tbuckley/cabot-search huggingface dataset:
Postdiagnosis social networks and lifestyle and treatment mechanisms in the Ater Breast Cancer Pooling Project (ABCPP).
Authors: Candyce H. Kroenke, Yvonne Michael, Xiao-Ou Shu, Elizabeth Poole, Marilyn L. Kwan, Bette J. Caan, Sarah Nechuta, John P. Pierce, Wendy Y. Chen
Journal: Journal of Clinical Oncology (2014)

115 Background: Larger social networks have been associated with better breast cancer survival. To investigate potential mediators, we evaluated associations of social network size and diversity with lifestyle and treatment factors associated with prognosis. Methods: We included 9,331 women from the After Breast Cancer Pooling Project who provided data on social networks within two years following diagnosis. A social network index was derived from information about the presence of a spouse or intimate partner, religious ties, community participation, friendship ties, and numbers of relatives. Diversity was assessed as variety of ties, independent of size. We used logistic regression to evaluate associations with outcomes and evaluated whether effect estimates differed using meta-analytic techniques. Results: Associations of social networks and outcomes generally did not differ by cohort. Because of the low prevalence of smoking and alcohol consumption in the Shanghai cohort, however, analyses of smoking and alcohol included US cohorts only. Women who were socially isolated (small networks) were more likely to be obese (body mass index&gt;30 kg/m 2 , OR=1.21, 95% CI:1.03-1.42) and have low physical activity (&lt;10 MET-h/wk, OR=1.53, 95% CI:1.34-1.75) compared to socially integrated women. Women with low network diversity were more likely to be current smokers (OR=3.68, 95% CI:2.19-6.19) and have high alcohol consumption (&gt;15 g/d alcohol, OR=2.43, 95% CI:1.60-3.69). Among node positive cases, socially isolated women were more likely not to receive chemotherapy (OR=1.52, 95% CI:1.03-2.25). By contrast, low network diversity, but not social network size, was associated with greater odds of not receiving adjuvant hormonal therapy (OR=1.52, 95% CI:1.03-2.23). Associations with surgery were nonsignificant. Conclusions: In a large pooled cohort, small, less diverse social networks measured post-diagnosis were associated with more adverse lifestyle factors and less intensive cancer treatment, which may help to explain poorer breast cancer prognosis in socially isolated women.
A novel tool to predict outcomes following radical cystectomy using age and co-morbidity status.
Authors: Jasmir Gopal Nayak, Sarah Holt, John L. Gore, Atreya Dash
Journal: Journal of Clinical Oncology (2015)

354 Background: Substantial morbidity and mortality is associated with radical cystectomy. Utilizing administrative data, we sought to develop a novel model combining age and co-morbidity status to determine the risk of clinically relevant outcomes including: prolonged length of stay (LOS), disposition to skilled nursing facility (SNF), mortality on index admission, and hospital readmission rates following radical cystectomy. Methods: From the Premier Perspectives Database, we identified patients who underwent radical cystectomy for bladder cancer between 2007-2013 using ICD-9 codes. Comorbidity was determined using the Elixhauser method. Prolonged LOS was defined as admissions exceeding 10 days. Hospital readmissions were flagged if they occurred in the month of surgery or the month after regardless of the reason. Probabilities were derived from multivariable logistic regression models that additionally adjusted for provider volume (based on quartiles), payer, patient marital status, and hospital urban/rural status. Results: We identified 6,460 radical cystectomy patients, of whom 16% were discharged to a SNF, 37% had a prolonged LOS, and 2% died during the index admission. Among patients who were discharged home after surgery, 27% were readmitted. Prolonged LOS was associated with increasing comorbidities and age &gt;70 (p&lt;0.001). The adjusted likelihood of readmission increased with increasing burden of comorbid conditions (p&lt;0.001) (Table), however, was not associated with age group. The likelihood of being discharged to a SNF increased with increasing age and increasing number of comorbidities (p&lt;0.001). Mortality was associated with 3 or more comorbidities and age &gt;70. Conclusions: We present adjusted disposition and mortality rates following radical cystectomy for bladder cancer stratified by patient age and comorbidity. These data may inform preoperative patient counseling regarding the potential for prolonged recovery and mortality and facilitate improved shared decision-making between patients and clinicians anticipating cystectomy for bladder cancer.
Rates of bone mineral density measurement in men with prostate cancer starting androgen deprivation therapy.
Authors: Maria Suarez-Almazor, Prashanth Peddi, Ruili Luo, Hoang Nguyen, Linda S. Elting
Journal: Journal of Clinical Oncology (2012)

174 Background: Men with prostate cancer on androgen deprivation therapy (ADT) are at risk for accelerated bone loss and osteoporotic fractures. Current National Comprehensive Cancer Network (NCCN) guidelines recommend dual-energy X-ray absorptiometry (DXA) scan for risk assessment when starting ADT. Our objective was to determine if DXA scans were performed prior or soon after ADT initiation among men with prostate cancer. Methods: In this claims-based database linkage study, men with prostate cancer were identified fromthe Texas Cancer Registry between 2006-2007 and their records were linked with Medicare databases parts A, B and D to identify claims for ADT using generic names, predefined J codes and ICD codes. Part D claims are currently available for years 2007 and 2008. DXA claims were obtained using CPT/HCPS codes from Medicare part A and part B. Patients were considered to have undergone a DXA exam, useful as a baseline screening test for ADT therapy if a claim could be identified within 2 years before starting ADT therapy, or 6 months afterwards. Multivariate logistic regression models were performed to examine determinants of DXA use. Results: 1,647 men 65 years and older were included in the study. A total of 144 (8.3%) had a DXA scan obtained within 2 years and 6 months after initiation of ADT. Age older than 75 years, history of prior bisphosphonate usage and residence in the metropolitan area were statistically significantly associated with higher likelihood of obtaining DXA. Race, gender, median income, high school percentage, number of ADT claims, and type of ADT used were not associated with DXA usage. Conclusions: Despite the importance of osteoporosis screening, men with prostate cancer and Medicare insurance, in the state of Texas, had very low DXA utilization rates prior, or soon after, the initiation of ADT. Further research is needed to identify barriers to adherence to recommendations for the evaluation of bone health in patients with prostate cancer.
Staging laparoscopy and neoadjuvant chemotherapy of biweekly docetaxel and S-1 for gastric cancer with peritoneal dissemination.
Authors: Y. Kakeji, E. Oki, K. Yoshinaga, H. Saeki, E. Tokunaga, M. Morita, H. Kitao, Y. Emi, Y. Sakaguchi, Y. Maehara
Journal: Journal of Clinical Oncology (2010)

e14570 Background: Staging laparoscopy revealed minimal peritoneal gastric cancer cell dissemination, which cannot be detected by conventional computed tomography. The aim of this study was to retrospectively clarify the utility of staging laparoscopy andneoadjuvant chemotherapy of docetaxel and S-1 for gastric cancer with peritoneal dissemination. Methods: Eighty-three patients with primary gastric adenocarcinoma underwent laparoscopy with peritoneal lavage cytology in Kyushu University Hospital and seven affiliated hospitals. The eligibility for staging laparoscopy included macroscopic T2-4, N1-2, M0 by preoperative imaging studies. Forty-seven patients without peritoneal dissemination were enrolled in a neoadjuvant phase II study using Docetaxel and S-1. This study further analyzed twenty-seven patients with peritoneal dissemination. Docetaxel 35 mg/m2 was administered on days 1 and 15 of each cycle (i.e., every 4 weeks). S-1 40 mg/m2 was orally administered twice daily for 2 weeks, followed by a drug-free interval of 2 weeks. Results: An unsuspected peritoneal deposit was found in five cases and free cancer cells in 27 cases. Minimal peritoneal gastric cancer cell dissemination was recognized in almost one third of all cases (27/83, 33%) that had been diagnosed to not demonstrate peritoneal dissemination based on conventional imaging studies. Neoadjuvant chemotherapy of biweekly docetaxel and S-1 was performed in 16 patients. The most common grade 3–4 toxicities were neutropenia (23%) and leukocytopenia (15%). Eleven patients underwent a gastrectomy, which resulted in 8 R0 and 3 R2 resections. Neoadjuvant chemotherapy induced a pathological response in 6 cases (grade 1b, 2, 3; 55%) and downstaging of the disease in 9 of the 11 patients with positive cytology findings (82%). Conclusions: Staging laparoscopy is therefore considered to be a useful tool in the treatment strategy of gastric cancer with peritoneal dissemination. Neoadjuvant chemotherapy consisting of biweekly docetaxel and S-1 can be safely administered to patients undergoing a radical gastrectomy and D2 lymphadenectomy. The R0 resection and pathological response rates are also encouraging. No significant financial relationships to disclose.
Differences in clinical characteristics and treatment in hepatocellular carcinoma between Asians and non-Asians.
Authors: Kit Man Wong, Jonghun John Lee, Amy Wong, Geoffrey Liu, Morris Sherman, Sean P. Cleary, Jennifer J. Knox
Journal: Journal of Clinical Oncology (2014)

289 Background: Studies have demonstrated clinical differences in hepatocellular carcinoma (HCC) between Asians (AS) and non-Asians (NAS). In the US, AS are less likely to undergo liver transplant compared to Caucasians. Despite the large immigrant population in Canada, there has been no prior comparison of HCC in AS and NAS in the context of the Canadian universal health care system. We retrospectively evaluated the ethnic differences in HCC at the largest cancer centre in Canada. Methods: We analyzed 268 patients who enrolled in a Genetic Epidemiology Study of HCC (April 2010 to February 2013), where patients were asked to complete a questionnaire and give a blood sample at their first visit. Relevant clinical data were extracted and analyzed by descriptive statistics, t-test or Chi-square test. Results: The study population had a mean age of 61 years and 83% males. There were 45% AS, 49% Caucasians, and 6% other ethnicities. Etiologies of HCC included: Hepatitis B (HBV) 34%, Hepatitis C (HCV) 32%, non-alcoholic steatohepatitis 15%, alcohol 18%. Compared to NAS, HCC patients of Asian ancestry had significantly higher rates of HBV (60% vs. 12%, p&lt;0.001). At diagnosis, 83% of patients were Child-Pugh A (mean MELD score 9.2). Ethnicity had no impact on Child-Pugh class, multifocal disease or macrovascular invasion. However, MELD scores were lower in AS (p=0.02). Overall, 71% of cases were initially treated with curative intent. Patients underwent various treatment modalities: liver transplant 13%, resection 31%, radiofrequency ablation 39%, transarterial chemoembolization (TACE) 21%, radiation 17%, systemic therapy 27%. AS had higher resection rates (41% vs. 22%, p&lt;0.001), while no differences were observed for other treatments. Duration of response was 11.7 months for TACE (AS 14.2, NAS 10.5), 7.5 months for sorafenib (AS 6.8, NAS 8.1). Rate of intolerance to sorafenib was 24% (AS 27%, NAS 22%, p=0.63). This analysis was limited by inherent bias in the selection of study patients. Conclusions: AS with HCC tend to have HBV and lower MELD scores, and to undergo resection in a public health care setting with no differences in the uptake of other therapies. An analysis of survival based on ethnicity will be reported.
Preliminary results from a multicenter, phase II, randomized, noncomparative clinical trial of radiation and temozolomide with or without vandetanib in newly diagnosed glioblastoma (GBM).
Authors: E. C. Quant, T. Batchelor, A. B. Lassman, D. Schiff, T. J. Kaley, E. Wong, T. Mikkelsen, J. Drappatz, A. D. Norden, R. Beroukhim, S. E. Weiss, B. M. Alexander, C. Sceppa, M. Gerard, S. D. Hallisey, C. A. Bochacki, K. H. Smith, A. Muzikansky, P. Y. Wen
Journal: Journal of Clinical Oncology (2011)

2069 Background: EGFR and VEGFR signaling have been implicated in the development and growth of GBM. Simultaneous inhibition of both pathways may be more effective than inhibiting a single pathway. In addition, angiogenesis inhibitors may enhance radiation sensitivity. Vandetanib is an inhibitor of VEGFR-2 and EGFR tyrosine kinase activities that has previously been shown to have anti-tumor activity in human glioma models. We conducted a phase II study of vandetanib in patients with newly-diagnosed GBM in combination with radiation (RT) and temozolomide (TMZ). Methods: A total of 110 newly-diagnosed GBM patients (pts) will be randomized in a ratio of 1:2 to Arm A: RT/TMZ (38 pt) or Arm B: Vandetanib 100 mg daily (76 pts) + RT/TMZ. All pts will receive RT (60 Gy) and concurrent TMZ 75 mg/m2 daily, followed by adjuvant TMZ for up to 12 cycles (150-200 mg/m2 on days 1-5 of each 28 day cycle). Pts with age ≥ 18, Karnofsky performance status ≥ 60, no enzyme inducing antiepileptics are eligible. The study will have 88% power to detect a 15% increase in overall survival rates at the 15 months evaluation time point compared to historical controls, using a one-sided binomial hypothesis test with an alpha of 0.1. Primary endpoint will be overall survival (OS) from the date of randomization. Secondary endpoints include 12-month survival, median time to tumor progression, and safety. Outcomes will be correlated with tumor genotype, circulating endothelial cells and progenitor cells, plasma angiogenic proteins, and perfusion MRI. Results: To date, we have enrolled 85 pts (29 in Arm A, 56 in Arm B) with median age 59 yrs (range: 23-82) and median KPS 90 (range: 60-100). Most frequent Gr3/4 AEs in the vandetanib arm were lymphopenia (18%), thrombosis (7%), transaminitis (5%) and leukopenia (5%). Conclusions: Vandetanib is reasonably well tolerated when combined with standard chemoradiation in newly diagnosed GBM. Updated efficacy and toxicity data will be presented.
Current era clinical outcomes of castration-resistant prostate cancer in real-life population study in Quebec, Canada.
Authors: Joice Rocha, Marie Vanhuyse, Armen G. Aprikian, Fabio L. Cury, Alice Dragomir
Journal: Journal of Clinical Oncology (2015)

226 Background: Prostate cancer (PCa) death is mainly due to castration-resistant PCa (CRPC) which results from disease progression despite androgen ablation therapy (ADT). Little is known about clinical outcomes and trends of real-life CRPC management in the present era, which has become very complex. Our study aimed to analyze healthcare services use, clinical outcomes and survival trends in real-life management of CRPC in Quebec, Canada. Methods: The study cohort consisted of 7,123 patients which shown evidence of CRPC from January/2001 to July/2013, selected from the public healthcare insurance programs the Régie de l’Assurance Maladie du Québec (RAMQ) databases. Survival was evaluated by Kaplan-Maier and the difference in survival between pre-/post-docetaxel (Doc) (2002-2005 vs 2008-2011) era by log-rank test. The association between Doc exposure and survival was evaluated by Cox proportional hazards model adjusted for several co-variables. Results: Chemotherapy was offered to 17% of patients, while 45% were kept on maximal androgen blockade (MAB) alone, or offered Abiraterone (3%). Androgen targeted therapies (MAB or Abiraterone) were the treatment of choice for the elderly population (mean age 78.8 and 78 ±7, respectively) while chemotherapy was offered to younger patients (mean age 72 ±7.3). Survival rates at 1 and 2 years after the initiation of chemotherapy were 52% and 26% in post-Doc era vs 46% and 17% in the pre-Doc period. In patients receiving first line chemotherapy only, hospitalization due to PCa was a poor prognostic predictor (HR: 2.0; 95%CI: 1.5-2.6), as expected. In addition among patients without previous hospitalization the risk of death was higher in the pre- vs post-Doc era (HR: 1.7 CI: 1.003-2.851). Conclusions: Patient age seems to be a strong determinant in CRPC therapy selection. In patients without serious complications leading to hospitalization, survival was greatly improved in the post-Doc era. Our data also supports that patients older than those in the TAX327 trial (72 vs 68) may equally benefit from chemotherapy. This is encouraging as we hope to observe comparable results for new approved therapies for CRPC.
High local recurrence of Wilms tumor: A single institutional experience at western region of Saudi Arabia
Authors: T. M. Khattab, S. K. Felimban, L. A. Allah, C. J. H. Fryer
Journal: Journal of Clinical Oncology (2005)

8559 Background: Controversy exists between an initial surgical resection versus preoperative chemotherapy in the management of Wilms’ tumor. Objective: Evaluate effect of a pre-operative approach in the management of Wilms’ tumor in terms of local recurrence and survival versus early nephrectomy. Methods: A retrospective review was undertaken of patients with Wilms’ tumor treated from 1986–2000. Pathology was reviewed using NWTS V criteria. Staging and treatment were based on the UKW3 protocol. Patients were evaluated for local recurrence and survival. Results: Thirty-five patients (16 male) were treated during the study period. Stage distribution was Stage I 4 pts. Stage II 8 pts. Stage III 14 pts. Stage IV 4 pts. Stage V 5 pts. Histology was favorable (FH) in 31, the unfavorable cases were; anaplastic 2, clear cell sarcoma 1, rhabdoid 1. Eight patients 8/35 (23%) developed local recurrence (LR). Six isolated, One patient had simultaneous local and distant (lung) recurrence and another pt.developed second local recurrence after isolated first pulmonary recurrence and an additional pt.developed isolated pulmonary recurrence. Thirteen (13) pts.were subjected to pre-operative chemotherapy (POC); 19 pts.were subjected to early surgery and 3 pts. data not available. Two (2) of 13 patients receiving pre-operative chemotherapy were UH compared to 2/19 patients treated with initial resection. Stage distribution of patients receiving POC was: Stage III 5; Stage IV 3; Stage V 5. LR occurred in 6 /13 (46%) patients receiving POC compared to 2/19 (10%) in patients having initial resection. Survival by histology was FH 80% and UH 25%. All local recurrece died except isolated pulmonary recurrence. Conclusions: Cytoreduction approach using Actinomycin-D and Vincristine was applied to Stage V and to Stage IV patients. The high local recurrence rate seen in our population is attributed to unfavorable histology, unresectable tumor, stage III & stage IV disease and the prolonged delay in initiation of definite therapy to primary lesion. Many of our patients were deemed inoperable at diagnosis. Earlier surgical intervention or early utilization of irradiation in inoperable cases might reduce our high recurrence rate. No significant financial relationships to disclose.
Psychosocial outcomes in active treatment through survivorship.
Authors: Sarah C. Reed, Janice Bell, Robin L. Whitney, Andra Davis, Rebecca Salisbury Lash, Katherine Kim, David Copenhaver, Richard J. Bold, Jill G. Joseph
Journal: Journal of Clinical Oncology (2014)

241 Background: An estimated 13.7 million cancer survivors live in the United States, a population projected to reach 18 million in 2022. Late- and long-term psychological and emotional effects of cancer can be severe and unfortunately, often go unrecognized and untreated. Few population based data exist that capture psychosocial outcomes across the cancer continuum, from active treatment through survivorship. Methods: We analyzed the Medical Expenditure Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (n=1,592) to examine psychosocial outcomes among active treatment and survivorship patients across the post-treatment trajectory. Survey-weighted regression models were used to determine the risk of depression (PHQ-2), psychological distress (K-6) and cancer-specific worry related to recurrence. The primary independent variable was post-treatment survivorship status, categorized in years (1-2; 3-4; 5-9; 10-20; &gt;21years) compared to active treatment as the reference group. All models were adjusted for plausible confounding variables (age, sex, race/ethnicity, marital status, employment, income, education, health insurance and health status). Estimates are generalizable to US non-institutionalized populations. Results: No significant difference in the risk of depression (PHQ-2) or psychological distress (K-6) was evident between those in active treatment and cancer survivors at any time post-treatment and those in active treatment. In contrast, cancer-specific worry was significantly higher among those respondents in active treatment (OR 4.3; 95% CI: 2.8, 6.6) compared to those post-treatment. Within the post-treatment survivorship categories, cancer-specific worry generally declined with time post-treatment; however these associations were only significant among those whose treatment was more than 20 years ago (OR= 0.12; 95% CI: 0.04, 0.36) relative to those in active treatment. Conclusions: Psychosocial concerns are pervasive among cancer survivors and are similar to concerns among individuals undergoing active treatment. These findings highlight unmet psychosocial needs among cancer survivors and demonstrate the importance of targeted interventions across the survivorship continuum.
The 2016 Revised World Health Organization Classification of 'Myelodysplastic Syndrome with Isolated Del(5q)'; Prognostic Implications of Single Versus Double Cytogenetic Abnormalities
Authors: Mark Gurney, Mrinal M Patnaik, Curtis A. Hanson, Mark R. Litzow, Aref Al-Kali, Rhett P. Ketterling, Ayalew Tefferi, Naseema Gangat
Journal: Blood (2016)