tbuckley/cabot-search huggingface dataset:
Role of Locoregional Treatment in Vulvar Cancer With Pelvic Lymph Node Metastases: Time to Reconsider FIGO Staging?
Authors: Ashwin Shinde, Richard Li, Arya Amini, Yi-Jen Chen, Mihaela Cristea, Wenge Wang, Mark Wakabyashi, Ernest Han, Catheryn Yashar, Kevin Albuquerque, Sushil Beriwal, Scott Glaser
Journal: Journal of the National Comprehensive Cancer Network (2019)

Vulvar cancer with pelvic nodal involvement is considered metastatic (M1) disease per AJCC staging. The role of definitive therapy and its resulting impact on survival have not been defined.Patients with pelvic lymph node-positive vulvar cancer diagnosed in 2009 through 2015 were evaluated from the National Cancer Database. Patients with known distant metastatic disease were excluded. Logistic regression was used to evaluate use of surgery and radiation therapy (RT). Overall survival (OS) was evaluated with log-rank test and Cox proportional hazards modeling (multivariate analysis [MVA]). A 2-month conditional landmark analysis was performed.A total of 1,304 women met the inclusion criteria. Median follow-up was 38 months for survivors. Chemotherapy, RT, and surgery were used in 54%, 74%, and 62% of patients, respectively. Surgery was associated with prolonged OS (hazard ratio [HR], 0.58; P<.001) but had multiple significant differences in baseline characteristics compared with nonsurgical patients. In patients managed nonsurgically, RT was associated with prolonged OS (HR, 0.66; P=.019) in MVA. In patients undergoing surgery, RT was associated with better OS (3-year OS, 55% vs 48%; P=.033). Factors predicting use of RT were identified. MVA revealed that RT was associated with prolonged OS (HR, 0.75; P=.004).In this cohort of women with vulvar cancer and positive pelvic lymph nodes, use of RT was associated with prolonged survival in those who did not undergo surgery. Surgery followed by adjuvant RT was associated with prolonged survival compared with surgery alone.
Body mass index and outcomes of cardiac resynchronization with implantable cardioverter‐defibrillator therapy in older patients with heart failure
Authors: Justin B. Echouffo‐Tcheugui, Frederick A. Masoudi, Haikun Bao, Jeptha P. Curtis, Paul A. Heidenreich, Gregg C. Fonarow
Journal: European Journal of Heart Failure (2019)
Infographic. Risk profile for sport-related post-traumatic knee osteoarthritis
Authors: Jackie L Whittaker, Ewa M Roos
Journal: British Journal of Sports Medicine (2019)

Despite its incontrovertible physical, psychological and social benefits, sport is a leading cause of joint injuries. In the short term, injuries may lead to missed training and competition, kinesiophobia, depression, social isolation, withdrawal from sport, reinjury and physical inactivity. In the long term, injuries are associated with obesity and reduced quality of life. Sport-related joint injuries also increase athletes’ risk of post-traumatic osteoarthritis (PTOA)1 and in doing so, contribute to the enormous and expanding societal burden of osteoarthritis. Unlike other forms of osteoarthritis, PTOA occurs at an early age and progresses more rapidly than idiopathic osteoarthritis.

Strategies to prevent PTOA can be …
Correlation of bone marrow micrometastasis to TNM stage of colorectal tumors
Authors: M. Soni, S. Saha, A. Korant, B. Chakravarty, S. Arora, D. Iddings, S. Sirop, R. Bisnoi, D. Wiese, T. Singh
Journal: Journal of Clinical Oncology (2009)

e15039 Background: Bone marrow (BM) micrometastasis(M) has been shown to be an important prognostic factor in Breast Cancer. However, there is paucity of data for BMM in Colorectal Cancer(CrCa). Hence a study was undertaken to find any correlation between TNM staging with BMM in CrCa patients(pts). Methods: A total of 155 consecutive patients(pts) from March 2004-October 2008 with CrCa were included in the study. Prior to resection of the primary tumor, pts underwent bilateral posterior-superior-iliac spine BM aspiration and samples were examined for presence of micrometastasis by Automated Cellular Imaging System using Chroma Vision Cytokeratin Detection Kit to detect cells expressing CK 8 as defined by CAM 5.2 monoclonal antibody. BMM and TNM staging were recorded and analyzed for correlations. Results: Of 155 CrCa pts, 11.6%(18/155) were found to have BMM. BMM was positive(+ve) in 50%(9/18) bilaterally and 50%(9/18) unilaterally. BMM was +ve in 11.5%(13/113) of colon pts and 12%(5/42) of rectal pts. When analyzed by T stage in colon pts, BMM was present in 10.5%(2/19) of T1 pts, 16.6%(2/12) of T2 pts, 14% (6/42) of T3 pts, 37.5%(3/8) of T4 pts, and 16%(5/31) of M1 pts. Upon analyzing rectal cancer pts data, BMM was found in 8.3%(1/12) of T1 pts, 16.6%(3/18) of T3 pts and 16.6% (3/18) of M1 pts. Of 113 total Colon pts, 27%(31/113) had nodal disease without distant metastasis(stage III); 13%(4/31) of these pts had BMM with 60% (3/5) unilaterally and 40%(2/5) bilaterally. In the Rectal group, 16%(7/42) had stage 3 disease; 14% (1/7) of stage 3 rectal pts had BMM. Conclusions: BMM did not correlate with tumor size, nodal status or distant metastasis. This discrepancy between tumor stage and BMM suggests BMM to operate independently of TNM staging. Further studies correlating prognosis and disease free survival in +ve BMM pts are needed to examine the significance of BMM in CrCa. [Table: see text] No significant financial relationships to disclose.
Lack of genotype-phenotype correlation in basal cell nevus syndrome: A Dutch multicenter retrospective cohort study
Authors: Betül Cosgun, Marie G.H.C. Reinders, Michel van Geel, Peter M. Steijlen, Antonius F.W. van Hout, Edward M. Leter, Jasper J. van der Smagt, Johanna M. van Hagen, Lieke P.V. Berger, C. Marleen Kets, Anja Wagner, Cora M. Aalfs, Frederik J. Hes, Lizet E. van der Kolk, Johan J.P. Gille, Klara Mosterd
Journal: Journal of the American Academy of Dermatology (2019)
Immunotransplantation for multiple myeloma using allogeneic peripheral blood stem cell transplantation
Authors: E. S. Santos, S. Shah, J. Rink, R. S. Weiner, A. M. Miller, H. Safah
Journal: Journal of Clinical Oncology (2007)

17516 Background: Despite the improvement seen in patients with multiple myeloma (MM) treated with autologous hematopoietic cell transplantation (auto-HCT), most of the patients relapse or die of their disease. The objective of the study was to decrease toxicity of allogeneic HCT for MM patients while allowing the benefit of graft-versus-myeloma effect by using a non-myeloablative HCT (NM- HCT) approach. Methods: Newly diagnosed or previously treated myeloma patients of any stage were enrolled. All patients but one received VAD regimen prior to conditioning regimen which consisted of Fludarabine at 30 mg/m2/day on days -5, -4, -3 and Melphalan at 80 mg/m2 x 2 on days -2 and -1. Graft-versus-host disease (GVHD) prophylaxis included cyclosporine 3 mg/kg intravenously on day -2 and methotrexate at 10 mg/m2 intravenously on days 3, 6, and 11. Results: A total of 8 MM patients (4 IgG, 1 IgA, 1 light chain restriction, 2 non-secretory MM) with a median age of 46 years old (range, 35 to 57 years) have been enrolled. Only one patient received 3 regimens prior to NM-HCT. The initial responses to therapy prior to NM-HCT were: 2 CR, 1 nCR, and 5 PR. All patients received identical 6/6 HLA sibling donor stem cells. All patients but one attained CR (88%) after NM-HCT. The median time for ANC engraftment (≥ 500/mm3) was 12.5 days (range, 10–22 days). Four patients developed acute GVHD grade I-II (3 skin, 1 gastrointestinal); all of them responded well to methylprednisolone treatment. Four patients developed chronic GVHD (grade I-II). The 100-day mortality rate was 12% (1 patient died at day + 96 without evidence of MM). Post-transplant, all patients have reported a Karnofsky’s scale performance status between 80%-100%. Two patients relapsed after 31 months post-transplantation. After a median follow-up of 46 months, median survival has not been reached. Only 1 patient who relapsed has received treatment including auto-HCT. Conclusions: NM-HCT is a feasible treatment option in MM patients with a manageable toxicity profile and acceptable treatment-related mortality. Longer follow-up is needed to evaluate for graft-vs- myeloma effect using this approach. No significant financial relationships to disclose.
Oncologic kidney surgery in obese patients.
Authors: Mohab W. Safwat, Rebecca O'Malley, Attwood Kristopher, Diana Mehedint, Ramkishen Narayanan, Thomas Schwaab
Journal: Journal of Clinical Oncology (2012)

e15039 Background: Obesity adds significant operative challenge to kidney surgery. Its impact on minimally invasive kidney surgery has not been well defined. We evaluated the impact of obesity on open and minimally invasive kidney surgery (MIS) for kidney tumors. Methods: Patients in our prospectively collected IRB-approved kidney database were divided into 5 groups as determined by the World health organization Body mass index (BMI) classification: less than 25.0, 25.0-30.0, 30.0-35.0, 35.0-40.0, and more than 40.0 Kg/m2. Patient characteristics, and peri-operative data were recorded and compared between the different groups and between surgical approches(open vs. MIS) using the Kruskal Wallis and Chi Square tests for continuous and categorical data, respectively. The potential association between BMI and the continuous measures of OR time, Post op stay and EBL were assessed using spearman Correlations. Results: Of the 620 patients identified, 142 (22.9 %) had healthy weight, 180 (29.0%) were overweight, and 298 (48.1%) were obese. Most had grade 1 obesity (BMI 30-34, 167, 26.9%), grade 2 obesity (BMI 35-40, 76, 12.3%), and grade 3 obesity (BMI &gt; 40, 55, 8.9%). As expected, the ASA score rose with degree of obesity (p=&lt;.001). EBL (estimated blood loss), OR (operative time) time, Room time and post-operative stay differed significantly in the 5 groups of patients (p=0.001, p=0.003, p=&lt;0.002, p= &lt;.001, p=.002), respectively. While intra-operative complications did not differ between the obesity groups, obese patients had a higher rate of high grade Clavien complications (p=0.026). Interestingly, the surgical approach (open vs. MIS) and type of nephrectomy ( radical vs. partial) did not correlate with degree of obesity or complications, even when adjusted for stage. Conversion rates for MIS did not correlate with degree of obesity. Conclusions: Nephrectomy in obese patients results in incresed high grade of postoperative complications. Surgical approach does not appear to have any impact on peri-operative outcomes.
Abstract 11416: Reduction of Renal Fibrosis as Well as Cardiac Pro-fibrotic and Pro-Inflammatory mRNA Expression by an Oral Charcoal Adsorbent, AST-120, in Post-MI Rats
Authors: Suree Lekawanvijit, Andrew R Kompa, Minako Manabe, Darren J Kelly, Henry Krum
Journal: Circulation (2011)

Introduction: Pathological renal interstitial fibrosis occurs following myocardial infarction (MI) in the rat. Indoxyl sulfate (IS), a uremic toxin, is increased in chronic kidney disease (CKD), an...
Chronic Obstructive Pulmonary Disease and Breathlessness in Older Workers Predict Economic Inactivity. A Prospective Cohort Study
Authors: Susie J. Schofield, Annette Woods, Joanna Szram, Anthony J. Newman Taylor, Paul Cullinan
Journal: American Journal of Respiratory and Critical Care Medicine (2019)

Rationale: There is an aspiration to retain increasing numbers of older workers in employment, and strategies to achieve this need to make provision for the increasing prevalence of chronic diseases with age. There is a consistent body of cross-sectional evidence that suggests that patients with chronic obstructive pulmonary disease are more likely to have adverse employment outcomes.Objectives: We report the findings of the first longitudinal study of this issue.Methods: We recruited full-time employed men and women in their 50s and followed them for a period of 18 months; we examined, after adjustment for potential confounders, the associations between breathlessness and airway obstruction at baseline and loss of employment in the intervening period.Measurements and Main Results: Among participants responding to the follow-up questionnaire (1,656 of 1,773 [93%]), the majority (78.5%) continued in full-time employment, but 10.6% were in part-time employment and 10.9% were no longer in paid employment. The adjusted risk of loss of employment was significantly increased for those with moderate or severe chronic obstructive pulmonary disease (risk ratio, 2.89; 95% confidence interval, 1.80-4.65) or breathlessness (risk ratio, 3.07; 95% confidence interval, 2.16-4.37) at baseline. There was no evident modification by sex or by manual/nonmanual work.Conclusions: Airway obstruction and breathlessness are independently associated with premature loss from the workforce in older workers; these observations provide strong support to the available cross-sectional evidence and suggest that interventions to help those with chronic obstructive pulmonary disease who wish to remain in work need to be tested.
Immunogenicity and safety of the adjuvanted recombinant zoster vaccine in adults with haematological malignancies: a phase 3, randomised, clinical trial and post-hoc efficacy analysis
Authors: Alemnew F Dagnew, Osman Ilhan, Won-Sik Lee, Dariusz Woszczyk, Jae-Yong Kwak, Stella Bowcock, Sang Kyun Sohn, Gabriela Rodriguez Macías, Tzeon-Jye Chiou, Dimas Quiel, Mickael Aoun, Maria Belen Navarro Matilla, Javier de la Serna, Samuel Milliken, John Murphy, Shelly A McNeil, Bruno Salaun, Emmanuel Di Paolo, Laura Campora, Marta López-Fauqued, Mohamed El Idrissi, Anne Schuind, Thomas C Heineman, Peter Van den Steen, Lidia Oostvogels, Kadir Acar, Boris Afanasyev, Aránzazu Alonso Alonso, Veli-Jukka Anttila, Pere Barba Suñol, Norbert Blesing, Terrance Comeau, Teresa del Campo, Patricia Disperati, Richard Eek, HyeonSeok Eom, Gianluca Gaidano, Sebastian Grosicki, Thierry Guillaume, Wojciech Homenda, William Hwang, Nikolay Ilyin, Anna Johnston, Seok Jin Kim, Ching-Yuan Kuo, Aleksey Kuvshinov, Dong-Gun Lee, Jae Hoon Lee, Je-Jung Lee, Stephane Lepretre, Albert Kwok-Wai Lie, Alessandro Lucchesi, Ahmed Masood, Naheed Mir, Anna Carolina Miranda Castillo, Kathleen Mullane, Alexandr Myasnikov, Raquel Oña Navarrete, Karlis Pauksens, Andrew Peniket, Jaime Perez de Oteyza, David Pohlreich, Humphrey Pullon, Philippe Quittet, Philippe Rodon, Lars Rombo, Olga Samoylova, Johan Sanmartin Berglund, Ariah Schattner, Dominik Selleslag, Marjatta Sinisalo, Faisal Sultan, Koen Theunissen, Paul Turner, Po-Nan Wang, Lucrecia Yáñez San Segundo, Jo-Anne Young, Pierre Zachee, Francesco Zaja
Journal: The Lancet Infectious Diseases (2019)
Evolution of statistical methodology and design of phase II/III clinical trials in non-small cell lung cancer (NSCLC)
Authors: R. K. Bagai, A. Dowlati
Journal: Journal of Clinical Oncology (2006)

7108 Background: A significant heterogeneity exists in the design and reporting of phase II and III therapeutic clinical trials in NSCLC. This has led to difficulty in interpretation of these trials leading to over- or underestimation of therapeutic efficacy. We set out to investigate the statistical methodology and design reporting of chemotherapeutic trials in NSCLC published in the Journal of Clinical Oncology (JCO) over 20 years. Methods: We identified all phase II and III NSCLC chemotherapy trials published in the JCO from January 1983 to August 2005. All manuscripts were reviewed to evaluate components of statistical design that were reported, including: sample size calculation, power, type I error, single or multiple drug trials, relative response sought in phase II trials and improvement in survival time or response rate sought in phase III trials. Results: One hundred forty eight trials were identified. 52% of studies were phase III and 48% were phase II. The majority (78%) were conducted in advanced stage NSCLC. Sample size calculations were reported for only 58% of phase III studies and 31% of phase II studies. Power was reported in 66% of phase III studies and 13% of phase II trials. Type I error was reported in 47% of phase III studies and 17% in phase II studies. 60% of phase III trials defined endpoints (percentage improvement in survival time, improvement in survival time in months or increase in response rate). 41% of phase II trails defined the target response rate, ranging from response rates of 15% to 70%. The frequency of adequate reporting of statistical design was shown to increase from 31% in 1990–1995 to 64% in 2000–2005 ( table ). Conclusions: Significant heterogeneity exists in trial design and reporting of phase II and III trials in NSCLC. This impacts the ability to adequately interpret these studies. More widespread application of statistical methods in planning and reporting of lung cancer clinical trials are necessary to increase reliability of data. [Table: see text] No significant financial relationships to disclose.
Multicentric ipilimumab experience in Turkish patients with metastatic melanoma: MIPI-TURK at 30 months of follow-up.
Authors: Alper Sevinc, Hande Turna, Mustafa Ozdogan, Suleyman Buyukberber, Gokhan Demir, Erhan Gokmen, Nil Molinas Mandel, Semra Paydas, Hakan Akbulut, Ismail Celik
Journal: Journal of Clinical Oncology (2013)

e20006 Background: Ipilimumab, an anti-CTLA-4 (cytotoxic T lymphocyte-associated antigen) monoclonal antibody has been shown to enhance immune responses and improve overall survival in patients with metastatic melanoma. The authors report retrospectively on metastatic melanoma patients treated under the Expanded Access Program in Turkey among 13 centers. Methods: Patients with metastatic melanoma were treated with ipilimumab 3 mg/kg every 3 week for 4 doses. Response evaluation was done on week 12. Patients with complete response (CR), partial response (PR), and stable disease (SD) at week 12 were eligible for re-treatment. Results: A total of 97 patients enrolled with 77 evaluable. Ipilimumab treatment was given as 2 nd (20.0%), 3 rd (64.3%), and 4 th (15.7%) line. The rate of the patients receiving ipilimumab for 1, 2, 3, and 4 doses were 5.2%, 11.7%, 16.9%, and 62.3%, respectively. Seven of 77 patients were eligible for re-treatment. G1/2, G3/4, and G5 adverse events were reported in 23.4% (18/77), 14.3% (11/77), and 2.6% (2/77) of the patients, respectively. The most common G1/2 immune related adverse events were rash (14.3%), muscle weakness (10.0%), and gastrointestinal side effects (8.6%). There were seven G3 side effects (diarrhea in 4, muscle weakness in 1, hypothyroidism in 1, and GI bleeding in 1 patient) and four G4 side effects (thrombocytopenia in 1, diarrhea in 1, sinus tachycardia in 1, and multiple organ failure in 1 patient). Two deaths (G5) were associated with hepatic AEs. Regarding the response evaluation, there was no CR within 16 months of follow-up period and the median overall progression free survival duration was 2 months (95% CI, 1.6-2.5). The disease control rate was 38.8% (PR: 16.3% and SD: 22.5%). Median time to progression was 2 months (95% CI, 1.8-3.1 months). Of the patients, 31.9%, 22.2%, and 19.2% survived within 12, 24, and 30 months of follow-up period, respectively, and the median overall survival duration was 6 months (95% CI, 3.5-8.5). Conclusions: Ipilimumab treatment resulted in favorable clinical benefit for metastatic melanoma patients. Data generated by 13 centers revealed an efficacy and safety profile consistent with the currently available ipilimumab trials.
Treatment of adult rhabdomyosarcoma
Authors: A. P. Staddon, J. J. King, C. M. Ogilvie, L. Hartner, E. J. Fox, R. D. Lackman
Journal: Journal of Clinical Oncology (2007)

20526 Background: Adult rhabdomyosarcomas are rare tumors that are clinically aggressive with high rates of metastasis. This study aimed to determine short-term patient outcomes and responses to chemotherapy using doxorubicin, ifosfamide, and vincristine in the treatment of adult rhabdomyosarcomas. Methods: After IRB approval, 13 adult rhabdomyosarcoma patients (8 males, 5 females) were identified from 1998 until 2006. Of these patients, 6 had metastatic disease on presentation, 4 had neoadjuvant treatment, and 3 had adjuvant treatment. One patient with metastatic disease refused treatment. Twelve patients were treated with doxorubicin, ifosfamide, and vincristine initially with 2 patients also receiving cyclophosphamide and VP-16. The standard regimen was doxorubicin 25 mg/m 2 D1- 3, ifosfamide 2.5 gm/m 2 D1–4, and vincristine 1.4 mg/m 2 D1,8 every 21 days. The majority of patients received 6 cycles of chemotherapy. Average age was 48 years (20 to 73 years). Seven had pleomorphic subtype, 3 alveolar, and 2 embryonal. The primary tumor was in the upper extremity in 4 patients, lower extremity in 5, chest wall in 2, and cervix in 1. Outcome measures were response to chemotherapy, disease status at last follow-up, and survival from the initiation of treatment. Results: Of the 5 treated patients with metastatic disease on presentation, 1 had a complete response (CR) and has no evidence of disease (NED) post-resection at 14 months. 1 had progression and is alive with metastasis at 5 months. 3 patients had a partial response (PR) with later progression and died of disease at 8, 14, and 24 months. Of the 4 patients treated neoadjuvantly, 3 are currently alive NED at 7, 10, and 10 months (2 had pathologic CR and 1 had PR) and 1 patient had a PR with later progression and died at 19 months. Of the 3 patients treated with adjuvant chemotherapy, all 3 are alive NED at 2, 17, and 37 months. Median overall survival was 12 months with 8/12 (67%) alive at last follow-up and 7/12 (58%) alive NED at a median of 10 months. Conclusions: Treatment of adult rhabdomyosarcoma using doxorubucin, ifosfamide, and vincristine shows significant activity with some pathologic CRs and a 58% disease-free survival rate at a median of 10 months. No significant financial relationships to disclose.
Benefits of Supplemental Ultrasonography With Mammography
Authors: Ellen B. Mendelson, Wendie A. Berg, Paula B. Gordon
Journal: JAMA Internal Medicine (2019)

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