.43, 1.34; p=0.3) and metastasis free survival (0.55, 95% CI 0.24, 1.29; p=.2) although these were not significant. Conclusions: Neoadjuvant chemohormonal therapy followed by RP was associated with lower observed rates of BCR and metastasis compared to a prostatectomy only group; however these results were not significant. Because this treatment strategy has known harms and unproven benefit, this strategy should only be instituted in the setting of a clinical trial.
Non-steroidal anti-inflammatory drugs and the risk of oral cancer in current and former smokers - [REMOVED]
Authors: J. Sudbø, J. J. Lee, S. M. Lippman, J. Mork, A. J. Dannenberg, S. Sagen, A. Ristimäki, A. Sudbø, L. Mao, W. Kildal, A. Reith
Journal: Journal of Clinical Oncology (2005)

1007 This abstract has been removed. The presentation of this abstract was made at another, earlier meeting. (See Abstract #4377, 2005 Proceedings of the AACR Online, along with AACR's Retraction.) See also http://www.rikshospitalet.no/view/readavdi.asp?nPubID=5882&department=English for additional information