tbuckley/cabot-search huggingface dataset:
Clinicopathologic characteristics that affect the treatment and recurrence of rectal carcinoid tumor in Korea.
Authors: Dong Ho Lee, Young Soo Park, Jae Jin Hwang, Hyun chae Jung
Journal: Journal of Clinical Oncology (2016)

684 Background: The increase of colonoscopy procedures has led to an increase in the diagnosis of rectal carcinoid tumors. The aim of this study was to evaluate the clinical and pathological characteristics that affect the treatment and recurrence of rectal carcinoid tumors. Methods: Between 2003 and 2014, the medical records of patients with rectal carcinoid tumors were retrospectively reviewed. Patient and tumor characteristics, treatment and recurrence were analyzed. Results: The mean age was 51.7 ± 11.7 (range, 22-80 years) and the male to female ratio was 1:0.58. The mean tumor size was 8.7 ± 4.9 (3-27) mm. Four hundred-seven out of 424 patients were treated by endoscopy (mean size of tumor: 8.6 ± 3.6 mm) and 17 were treated by surgery (mean size of tumor: 12.5 ± 5.7 mm, p = 0.023). However, the histology showed that 87 patients treated by endoscopy had positive resection margins; 68 cases (16.0%) had a polypectomy and 19 cases (4.4%) had a endoscopic mucosal resection (p = 0.033). The mean follow-up duration was 29.1 ± 31.3 months, and there were five recurrences of rectal carcinoid tumors.All cases of recurrence of rectal carcinoid tumor were successfully re-treated by additional endoscopic resection. Conclusions: Endoscopic resection was an effective method for the treatment of rectal carcinoid tumors. Moreover, even for small rectal carcinoid tumors, follow-up examination should be performed to evaluate for tumor recurrence.The recurrence of rectal carcinoid tumor should be successfully controlled by additional endoscopic resection.
Economic implications of preoperative PET-CT scanning in potentially resectable non-small cell lung cancer (NSCLC).
Authors: D. Ho, M. Gopal, M. O. Ojelabi
Journal: Journal of Clinical Oncology (2010)

e16551 Background: Recent studies have demonstrated a benefit with the use of preoperative PET-CT scanning in patients with potentially resectable non-small cell lung cancer (NSCLC). Fischer B, NEJM 2009 found that pre-operative PET-CT decreased futile thoracotomies by 21%, with no significant difference in justifiable thoracotomies and overall survival. Futile thoracotomy was described as disease recurrence or patient's death within 12 months after surgery.The 21% decrease was similar to the 20% decrease from PET scanning reported by van Tinteren H, Lancet 2002. Better patient selection with PET/CT, not only decreases unnecessary thoracotomies, but tailoring therapy based on PET/CT will result in significant cost savings for the health care system. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) Program Stage Distribution to estimate the incidence of nonmetastatic NSCLC (localized 16.2%, regional 22%, unstaged-9%), the cost of pre-operative PET-CT in all potentially resectable patients was determined. Cost estimates for PET-CT was obtained from Medicare reimbursement data and that of lobectomy/pneumonectomy from the Healthcare Cost and Utilization Project (HCUP) of the U.S. Department of Health and Human Services. Based on the data obtained, the amount saved by reduction in the number of futile thoracotomies was calculated. Results: Based on an annual estimated incidence of 98,855 potentially resectable NSCLC cases, upfront PET-CT would cost $115.2 million ($1,165.32/patient). Based on the HCUP 2007 data, the number of lobectomies and thoracotomies performed for cancer of the lung and bronchus was 47,668. The mean charge was $62,280 for a mean 7.8 days' hospital stay, with mortality rate of 2.57% and aggregate cost of $2.97 billion. With the assumption that preoperative PET-CT would reduce futile thoracotomies by 21% (Fischer et al), theoretical cost savings would be $623.7 million; considering the cost of PET-CT, annual net savings would be $2.97 billion. Conclusions: Our analysis demonstrates that routine use of pre-operative PET/CT would result in better patient selection for surgical resection, significant cost savings and also reduce delay in selecting appropriate therapy. No significant financial relationships to disclose.
Phase II study of weekly topotecan in patients with relapsed platinum-sensitive ovarian or peritoneal cancer
Authors: R. T. Morris, R. D. Alvarez, J. Malone, C. Bryant, S. J. Andrews, L. Kilgore, G. D. Phibbs, L. Heilbrun, A. R. Munkarah
Journal: Journal of Clinical Oncology (2005)

5058
Research participants’ views of nontherapeutic biopsies
Authors: R. D. Pentz, Z. Xu, S. Lonial, J. S. Kauh, R. M. O’Regan, E. K. Waller, D. M. Shin, H. Fu, F. Khuri
Journal: Journal of Clinical Oncology (2008)

13529 Background: Non-therapeutic research procedures are ethically controversial. Biologic targeted cancer therapies are best evaluated by molecular studies of tumor tissue, often requiring serial non-therapeutic biopsies (NTBs) that offer no patient benefit. The current ethical guidelines for such procedures were crafted with no input from potential research participants. It is imperative that participants’ voices be heard. Only one flawed study including only 14 research participants has been done. Objectives: 1. To assess potential trial participants’ willingness to undergo and understanding of NTBs. 2. To identify factors associated with lack of understanding that may serve as targets for improving informed consent. Methods: Adults offered enrollment in phase I clinical trials were interviewed and completed a survey. The interview included a clear explanation that results from NTBs are not used in patient care. Frequencies of responses were calculated. Logistic regression method was used to model high chance (above mean) of personal benefit from a biopsy v. low chance. Results: Of 40 patients interviewed, 69% were white, 21% black, 77% college-educated, 52% female, and 63% earned > $60,000. 75% of participants reported that inclusion of a mandatory NTB would not affect their decision to participate in a study. 70% would undergo an optional NTB. 24% stated that 100% of patients will benefit from a NTB, (mean: 65% of patients will benefit). 21% stated there was a 100% chance of benefit for themselves (mean: 70% chance of benefit). Belief in a high chance of benefit was significantly correlated only with the belief that many treatment options remain (OR=0.279, p=0.044, 95% C.I. [0.081, 0.964]). 38% stated they had lots of options available. Participants reported that their views were due to their effort to have a positive attitude (47%), expressed what they hope is true (24%) or expressed just the facts (24%). Conclusion: NTBs are not a barrier to research participation. Therapeutic misconception about NTBs is very resistant to explicit explanation of non-benefit. These participants may be optimists given their emphasis on a positive attitude and hope and their belief that lots of treatment options remain though phase I eligible with no curative treatments available. No significant financial relationships to disclose.
The Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) Predicts Survival and Non-Relapse Mortality in Lymphoma and Myeloma Patients Undergoing Reduced-Intensity or Non-Myeloablative Allogeneic Stem Cell Transplantations .
Authors: Lucia Farina, Benedetto Bruno, Francesca Patriarca, Francesco Spina, Roberto Sorasio, Mara Morelli, Renato Fanin, Mario Boccadoro, Paolo Corradini
Journal: Blood (2008)
Limited-stage diffuse large B-cell lymphoma (DLBCL) treated with abbreviated systemic therapy and consolidation radiotherapy: Involved field radiotherapy (IFRT) versus involved nodal radiotherapy (INRT≤5cm).
Authors: B. A. Campbell, J. M. Connors, R. D. Gascoyne, T. Pickles, W. J. Morris, L. H. Sehn
Journal: Journal of Clinical Oncology (2010)

8009 Background: Optimal management of limited-stage DLBCL is still evolving. Current strategies commonly include a combination of chemotherapy, biological therapy and consolidation radiotherapy (RT). We review the long term outcomes of limited stage DLBCL, focusing on RT field size: IFRT versus INRT≤5cm. Methods: Eligibility required a diagnosis of limited stage DLBCL between 1/1/81 and 12/31/07. Exclusion criteria were stage III/IV, bulk ≥ 10cm, B symptoms or testicular primary. Systemic therapy involved 3 cycles of CHOP / CHOP-like chemotherapy; rituximab was added beyond 2003. Era-specific guidelines for RT were: IFRT until 1996; INRT≤5cm after 1996. INRT≤5cm was defined as RT to the pre-chemotherapy involved nodes with margins ≤ 5cm to account for movement and set-up variation. Results: 288 patients were eligible: 61% male; 56% aged > 60 years; 34% stage IIA; 55% extranodal disease; 19% elevated LDH; 45% ECOG ≥ 1; 74% stage-adjusted IPI ≥ 1. 15% received rituximab. RT groups were: IFRT 138 (48%), INRT≤5cm 150 (52%). Median follow-up of living patients was 96 months. 64 patients relapsed: IFRT 32 (23%), INRT≤5cm 32 (21%). The most common site of failure was outside the RT field: IFRT 24 (17%), INRT≤5cm 26 (17%). After INRT≤5cm, marginal recurrence (defined as relapse beyond the INRT≤5cm field but within a conventional IFRT field) occurred in 3 (2%) patients. At 5 years, time to progression (TTP) was 84%, progression-free survival (PFS) 75% and overall survival (OS) 82%; with no significant difference between the two RT groups. Long term follow-up showed a late plateau in TTP: only 2 relapses occurred after 13 years. Age was the only significant predictive factor for TTP (p = 0.009) and OS (p < 0.001). Prognostic factors for PFS were age (p < 0.001) and performance status (p = 0.050). RT field size was not a significant predictor for TTP, PFS or OS. Conclusions: For patients with limited-stage DLBCL treated with combination therapy, distant relapse was the most common site of failure, with a clinically significant late relapse rate to 13 years. Reducing the RT field size to INRT≤5cm appears safe with no detriment in TTP, PFS or OS. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Roche
Prevalence of myofascial pain syndrome in patients with incurable cancer.
Authors: Hiroto Ishiki, Junya Kinkawa, Aya Watanabe, Chie Watanabe, Tsukuru Chiba, Naoki Shimada, Keisuke Ariyoshi, Masanori Nojima, Satoru Iwase, Arinobu Tojo
Journal: Journal of Clinical Oncology (2016)

97 Background: Myofascial pain syndrome (MPS) is a condition that involves skeletal muscles. It is caused by overload or disuse of muscles and is characterized by extreme tenderness in the muscles with taut bands. Treatment for MSP is different from that for cancer-related pain. Cancer patients have many factors that cause restriction of body movement and posture. Although cancer patients appear to demonstrate risk factors for MPS, its prevalence has not been reported in patients with incurable cancer. This study was conducted to investigate the prevalence of MPS in patients with incurable cancer. Methods: The data for patients with incurable cancer who received palliative care by our department between September 2015 and March 2016 were retrospectively investigated. We examined the prevalence of MPS. MPS was diagnosed on the basis of the Rivers criteria (RC) and Simons criteria (SC). We also examined the following factors associated with MPS: performance status (PS), use of medical devices (MD), and primary cancer sites. The primary outcome was the prevalence of MPS using the RC. Secondary outcomes included the prevalence of MPS using the SC, and the relationship between MPS and either PS or MD. Results: Thirty-four patients with incurable cancer were identified. The clinical characteristics are as follows: age (median, range): 65 (39-89) years; male/female ratio: 16/18; primary sites: pancreas (n = 8), breast (n = 8), lung (n = 4), colorectal (n = 4), head and neck (n = 2), and other primary sites (n = 8). Seventeen of 34 patients (50%) had a PS 3 or 4. Twenty-two patients (64.7%) complained of pain. MPS using the RC was detected in 10 patients (29%). MPS using the SC was detected in 20 patients (59%). Of 22 patients who complained of pain, MPS using the RC was detected in 10 (45%) patients and MPS using the SC was detected in 20 (90%) of patients. Patients with central venous port (CVP) devices had a significantly higher number of MPS lesions than patients without CVP devices (p = 0.029). Conclusions: A very high prevalence of MPS was detected in our study population. MPS should be considered when patients with incurable cancer complain of pain. A multi-center prospective study will be conducted to confirm our findings.
Long-term history of fasting blood glucose level and the risk of pancreatic cancer: A nested case-control study.
Authors: K. Stefani, H. C. Kim, S. V. Ahn, K. S. Choi, I. Suh
Journal: Journal of Clinical Oncology (2011)

1549 Background: Many epidemiological studies have investigated the association between diabetes and pancreatic cancer (PC) as either a risk factor or manifestation, yet there have not been many studies which looked at long-term fasting blood glucose change before the diagnosis of PC. The aim of this study was to investigate the association between long-term changes in fasting blood glucose and PC risk in Korean adults. Methods: We performed a nested case-control study in the Korea Medical Insurance Corporation Study cohort which consists of 108,461 men and 64,119 women aged 35 to 59 years old. Fasting blood glucose levels were repeatedly measured every 2 years from 1990 to 2000. Hospital admissions or deaths due to PC were ascertained using the Death Statistics Database from the National Statistical Office and the National Health Insurance Claim Database. The cases consisted of 216 people with PC between 1993 and 2003, and the controls were 1080 people without PC at the time of sampling. We sampled five controls per each case using incidence-density sampling and matching for sex and age. Difference in the fasting glucose level between cases and controls were assessed using conditional logistic regression analyses. Results: Patients with PC had higher fasting glucose levels, compared to controls, from at least 10 years prior to the diagnosis. Moreover, patient’s fasting glucose level started to increase 2-3 years prior to the diagnosis of PC. Mean difference (case’s value minus control’s value) was 6.2 mg/dl at 10-11 years prior to diagnosis (p=.007), 4.3 mg/dl at 8-9 years prior to diagnosis (p=.002), 6.8 mg/dl at 6-7 years prior to diagnosis (p=.077), 4.5 mg/dl at 4-5 years prior to diagnosis (p=.025), 10.2 mg/dl (p=.155) at 2-3 years prior to diagnosis, and 12.2 mg/dl (p=.026) at 0-1 year prior to diagnosis. Conclusions: These results support that long-term history of high fasting glucose level is associated with the risk of PC and an abrupt increase of fasting glucose level may be an early manifestation of PC. This study was supported by a grant of the Korean Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea (Grant No. A040152).
Efficacy of sorafenib in advanced renal cell carcinoma (RCC) independent of prior treatment, histology, or prognostic group.
Authors: Alireza Tafreshi, Eddy Thientosapol, Mun Sem Liew, Yuan Guo, Melissa Quaggiotto, Michael J. Boyer, Ian D. Davis
Journal: Journal of Clinical Oncology (2013)

465^ Background: Multiple targeted therapies have become available for RCC over the past decade. Sorafenib is an orally active multikinase inhibitor which has been shown to improve progression free survival in low-risk and intermediate-risk status advanced clear-cell RCC after previous systemic therapy. Methods: Between May 2006 and December 2010, patients with advanced RCC with either clear cell or non-clear cell histopathology who had progressed on prior systemic chemotherapy or were treatment naïve, ECOG performance status 0-2, commenced treatment with sorafenib (400-mg twice daily continuously) through an expanded access clinical trial in two tertiary centres in Sydney and Melbourne. We report the pooled outcomes of these two studies. Results: Total 47 patients with metastatic RCC were treated with sorafenib. The median overall survival of advanced RCC was 11.9 months. After median follow up of 51.3 months, the median PFS was 6.5 months. 38 patients died by the time of analysis. Overall 1 patient showed complete response (CR), 6 patients (13%) had partial response (PR), and 29 patients (62%) had stable disease (SD) as the best response. 8 (17%) had non-clear cell histopathology and 5 (10%) had sarcomatoid features. In non-clear cell cohort, 5 patients (62.5%) showed SD. 23 (49%) patients were treatment naïve; 1/23 showed CR, 5/23 had PR and 13/23 had SD (clinical benefit: 83%). Overall 14 (30%) and 22 (47%) patients had high risk status according to MSKCC and Heng prognostic scores, respectively. Median PFS for poor prognostic patients was 5.1 and 4.2 months based on MSKCC and Heng scores, respectively. In MSKCC poor prognostic group, 1 patient had CR, 2/14 showed PR and 8/14 had SD (clinical benefit: 79%). In Heng poor prognostic group, one patient had CR, 2/22 showed PR and 13/22 had SD (clinical benefit: 73%). Sorafenib-related serious adverse events were seen in 10 patients. The most common adverse events were hand-foot syndrome (53%), rash (47%), fatigue (42%), nausea (40%), and diarrhoea (32%). Conclusions: This study confirms the efficacy and tolerability of sorafenib in a different spectrum of advanced RCC patients including non-clear cell histology, poor prognostic status and as first-line treatment. Clinical trial information: ACTRN12606000140550.
Association between PSA declines at 4 weeks and OS in patients treated with abiraterone acetate (AA) for metastatic castration resistant prostate cancer (mCRPC) after docetaxel.
Authors: Pasquale Rescigno, David Lorente, Roberta Ferraldeschi, Diletta Bianchini, Spyridon Sideris, Zafeiris Zafeiriou, Alan David Smith, Niven Mehra, Emily Grist, Anuradha Jayaram, Michael Paul Kolinsky, Raquel Perez Lopez, Joaquin Mateo, Chris Parker, David Paul Dearnaley, Emma Hall, Nina Tunariu, Gerhardt Attard, Johann Sebastian De Bono
Journal: Journal of Clinical Oncology (2015)

215 Background: Falls in prostate specific antigen (PSA) levels by 50% from the baseline at 12 weeks are currently used to assess response to treatment for mCRPC (Scher et al, 2008). However PSA decline algorithms do not provide robust intermediate endpoints of overall survival (OS) benefit in mCRPC. We evaluated the association between PSA decline at 4 weeks and OS. Methods: We identified mCRPC patients who had received treatment with abiraterone acetate (AA) plus prednisolone post-docetaxel at the Royal Marsden (London, UK) between 01.01.2006 and 30.04.14. Patients were eligible for this analysis if they had PSA levels assessed at baseline, after 4 weeks and 12 weeks of treatment. PSA response at 4 weeks was defined as a ≥30% (PSA4w30) and ≥50% (PSA4w50) decline from baseline (PSABL). Association with outcome was analyzed using multivariate Cox regression and log-rank analyses. A significant p-value of 0.0167 was pre-specified to account for multiple testing. Demographics and clinical data were retrospectively collected from the hospital electronic patient record system (EPR). Results: We identified 124 patients who had received AA post-docetaxel and were eligible for this analysis. PSA4w30 was associated with longer OS (median OS 11.1 vs. 6.8 months; HR 0.50; 95% CI 0.32-0.80; p=.004). PSA4w50 was not associated with OS. A ≥50% PSA decline at 12 weeks (PSA12w50), the standard response measure, was also associated with OS (median OS 9.3 vs. 8.2; HR 0.49; 95% CI 0.29-0.80; p=.005). PSA4w30 was significantly associated with PSA12w50 (p&lt;.001). Lack of a PSA response at 4 weeks correlated with a lack of response at 12 weeks (p=0.000), with a sensitivity of 84.9% [95% CI 75-91.4] and a specificity of 86.5% [95%CI 72–94.1]). PSA4w30 remained significantly correlated with OS (P&lt;.001) in multivariate analyses including other established prognostic factors in mCRPC (ECOG PS, albumin, PSABL, ALP, LDH, Hemoglobin). Conclusions: Further studies to identify mCRPC patients not responding to treatment as early as possible are warranted; PSA4w30 may be useful to help identify patients unlikely to benefit from AA.
Patient safety in Danish cancer care: Results from complementary studies.
Authors: Janne Lehmann Knudsen, Henriette Lipzack, Cecilie Sperling, Mette Sandager
Journal: Journal of Clinical Oncology (2012)

216 Background: Cancer care has been a top political priority in Danish health care for the past 12 years, but there has been no specific attention towards patient safety. During the past three years, the Danish Cancer Society has carried out several studies, and in 2011 a National working group with all central stakeholders was established together with the Multidisciplinary Cancer Groups. The aim is to provide an overview of safety hazards during the cancer journey based on four different studies addressing the perspective of the health care professionals as well as the patients, and to outline the challenges in the monitoring safety in cancer based on these. Methods: Data from four studies will be presented: (1) 2,429 cancer related adverse event reports from the national Danish Patient Safety Database; (2) retrospective chart review identifying harm in 572 patient records in five inpatients cancer settings using the Global Trigger Tool; (3) errors experienced by 4,262 patients participating in a nationwide survey addressing needs and experiences with healthcare from first contact until completion of primary treatment; (4) errors experienced by the same group of patients during follow-up and rehabilitation two years after diagnosis. Results: The hazards measured varies from according to the methods used; The cancer specific AE reports were primarily related to medication, clinical, process documentation, and clinical administration. Physical harm using GTT was identified in 28% of admissions related to clinical processes, infections, and medication. 10% of the patient reported errors during contact with GP, 15% during diagnostic at hospital and 25 % during treatment. Delay, insufficient information, medication errors, and logistic errors were the most dominant errors. The results adressing patient experienced errors during follow-up and rehablitation are being analyzed. Conclusions: There are specific and serious safety challenges in cancer care and systematic monitoring is needed. Asking the patients add new knowledge. There is a need for critical evaluation of which methods to use for measuring.