tbuckley/cabot-search huggingface dataset:
Do we have early detection of cutaneous melanoma in Russia? Single-institution observational study.
Authors: Igor Samoylenko, Galina Kharkevich, Igor A Utyashev, Yana V Vishnevskaya, Kristina Vyacheslavovna Orlova, Lev V. Demidov
Journal: Journal of Clinical Oncology (2014)

e20027 Background: Despite the quite low melanoma incidence in Russia (approx. 5 per 100 000) mortality rate is very similar to countries with higher incidence (approx. 2 per 100 000). We believe this is a consequence of poor early detection. Methods: We performed a continuous retrospective observational study which covered all primary melanoma patients referred to our institution from 01Jan2009 to 31Dec2009 and from 01Jan2013 to 31Dec2013. Only patients with cutaneous melanoma stage I or II were included in the analysis. We analyze morphological and clinical features for all cases to reveal any improvements in early detection during last 5 years. Results: In total 83 patients with primary cutaneous melanoma were identified in 2009 and 77 in 2013. 21 and 17 pts were excluded due to simultaneous regional lymph nodes metastases (in 2009 and 2013 respectively). From 61 and 60 pts 23 (38%) and 24 (40%) were male in 2009 and 2013 respectively (p>.5). Mean age was 52.05±14.8y and 57.83±13.7y in 2009 and 2013 respectively (p=0.26). Melanoma of the trunk, upper limbs lower limbs, head and neck was detected in 47.5% pts, in 9.8% pts, 34.4% pts, and 8.2% pts (all pts). Superficial-spreading melanoma (SSM), nodular melanoma (NM), SSM+NM and lentigo maligna melanoma were identified in 23%, 55.7%, 18.0% and 3.3% pts respectively (all pts). Mean Breslow thickness was 4.48±3.87 mm (median 3.00 mm) in 2009 and 4.55±4.89 mm (median 3.00 mm) in 2013 (p>.5). Ulcerated tumors were detected in 38 (62,3%) pts and in 36 (60%) pts in 2013 (p>.5). AJCC stage IA, IB, IIA, IIB, IIC was established for 11 (18%), 8 (13.1%), 5 (8.2%), 14 (23.0%), 22 (36.1%) respectively in 2009 and 12 (20%), 5 (8.3%), 8(13.3%), 11(18.4%), 24 (40%) respectively in 2013 (p>.5). Conclusions: According to our single institution experience extremely high proportion of patients in Russia at diagnosis had very thick and ulcerated melanoma which may leads to higher mortality rates. Nothing had been changed in 2013 since 2009. National program for melanoma early detection is required.
Predictors of rectal cancer resection at high-volume hospitals among Medicare patients.
Authors: Mary E. Charlton, Catherine Chioreso, Irena Gribovskaja-Rupp, Chi Lin, Marcia M Ward, Charles F Lynch, Elizabeth A. Chrischilles
Journal: Journal of Clinical Oncology (2018)

808 Background: Hospitals that perform high volumes of rectal cancer resections achieve superior rates of sphincter preservation and survival compared to those that do not, but many rectal cancer resections are still performed in low-volume centers. We aimed to determine the patient, provider and pathway characteristics associated with receipt of surgery from high-volume hospitals. Methods: Patient and provider characteristics were extracted from the SEER-Medicare database for Medicare beneficiaries (age 66+) with stage II/III rectal adenocarcinoma diagnosed 2007-2011 who received rectal cancer-directed surgery. Hospitals were divided into quartiles by volume of rectal cancer resections, and were also classified by NCI cancer center designation. Results: 2056 patients were included, and 57% received surgery in a high-volume hospital or NCI-designated center. Those residing in census tracts classified as rural and having higher median incomes, lower poverty, and higher levels of education more frequently received surgery in high-volume hospitals; there were no differences by age, gender, stage, or co-morbidity status. 55% of patients received surgery at the same facility where they received the colonoscopy that identified their cancer. In multivariate analyses, the strongest predictor of receiving one’s surgery in a high-volume hospital was receipt of colonoscopy at a high-volume facility (OR = 3.75, 95% CI: 2.93-4.79). Those treated in high-volume hospitals more often had guideline-recommended staging (TRUS/MRI) and treatment (neoadjuvant chemoradiation). Conclusions: Rectal cancer patients tended to stay at the facility where their cancer was diagnosed; and did not typically seek out high-volume providers if their colonoscopy was performed in a low-volume facility. This suggests that colonoscopists may have substantial influence over where patients receive surgery. Given that rurality, income and education appear to more strongly predict receipt of surgery at a high-volume hospital compared to clinical characteristics, further research is needed to understand considerations driving patient decisions and referring providers’ recommendations for care.
Abstract 13294: Valve Mediated Hemodynamics and Their Association With Ascending Aortic Diameter in Bicuspid Aortic Valve
Authors: Vrishank Raghav, Alex J Barker, Daniel Mangiameli, Lucia Mirabella, Michael Markl, Ajit Yoganathan
Journal: Circulation (2016)

Introduction: Bicuspid aortic valve (BAV) is the most common congenital heart defect, affecting 1-2% of the US population. Valve-mediated hemodynamics have been postulated to contribute to the cause and progression of ascending aorta (AAo) disease. Hypothesis: Aortic valve morphology and hemodynamics affect distal AAo diameter in subjects with BAV disease. Methods: Four-dimensional flow MRI was used to evaluate the hemodynamics in the proximal AAo of 52 subjects: size-matched controls with tricuspid aortic valves (n = 24) and BAV patients with aortic dilatation (n = 14 right and left coronary cusp fusion (RL-BAV); n = 14 right and non-coronary cusp fusion (RN-BAV)). A semi-automated technique was used to systematically quantify hemodynamic metrics (flow angle, flow displacement, and jet quadrant) and valve morphology (orifice circularity) for all subjects, as illustrated in the figure. A regression analysis was conducted to develop a relationship between upstream hemodynamics and distal AAo diameter. Results: RN-BAV subjects displayed a stronger correlation between hemodynamic metrics in the proximal AAo with diameter in the distal AAo when compared to size-matched TAV controls and RL-BAV subjects. The distal AAo diameter was found to be strongly correlated to the flow displacement (R 2 adjusted = 0.75) and flow angle (R 2 adjusted = 0.66) measured at the sino-tubular junction (STJ) in RN-BAV subjects. Orifice circularity was also strongly correlated (R 2 adjusted = 0.53) to the proximal AAo diameter in RN-BAV subjects. Conclusions: The findings in this work demonstrate that the hemodynamics in the STJ are significantly correlated to the distal AAo diameter in RN-BAV subjects. The hemodynamic metrics demonstrated more statistical significance than valve morphology when considering correlations to distal aortic size. These results could be used to design efficient imaging protocols for better prognosis of BAV-related aortopathy.
Delay diagnosis and timely referral of children with cancer to a care center specialized in pediatric oncology: Experience at National Medical Center “20 de Noviembre” ISSSTE, Mexico City.
Authors: Farina Esther Arreguin-Gonzalez, Sandra Paez, Yadira Janet Gonzalez-Paredes, Marta Zapata-Tarres, Guadalupe Frias-Vazquez, Jose de Jesus Figueroa Carbajal
Journal: Journal of Clinical Oncology (2014)

e21018 Background: Cancer is the second cause of death in childhood. Prognosis has improved due to multidisciplinary treatment. In developing countries there is a delay in the referral of patients to specialized medical centers in pediatric cancer treatment thus worsening the prognosis. Aim: To describe the time between the beginning of symptoms and signs of illness and the final definitive diagnosis of cancer. Methods: Medical records of 456 pediatric patients with cancer treated in the last ten years at the Department of Oncology of Centro Medico Nacional 20 de Noviembre ISSSTE in Mexico City were reviewed. Results: Diagnosis distribution was similar to the one reported in the literature. Most of our patients came from Mexico City. 26.5% consulted a medical doctor within the first five days of the first symptom. From the first doctor consulted by the patients to the referral to the cancer unit we found an average delay of 105 days ( minimum 69 maximum 240) while the delay in the cancer unit to the final diagnosis the average took 9 more days ( minimum 5 maximum 14). The average number of doctors that the patients consulted before the pediatric oncologist was 4 (minimum 2 maximum 20). Conclusions: There is an important delay in the referral of sick children to a cancer center. We must consider a better education of medical and administrative people in order to give a better attention.
Factors associated with bone fractures following hematopoietic stem cell transplantation.
Authors: Xerxes Pundole, Richard E. Champlin, Huifang Lu
Journal: Journal of Clinical Oncology (2014)

9600 Background: The number of long-term survivors of hematopoieticstem cell transplantation (HSCT) is growing. These survivors have increased bone fragility and susceptibility to fracture, leading to death and long-term disability; however, risk factors associated with fractures in these survivors are unclear. Methods: We conducted a retrospective study of patients who received HSCT from January 1, 1997, to December 31, 2011, at The University of Texas MD Anderson Cancer Center. Kaplan-Meier survival function plots and Cox proportional hazard models were used. Results: A total of 7,650 patients underwent HSCT during the 15-year period. Among them, 631 (8%) developed at least 1 fracture after HSCT; approximately 11% (n = 440) of those who underwent autologous HSCT and 5% (n = 191) of those who underwent allogeneic HSCT developed a fracture. Univariate Cox proportional hazard analyses showed that age >50 years at the time of HSCT, multiple myeloma or solid organ tumors, and autologous HSCT were associated with a higher hazard of developing a fracture. In a multivariable model including all predictors of interest (age at HSCT, sex, and race) except type of HSCT, age >50 years at the time of HSCT (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.09-1.56), multiple myeloma (HR, 4.96; 95% CI, 4.13-5.95), and solid tumors (HR, 1.61; 95% CI, 1.18-2.21) were associated with an increased risk of developing a fracture. In another multivariable model with type of HSCT included, and indication not included showed that age >50 years at the time of HSCT (HR, 1.94; 95% CI, 1.64-2.30) and autologous HSCT (HR, 1.58; 95% CI, 1.33-1.88) were associated with an increased risk of developing a fracture. Conclusions: HSCT and its associated treatment particularly increase the risk of fractures in those who undergo autologous HSCT and are older than 50 years. Regular screening to prevent bone loss should be initiated early, and establishment of a new fracture risk assessment tool is warranted in this patient population.
Association of overall survival with weight gain during treatment, initial body mass index (BMI), and glucose intolerance (GI) in advanced non-small cell lung cancer (NSCLC) patients.
Authors: Mohammed S. Azeem, Sanjib Basu, Shruthi Melinamani, Marta Batus, Ravi Pithadia, Jeffrey Allen Borgia, Philip Bonomi, Mary J. Fidler
Journal: Journal of Clinical Oncology (2014)

e19033 Background: Weight gain on therapy has a favorable prognosis in non-small cell lung cancer though elevated BMI correltates with inferior outcomes in malignancies such as breast, colon, and esophageal cancer. This study correlates weight gain at 6 and 12 weeks with overall survival (OS) in patients(pts) with locally advanced or NSCLC treated with front line platinum doublet chemotherapy. Methods: Pts with newly-diagnosed locally advanced/metastatic NSCLC treated first-line with platinum doublet chemotherapy from June, 2011 to August, 2012 were included. Weight was recorded at baseline, 3, 6, and 12-week intervals from initiation of therapy. The association with OS was assessed using Kaplan Meir methods and Cox proportional hazards regression. Multivariate Cox PH analysis with interaction was used to explore effects of weight gain in pts with a diagnosis of glucose intolerance or diabetes (GI). Results: 134 pts were included: median age 68, PS 1/2 82%, median BMI 24.8. 39% patients gained weight on treatment. Weight gain vs weight loss at 6 and 12 weeks was associated with improved OS (31.2 vs 13.6 months (mo), p = .03, p=.011 respectively). Six week weight gain had favorable association with OS within BMI < 25 and > 25 subgroups (p=.07, p=.12, respectively). At 12 weeks this trend continued for BMI < 25 subgroup and was strongly significant for BMI >25 (Median not reached vs 14.7 mo, p=.30 and median 31.2 vs 11.9 mo, p = .008) 21 patients had GI; there was no impact of GI on OS (p=.39). 12 week weight gain showed the opposite trend for OS in patients with GI ( 10.2 vs 14.4 mo p=.68). A multivariate analysis showed a differential effect of weight gain on OS in the GI and non-GI groups (p-value for interaction = 0.07). Conclusions: The association between superior survivial and weight gain on chemotherapy in this group of NSCLC pts regardless of BMI suggests that controlling NSCLC may inhibit cancer induced cachexia, and, conversely raises the possibility that novel agents which inhibit cancer cachexia might inhibit NSCLC growth. The reverse survival trend in diabetic pts may be related to altered glucose metabolism and warrants further study.
Health Impact Assessment of Transportation Projects and Policies: Living Up to Aims of Advancing Population Health and Health Equity?
Authors: Brian L. Cole, Kara E. MacLeod, Raenita Spriggs
Journal: Annual Review of Public Health (2019)

Health impact assessment (HIA) is a forward-looking, evidence-based tool used to inform stakeholders and policy makers about the potential health effects of proposed projects and policies and to identify options for maximizing potential health benefits and minimizing potential harm. This review examines how health equity, a core principle of health impact assessment (HIA), has been operationalized in HIAs conducted in the United States in one sector, transportation. Two perspectives on promoting health equity appear in the broader public health research literature; one aims at reducing disparities in health determinants and outcomes in affected populations, whereas the other focuses on facilitating community participation and self-determination. Variations in how these perspectives are applied in HIA informed our typology of five ways of addressing health equity in HIA. Transportation HIAs commonly included two of these-selecting vulnerable populations for the focus of the HIA and stakeholder engagement, seen in more than 70% of the 96 HIAs reviewed. Fewer than half of the HIAs assessed current health disparities or changes in their distribution. Only 15% of HIAs addressed equity by focusing on capabilities development or empowerment. Routinely assessing and reporting how an HIA aims to address health equity might better manage expectations and could make HIA practitioners and users more conscious of how an HIA can realistically be used to advance health equity.
Characteristics of Long-Term Survival of Patients with MDS Treated with 5-Azacytidine. Results from the Hellenic 5-Azacytidine Registry
Authors: Panagiotis Theodorou Diamantopoulos, Vassiliki Pappa, Ioannis Kotsianidis, Argiris Symeonidis, Athanasios Galanopoulos, Eleni Papadaki, Eleftheria Hatzimichael, Maria Dimou, Dimitrios Gogos, Panagiotis Zikos, George Vassilopoulos, Stamatis J. Karakatsanis, Aikaterini Megalakaki, Elena E. Solomou, Sotirios Papageorgiou, Alexandra Kourakli, Georgios Kyriakakis, Maria Papaioannou, Achilles Anagnostopoulos, Panayiotis Panayiotidis, Nora-Athina Viniou
Journal: Blood (2018)
Results from an interdisciplinary palliative rehabiliation program for patients living with advanced cancer.
Authors: Martin Robert Chasen, Andrea Feldstain, Ravi Bhargava, Sophie Lebel, Jose Pereira
Journal: Journal of Clinical Oncology (2014)

9525 Background: After treatment, patients with active cancer face a considerable burden from the effects of both the disease and its treatment. Symptom burden has been found to remain consistent until a few weeks before death, when it worsens. The Palliative Rehabilitation Program (PRP) is an interdisciplinary program designed to ameliorate disease effects and to improve the patient’s functioning. A particular concern in Palliative Care is depression, which is known to impair functioning and recovery. Depression is also one of the top-two reasons for referral to the PRP, each year. The present study evaluated changes in functioning, symptoms, and well-being after the program. As well, a pilot longitudinal study of symptoms of depression was conducted, three months following PRP completion. Methods: There were 171 referred patients with advanced cancer who enrolled in the 8-week PRP; 108 completed the program. Measures of physical, nutritional, social, and psychological functioning were evaluated at entry to the program and at completion. At 3-month follow-up, 20 patients returned self-report measures of depression by mail. Results: Participants experienced significant improvements in performance status (p < 0.000), nutrition (p = 0.003), symptom severity (p = 0.021 to 0.000), symptom interference with functioning (p = 0.001 to 0.000), fatigue (p = 0.008 to 0.000), and physiological measures (p = 0.002 to 0.000). Symptoms of depression continued to decrease following PRP completion (linear trend: p=0.002). Updated results will be presented. Conclusions: Patients living with advanced cancers who underwent the PRP experienced significant improvement in functioning across several domains. Improvements in depression scores continued to improve after completion.
Updated Phase 1 Results of Zuma-3: Kte-C19, an Anti-CD19 Chimeric Antigen Receptor T Cell Therapy, in Adult Patients with Relapsed/Refractory Acute Lymphoblastic Leukemia
Authors: William G. Wierda, Michael R. Bishop, Olalekan O. Oluwole, Aaron C. Logan, Maria R. Baer, William B. Donnellan, Kristen M. O'Dwyer, Januario E. Castro, Gary J. Schiller, Houston Holmes, Mehrdad Abedi, Armin Ghobadi, Martha L. Arellano, Adriana K. Malone, John M. Pagel, Armen Mardiros, Tong Shen, Remus Vezan, Rajul K. Jain, Bijal D. Shah
Journal: Blood (2018)
Capecitabine maintenance after first-line induction chemotherapy with docetaxel, cisplatin, and fluorouracil in patients with advanced gastric cancer.
Authors: Basak Oyan, Orhan Onder Eren, Ozlem Sonmez
Journal: Journal of Clinical Oncology (2014)

e15003 Background: Chemotherapy improves the survival of patients with advanced gastric cancer, but patient survival remains less than 12 months despite optimal treatment. Maintenance therapy after first-line chemotherapy to prolong survival has not been tested in advanced gastric cancer setting. We report a retrospective, consecutive non-randomized group of patients who received capecitabine maintenance after first-line induction chemotherapy with docetaxel, cisplatin and fluorouracil (DCF). Methods: A total of 10 consecutive patients with advanced gastric cancer, who achieved response or stable disease after 6 cycles of DCF (D 75 mg/m2, C 75 mg/m2, FU 750 mg/m2/d x5, q3 weeks) or 12 cycles of modified DCF (D 40mg/m2, FU 400mg/m2, L 400mg/m2, FU 1000 mg/m2/day x2, C 40mg/m2 day 3 q14 days) induction chemotherapy, received capecitabine (1000mg/m2 bid d1-d14 q21 days) maintenance until progression. Results: The median number of maintenance cycles was 5. During the median follow-up of 20.3 months, 9 patients progressed and 8 patients died. The median time to progression (TTP) and overall survival (OS) were 10.4 months and 20.3 months, respectively. Two year survival rate was 26%. Conclusions: In the pivotal phase III randomized trial evaluating the efficacy of DCF as first line therapy in advanced gastric cancer, the median TTP and OS were 5.6 months and 9.2 months, respectively. Compared to these results, the TTP and OS achieved with capecitabine maintenance is promising, and needs additional investigation.
Phase 3 study of oral lenalidomide as maintenance therapy for patients with B-cell chronic lymphocytic leukemia (CLL).
Authors: Asher Alban Akmal Chanan-Khan, Andrey Zaritskey, Miklos Egyed, Samuel Vokurka, Olga Samoylova, Anna Schuh, David Simpson, Jay M. Mei, Natalia Oliveira, Oliver Kong, Robin Foà
Journal: Journal of Clinical Oncology (2014)

TPS7125 Background: Despite recent advances in chemo-immunotherapy combinations for the treatment (Tx) of CLL, most patients (pts) relapse and eventually die from the disease. Maintenance therapy has made impact in other B-cell cancers, such as myeloma; its role and the optimal agent in CLL is unknown. Recent trials of rituximab have shown promise as maintenance therapy; however, the clinical use may be limited due to the intravenous formulation. Lenalidomide (LEN) shows encouraging efficacy in CLL pts; this and its positive impact on survival outcome as maintenance Tx in myeloma pts rationalizes its investigation in CLL. Additionally, the oral formulation makes it better suited as a long-term, single-agent Tx regimen. Methods: This phase 3, multicenter, randomized, double-blind, placebo controlled, parallel-group study investigates the efficacy and safety of oral LEN as maintenance therapy for CLL pts who showed a partial response (PR) to second-line therapy. Primary objectives are PFS and OS. Secondary objectives include safety, tumor response, response duration and health-related quality of Life. Additionally, the occurrence of secondary primary malignancy is monitored. Eligible pts (≥18 years) have previously received a chlorambucil-, a purine analog-, an anti-CD20-antibody-, or a bendamustine-based regimen in first- and/or second-line therapy, and must have achieved ≥PR to second-line therapy. Pts with del(17p) may have previously received an alemtuzumab-containing regimen. 400 pts (260 pts currently enrolled) with ≥PR following second-line therapy will be enrolled and randomized (1:1) to either the placebo or the LEN arm. Pts will receive placebo or 2.5 mg LEN per day (QD) on days 1-28 of each 28-day cycle. Subsequent LEN dose escalation to 5 mg QD at cycle 2 and to 10 mg at cycle 6 may occur, if tolerated in the previous cycle. Prior to study commencement, pts are tested for poor prognostic indicators (del(17p), del(11q), unmutated IGVH and high B2M). Exploratory biomarkers include (ZAP-70, immune cell analysis and CD80). This study is conducted in accordance with good clinical practice and all applicable regulatory requirements. Clinical trial information: NCT00774345.
Abstract 14836: Characteristics of Daily Life Activity and Its Impacts on Hepatic Congestion in Patients After Fontan Surgery
Authors: Akiko Yana, Seiko Kuwata, Clara Kurishima, Hirofumi Saiki, Yoichi Iwamoto, Hirotaka Ishido, Satoshi Masutani, Hideaki Senzaki
Journal: Circulation (2017)

Background: In Fontan patients, central venous pressure (CVP) is higher than normal and increases further with physical activity (PA). Therefore, excessive daily life PA may greatly affect the prog...