tbuckley/cabot-search huggingface dataset:
Impact of infectious complications on long-term survival following colorectal cancer surgery.
Authors: Ali Mokdad, Hannah Hirsch, Ibrahim Nassour, Nicholas Borja, Glen C. Balch, Patricio Polanco
Journal: Journal of Clinical Oncology (2016)

531 Background: Colorectal cancer surgery is associated with significant postoperative morbidity, which may have long-term implications on patient outcomes. We hypothesize that operative complications following surgery for colorectal cancer are associated with increased recurrence and worse survival. Methods: Using a prospectively maintained database, we reviewed patients with colorectal cancer that underwent a curative resection from 2008 to 2015. Patients were categorized by presence of any complication within 90 days from surgery and by type of complication, infectious and non-infectious. We compared clinical, pathological, and perioperative data using t-test, chi-squared test, and ANOVA. We compared overall (OS) and recurrence free survival (RFS) using Kaplan Meier and log-rank test. Multivariable Cox regression was used to compare mortality and recurrence. Results: Two hundred and twenty-nine patients underwent 104 colon and 125 rectal cancer resections (20 pelvic exenterations, 83 low anterior and 17 abdominoperineal resections) were followed for a median of 23 months. Fifty percent were completed minimally invasively. Postoperative complications occurred in 52%; 19% had a major complication (Clavien-Dindo 3-4). Postoperative complications were more likely to occur in open (61% vs. 38%, p &lt; 0.01) and rectal operations (63% vs. 42%, p = 0.02). On multivariable analysis, OS and RFS were not statistically different in patients with complications. Patients with infectious complications had worse 3-year survival when compared to patients with non-infectious complications and without complications (58%,69%,76%, p = 0.04). Recurrence at 3 years was also significantly different among the three groups (p = 0.03). Infectious complications remained associated with worse overall survival (HR 1.8; 95% CI 1.02,3.26) and recurrence free survival (HR 1.9; 95% CI 1.06,3.39) after adjusting for patient, tumor, and perioperative data. Conclusions: Infectious complications following colorectal cancer surgery are associated with worse OS and RFS independent of tumor stage, type of surgery, and technique. Current research is ongoing to explore possible etiologies of this association.
Histopathologic types of non-Hodgkin lymphomas according to the current WHO classification in the Sulaimaniya Province of Iraqi Kurdistan.
Authors: S. S. Mohammed, A. K. Sheikha, A. M. Saaed, S. Y. Sheet, M. Khasraw
Journal: Journal of Clinical Oncology (2011)

e18550 Background: Non-Hodgkin Lymphoma (NHL) classification is challenging. In Iraq the Working Formulation has been the standard classification over the last decades. It is generally accepted nowadays to use the recently updated 2008 WHO classification of tumours of hematopoietic and lymphoid tissues according to immunological,cytogenetic and morphologic features. A novel effort in Iraq has started over the last two years at Shorsh and Hiwa Hospitals to introduce standardized histopathological, andimmunohistochemical analysis of different lymphomas according to the new WHO classification. Methods: We obtained the required institutional approvals to conduct a retrospective review of all records of NHL patients diagnosed, admitted and managed at Hiwa hospital, the only cancer center at Sulaimaniya province of Iraqi Kurdistan during the period (January 1st 2007 to July 1st 2010). The aim was characterizing this population and defines the incidences of NHL subtypes. All histopathogical diagnoses were made at Shorsh Hospital. All patients were classified according to the new 2008 WHO classification. In addition, it was planned to compare incidences of NHL subtypes with international and national data available. Results: One hundred and seventeen patients were diagnosed with NHL. Male was 59% (n=69) and female was 41% (n=48). Median age was 39 year (range 1 - 90). Children (age< 16) constituted 26% (n=30). The subtypes of NHL were: diffuse large B-cell lymphoma “DLBCL” 51% (n=58), Burkitt 16% (n=20), SLL 7% (n=8), follicular lymphoma 5% (n=5), lymphoblastic 5% (n=6), marginal zone lymphoma 5% (n=5), splenic marginal zone lymphoma 3% (n=3), mantle cell lymphoma 2%(n=2), mycosis fungoids and Sezary syndrome 2% (n=2) and anaplastic large cell lymphoma 2% (n=2). The DLBCL included 3.5% (n=4) primary CNS lymphomas. Conclusions: Histopathological types of B-cell NHLs in our cohort from Iraq were generally comparable to international figures. However, similar to other African and Middle Eastern studies Burkitt lymphoma was more common in our series than Western figures, follicular lymphoma was uncommon and T-cell lymphomas were rare.
Perceived versus measured functional vaginal capacity in cancer patients with sexual function concerns.
Authors: Vanessa Kennedy, Emily Abramsohn, Lisa Asiedu, Jennifer Makelarski, Kristen Wroblewski, Amber Matthews, Seiko Diane Yamada, Stacy Tessler Lindau
Journal: Journal of Clinical Oncology (2013)

9528 Background: Actual and perceived loss of vaginal capacity can be a source of distress among female cancer survivors. The objective of this study was to assess perceived (PC) versus measured (MC) functional vaginal capacity in patients presenting with sexual function concerns. Methods: This was a cross-sectional registry-based study of women seen at the Program in Integrative Sexual Medicine for Women and Girls with Cancer (PRISM) Clinic. During the visit, patients were presented with graduated vaginal dilators and asked to select the largest dilator they perceived could be inserted without pain (PC) and the dilator representing their desired functional capacity (DC) (for patients with a male partner, this was the size closest to the partner’s erect penis). Two models of dilators were offered. Dilators were numbered 1-24 in order of increasing volume. If the patient could accommodate the dilator chosen as PC without pain, she was examined with dilators of gradually increasing size until the patient reported discomfort. The largest dilator tolerated without pain was MC. Differences between PC and MC, and between DC and MC were calculated. The association between penetrative sexual activity in the prior 4 weeks and accuracy of PC was assessed using the Mann-Whitney U test. Results: Mean patient age was 46 years (range 21-80, N=69). Most patients had breast (60%) or a gynecologic cancer (23%). Nearly half reported two or more sexual concerns; painful intercourse (81%), vaginal complaints (21%), and loss of libido (19%) were most common. Mean PC was 16.9 (SD 5.2, range 3-24), mean MC was 20.8 (SD 3.4, range 10-24), and mean DC was 21.8 (SD 3.4, range 6-24). PC equaled MC in 22%. PC was less than MC in 75% and less than DC in 81% of patients. Of patients with PC less than DC, 41% had MC equal to or larger than DC. PC was closer to MC in patients reporting penetrative sexual activity in the prior 4 weeks (p=0.03). Conclusions: In this single-site study, many cancer survivors seeking care for sexual concerns underestimate their functional vaginal capacity. Further study is needed to determine whether correcting patient perception of capacity lessens distress and improves function.
Retrospective review of doxorubicin plus sorafenib as second-line therapy in hepatocellular carcinoma (HCC).
Authors: Ghassan K. Abou-Alfa, Jennifer Ma, Eileen Mary O'Reilly, Bolorsukh Gansukh, Joanne F. Chou, Marinela Capanu, Leonard Saltz
Journal: Journal of Clinical Oncology (2012)

298 Background: Doxorubicin plus sorafenib has yielded an improved overall survival, progression-free-survival, and time-to-progression when compared to doxorubicin plus placebo, in the first line setting in patients with advanced HCC (Abou-Alfa, GK, et al. JAMA 2011). We explored the activity of doxorubicin and sorafenib following sorafenib failure. Methods: An IRB exemption was obtained to identify patients with HCC who were treated with doxorubicin and sorafenib after sorafenib failure. Demographic data, including age, gender, race, stage of disease, and risk factors were collected. Data were collected on treatment doses, duration, response, and adverse events including left ventricular ejection fractions (LVEF). Median progression-free survival (PFS) and overall survival (OS) were calculated from the start of combined therapy. Results: N=14 patients: Median age 60 years (range 43-70), median KPS 80%, 12 males (86%), 4 stage III (29%)/10 stage IV (71%), 8 HBV (57%) /3 HCV (21%). The median number of doxorubicin doses was 3 (range 1-11). Eight patients had grade 3-4 toxicities, including neutropenia, febrile neutropenia, thrombocytopenia, hepatitis B flare, dehydration, nausea, vomiting, mucositis, pain, and seizure. No &gt;20% relative drops in LVEF from baseline were noted. There were no toxicity-related deaths. There were no objective responses. Of 14 evaluable patients, 5 (36%) had SD for ≥ 4 months, and 9 (64%) had POD. Median PFS was 3.4 months (95% CI 2.30-8.36), and OS 10.1 months (95% CI 4.34-11.45). Conclusions: In this small retrospective review of a select group of patients, doxorubicin plus sorafenib was tolerable, albeit with substantial toxicity. Doxorubicin and sorafenib may have activity after sorafenib failure however whether this is due to a synergy between the drugs, or to doxorubicin alone, cannot be determined from this review. A formal evaluation of doxorubicin plus sorafenib versus doxorubicin alone, versus best supportive care in the second line setting is warranted.
Treatment outcome and safety of docetaxel as the third-line chemotherapy in advanced gastric cancer after progression or after failure of FOLFOX and FOLFIRI-based sequential chemotherapy.
Authors: I. Hwang, J. Kang, B. Park, S. Park, M. Jang, S. Kim
Journal: Journal of Clinical Oncology (2011)

133 Background: We performed multicenter retrospective study to evaluate the activity and the safety of a docetaxel as the third-line chemotherapy in advanced gastric cancer (AGC) patients who had undergone oxaliplatin (FOLFOX) and irinotecan (FOLFIRI)-based chemotherapy regimens. Methods: Thirty-eight patients with AGC previously treated were eligible for this study. Patients received docetaxel 30 mg/m 2 +/- cisplatin 30 mg/m 2 IV on day 1, 8 or docetaxel 60 mg/m 2 +/- cisplatin 60 mg/m 2 IV on day 1 every 3 weeks until disease progression, and responses were assessed after every two cycles according to RECIST criteria and toxicity was evaluated by NCI-CTC. Results: Thirty-two out of 38 patients were evaluable for response. A total of 95.1 cycles of chemotherapy (median 2, range 0.5–7) were administered. Relative dose intensities of docetaxel and cisplatin were 93.4% and 87.8%, respectively. The overall response rate was 15.6% and the disease control rate was 50%. With a median follow-up duration of 3.1 months (range 0.3-14.3 months), 36 patients had disease progression, and 34 patients had died at the time of analysis. The median progression-free survival was 1.8 months (95% CI, 1.3–2.3 months). The median overall survival was 3.1 months (95% CI, 2.3–3.9 months). Grade 3 or 4 hematologic toxicities included neutropenia in thirteen patients (38.3%), febrile neutropenia in four patients (11.7%). and thrombocytopenia in one patient (2.9%). Other grade 3 or 4 toxicities included neuropathy in three patients (8.8%) and mucositis in two patients (5.9%). There were three treatment-related deaths (8.8%) caused by infection associated with neutropenia. Conclusions: Salvage docetaxel chemotherapy in AGC patients failed in oxaliplatin and irinotecan-based treatment is not recommend routinely. However, selected patients with good performance status and sufficient albumin levels may have derived some survival benefits from salvage chemotherapy. No significant financial relationships to disclose.
Prognostic Relevance of t(4;14) and Expression of FGFR3 and TACC3 in Newly Diagnosed Patients with Multiple Myeloma.
Authors: Carolina Terragna, Matteo Renzulli, Nicoletta Testoni, Chiara Nicci, Tiziana Grafone, Patrizia Tosi, Elena Zamagni, Claudia Cellini, Delia Cangini, Paola Tacchetti, Giulia Perrone, Simona Soverini, Giovanni Martinelli, Michele Baccarani, Michele Cavo
Journal: Blood (2005)
Successful Long Term Therapeutic Expression of Factor VIII in Hemophilia A Dogs After Administration of AAV-cFVIII Using a Two-Chain or Single Chain Delivery Approach.
Authors: Denise E. Sabatino, Ekaterina Altynova, Amy M. Lange, Shangzhen Zhou, Elizabeth P. Merricks, Aaron M. Dillow, Timothy C. Nichols, Valder R. Arruda, Haig H. Kazazian
Journal: Blood (2009)
Single institution, retrospective comparison of toxicity and outcome for static 5-field IMRT versus VMAT in the delivery of prostate and pelvic nodal irradiation in high-risk prostate cancer.
Authors: Philip Geoffrey Turner, Suneil Jain, Gemma Corey, Darren M. Mitchell, Karen Tumelty, Denise Irvine, Jacqueline A. Harney, Fionnuala Houghton, Jonathan McAleese, Lin Shum, David P. Stewart, Joe M. O'Sullivan
Journal: Journal of Clinical Oncology (2016)

147 Background: There is emerging evidence for the role of pelvic nodal irradiation in high-risk prostate cancer. We have assessed the toxicity rates and outcomes with 2 different radiotherapy techniques. Methods: The baseline disease metrics, toxicity and outcome data for men treated at our institution with prostate and pelvic nodal irradiation during a 2 year period were retrospectively collected. The radiotherapy technique, either 5-field IMRT or VMAT was recorded along with a single dose-level to indicate normal tissue exposure (V50 to bowel and rectum, that is the percentage of total organ receiving ≥ 50Gy). Results: 67 men with a median age of 64 years were identified; 83.6% were Gleason ≥ 8, 82.1% were ≥ T3a, 50.7% were N1, 4.5% were M1a/M1b. All had neoadjuvant and concurrent hormone therapy. All received 74Gy to prostate; 70.1% received 60Gy to pelvic nodes, 28.4% received 55Gy to pelvic nodes (1 patient received 56Gy). 55.2% were treated with static IMRT and 44.8% with VMAT with no significant difference in nodal dose received by static vs VMAT groups. Median follow up was 25 months. Analysis found V50 rectum was significantly lower in those treated with VMAT compared to static IMRT (48.5% vs 54.76% p = 0.001). Acute bowel toxicity rates (RTOG grade) were 80.6% grade &lt; 2, 19.4% grade 2, nil &gt; grade 2. Late bowel toxicity rates (RTOG grade) were 88% grade &lt; 2, 12% grade 2, nil &gt; grade 2. There was no significant difference in rates of acute or late bowel toxicity in groups treated with static IMRT vs VMAT. 13 patients (19.4%) underwent lower GI endoscopy during follow up, 9 had radiation proctitis. There was no significant difference in rates of endoscopy or proctitis for VMAT vs IMRT groups. 11.9% of patients developed biochemical failure during follow up. Rates of biochemical failure were not significantly different in groups separated by dose to pelvic nodes or radiotherapy technique. Conclusions: In a single institution, retrospective analysis, prostate and pelvic nodal irradiation is associated with acceptable rates of toxicity. Treatment with VMAT is associated with a significantly lower V50 rectum than that delivered by static IMRT.
Brachytherapy boost and cancer-specific mortality in favorable high-risk and other high-risk prostate cancer.
Authors: Vinayak Muralidhar, MIchael H. Xiang, Peter F. Orio, Neil E. Martin, Clair Beard, Felix Yi-Chung Feng, Karen E. Hoffman, Paul L. Nguyen
Journal: Journal of Clinical Oncology (2016)

52 Background: A randomized trial has recently reported improved 5-year biochemical recurrence-free survival with brachytherapy (BT) boost compared with external beam radiation therapy (EBRT) boost in intermediate- to high-risk prostate cancer. Recent retrospective data suggest that BT boost may also confer a cancer-specific survival benefit in the high-risk subgroup. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4+4 = 8, PSA &lt; 10 ng/mL or T1c, Gleason 6, PSA &gt; 20 ng/mL). Methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with EBRT or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM) after EBRT+BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results: BT boost was not associated with an improvement in 5-year PCSM compared with EBRT alone among patients with favorable high-risk disease (1.6% vs 1.9%; adjusted hazard ratio [AHR] 0.56; 95% confidence interval [CI], 0.21 to 1.52, P = 0.258) and intermediate-risk disease (0.7% vs 0.9%; AHR 0.83; 95% CI, 0.59 to 1.16; P = 0.270). Others with high-risk disease had significantly lower 5-year PCSM when treated with BT boost compared with EBRT alone (3.9% vs 5.0%; AHR 0.73; 95% CI, 0.55 to 0.95; P = 0.022). Conclusions: Brachytherapy boost is associated with a decreased rate of PCSM in men with high-risk prostate cancer, but this benefit was not seen among patients with favorable high-risk disease. This suggests that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high risk disease.
The evaluation of demographic, clinicopathologic characteristics, and treatment modalities of malignant pleural mesothelioma in southwest of Turkey: A single-center experience.
Authors: A. Sezer, A. T. Sümbül, H. Abali, U. Disel, F. Kose, A. A. Besen, C. Karadeniz, O. Ozyilkan
Journal: Journal of Clinical Oncology (2011)

e18037 Background: Malignant pleural mesothelioma is a rarely seen lethal malinancy caused by asbetosis exposure. It is more frequently seen in some regions in our country. In this retrospective study, we aimed to analyse demographic, clinical, pathological data and treatment related features in 54 patients. Methods: Of the patients, 34 (55.6%) were male and 20 (44.4%) female with a M/F ratio of 1.7. Median age in men was 60.3 (38.2-77.2) years and 65.8 (37.7-77.5) years in women. In 35 (64.8%) exposure to asbestosis were present, 9 patients (16.7%) had no history and in 10 (18.5%) it was unknown. Epithelial type was found in 27 (50.0%), followed by mixed type in 7 (13.0%) patients, and in 20 (37.0%) subtype could not be determined. The disease was staged as IV in 37 (68.5%) patients. In 28 patients (51.9%), it was right-sided and in 1 (1.9%) bilateral, in remaining it was left-sided. The most frequently seen metastatic sites were lungs, mediastinum, diaphragm, liver, thoracal wall and bones in decreasing order. Results: Of the patients, 36 (66.6%) received 1st line and 20 (37%) 2nd line chemotherapy. Eighteen patients (33.3%) recevied radiotherapy; 11 (20.3%) palliative and 7 (12.9%) curative intend. Median overall survival (OS) was 12.0 months (CI95%: 7.2-16.8). OS was not affected by smoking history (p=0.511), alcohol consumption (p=0.367), family history (p=0.679), pleural effusion presence (p=0.808), operation (p=0.146), symptome at presentation (p=0.661) and type of 1st line chemotherapy (p=0.161). On the contrary, it was affected by being with ECOG PS (Eastern Cooperative Oncology Group-performans status) of 0-1 (p=0.097), clinical stage (p=0.072), having mixed type histology (p=0.079), left-sided disease (p=0.01), receiving chemotherapy (p<0.01), having only single sided pelural effusion (p=0.018) and type of 2nd line chemotherapy (p=0.025). Conclusions: In conclusion, OS of our patients was better than the known figures, seeming to be positively affected by early stages, better ECOG PS and having received chemotherapy. Overall treatment success seems to be comparable to what is being currently expected.
Use of subcutaneous amifostine during radiation therapy: A prospective study
Authors: D. N. Sharma, P. K. Julka, R. Sharma, G. K. Rath, P. S. Sridhar
Journal: Journal of Clinical Oncology (2005)

8258 Background: Though intravenous amifostine has been shown effective radioprotectant during radiation therapy (RT) in several trials but it is associated with side effects like nausea, vomiting and hypotension. The subcutaneous (s.c.) route, of late, is reported to be more convenient and equally effective in reducing the radiation related toxicity. The aim of trial is to study the tolerance and safety of s.c. administration of amifostine during RT in our set-up. Methods: Any patient suitable for curative RT with or without chemotherapy was eligible for inclusion. Till now, we have enrolled and studied 40 patients. There were 29 males and 11 females with median age of 62 years (range 41–80 years). The primary sites were: head and neck, 22; prostate, 7; cervix, 3; esophagus, 2; rectum, 2; ovary, urinary bladder, non-Hodgkin’s lymphoma, endometrium one each. Twenty three out of 40 patients received RT without chemotherapy and rest 17 received concurrent chemo-RT. Amifostine 500 mg was administered s.c. 30 minutes prior to each fraction of RT in all 40 patients. Oral antiemetics were given before administration of the amifostine. All patients were monitored every day for various effects like nausea, vomiting, skin rash, fever etc. RTOG criteria were used for the assessment of radiation related toxicity. Results: Amifostine related toxicities were observed in 14 patients but none had to discontinue treatment. Nausea/vomoting, skin rash, fever and hypotension were observed in 9, 6, 4 and 0 patients respectively. Nine patients had interruptions in the radiation treatment (7 due to radiation toxicity and 2 due to chemotoxicity). Three patients could not complete the planned course of RT due to persistent grade III mucosal toxicity; all three of them were receiving head and neck irradiation. No patient with pelvic irradiation (for carcinoma prostate) had interruption in the course of radiation therapy. Chemotherapy was stopped in two patients due to chemo-toxicity. The median dose of RT was 62 Gy (range 30–72 Gy). Conclusion: Subcutaneous administration of amifostine during irradiation/chemo-irradiation has been found feasible, tolerable and convenient in our setup. No significant financial relationships to disclose.