tbuckley/cabot-search huggingface dataset:
A prospective cohort study to reduce operative risk in stage I gastric cancer patients with metabolic syndrome: Preoperative exercise versus surgery alone.
Authors: Haruhiko Cho, Akira Tsuburaya, Naoki Hirabayashi, Junya Shirai, Toru Aoyama, Tsutomu Hayashi, Takanobu Yamada, Takaki Yoshikawa, Satoshi Morita, Junichi Sakamoto
Journal: Journal of Clinical Oncology (2013)

e15112 Background: Although obesity influences the technical difficulty of surgery, a reasonable marker of abdominal obesity is not confirmed and effective intervention has never been applied to reduce the operative risk in patients with abdominal obesity. Methods: To reduce the surgical difficulty and risk in gastric cancer patients with abdominal obesity, a preoperative exercise protocol was designed for stage I gastric cancer patients who were diagnosed to have metabolic syndrome (MetS). Results: In total, 51 patients (33 who underwent surgery alone, 18 who were treated with preoperative exercise) were registered in this study. Visceral fat areas (VFA) were estimated by CT scan, and they were associated most strongly with waist, followed by HDL cholesterol, and BMI. In the exercise group, all patients completed protocol treatment, without disease progression and &gt; grade2 exercise-associated adverse events. VFA of the exercise group were larger than that of the surgery alone group at registration (221cm 2 /180cm 2 , p=0.028), then reduced after exercise to non-significant level with surgery alone group (201cm 2 /180cm 2 , p=0.264). There were no significant differences of intraoperative blood loss (262mL/201mL: p=0.465) and incidence of perioperative morbidity (27.7%/29%, p=1.000) between exercise and non-exercise groups. Multivariate logistic regression analysis detected intraoperative blood loss (&gt; 380mL) as significant risk factor (p=0.023) for perioperative morbidity. Conclusions: Waist was surrogate marker for VFA in this study, thus can be a candidate of simple indicator of abdominal obesity. Preoperative interventional exercise did not directly reduce operative risk of gastric cancer with MetS; however, it was associated indirectly with risk reduction by improving surgical difficulty.
Circulating Tumor Cell Clusters in Patients with Metastatic Breast Cancer: a SWOG S0500 Translational Medicine Study
Authors: Costanza Paoletti, Jieling Miao, Emily M. Dolce, Elizabeth P. Darga, Madeline I. Repollet, Gerald V. Doyle, Julie R. Gralow, Gabriel N. Hortobagyi, Jeffrey B. Smerage, William E. Barlow, Daniel F. Hayes
Journal: Clinical Cancer Research (2019)

Metastasis requires malignant cell circulation from the primary to a distant tissue. Elevated levels of circulating tumor cells (CTC) portend a poor prognosis in breast and other cancers. Recent studies have suggested that CTC clusters may be a factor in the metastatic process. We conducted a prospective retrospective study of the SWOG0500 clinical trial to test whether CTC clusters are associated with poorer prognosis.CTC CellSearch galleries from SWOG0500 trial were reread using prespecified criteria for CTC clusters, doublets, and enumeration. Survival analysis methods include Kaplan-Meier plots and log-rank tests.Patients were classified into three prognostic subgroups based on baseline CTC/7.5 mL whole blood (WB): Arm A: <5CTC; Arm B/C: ≥5CTC and then B (<5CTC) and C (≥5CTC)/7.5 mL WB at first follow-up. At baseline, 19% of patients had CTC doublets or clusters, which were more likely in Arm B/C versus Arm A (38% vs. 1.4%; P < 0.0001). Furthermore, doublets or clusters were significantly more common in patients who were ultimately assigned to Arm C versus B (54% vs. 25%; P < 0.0001). In Arm C, doublets and clusters were associated with worse overall survival than only doublets, clusters, or no doublets nor clusters at baseline (P = 0.008) and first follow-up (P = 0.010). When compared with enumeration alone, doublets, clusters, or both were not prognostic in patients who had 5-19 or ≥20 CTC/7.5 mL WB.In patients with metastatic breast cancer starting first-line chemotherapy, mortality is independent of the presence of CTC clusters, but rather depends on the number of CTC/7.5 mL WB.
Serum CEA and CA 15-3 levels according to breast cancer subtypes.
Authors: Isa Dede, Gungor Utkan, Hakan Akbulut, Yuksel Urun, Dilsa Mizrak, Fikri Icli
Journal: Journal of Clinical Oncology (2013)

e11511 Background: Carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 15-3 are frequently elevated in patients with metastatic breast cancer (MBC). In this study we aimed to correlate levels according to breast cancersubtypes with MBC. Methods: From January 2008 to December 2012, ninety-eight patients with MBC who were treated at Ankara University School Of Medicine, Department of Medical Onkology were included in this study.Serum levels of CEA and CA 15-3were measured and compared according to tumor estrogen receptor (ER), progesteron receptor (PR), and human epidermal growth factor receptor 2 (HER2) status. Results: In this cohort, overall ER,PR and HER2 positivity rates were 65 %,68%,and 58%, retrospectively. Positivite ER status was associated with elevated levels of CA 15-3 and cea. Of these, CA 15-3 levels elevated in 40.5% of ER positivite and 24.1 % of ER negativite patients (p=0.027). Similarly, 46.8 % of ER positivite and 18.2% of ER negativite patients had elevated levels of CEA (P=0.022). no association between PR and HER2 status and tumor markers was observed. Conclusions: The breast cancer subtypes are correlated with serum levels of tumor markers in patients with MBC. Tumor markers elevation may be associated with biological background of breast cancer subtypes. Further validation is needed to determine the role of these markers in diffrent tumor types for monitoring patients with MBC.
Paediatric spitzoid proliferations
Authors: D.W. Bartenstein, J.M. Fisher, C. Stamoulis, C. Weldon, J.T. Huang, S.E. Gellis, M.G. Liang, B. Schmidt, E.B. Hawryluk
Journal: British Journal of Dermatology (2019)

Spitz naevi are a type of mole (brown skin lump). They are smooth, rounded, pink, red or brown. They contain pigment cells known as spitzoid proliferations. Some spitz naevi look quite worrying, growing rapidly and dark brown in colour, and yet turn out to be benign (harmless) when looked at under the microscope, while others contain atypical (abnormal) or even malignant cells. Even viewing them under a powerful magnifying glass (dermatoscope) does not show whether they are malignant (cancerous); genetic tests provide clues but are not easily available. Consequently it is hard to advise patients, especially children because most of the published data is from adults. So these American doctors reviewed 622 spitzoid proliferations removed at Boston Children's Hospital between 1994 and 2012. Most (82.3%) were benign, 17.2% contained cells that looked worrying (atypical) and 3 (0.5%) turned out to be malignant melanomas. On further investigation they found that patients with malignant lesions were, on average, older (17.2 years) than those with atypical or benign lesions (7.2 and 7.4 years respectively), but tumour type was not linked with skin colour or gender. The 3 melanomas occurred in white people, one on the arm, and the other two on or around the buttocks. Two of the 3 had other tumours but all 3 were alive with no recurrences of skin tumour when last reviewed 4‐17 years after diagnosis. Five typical spitz naevi came back as atypical naevi after being partially removed. The authors conclude that it may not be necessary to remove benign‐looking spitz naevi in children.
Standardisation of myositis-specific antibodies: where are we today?
Authors: Michael Mahler, Jean-Baptiste Vulsteke, Xavier Bossuyt, Ellen De Langhe, Minoru Satoh
Journal: Annals of the Rheumatic Diseases (2019)

With interest we read the recent article by Espinosa-Ortega et al 1 comparing a line immunoassay (LIA) and immunoprecipitation (IP) for the detection of autoantibodies associated with idiopathic inflammatory myopathies (IIM). Historically, most of the clinical associations of myositis specific antibodies (MSAs) and myositis associated antibodies (MAAs) have been established using IP. Consequently, it is important to compare newer technologies such as LIA and dot blots (DB) to IP, which does not imply that IP is correct in all instances or that IP should be regarded as the ‘gold standard’.

In a recent study that compared LIA and IP, poor agreement was found for several MSAs.2 In the letter by Espinosa-Ortega et al , the authors made a similar analysis, comparing IP and LIA in a cohort of 110 patients with IIM. For the LIA, the study also included controls (n=60). A strength of the study is the use of both protein and RNA IP performed in a reference centre for IP. In the interest of assay evaluation and standardisation, it is valuable to provide data showing a more statistics-based approach for method comparison. Due to the rarity of several of the MSAs, large cohorts with thousands of patients are needed to carefully validate the positive agreement between methods. …
Prospective evaluation of incidence and pattern of nausea in patients receiving combined chemotherapy and radiotherapy (RT) above the diaphragm
Authors: R. S. Axelrod, M. Machtay, M. Werner-Wasik, R. Anne, H. Schlossberg, M. Laudadio, D. Kotak
Journal: Journal of Clinical Oncology (2009)

e20676 Background: Nausea (N), vomiting (V) remain distressing effects of chemotherapy. Prevalence of N, V in patients (pts) receiving daily (5/7) RT with weekly (wkly) doublet chemotherapy is not well studied. Methods: We used a modified Functional Living Index Emesis (FLIE) (Lindley and Mullin) to study N, V in pts receiving 2 chemotherapy agents with RT for upper aero-digestive malignancies. Exclusion criteria were: other causes of N,V or RT below the diaphragm. Pts completed a written questionnaire wkly during therapy. A 6 point scale was used, 0 representing no symptoms and 6 representing intolerable or uncontrolled symptoms. Questions addressed N, V, use of medication in daily diary and overall wkly assessment of N, V, ability to eat, effectiveness of medications and effect on daily routine. Results: 21 Patients enrolled: 15 completed 4 weekly questionnaires, 17 completed 3. Most patients received a total of 5 weekly chemotherapy treatments. Participants: 17 M: 4 F with 17 head/neck sites, 4 lung. 6 pts received wkly carboplatin (AUC 2) and paclitaxel (45/m2 for lung, 30/m2 for h/n); 15 pts cisplatin (20/m2) and paclitaxel. All patients received our standard anti emetic therapy (steroids and 5 HT3 receptor antagonist). Pts with early nausea tended to experience continued or worsened symptoms despite anti emetic therapy; at wk 4, more pts experienced V. Selected results are shown in the table . Conclusions: The modified FLIE questionnaire was a useful tool for evaluation. Despite advances in anti emetic therapy, nausea and vomiting resulting from the combination of radiation therapy with dual agent chemotherapy exerts a significant adverse effect on daily comfort but little effect on overall function. [Table: see text] [Table: see text]
A matched pair analysis of intra- and postoperative catumaxomab in patients with ovarian cancer from a multicenter, single-arm phase II trial versus a consecutive single-center collective of ovarian cancer patients without immunotherapy.
Authors: Klaus Pietzner, Radoslav Chekerov, Alexander Reinthaller, Daniel Reimer, Toralf Reimer, Lukas Angleitner-Boubenizek, Miriam Tschirschmann, Horst Lindhofer, Elena Ioana Braicu, Christina Fotopoulou, Jalid Sehouli
Journal: Journal of Clinical Oncology (2012)

5080 Background: Advanced ovarian cancer is still connected to high mortality rates due to intraperitoneal tumor cells that survive radical cytoreductive surgery as well as adjuvant chemotherapy. These persistent tumor cells need to be targeted in order to improve survival. Catumaxomab has demonstrated the ability to kill EpCAM-positive intraperitoneal tumor cells of ovarian cancer patients in studies aiming to controll malignant ascites in the recurrent setting. This analysis was conducted to investigate the efficacy of intraperitoneal catumaxomab at the timepoint of primary cytoreductive surgery and postoperative period, prior to standard adjuvant chemotherapy. Methods: Ovarian cancer patients undergoing radical surgery received one intraoperative (10 μg) followed by four subsequent intraperitoneal (i.p.) dosages (10, 20, 50 and 150 μg) of catumaxomab on days 7, 10, 13, and 16, respectively. Because of the single arm design of the study, the patients treated with catumaxomab were compared in a matched pair analysis to consecutive patients with primary ovarian cancer who received standard treatment without catumaxomab in a large center, in order to compare survival. The two main prognostic factors of stage and level of tumorreduction were chosen as matching criteria. Results: Of 58 patients screened, 41 were treated with catumaxomab and available for survival evaluation. Median age was 57 years in the catumaxomab group and 59 years in the matched-pair control group. The most comon histology was the serous subtype with 70.7 % in the catumaxomab and 80.5 % of the patients in the control group. The median for overall survival was reached for the historical consecutive matched-pair control collective, but is not yet reached for the catumaxomab group. However, 3-year survival data were available for both groups and showed survival of 85.4% (35) in the catumaxomab group and 63.4% (26) in the matched-pair control group (p-value: 0.041; HR 2.073) Conclusions: There seems to be a trend to beneficial 3-year survival in the catumaxomab group, suggesting that a phase III trial is warranted.
British Society of Gastroenterology guidelines for oesophageal manometry and oesophageal reflux monitoring
Authors: Nigel J Trudgill, Daniel Sifrim, Rami Sweis, Mark Fullard, Kumar Basu, Mimi McCord, Michael Booth, John Hayman, Guy Boeckxstaens, Brian T Johnston, Nicola Ager, John De Caestecker
Journal: Gut (2019)

These guidelines on oesophageal manometry and gastro-oesophageal reflux monitoring supersede those produced in 2006. Since 2006 there have been significant technological advances, in particular, the development of high resolution manometry (HRM) and oesophageal impedance monitoring. The guidelines were developed by a guideline development group of patients and representatives of all the relevant professional groups using the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. A systematic literature search was performed and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool was used to evaluate the quality of evidence and decide on the strength of the recommendations made. Key strong recommendations are made regarding the benefit of: (i) HRM over standard manometry in the investigation of dysphagia and, in particular, in characterising achalasia, (ii) adjunctive testing with larger volumes of water or solids during HRM, (iii) oesophageal manometry prior to antireflux surgery, (iv) pH/impedance monitoring in patients with reflux symptoms not responding to high dose proton pump inhibitors and (v) pH monitoring in all patients with reflux symptoms responsive to proton pump inhibitors in whom surgery is planned, but combined pH/impedance monitoring in those not responsive to proton pump inhibitors in whom surgery is planned. This work has been endorsed by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG) under the auspices of the oesophageal section of the BSG.
Are there racial differences in colorectal cancer care timeliness among users of the Veterans Affairs Healthcare System?
Authors: Leah L. Zullig, George L. Jackson, Morris Weinberger, Dawn T. Provenzale, Bryce B. Reeve, William Ruffin Carpenter
Journal: Journal of Clinical Oncology (2013)

6555 Background: The Veterans Affairs (VA) healthcare system is the largest integrated healthcare system in the United States. While the quality of VA colorectal cancer (CRC) care is well chronicled, there is a paucity of literature describing racial differences in timeliness of VA CRC care. The objective of this analysis was to examine potential racial differences in CRC care timeliness. Methods: Data were from the VA External Peer Review Program (EPRP), a nationwide VA quality-monitoring program. Included patients must have been Caucasian or African American, diagnosed with non-metastatic CRC between 2003 and 2006, and received definitive CRC surgery. We examined 3 timeliness metrics – time from: 1) surgery to initiation of adjuvant chemotherapy (Stage II-III), 2) surgery to surveillance colonoscopy (Stage I-III), and 3) surgery to death (Stage I-III). Unadjusted analyses used Log-rank and Wilcoxon tests. Adjusted analyses used Cox proportional hazard models. Results: In adjusted Cox regression there were no racial differences in time to initiation of chemotherapy (HR 0.82, p=0.61) or surgery to death (HR 0.94, p=0.0.49). In adjusted Cox regression, Caucasian race was protective, with shorter time to first surveillance colonoscopy (HR 0.63, p=0.02). The median time to colonoscopy was 367 and 383 days for Caucasian and African American patients respectively. Conclusions: Caucasian patients receive follow-up colonoscopies slightly sooner than African American patients in VA; the difference between median times by race is only 16 days. Though statistically significant, this difference is not clinically meaningful since no scientific evidence suggests differing benefits of surveillance colonoscopy in a small timeframe.
Microanatomic characteristics of melanoma metastases in the sentinel node(s) (SN) predict survival and question the need for complete lymph node dissection (cLND)
Authors: A. C. Van Akkooi, J. H. De Wilt, C. Verhoef, P. I. Schmitz, A. N. Van Geel, M. Kliffen, A. M. Eggermont
Journal: Journal of Clinical Oncology (2006)

8005 Introduction: The SN procedure has become a widely used staging procedure for stage I/II melanoma patients. We previously reported on the high SN+ identification rate with the use of the EORTC MG group pathology protocol (van Akkooi et al., Eur J Cancer: 2006, in press). Because only approximately 20% of SN positive patients have additional non-SN lymph node involvement in the cLND specimen, we have proposed to identify a SN+ patient group, which can be spared a cLND. Therefore further microanatomic analyses of the metastatic SNs has been performed to identify patient/tumor or SN factors which predict DFS and OS as well as additional non-SN nodal positivity. Methods: 262 stage I/II pts were included into the SN database between 10/97 and 5/04. 77 were SN+ (29%). 74 pts had SN material for re-evaluation in this study. Microanatomic analysis categorized a.o. the location of tumor cells; subcapsular, parenchymal (or combined), multifocal or extensive; the Starz classification and the measurement of the amount of tumor load (in mm). Tumor load was quantified by size: &lt;0.1mm (single melanoma cells), 0.1 - 1.0mm, &gt;1.0mm. DFS, OS and additional non-SN positivity was calculated for all the microanatomic analyses. Results: Mean/Median Breslow was 3.5/3.0 (0.8 - 12.0) mm, mean/median FU was 35/30 (6 - 81) months. There were no signif. differences in OS or additional non-SN positivity for the different loc. of involvement. The estimated 5yr OS rates were 100%, 63% and 35% for the different groups of tumor load, &lt;0.1mm, 0.1 - 1.0mm, &gt;1.0mm respectively (Figure)(P=0.03). There were no patients with add. non-SN positivity in the group with involvement &lt;0.1mm. On multivariate analysis the tumor load was the most important prognostic factor for DFS (P=0.005) and OS (P=0.03). DFS, OS and add. non-SN positivity of all other analyses will be presented at the meeting. Conclusions: It is questionable whether SN with onlysingle cells involvement (&lt;0.1mm) should be considered positive. Dist. mets are exceedingly rare (1/16 = 6.3%) and was identical to the SN- patient pop., and non-sentinel node involvement was not observed at all. These patients should probably not undergo add. LND and may not be considered stage III patients. No significant financial relationships to disclose.
Effect of immunization with Ii-key modified HER2 (776-790) peptide vaccine (AE37) on immunologic responses in prostate cancer patients.
Authors: Sonia A. Perez, Eleftheria Anastasopoulou, Efi Pappou, Panagiotis Tzonis, Stratos Bisias, Anastasios Thanos, Eric von Hofe, Michael Papamichail, Constantin N. Baxevanis
Journal: Journal of Clinical Oncology (2013)

e16037 Background: We have shown that the AE37 vaccine (Ii-Key modified HER2(776-790) peptide) is safe and induces HER2/neu–specific cellular immune responses in patients with prostate cancer (Perez SA et al Clin. Cancer Res. 2010, 16:3495). We now present data from 4-year immunological assessments of prostate cancer patients who received AE37. Methods: Seventeen patients in a phase I study were given 6 doses of AE37 at monthly intervals and one additional dose a year after initiating treatment. Immunological testing to assess active versus suppressive immunity was conducted one month (intermediate-term immunomonitoring [ITI]) and 3 years (long-term immunomonitoring [LTI]) after the final dose of AE37. ELISPOT and proliferation assays were conducted to assess cytokine secretion and mitogenic response to antigen. DTH reactions were measured to assess in vivo immune response to antigen. All assays were conducted using native HER2(776-790) peptide (AE36). The percent Treg cells and ng/ml TGFβ were determined as markers for immune suppression. Results: Neither ELISPOT nor proliferation assays were statistically different at LTI compared to ITI. While clearly above pre-vaccine responses, the drop in DTH was statistically significant (p &lt; 0.05). Similarly, the increase in Treg cells and circulating TGFβ was also statistically significant. An increase of &gt;200 % in PSA-doubling time at any point during the study was observed in 6/17 patients, with 3 retaining this effect to 5 years. Conclusions: AE37 generates immunological memory associated with possible clinical efficacy in spite of Tregs and TGF-β levels returning at 4 years after being decreased for up to 6 months after initial AE37 vaccination. These results support further randomized testing of the AE37 vaccine. Clinical trial information: 2006-003299-37. [Table: see text]