tbuckley/cabot-search huggingface dataset:
Intermittent bicalutamide in recurrent non-metastatic castrate sensitive prostate cancer: A single institution experience.
Authors: Mark Prentice, Reena Davda, Kimberley Durno, Heather Ann Payne
Journal: Journal of Clinical Oncology (2019)

307 Background: Despite radical treatment, a proportion of men with prostate cancer will develop localized recurrence. Intermittent LHRH analogue (LHRHa) therapy has shown equivalence to long-term hormone manipulation with reduced toxicity. The non-steroidal competitive androgen receptor antagonist, bicalutamide, offers disease control with a further reduced toxicity profile. We report our institution’s experience of intermittent bicalutamide therapy (IBT) in recurrent non-metastatic castrate sensitive disease. Methods: Patients with biochemical recurrence and non-metastatic status on conventional imaging treated with IBT April 2016-November 2017 are reported. Previous LHRHa in the radical setting was allowed if testosterone recovery had occurred. For inclusion, one full course of IBT therapy had to be completed and treatment break commenced. Dose was 150mg with all other treatment decisions were at clinician discretion. Results: 103 men were identified with 4 were excluded due to insufficient data or failure to start treatment break. Mean age at initial diagnosis was 64.5yrs and, at commencement of IBT, 71.7. Mean overall time on IBT was 47months (20 and 27 months on and off treatment respectively). The longest recorded time on IBT was 153 months. 1 patient completed 8cycles of IBT. Mean number of cycles was 2.8 (range 1-8). Mean length of treatment break reduced with successive cycles of therapy measuring less than time on treatment after cycle 4. Of 39 patients with follow up therapies recorded, 77% received continuous bicalutamide as second line therapy. Conclusions: IBT offers a valid alternative to intermittent LHRHa therapy in recurrent non-metastatic castrate sensitive prostate cancer with the advantage of an improved toxicity profile benefiting patients. Further work to assess long-term outcomes in this patient population is warranted.[Table: see text]
Awareness of KRAS testing by oncologists and panitumumab use in colorectal cancer patients: A European survey.
Authors: Jorg Trojan, Aliki Taylor, Jan-Henrik Terwey, Gerry Downey, George Kafatos, Pilar Garcia Alfonso, Jiri Tomasek, Laurent Mineur, Han van Krieken, Giuseppe Aprile
Journal: Journal of Clinical Oncology (2015)

547 Background: Panitumumab (Pmab) is licensed for treatment in metastatic colorectal cancer (mCRC) patients with wild type KRAS mutation status (US) and wild type RAS (KRAS and NRAS) mutation status (most other countries). To resolve uncertainties about KRAS testing, a survey and medical records review (MRR) are being carried out in Europe in three rounds: the first two rounds (2012-2013) evaluated KRAS testing and round 3 is evaluating RAS testing. These studies are specific obligations in Europe for the conditional marketing authorization for Pmab. Here we present results of rounds 1 and 2. Methods: Eligible oncologists were contacted by telephone in nine European countries (France, Germany, Italy, Spain, Czech Republic, Netherlands, Belgium, Denmark, and Sweden). To be eligible, the physician was required to be a practicing oncologist and have prescribed Pmab to mCRC patients. Results: 299 of 301 (99.3%) oncologists participating in the survey were aware of the need to perform KRAS testing prior to first dose of Pmab and 294 (97.7%) were aware of patients’ KRAS mutation status prior to first dose. 283 of 301 (94.0%) did not prescribe Pmab to mCRC patients with mutant or unknown KRAS status. 164 physicians administered Pmab simultaneously with oxaliplatin-containing chemotherapy to patients and 10 (6.1%) to patients with mutant or unknown KRAS status. 306 patients from 79 participating oncologists were included in the MRR. 302 of 306 mCRC patients (98.7%) were tested for KRAS tumor status, known by the oncologist before first dose of Pmab. 299 of 302 patients (99.0%) had wild-type KRAS tumor status. 83 of 85 patients (97.6%) treated with Pmab and oxaliplatin-containing chemotherapy had wild-type KRAS tumor status. 55 of 56 linked pathology laboratories (98.2%) participated in a Quality Assurance scheme; all used a CE marked or otherwise validated KRAS detection method. Conclusions: Results from both studies show a high level of knowledge among oncologists of the need for KRAS testing in mCRC patients prior to treatment with Pmab and the contraindication with oxaliplatin-containing chemotherapy with mutant or unknown KRAS tumour status. The final round of this study evaluating RAS testing in Europe is currently underway.
Abstract 11988: Waist Circumference and Systolic Blood Pressure Are Predictors of Left Ventricular Hypertrophy in Healthy Individuals
Authors: Yuka Manaka, Haruki Sekiguchi, Mayu Takano, Makiko Kimura, Yufuko Takahashi, Fujio Tatsumi, Eri Watanabe, Ken Shimamoto, Masatoshi Kawana
Journal: Circulation (2015)

Introduction: Left ventricular hypertrophy (LVH) is considered to be a cause of heart failure. Previous studies indicated that patients with metabolic syndrome (MetS) and obesity might be at risk for cardiovascular disease (CVD). However, little is known about which MetS factors contribute to the development of LVH in healthy adults. Hypothesis: The aim of this study was to identify factors related to CVD and major organ dysfunction that could act as predictors of LVH based on thorough medical examinations of healthy subjects. Methods: A total of 1056 participants without diabetes mellitus, systolic dysfunction, chronic kidney disease, or other heart diseases underwent a thorough physical examination including transthoracic echocardiography. LV mass index (LVMI) ≥ 51 g/m2.7 was considered LVH. Single and multiple logistic regression analyses of LVMI and cardiovascular risk factors, including MetS factors and indicators of major organ dysfunction, were performed. Obese subjects (WC ≥ 85 cm in males and ≥ 90 cm in females) and non-obese subjects were also analyzed separately. Results: A total of 980 adults (age 62.8 ± 12.7 y, male 573) were analyzed, and LVH was observed in 21.5% of subjects (n = 211, male 155). Overall, 33.0% (43 of 434) of obese subjects had LVH. LVH was correlated with age, systolic blood pressure (SBP), diastolic BP, estimated glomerular filtration rate, total bilirubin, fasting blood sugar, HbA1c, and WC. Multiple logistic regression analysis indicated that age, high SBP (≥130 mmHg) and WC were independent predictors of LVMI (odds ratios 1.05, 1.99, 3.03; 95% confidence intervals 1.01-1.06, 1.42-2.79, 2.16-4.25, respectively, P&lt;0.01). In obese subjects, aging, WC, and high SBP were independent predictors of LVMI, but WC was not an independent predictor of LVMI in non-obese subjects. Moreover, the average WC was significantly higher in both males and females in obese (47.7 ± 13.5, 47.9 ± 14.1 g/m2.7) than in non-obese subjects (41.1 ± 10.3, 37.8 ± 10.1 g/m2.7). Conclusions: WC and SBP are independent risk factors for LHV in healthy individuals and, therefore, might be useful for predicting cardiovascular disease during routine physical checkups.
Assessment of the diagnostic value of microsatellite instability in the urine of bladder cancer patients.
Authors: Hussein Mustafa Khaled, Abdel-Rahman Zekri, Mai B Mohamed, Fatma M Diab, Mona Abdellateif, Somaya Cancer El Deeb, Abeer M Badr, Sanaa O Abdallah, Abeer Ahmed Bahnassy
Journal: Journal of Clinical Oncology (2019)

384 Background: Microsatellite alterations in urine sediments have proved to be a promising tool for detection of bladder cancer (BC) due to its high sensitivity and specificity. Methods: We assessed the possible prognostic and predictive values of microsatellite alterations in tissue samples and urine sediments obtained from Egyptian patients with BC, and their utility as diagnostic, prognostic and predictive value. Microsatellite instability (MSI) and loss of heterozygosity (LOH) were assessed using 13 microsatellite markers in tumor tissue and urine sediments of 30 patients with BC. The concordance between MSI in tissue and urine samples was determined. Results: We found that MSI was more frequent than LOH (100% and 46.7%; respectively). D16S310, MBP and IFN-α showed the highest MSI frequency in urine samples (70%, 70% and 66.67%; respectively), while MBP, ACTBP2 and D9S171 (66.67%, 63.33%, and 60%; respectively) were the most frequently detected in tumor tissue. All markers correlated significantly with the pathological subtypes (more frequent in TCC) and hematuria. The concordance between tissue and urine was statistically significant for , D9S171, D16S476, FGA and ACTBP2 (P = 0.04, 0.015, 0.02 and 0.007; respectively). When we combined D16S476 and D9S171, the sensitivity, specificity, PPV and NPV reached (80.0%, 75.0%, 82.8% and 71.4%; respectively) for diagnosis of BC . Conclusions: Thus MSI in urine sediments could be a sensitive and reliable method for diagnosis of BC.
Comprehensive and epidemiological characterization of urachal adenocarcinoma: A pan-Canadian collaboration.
Authors: Belkaid Wiam, Zineb Hamilou, Denis Soulieres, Christina M. Canil, Pawel Zalewski, Daniel Yick Chin Heng, Vitor Da Silva, Mathias Castonguay, Bertrand Routy, Normand Blais
Journal: Journal of Clinical Oncology (2019)

516 Background: Urachal cancer is a rare form of urothelial cancer representing 0,1-0,2% of bladder cancers. The exact underlying cause of urachal cancer is still widely unknown and there is much speculation on multiple factors such as genetic and environmental ones that may play a role. Moreover, given the lack of treatment consensus, we proposed the first study that assesses the clinical, genetic and molecular features of this disease in Canada. Methods: This ongoing study is recruiting in Canadian centers from the year 2005 onwards. The clinical database is constructed using the hospital electronic medical file. In addition, pathological tissues are centralized for molecular and genetic analysis. Results: To this date, 15 patients were included, 12 males and 3 females. Median age was of 49 years old with a disease distribution of Stage II (4), Stage III (3) and Stage IV (4). 8/15 patients developed metastasis after initial cystectomy in the lungs (n = 7), peritoneum (n = 2), lymph nodes (n = 4), and bone (1). Median survival of all patients was 23 months. Metastatic patients after cystectomy had a shorter overall survival (OS) of 21 months compared to non-metastatic patients (OS – not reached). The majority of metastatic patients (6/8) died of their underlying malignancy. Conclusions: This study is an ongoing country-wide effort to expand knowledge of this poorly studied disease. With ongoing accrual, the clinical features will be better defined and further molecular characterization will be performed to better predict response to therapy.
Validation of heart failure prediction tool in cardio-oncology breast cancer population.
Authors: Moira Katherine Rushton, Freya L. Crawley, Wyanne Law, Nadine A. Graham, Christopher Johnson, Jeffrey Allen Sulpher, Susan Dent
Journal: Journal of Clinical Oncology (2015)

e17693 Background: While advances in breast cancer treatment, including targeted therapies such as trastuzumab have improved patient outcomes, short and long-term cardio-toxicity is a recognized risk. A clinical risk score (CRS) based on clinical risk factors has been derived for breast cancer (BC) patients (Ezaz et al, 2014), but remains untested in a real world clinical population. The objectives of this study are to apply this CRS to a real world breast cancer (BC) population seen in a dedicated cardio-oncology referral clinic (CORC) and correlate predicted versus actual risk of congestive heart failure (CHF) and cardiomyopathy (CM). Methods: BC patients referred to the CORC between October 2008 and August 2014 were reviewed retrospectively. Data was collected on patient demographics, cardiac risk factors, cardiac testing and outcomes. A CRS was calculated for each patient. Sensitivity, specificity, positive and negative predictive values of this risk score were evaluated using CHF/CM as the end-point. Results: 337 BC patients were reviewed; 14 were excluded because of missing data. Median age was 56 years old (range 25 - 87, SD 12); 217 (66%) had early stage (I-II) disease; 214 (66%) were ER positive; 181 (56%) were PR positive; and 199 (62%) were Her2 positive. 93% (n = 301) received adjuvant chemotherapy and 63% (n = 203) received targeted agents. Applying the CRS found 194 (60%) would be considered low risk to develop CHF/CM; 78 (24%) moderate risk; and 51 (16%) high risk. When applied to this population, the high-risk score cut-off had a 30.2% sensitivity (CI 18.7 – 44.5%) and 87.0% specificity (CI 82.2 % - 90.6%). Positive predictive value is 0.314 (CI 0.195 – 0.460) and negative predictive value is 0.86 (CI 0.816 – 0.901). Conclusions: This CRS has modest positive predictive value and good negative predictive value for CHF and CM in a contemporary sample of breast cancer patients. Patients with a high CRS may benefit from more intense cardiac evaluation in a clinic such as our CORC, since almost half of these patients develop CHF or CM. Most patients have a low or moderate CRS, and a lower risk of CHF/CM. Future work combining clinical risk scores with cardiac imaging and biomarkers may better predict cardiac risk during breast cancer therapy.
Serum cytokeratin 19 fragments: A novel preoperative prognostic marker in patients with upper urinary tract urothelial carcinoma.
Authors: Yuki Endo, Go Kimura, Jun Akatsuka, Kotaro Obayashi, Hayato Takeda, Tatsuro Hayashi, Yukihiro Kondo
Journal: Journal of Clinical Oncology (2019)

412 Background: Current guidelines do not yet provide any recommendations for any serum tumor markers in patients with upper tract urothelial carcinoma (UTUC). Even today radiological images cannot diagnose muscle invasion correctly. Previous studies have shown that serum cytokeratin levels were correlated with depth of tumor invasion and metastases in patients with bladder cancer. In this study we evaluated whether preoperative serum cytokeratin 19 fragment levels (sCK19) could be a prognostic marker for survival in patients who received nephroureterectomy (NU). Methods: 160 cases with UTUC underwent NU from December 2003 to 2014 at our institution. The median age was 73 years. Preoperative sCK19 was measured in 138 cases. The patients were divided into two groups, high sCK19 group (HG) and low group (LG) based on sCK19 (a cut-off value: 3.5 ng/mL). Cancer-specific survival (CSS) and progression-free survival (PFS) were measured by Kaplan–Meier curves and statistical analysis was performed by the log–rank test. Multivariate analysis was carried out using the Cox proportional hazards model. Results: Of 138 cases ≤pT1 was 54 (39%), pT2 in 31 (22%), pT3 in 45 (32%) and pT4 in 8 (5%). 37 cases (23%) were the HG and 101 (78%) were the LG. sCK19 were significantly correlated with pT (rs 0.213, p=0.013, Spearman rank correlation). The median follow-up time was 34.0 months. In all cases the 5-year CSS was 78% and PFS was 60%. The 5-year CSS of the HG (57%) was significantly lower than the LG (86%) (p=0.001). The 5-year PFS of the HG (36%) was significantly lower than that of the LG (67%) (p&lt;0.001). On univariate analysis, pT stage, lymphovascular invasion, positive margin (PM) and sCK19 were the significant factors for CSS. On multivariate analysis, sCK19 (HR4.2, p=0.001) and PM (HR2.9, p=0.001) were the independent poor prognostic factors. Conclusions: Preoperative sCK19 was the prognostic factor for the patients with UTUC. Systemic chemotherapy should be considered before NU in patients with high preoperative sCK19 levels independent of radiological findings.
The PRIME trial: Quality-adjusted survival in patients with <i>RAS</i> wild-type (WT) metastatic colorectal cancer (mCRC) receiving first-line therapy with panitumumab plus FOLFOX versus FOLFOX alone.
Authors: Jianmin Wang, Jun Dong, Guy Hechmati, Alan Rong, Gregory Maglinte, Beth L. Barber, Jean-Yves Douillard
Journal: Journal of Clinical Oncology (2015)

3543 Background: The pivotal phase III PRIME trial demonstrated that, compared with FOLFOX alone, panitumumab plus FOLFOX prolongs overall survival (OS) and progression-free survival (PFS) in patients with RAS WT mCRC without having a detrimental effect on overall quality of life. The objective of this analysis was to use the quality-adjusted time without symptoms of disease or toxicity of treatment (Q-TWiST) method to compare quality-adjusted survival between the treatment arms of PRIME. Methods: Patients with RAS WT mCRC from each treatment arm of PRIME were included in this analysis, and the area under the survival curve (AUSC) was estimated using the nonparametric Kaplan-Meier method (48 months follow-up). The AUSC was partitioned into three health states: toxicity (TOX), time without symptoms of disease progression or toxicity (TWiST, i.e., PFS minus TOX), and relapse (REL, ie, OS minus PFS). The durations of the health states were then adjusted using utility weights derived from patient-reported EuroQoL 5 measures. The null hypothesis of no difference between treatment arms was tested based on the normal approximation, with standard errors (SE) calculated by the bootstrap method. In the primary analysis, TOX consisted of grade 3 and 4 adverse events. A sensitivity analysis, with grade 2, 3, and 4 adverse events classified as TOX, was performed. Results: Of 1,183 patients with mCRC who were randomized, 512 patients had RAS WT tumors (panitumumab plus FOLFOX, n = 259; FOLFOX alone, n = 253) and were included in this analysis. Patients receiving panitumumab plus FOLFOX had a significantly longer Q-TWiST (20.5 months) than patients receiving FOLFOX alone (18.2 months) resulting in 2.3 ± 1.0 (SE) additional quality-adjusted months (P < 0.03). The sensitivity analysis yielded similar results, indicating that the analysis was robust. Conclusions: This Q-TWiST analysis showed that in a previously untreated RAS WT mCRC population, patients treated with panitumumab plus FOLFOX had a significantly improved duration of quality-adjusted survival compared with patients treated with FOLFOX alone. Clinical trial information: NCT00364013.
Abstract P083: Relationship Between Prevalent Cardiovascular Disease and 6-Year Incidence of Diabetes: Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Authors: Celestin Missikpode, Ramon A Durazo-Arvizu, Richard S Cooper, Sheila F Castaneda, Gregory A Talavera, Linda C Gallo, Maria M Llabre, Marisa J Perera, Krista M Perreira, Martha Daviglus, James P Lash
Journal: Circulation (2019)

Introduction: Cardiovascular disease (CVD) may prevent the adoption of healthy lifestyle habits such as physical activity, and thus may lead to weight gain and increased risk for lifestyle-related conditions such as diabetes mellitus (DM). Evidence suggests that medications commonly used in the management of CVD such as diuretics, β blockers, and statins are also associated with increased risk of diabetes. We examined the association of CVD with incident DM and investigated whether this association is mediated by change in BMI or medication use. Methods: Data from the HCHS/SOL Visit 1 (2008-2011) and Visit 2 (2014-2017) examinations were used to compare incidence of DM among persons with and without CVD at Visit 1. DM was defined using the American Diabetes Association criteria, and prevalent CVD using the Framingham Heart Study definition (i.e., self-reported history of coronary heart disease, cerebrovascular events, peripheral artery disease, or heart failure). Of the 8672 participants free of DM at Visit 1 and with complete data on DM at Visit 2 and on key covariates of interest, 2191 (25.3%) had prevalent CVD at baseline. A total of 2050 participants with CVD were matched to controls free of CVD at Visit 1 using 1:1 propensity matching. Covariates included in the propensity model were age, gender, educational attainment, marital status, Hispanic background, history of hypertension, family history of diabetes, health insurance coverage, chronic kidney disease at baseline, gestational diabetes, high cholesterol, metabolic syndrome, alcohol use, cigarette pack years, physical activity level, diet quality based on alternative healthy eating index, baseline BMI, baseline prediabetes. Matched pairs were analyzed. McNemar’s test was used to compare incidence of DM among cases and controls. The mediating effects of change in BMI and medication use were examined. Results: Covariate distributions were similar among participants with and without CVD. The incidence of DM among persons with CVD was 15.7% vs. 13.6% among those without CVD (p=0.06). No natural direct effect of CVD on DM was found. The association between CVD and incidence of DM was not mediated by change in BMI. On average, BMI increased by 0.38 (SE=2.56) and 0.33 (SE=2.50) among persons with and without CVD, respectively (p=0.55). The association between CVD and DM was indirectly mediated by the use of beta-blockers (percent mediated=24.8%), statins (percent mediated=9.8%), and diuretics (percent mediated=8.9%). Conclusion: There is slight evidence that medications used to treat CVD increase risk for new onset diabetes.
Approach to Groin Hernias
Authors: Kamal M. F. Itani, Robert Fitzgibbons
Journal: JAMA Surgery (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal