tbuckley/cabot-search huggingface dataset:
MRI-transrectal ultrasound cognitive fusion-targeted transperineal template-guided saturation prostate biopsies in a consecutive cohort of men.
Authors: Haim Matzkin, Snir Dekalo, Nicola J Mabjeesh
Journal: Journal of Clinical Oncology (2016)

43 Background: MRI of the prostate may improve diagnostic accuracy of prostate cancer. Different fusion approaches with transrectal ultrasound images are employed. Objective: To determine the detection rate of prostate cancer in men undergoing transperineal template-guided saturation biopsy (TTSB) with MRI-based cognitive fusion. Methods: Between the years 2010-2015, 164 consecutive men underwent a multiple-core prostate TTSB. Univariable and multivariable logistic regression analyses were used to address the relationship between clinical TTSB parameters and prostate cancer detection rate. Covariates consisted of age, prostate-specific antigen (PSA), prostate volume, PSA density, digital rectal examination findings, existence of suspicious prostate lesions on MRI, number of previous negative biopsy sets, and number of cores taken during TTSB. Results: Mean age was 65 years and mean PSA was 14 ng/ml, mean prostate volume was 63 ml. Seventy percent of patients had at least two previous negative transrectal biopsy series and another 19% had at least one negative biopsy. One-hundred and fourteen patients (70%) underwent prostate MRI prior to the biopsy. The detection rate of prostate cancer among these patients was 46% of which 69% had Gleason score ≥ 7. Men with a suspicious lesion on MRI (n=80) had a detection rate of 50%, compared to 33% in patients with negative MRI study. On multivariate analysis, the most significant independent predictive factor was PSA density (p= 0.001). Other nearly significant parameters were suspicious MRI lesion, prostate volume and suspicious digital examination. Of note, the prostate cancer detection rate among patients with no MRI study prior to TTSB was 26%. Conclusions: Utilizing MRI cognitive fusion approach increases the detection rate of clinically significant prostate cancer (Gleason score ≥ 7). In patients with existing suspicion for prostate cancer after multiple negative standard TRUS-guided biopsies, performing TTSB after taking into consideration the findings on MRI and PSA density will increase dramatically the detection rate of significant disease.
Pharmacokinetics (PK) of 2 Dosing Regimens of Palifermin in Patients (Pts) with Hematologic Malignancies (HM) Undergoing High-Dose Chemoradiotherapy and Hematopoietic Stem Cell Transplantation (HSCT).
Authors: Parnian Zia-Amirhosseini, Margaret Salfi, Dieter Elhardt, Jeff Aycock, Tsui Chern Cheah, Alessandra Cesano, David D. Hurd
Journal: Blood (2005)
Homozygous deletion of ADAM3A revealed by genome-wide analysis of early-stage NSCLC in China showed to be correlated with poor prognosis.
Authors: Y. Wang, X. Zhang, Y. L. Wu
Journal: Journal of Clinical Oncology (2011)

e21177 Background: As a highly heterogenous disease, individual variation in non-small cell lung cancer (NSCLC) survival outcome may in part be explained by genomic copy number variations. Here we conducted a study to identify novel genes whose focal copy number variations may correlate with the survival of patients after complete resection of early-stage NSCLC in China. Methods: High-resolution 244 K oligo array comparative genomic hybridization (CGH) was used to analyze DNA from formalin-fixed paraffin-embedded early-stage (IA-IIIA) NSCLC samples. Data of 117 samples passed quality control. Segment cluster value of 0.8 and -1.0 were used as the cut-off value for amplification group and homozygous deletion group according to the user manual of Nexus Copy Number™. Probe distributions of ADAM3A high copy variation samples were checked individually to verify the focal variations. Log rank test was performed to do survival analysis between groups. Kaplan-Meier curve was generated to show survival characteristics. Results: Focal amplification of ADAM3A was detected in 52.1% (61/117) of cases. While homozygous deletion was detected in 6.8% (8/117) of cases. Prognosis of patients with focal amplification of ADAM3A showed no statistical significant difference when compared with normal cohort (median OS 38.8 months versus 40.8 months; p = 0.864). Homozygous deletion of ADAM3A was associated with significantly poorer outcomes than normal cohort (median OS 12.4 months versus 40.8 months; p = 0.000). Prognosis of homozygous deletion group also showed poorer outcomes when compared with focal amplification cohort (median OS 12.4 months versus 38.8 months; p = 0.000). Conclusions: This genome-wide array analysis revealed that focal amplification or homozygous loss of ADAM3A are frequent genetic alterations in early-stage NSCLC. While group of focal amplification and normal group indicated no significant difference in prognosis, homozygous loss of showed to be correlated with poor prognosis in early-stage NSCLC in China. As little is known about ADAM3A except its role in fertilization, further studies are necessary to explore the mechanism for the prognostic impact of ADAM3A in NSCLC.
Prognosis of unresectable hepatocellular carcinoma: Comparison of seven staging systems (TNM, Okuda, BCLC, CLIP, CUPI, JIS, CIS) in a Chinese cohort.
Authors: Feng JIN Zhang, JUN ZHI Shu, YI CHUN Xie, QI LI, Hong XI Jin, Wei GU, Jian FANG Jiang, Quan CHANG Ling
Journal: Journal of Clinical Oncology (2016)

305 Background: Many liver staging systems that include the tumor stage and the extent of liver function have been developed. However, Prognosis assessment for hepatocellular carcinoma (HCC) remains controversial. In this study, the performances of 7 staging systems were compared in a cohort of patients with HCC who underwent non-surgical treatment. Methods: A total of 196 consecutive patients with HCC who underwent non-surgical treatment seen between January 1, 2004, and December 31, 2007, were included. Performances of TNM sixth edition, Okuda, Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), Chinese University Prognostic Index (CUPI), Japan Integrated Staging (JIS), and China integrated score (CIS) have been compared and ranked using concordance index (c-index). Predictors of survival were identified using univariate and multivariate Cox model analyses. Results: The median survival time for the cohort was 7.6 months (95% CI 5.6-9.7). The independent predictors of survival were performance status (P &lt;.001), serum sodium (P &lt;.001), alkaline phosphatase (P &lt;.001), tumor diameter greater than 5 cm (P =.001), portal vein invasion (P &lt;.001), lymph node metastasis (P =.025), distant metastasis (P =.004). CUPI staging system had the best independent predictive power for survival when compared with the other six prognostic systems. Performance status and serum sodium improved the discriminatory ability of CUPI. Conclusions: In our selected patient population whose main etiology is hepatitis B, CUPI was the most suitable staging systems in predicting survival in patients with unresectable HCC. BCLC was the second top-ranking staging system. CLIP, JIS, CIS, and TNM sixth edition were not helpful in predicting survival outcome, and their use is not supported by our data. Clinical trial information: 1103-10.
Age-specific prognostic factors for survival in patients with advanced ovarian cancer (OC) treated with platinum/taxane-based primary chemotherapy: A combined explorative analysis of three prospective phase III trials from the AGO study group.
Authors: F. Hilpert, A. M. Hempel, J. Hedderich, O. Junge, P. Harter, A. Du Bois, J. Pfisterer
Journal: Journal of Clinical Oncology (2011)

5057 Background: Age is a negative prognostic factor for survival in OC. This explorative analysis evaluates age-specific prognostic factors for survival in patients < or ≥ 70 years of age. Methods: Exploratory analysis of 3 prospective randomized trials (AGO-OVAR 3, 5, 7) investigating platinum/taxane-based chemotherapy in OC FIGO IIb-IV conducted between 1995-2002. Datasets from each trial were merged into a combined meta-dataset and patients were dichotomized according to an age of < or ≥ 70 years at randomization and must have received at least one cycle of the assigned treatment. Progression-free (PFS) and overall survival (OAS) were analysed by Kaplan Meier method and prognostic factors by cox regression analysis. Results: 3333 patients were eligible, 2974 (89.2%) < 70 and 359 (10.8%) ≥ 70 years of age. Median PFS was 23.8 and 18.4 months (p< 0.001) in the age group < and ≥ 70 years, median OAS was 45.9 and 29.6 (p<0.001) months, respectively. Age was an independent prognostic factor for PFS and OAS. Even in the subgroup of optimally treated patients (≥ 5 cycles, no residual tumor) the difference for PFS and OAS between age groups was 21 months (54.0 vs. 33.3, p=0.002) and 28 months (87.1 vs 58.7, p<0.001). Despite differences in magnitude, age-group-specific analysis indicated FIGO-stage, residual tumor, number of cycles, mucinous histology and body weight to be universal independent prognostic factors for survival in each age group. Dose reductions (OAS HR: 1.23 [1.08;1.42; p=0.03]) and ECOG (OAS HR: 1.44 [1.25;1.67; p<0.001]) were independent prognostic factors for survival in patients < 70 years of age but not in elderly patients (≥ 70). Conclusions: In the majority prognostic factors for survival have general validity in advanced OC patients < or ≥ 70 years of age. However, ECOG and dose reductions were prognostic significant in the younger subgroup only. This might indicate a more differentiated application of treatment in younger than in the elderly patients even under controlled clinical trial conditions.
Does androgen deprivation therapy impair renal function in patients with prostate cancer?
Authors: Koji Mitsuzuka, Atsushi Kyan, Tomonori Sato, Kazuhiko Orikasa, Minoru Miyazato, Narihiko Kakoi, Shintaro Narita, Takuya Koie, Tomonori Habuchi, Chikara Ohyama, Yoichi Arai
Journal: Journal of Clinical Oncology (2016)

323 Background: While the adverse effects of androgen deprivation therapy (ADT) in patients with prostate cancer are generally well-known among physicians, it is not clear whether ADT affects renal function. Therefore, the goal of the present study was to assess changes in renal function in response to ADT for 1 year. Methods: Patients with prostate cancer who were hormone-naïve and scheduled to receive long-term ADT were recruited between 2011 and 2013. Body weight and blood testing, including lipid and glucose metabolism and renal function, were recorded every 3 months during 1 year of ADT. Estimated glomerular filtration rate (eGFR) was calculated based on baseline age throughout ADT. Computed tomography (CT) was performed to measure psoas muscle area before and after 1 year of ADT to evaluate the influence of a decrease in lean mass on renal function. ADT was limited to a luteinizing hormone-releasing hormone agonist with or without bicalutamide. Patients who had severe renal dysfunction (eGFR &lt; 30 mL/min/m 2 ) or who had disease progression during 1 year of ADT were excluded from analyses. Results: Of 217 registered patients, renal function data were available from 170 patients who completed 1 year of ADT. Mean changes in serum creatinine and eGFR were 1.3% and 0.2%, respectively. Prostate specific antigen, clinical stage, body mass index, total testosterone, hemoglobin A1c, creatinine, eGFR, and comorbidities (e.g., hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease) at baseline were not associated with a change in renal function. Age &lt; 70 years at baseline was associated with an increase in eGFR in univariate and multivariate analyses (univariate: P = 0.01, multivariate: 95% confidence interval 1.13-4.87, P = 0.03). CT was performed in 72 patients before and after 1 year of ADT. The mean decrease in psoas muscle area was -8.4%. Decrease in psoas muscle area and increase of eGFR were more frequent in patients of age &lt; 70 years than in those of age ≥ 70 years (psoas muscle: -10.2% vs. -7.5%, P = 0.05; eGFR: 6.4% vs. 0.2%, P = 0.03). Conclusions: ADT did not impair renal function in patients with prostate cancer. eGFR was more likely to increase in younger patients, but this increase may be due to a decrease in lean mass. Clinical trial information: UMIN000004709.
Morbidity in long-term survivors after pancreatoduodenectomy for pancreatic adenocarcinoma.
Authors: Kathryn Tzung-Kai Chen, John Parker Hoffman
Journal: Journal of Clinical Oncology (2014)

307 Background: Because the focus of pancreatoduodenectomy for pancreatic adenocarcinoma is placed on disease-free and overall survival, morbidity in long-term survivors is not well described. We sought to evaluate outcomes of long-term survivors of pancreatic cancer after pancreatoduodenectomy. Methods: We identified 30 patients from our prospectively collected database of patients with pancreatic adenocarcinoma who had undergone pancreatoduodenectomy, and who were without evidence of disease with at least 40 months of follow-up. Demographics, treatment and pathologic characteristics were collected for review. Data with regards to long-term sequelae were also collected, particularly those complications requiring additional procedures and the development of metachronous cancers. Results: The median length of follow up was 83 months, with 60% of patients still alive. Half the patients were male, and the median age at diagnosis was 70 years. With regard to treatment, 80% of patients received chemoradiation, with half of these patients receiving it in the neoadjuvant setting. All patients received an R0 resection, although two patients required at least partial resection of the superior mesenteric or portal veins. Thirty-three percent of patients had N1 disease. Forty-four percent of patients did not have any significant subsequent sequelae. In the remainder, four patients (13%) developed ascites requiring repeated paracentesis or Denver shunt, with median time to development (MTD) of 63 months. Six patients (20%) developed a biliary stricture requiring stent placement (MTD 56 months), one patient developed portal venous thrombosis requiring a venous stent (MTD 52 months), and 3 patients (10%) experienced clinically significant gastric anastomotic ulcers (MTD 47 months). With regards to metachronous cancers, 2 patients developed subsequent lymphomas (MTD 92 months). Conclusions: Long-term survivors of patients who undergo pancreatoduodenectomy for pancreatic adenocarcinoma can develop significant late sequelae, which often can manifest more than three to five years after surgery. Continued follow-up and counseling is warranted.
Identifying patterns of breast cancer care provided at high volume hospitals: A classification and regression tree analysis.
Authors: Amanda L. Kong, Liliana E Pezzin, Ann B Nattinger
Journal: Journal of Clinical Oncology (2015)

69 Background: There is a growing body of literature linking hospital volume to outcomes in breast cancer. However, the mechanism through which volume influences outcome is poorly understood. The purpose of this study was to examine the relationship between hospital volume of breast cancer cases and patterns of processes of care in a population-based cohort of Medicare patients. Methods: A previously described and validated algorithm was applied to Medicare claims for newly diagnosed breast cancer cases in 2003 to identify potential subjects. Breast cancer patients were recruited to participate in a survey study examining breast cancer outcomes, and data was merged with Medicare claims and state tumor registries. Hospital volume was divided into tertiles. A Classification and Regression Tree (CART) model was performed to look for statistically significant relationships between patterns of processes of care and hospital volume. Results: Using CART analysis, eight patterns of care were identified that differentiated breast cancer care at high versus low volume hospitals. Sentinel lymph node dissection (SLND) was the single process of care that demonstrated the greatest differentiation across hospitals with differing volumes. Four patterns of care significantly predicted that a patient was less likely to be treated at a high volume hospital. Conclusions: Our study demonstrates differences in patterns of processes of care between low and high volume hospitals. Hospital volume was associated with several patterns of care that reflect the most current standards of care, particularly SLND. Greater adoption of these patterns by low volume hospitals could improve the overall quality of care for breast cancer.
Impact of concurrent medications use on outcome of pancreatic cancer: SEER Medicare analysis.
Authors: Muhammad Shaalan Beg, Arjun Gupta, Tyler Stewart, Ang Gao, Chul Ahn, Jarett Berry, Eric Mortensen
Journal: Journal of Clinical Oncology (2016)

e15729 Background: Preclinical studies have suggested concurrent non-antineoplastic medication use may impact pancreatic cancer. We performed an analysis to test this effect on pancreatic cancer outcome. Methods: Data from the Surveillance, Epidemiology and End Results (SEER)-Medicare with available part D data between 2006 and 2009 were analyzed. Cases with non-adenocarcinoma histology, autopsy only and death certificate only data were excluded. Drug use was defined as 1) having two prescriptions filled within 12 months of pancreatic cancer diagnosis (2rx/1yr) or 2) ever use. The following medication groups were analyzed: betablocker, statin, insulin, metformin, thiazolidinedione, warfarin and heparin. The primary end point was overall survival. Univariate analysis was performed to test the association of each medication class with survival. Stepwise Cox proportional hazard models were was employed to adjust for each medication group as well as age, gender, stage, site, race and Charlson comorbidity score. Results: There were 13,702 cases which met inclusion criteria and had available Part D data. There were 42.48% males, 77.07% were white and 34.00%had diabetes. Medication use and hazard ratio are summarized in table 1. On cox proportional hazard modeling beta blocker, heparin, insulin warfarin (2rx/1y) and betablocker, heparin, insulin (ever use) were associated were significantly associated with improved outcome (p < 0.05). Conclusions: Concurrent medication use, particularly betablockers, heparin and insulin may have an effect on pancreatic cancer outcome. Diabetes medications (metformin, TZD) did not have an impact in the multivariable model. This pharmacoepidemiological study adds to the interest in exploring use of concurrent medications in pancreatic cancer. Medication group Two rx in 12 months Ever use n HR n HR Betablocker 5209 0.92* 6339 0.95* Statin 4680 0.96* 5649 0.99 Insulin 2319 0.79* 2886 0.83* Metformin 2276 0.93* 2928 0.97 Thiazolidinedione 1037 1.03 1422 1.05 Warfarin 1857 0.88* 2540 0.95* Heparin 764 0.75* 1497 0.88*
High-grade transformation in acinic cell carcinoma of the salivary glands: A rare but important clinical entity.
Authors: K. A. R. Price, W. Shon, J. A. Davidson, J. E. Lewis, D. L. Price, J. J. Garcia
Journal: Journal of Clinical Oncology (2011)

5581 Background: The phenomenon of high-grade transformation (HGT) has been described in select salivary gland malignancies. Previous studies of salivary gland HGT have noted a propensity for recurrent disease, lymph node (LN) metastases, and poor overall survival (OS). We report the clinical and pathologic findings in cases of acinic cell carcinoma (AcCC) with HGT (AcCC-HGT). Methods: A retrospective clinical and histopathologic review was performed on 62 patients (pts) with AcCC who had surgery at the Mayo Clinic from 1985-2010. Microscopic review was performed by two pathologists (JJG, WS). Cases of AcCC-HGT were characterized by cytomorphologic pleomorphism, elevated mitotic activity, infiltrative growth pattern, stromal desmoplasia, and necrosis. Immunohistochemical and histochemical stains were performed on cases of AcCC-HGT (AE1/AE3, Cam 5.2, p63, S100, Mib-1, PAS, and PAS-D). Results: AcCC-HGT was seen in 7 of 62 pts (11%). The median age was 53.5 years (range 15-84, 31 female) for pts with AcCC versus 69 years (range 56-68, 5 female) for pts with AcCC-HGT. Histologically, an abrupt transition from a low- or intermediate-grade component into a discrete high-grade component was typically seen. The areas of HGT exhibited elevated proliferation based on MIB-1 expression and significant loss of zymogen granules using PAS and PAS-D staining. Initial treatment for all pts was surgery; 7 AcCC and 3 AcCC-HGT pts also had adjuvant radiation. LNs were positive in 8% of AcCC pts (4/52, 3 unknown) at initial surgery compared with 43% of pts with AcCC-HGT (3/7). Known distant metastases developed in 2% of pts with AcCC (1/55) and 71% of pts with AcCC-HGT (5/7). Five-year recurrence free survival (RFS) was 82.7% for pts with AcCC and 19.0% for pts with AcCC-HGT (p<0.0001). Five-year OS was 93.5% for pts with AcCC and 40% for pts with AcCC-HGT (p<0.0001). Adjusting for age and gender, the hazard ratios for RFS and OS for pts with AcCC-HGT were 13.4 (95% CI, 3.6-50.1, p=0.0001) and 8.8 (95% CI, 2.1-35.5, p=0.0022). Conclusions: AcCC-HGT is a rare and aggressive salivary gland malignancy. The presence of HGT should be considered when determining indications for neck dissection, chemotherapy, and radiation.
Chemotherapy in the terminal care of oncology patients: A Quality Oncology Practice Initiative (QOPI)
Authors: S. Kao, J. Shafiq, D. Adams
Journal: Journal of Clinical Oncology (2008)

9622 Background: Appropriately timed cessation of chemotherapy is integral to the quality assurance of an oncology service and to patient’s quality of life. There is minimal data available on the use of chemotherapy in patients at the end of life. Here we evaluated the proportion of patients receiving palliative chemotherapy and determined those who received chemotherapy within 2 and 4 weeks of death and evaluated associated factor. Methods: A retrospective electronic chart review of deceased oncology patients treated with palliative intent from April 2005 to March 2007 at LCTC and MCTC was performed. Patients’ age, gender, country of birth, cancer types, number of lines of chemotherapy, chemosensitivity of the tumour and treating specialist were recorded to determine potential influence on commencement of palliative chemotherapy and continuation within the last 2 and 4 weeks of life. Chi square test was utilised to determine the association of individual factors with each of the three outcome variables and a logistic regression model was constructed with all the significant (p<0.05) factors to determine their independent effect on the outcome. Results: 747 oncology patients died during the study period; median age 67 years (range 20–96); female 44%. Of these, 398 patients (53%) received palliative chemotherapy, with 8% and 18% receiving chemotherapy within the last 2 and 4 weeks of life respectively. Younger age (p<0.005), female gender (p< 0.025), specific cancer type (p<0.005), and increased chemosensitivity of the tumour (p<0.005) were predictors of commencement of palliative chemotherapy. In multivariate analysis, only age (p<0.005) and cancer type (p<0.005) remained as independent predictors. None of the above factors had a significant association with chemotherapy use in the last 2 weeks of patients’ life. Treating specialist was the only predictor determining chemotherapy use in the last 4 weeks of life (p<0.025). Conclusions: Younger age and tumour type are important predictors of whether or not patients receive palliative chemotherapy. The only significant predictor of whether patients receive palliative chemotherapy in the last 4 weeks of life is individual clinician’s practice. No significant financial relationships to disclose.