tbuckley/cabot-search huggingface dataset:
Prognostic factors of pancreatic neck cancer.
Authors: Seiko Hirono, Masaji Tani, Manabu Kawai, Ken-Ichi Okada, Motoki Miyazawa, Atsushi Shimizu, Yuji Kitahata, Masaki Ueno, Shinya Hayami, Yoshiyasu Shigekawa, Hiroki Yamaue
Journal: Journal of Clinical Oncology (2014)

355 Background: Pancreatic neck cancer is surrounded by common hepatic artery (CHA), gastroduodenal artery (GDA) and portal vein (PV), and easily invades nerve plexus around main arteries, such as CHA, celiac trunk, and superior mesenteric artery (SMA). Therefore, the resectablity of pancreatic neck cancer is low, and the biological behaviors have been unclear. In this study, we reviewed 59 resected pancreatic neck cancer cases to identify the prognostic factors. Methods: From 2000 to 2012, 305 patients with pancreatic cancer underwent surgical resection, and in 59 patients (19%) among them with pancreatic neck cancer, 49 patients underwent pancreatoduodenectomy, 5 subtotal pancreatectomy, 4 distal pancreatectomy with en-bloc celiac axis, and 1 total pancreatectomy. We defined borderline resectable pancreatic cancer as tumor abutted CHA, celiac trunk, or SMA, and classified radiographic types of PV invasion into A (normal), B (unilateral), C (bilateral), or D (complete obstruction) by CT imaging. We analyzed retrospectively clinicopathological characteristics and prognostic factors for pancreatic neck cancer. Results: Pancreatic neck cancer was smaller than other located pancreatic cancer (21.1±7.0 vs. 32.0±13.5 mm, P&lt;0.01), and the rate of pathological PV invasion was higher in pancreatic neck cancer (36 vs. 20%, P=0.01). In patients with pancreatic neck cancer, pathological PV invasion was observed in 0% of type A (0/9), 14% of type B (3/22), 48% of type C (10/21), and 86% of type D (6/7), and 37 patients (63%) had lymph node metastasis. In 32 patients with borderline resectable pancreatic neck cancer, neoadjuvant chemo(radiation)therapy (NAC) reduced the R1 rates (P=0.04) Pathological PV invasion, tub2/3 and lymph node ratio &gt;0.1 were independent poor prognostic factors for pancreatic neck cancer (P&lt;0.01, P=0.03, and P=0.03, odds ratio; 7.1, 2.8, and 3.1, respectively). Conclusions: Pancreatic neck cancer often had PV invasion even if CT imaging showed unilateral abutment, indicating that combined PV resection may be necessary for R0 resection of pancreatic neck cancer with radiological PV abutment. NAC may improve R0 resection rates and postoperative survival for pancreatic neck cancer.
Genomic differences and survival in African Americans with metastatic clear cell renal cell carcinoma in the targeted therapy era.
Authors: Tracy Lynn Rose, Bhavani Krishnan, Adam Rea Kuykendal, Angela Smith, Matthew I. Milowsky, William Y. Kim
Journal: Journal of Clinical Oncology (2016)

504 Background: African American (AA) patients with RCC have historically had inferior survival relative to Caucasians. There is little data on racial differences in tumor biology between AA and Caucasians to explain this disparity. In addition, it is not known if racial differences may result in differential response to targeted therapy and if the disparity has changed over time. Our study aims to define racial differences in tumor biology between AA and Caucasians with clear cell RCC (ccRCC) and to evaluate if observed differences in tumor biology are reflected in survival rates in the era of targeted therapy. Methods: We identified AA and Caucasian patients with stage IV clear cell RCC (ccRCC) in the National Cancer Data Base (NCDB) and analyzed survival of AA and Caucasians in the pre- and post-targeted therapy eras (1998-2004 and 2006-2011). We then analyzed The Cancer Genome Atlas (TCGA): Renal Clear Cell Carcinoma dataset to determine differences in somatic mutation rate, molecular subtype, and RNA expression between AA and Caucasians. Results: Overall survival (OS) is significantly longer in Caucasians than AA (9.2 vs 6.5 months, p &lt; 0.01). The adjusted HR for death for AA compared with Caucasian patients was 1.08 (95% CI 1.01-1.14) in the post-targeted therapy era, which was unchanged from the pre-targeted therapy era (HR 1.07, 95% CI 1.01-1.14). AA patients were less likely than Caucasians to have VHL mutations (17% vs 50%, p = 0.04) and were enriched in the ccB molecular subtype (79% in AA vs 45% in Caucasians, p &lt; 0.01). RNA expression revealed upregulation of several HIF-associated pathways in Caucasian compared with AA patients. Conclusions: ccRCC in AA have less frequent VHL mutations, are enriched in the ccB molecular subtype, and have less upregulation of HIF-associated pathways than Caucasians. These molecular features predict for decreased responsiveness to VEGF-targeted therapy and inferior survival in AA compared to Caucasians. Data from a large national database confirm that AA patients maintain inferior survival compared to Caucasians in the era of targeted therapy, potentially related to underlying tumor biology.
A novel breast cancer screening platform: An epitope-based biomarker coupled to electrochemical sensor.
Authors: Yara Cristina Paiva Maia, Thaise Gonçalves Araújo, Diego Leoni Franco, Fausto Emilio Capparelli, Vanesssa Silva Ribeiro, Patrícia Tieme Fujimura, Luanda Calábria, Carlos Eduardo Paiva, Donizeti Wilian Santos, Juliana Almeida Franco, João Marcos Madurro, Ana Graci Brito-Madurro, Renata Nascimento Freitas, Luiz R. Goulart
Journal: Journal of Clinical Oncology (2015)

9 Background: The subtractive proteomic selection technology called Phage Display (PD) has been extensively used by our group in the discovery of high affinity ligands to target tissues and molecules. We have selected specific ligands against IgG purified from BC tissues, which was successfully coupled to an electrochemical sensor to detect the tumor-specific immune response. Methods: After PD selections, all immunoreactive peptide ligands were further characterized by DNA sequencing, in vitro translated and submitted to bioinformatic analyses. Further validations were performed by ELISA. We then used one synthetic peptide (SF4) for the construction of an immunosensor, which was applied to patients and control samples for final validation. Electrochemical impedance spectroscopy (EIS) was performed. Results: We have selected the F4 peptide for final validation and sensor construction due to its capability of detecting IgG in the peripheral blood and the excellent ELISA ratio BC:BBD, discriminating more than 70% of BC patients. The synthetic peptide reached a good precision in BC diagnosis (68%), but surprisingly, the selected F4 clone presented the highest sensitivity and specificity, (77.8% and 85.7%, respectively), suggesting that it can be used as a diagnostic reagent for early BC screening prior to imaging and pathological analyses. The electrochemical sensor that was built with the epitope-based peptide discriminated all IgG from BC and healthy individuals. Results with the EIS sensor demonstrated that the presence of (SF4) peptide IgG generated higher resistivity (-Z ') compared to the system containing only the peptide or the control sera. This is justified by the fact that with the immobilized biological peptide layer was correctly conjugated with the IgG forming an antigen: antibody complex that led to an increased resistance to the charge transfer system, producing a decrease in electron transfer between the iron-coupled / ferricyanide redox and the electrode surface. Conclusions: An electrochemical sensor using an epitope-based biomarker was developed, which allows for the first time BC screening using a very simple platform that could be an important auxiliary tool to mammography imaging.
HLA-G Transference From Multipotent Mesenchymal Stromal Cells to Activated T-Lymphocytes.
Authors: Rodrigo A Panepucci, Felipe Saldanha-Araujo, Kelen C R Malmegrim, Fabio M Oliveira, Patricia V B Palma, Camila C B O Menezes, Maristela D Orellana, Dimas T Covas, Marco A Zago
Journal: Blood (2009)
The efficacy of trimodality bladder-sparing treatment in bladder cancer
Authors: M. C. Liebman, S. Wu
Journal: Journal of Clinical Oncology (2008)

16006 Background: Bladder-sparing trimodality therapy utilizing transurethral resection of the bladder tumor (TURBT), radiation and chemotherapy has become an important alternative to radical cystectomy in patients with invasive bladder cancer. Many single-arm studies report that trimodality therapy is effective, and its outcome may be comparable to radical cystectomy. We have conducted a meta-analysis of these studies to better evaluate the overall efficacy of bladder-sparing therapy in comparison with radical cystectomy. Methods: We searched Pubmed database for the past twenty years and abstracts from the American Society of Clinical Oncology Annual Meetings for the past three years to identify relevant studies. Eligible trimodality bladder-sparing studies included TURBT combined with the institution's chosen protocol of radiation and chemotherapy and clinical trials. Eligible radical cystectomy studies included three major surgical series. The summary complete response (CR), 5-year overall survival rates, and the 5-year survival rate with intact bladder were calculated using the random-effects or the fixed-effects model based on the heterogeneity of studies. Results: A total of 1211 patients in 10 studies with trimodality therapy were included for analysis. The summary CR rate was 67.0% (95% CI: 59.3–73.9%). Among patients with data available, the summary 5-year overall survival rate was 51.6% (95% CI: 46.8–56.5%), while the summary 5-year survival rate with intact bladder was 43.1% (95% CI: 39.8–46.5%). A total of 1250 patients in 3 major studies with radical cystectomy were included for analysis. The summary 5-year overall survival rate was 59.6% (95% CI: 56.9–62.3%). Interestingly, a comparison of the 5-year overall survival rates of the two approaches showed a significant difference with a risk ratio of 86.6% (95% CI: 80.4- 93.3%, p<0.001) in favor of radical cystectomy. Conclusions: Trimodality bladder-sparing therapy is a valuable alternative to radical cystectomy in selected patients with invasive bladder cancer. Favorable 5-year overall survival may be associated with cystectomy instead of the bladder-sparing approach. Radical cystectomy remains the standard of care for invasive bladder cancer. No significant financial relationships to disclose.
The treatment of primary melanoma at a community teaching hospital: A study of compliance with NCCN guidelines.
Authors: I. Ashley, S. Jubelirer, C. A. Welch
Journal: Journal of Clinical Oncology (2011)

e16634 Background: With the increasing incidence of primary melanoma a greater number of physicians will need to be knowledgeable in the appropriate treatment of melanoma patients. Compliance with NCCN guidelines may lead to less morbidity, more accurate staging, and improved outcomes. Methods: We retrospectively studied 301 patients seen at Charleston Area Medical Center, (a large university affiliated community hospital) from 2000-2007 with primary melanoma identified from out cancer registry. We confirmed treatment data by reviewing pathology and operative reports and reviewing outpatient records. Results: Our overall compliance with NCCN guidelines with respect to surgical margins and sentinel lymph node staging was 71% and 69%, respectively. Documented margins of excision conformed to NCCN guidelines in 67% of Tis tumors, 66% of T1 tumors, 82% of T2 tumors, 74% of T3 tumors, and 59% of T4 tumors. Compliance with sentinel node biopsy guidelines was documented in 90% of Tis tumors, 45% of T1 tumors, 79% of T2 tumors, 88% of T3 tumors, and 92% of T4 tumors. The most important factor found to be associated with noncompliance was age > 80 years. Conclusions: We found that treatment conformed to NCCN guidelines in only two-thirds of our patients. Further investigation is needed to determine the effect of this on patient outcomes.
Operational efficiencies in the infusion center: Improving nursing efficiencies and patient wait times while decreasing costs.
Authors: Alyssa Garth, Susan Schreiner, Dawn Jourdan
Journal: Journal of Clinical Oncology (2013)

56 Background: Decreased nursing efficiency and patient assignments has increased patient wait times and has significant implications on overall patient flow in the infusion center and labor dollars. Historically, staff nurses signed up for their patients, and took an average of 2 patients at one time. This created disparity in patient/staffing ratios, high number of labor dollars per worked infusion and an overall atmosphere of inequity among the nurses. Methods: Patient flow and labor cost were examined. Analysis of the nursing staffing matrix led to the creation of a patient placement nurse, taken from the daily staff allocation, assigning patients based on current patient assignment and acuity of patients. Nurses were identified to learn the patient placement nurse role based on critical thinking and organizational skills. With the assistance of a patient locator system, the patient placement nurse is able to identify when a patient’s wait begins and which nurse is the best choice to be assigned. A system was implemented in which a staff nurse was assigned a patient every 30-40 minutes with a maximum patient assignment of 4 concurrently. A standard 1:3 nurse to patient ratio was established unless a patient’s acuity prohibited this ratio. Results: Nursing ratios stabilized at 1:3. Staff became more efficient and work was reorganized for less subjectivity in patient assignments, producing more equitable workloads. This resulted in an increase in patients seen within 15 minutes improving from 69.8% to 85.3%. In addition, it allowed for the elimination of one nurse per day shift, resulting in a cost savings of approximately a 1.0 FTE/week or average annual salary of $62,129. Conclusions: Development of a standardized patient placement process can increase infusion center efficiencies and stabilize nursing workload, as well as decrease patient wait time and reduce the cost per infusion. This supports a delivery of patient-centered care while utilizing staff efficiently and appropriately and decreasing cost.
Survival among elderly metastatic breast cancer patients in the United States.
Authors: K. L. Davis, S. Iyer, S. Candrilli
Journal: Journal of Clinical Oncology (2011)

e16500 Background: The main objective is to assess predictors of survival in the elderly metastatic breast cancer patients in the United States Medicare population. Methods: A retrospective study was conducted among subjects aged ≥65 years and diagnosed with metastatic breast cancer between 1/1/00 and 12/31/05 using the SEER-Medicare linked database. For each subject, an index date was defined as the date of first observed metastatic breast cancer diagnosis. A subgroup of patients prescribed herceptin, a targeted therapy HER2+ve patients was identified. Survival rates (1-year and 5-year) were assessed. A Cox proportional hazards model was used to assess predictors of survival. Age, race, nodal status, hormone receptor status, Charlson Co-morbidity Index score and chemotherapy use were examined as covariates. Results: We identified 3,163 patients with metastatic breast cancer and an average follow up period of 29 months, of which 345 (10%) patients were prescribed herceptin. The 1-year and 5-year survival rates were 76% and 10% respectively with a mean survival of 2.4 years (median 2.1 years) in the overall population. Among patients prescribed herceptin (HER2+ve patients), the 1-year and 5-year survival rates were 85% and 6% respectively (mean 2.6 years). Among all patients, hormone receptor status double negative was associated with an increased risk of death {ER +ve/PR + ve [hazard ratio HR= 0.470; p<0.001], ER +ve/PR –ve [HR= 0.521; p<0.001] vs. ER-ve/PR-ve} as were a higher nodal involvement (>3 nodes) [HR = 1.557; p<0.0001 vs. 0 nodes] and higher Charlson Co-morbidity Index score [HR = 1.024; p<0.0001]. Age 65-74 [HR= 0.719; p<0.0001 vs. age > 85], age 75-84 [HR= 0.816; p<0.05 vs. age > 85] and chemotherapy use [HR] = 0.68; p<0.0001) were associated with a significant decrease in mortality risk. In the herceptin treated subgroup, ER-ve/PR+ve was associated with a significantly higher risk of death (HR= 3.396; p < 0.05) while ER+ve/PR-ve was associated with a lower risk of death ([HR] = 0.548; p <0.05) vs ER-ve/PR-ve. Conclusions: Hormonal status, greater nodal involvement, older age and increased co-morbidity burden were found to be significant predictors of death in elderly metastatic breast cancer patients.
Treatment and outcome of patients with invasive extramammary Paget's disease.
Authors: A. Karam, O. Dorigo
Journal: Journal of Clinical Oncology (2011)

5043 Background: The outcome of patients with invasive extramammary Paget’s disease (EMPD) is poorly studied since published reports include only small numbers of patients. The goal of the current study was therefore to analyze the incidence, treatment approaches and outcome of patients with invasive EMPD using data from the Surveillance, Epidemiology and End Results (SEER) program. Methods: We searched the SEER program data base for patients diagnosed with invasive EMPD between 1973 and 2007. Demographic data, outcome and therapeutic modalities were included in the analysis. Disease specific survival (DSS) was calculated from the time of original diagnosis. Survival curves were constructed using Kaplan Meier method and compared using Mantel-Cox Log Rank analysis. Multivariable regression analysis using the Cox proportional hazard methods was used to compare the relationship between the variables in the model. Results: 1439 patients were diagnosed with invasive EMPD. Most patients (72.1%) had localized disease, while 15.3% had locoregional spread, 2.2% presented with distant disease, and 10.4% were unstaged. The 5-year DSS was 94.9% for localized disease, 84.9% for regional disease, 52.5% for distant disease, and 87.8% for unstaged disease. 1268 (88.1%) patients underwent site specific surgery and 140 (9.7%) patients did not undergo surgery. 1335 (92.8%) patients did not receive any radiation therapy and 92 (6.4%) patients received radiation therapy. Multivariate analysis showed a significantly shorter DSS associated with older age, stage and use of radiation (HR for death 1.06, 2.58, 2.72 95% CI 1.04-1.09, 1.51-4.41, 2.03-3.63 respectively) whereas site specific surgery was associated with a significantly improved outcome (HR for death 0.51 95% CI 0.27-0.98). Sex was not associated with DSS (HR 0.82, 95% CI 0.54-1.25). Conclusions: The DSS of patients with invasive EMPD is generally favorable. A poor outcome was associated with older age, advanced stage disease and the use of radiation therapy. The association between a shortened DSS and the use of radiation therapy is surprising and warrants further investigation.
HER2-enriched subtype as a predictor of pathological complete response following trastuzumab and lapatinib without chemotherapy in early-stage HER2-positive breast cancer (PAMELA): an open-label, single-group, multicentre, phase 2 trial
Authors: Antonio Llombart-Cussac, Javier Cortés, Laia Paré, Patricia Galván, Begoña Bermejo, Noelia Martínez, Maria Vidal, Sònia Pernas, Rafael López, Montserrat Muñoz, Paolo Nuciforo, Serafín Morales, Mafalda Oliveira, Lorena de la Peña, Alexandra Peláez, Aleix Prat
Journal: The Lancet Oncology (2017)
Percutaneous and laparoscopic-assisted cryoablation of small renal cell carcinomas.
Authors: Tommy Kjaergaard Nielsen, Oyvind Ostraat, Michael Borre, Truls E Bjerklund Johansen
Journal: Journal of Clinical Oncology (2012)

462 Background: To evaluate the complication rate and short term oncological outcome of small renal cell carcinomas treated with cryoablation. Methods: 91 biopsy verified renal cell carcinomas were cryoablated between 2006-11. Patients treated had primarily T1a tumors, but exceptions were made. Patients with tumors not directly accessible percutaneously were selected for laparoscopy. To ensure complete coverage of the tumor, cryoneedle placement and freezing procedure was peroperatively monitored by ultrasound in both modalities. Presice machine with Ice-Seet and Ice-Rod needles from Galil Medical was used. Treatment was considered successful when tumors gradually shrunk and showed no sign of contrast enhancement, assessed by CT or MRI. Results: Mean patient age and tumor size was 65 yr [17 - 83] and 26 mm [10 - 62], respectively [min-max]. Treatment modalities consisted of percutaneous route; n=34 (47%) and laparoscopic guided; n=39 (53%). The mean follow-up time was 19 months [1 - 56]. 18 patients were excluded from follow-up analysis (8 pt. with short observation time, 5 pt. treated despite severe co-morbidity with no planned follow-up, 3 pt. lost to follow-up, 1 pt. emigrated, 1 pt. died as a result of bleeding from perforation of iliac artery by troicar). Residual tumor was diagnosed by imaging in 10 patients (perc n=6 and lap n=4, p&gt;0,05) after a mean follow-up time of 13 months [1 - 31]. Diagnosis was confirmed by biopsy in all but one case, in which the diagnosis was necrosis. Of the 10 patients with residual tumor, 8 patients were reablated and 2 patients were referred to oncological treatment. Cancer specific survival was 100%. Overall survival was 91%. Complications: 8 pt. had minor bleeding in relation to cryoneedle removal, requiring Tachosil. 1 pt. had subcutaneous bleeding, 2 pt. was readmitted due to pain and discharged the following day. No patients required blood transfusion. Conclusions: Although percutaneous and laparoscopic guided cryoablation are minimally invasive procedures and the overall complication rate is low, serious complications may occur. Close follow-up and continuous evaluation of criteria for patient selection and relapse is necessary. An international database is recommended.
Oncological outcome after laparoscopic radical prostatectomy: 10-year experience
Authors: K. Touijer, A. Cronin, A. Vickers, B. Guillonneau, F. Secin
Journal: Journal of Clinical Oncology (2008)

16017 Purpose: We analyzed the oncological outcome after laparoscopic radical prostatectomy (LRP) in a consecutive series of patients with prostate cancer. Materials and Methods: From 1998 to 2007, 1564 consecutive patients (median age 61 years, IQ range 56, 66) with clinically localized prostate cancer (cT1c-cT3a) were treated with LRP at IMM (Paris, France) or MSKCC (New York, USA). Progression of disease was defined as a PSA of 0.1 ng/ml or greater, or initiation of secondary therapy and was available for 1422 patients. Patients were stratified as low, intermediate or high risk based on the pretreatment prostate cancer nomogram progression free probability of ≥90%, 89% to 71% and ≥ 70% respectively. Results: The overall 5-year probability of freedom from progression was 79% (95% CI 74%-82%). For low, intermediate and high risk cancer, the 5-year progression free probability was 92% (95% CI 85%-95%) 77% (95% CI 71%-82%) and 53% (95% CI 40%-65%) respectively. Surgical margins were positive in 12.5% of cases. The 5-year progression free probability was 49% (95% CI 35%-61%) when the surgical margins were positive vs. 83% (95% CI 79%-86%) in negative surgical margins cases. Nodal metastases were detected in 3% of the patients after limited pelvic lymph node dissection and in 10% after a standard pelvic lymph node dissection (p<0.0001). The 3 year probability of freedom from progression for node positive patients was 46%. There were 22 overall deaths and 2 deaths from prostate cancer. Conclusion: Laparoscopic radical prostatectomy provided 5-year cancer control in 79% of patients with clinically localized prostate cancer and 53% of those with high risk cancers. A pelvic lymph node dissection limited to the external iliac nodal group is inadequate for detecting nodal metastases. No significant financial relationships to disclose.