tbuckley/cabot-search huggingface dataset:
A prospective study evaluating functional outcome of palliative transurethral resection in locally advanced and metastatic prostate cancer.
Authors: Dig Vijay Singh, Sandhya Sood, Yogesh Arora, Richa Goyal
Journal: Journal of Clinical Oncology (2015)

e16007 Background: Bladder outlet obstruction is the most frequent complication of locally advanced and metastatic prostate cancer. There is paucity of studies delineating results of palliative transurethral resection of the prostate (pTURP), the most common surgery done for this complication. Our aim was to assess functional outcome among patients undergoing pTURP prospectively. Methods: In this prospective study, 112 patients of locally advanced and metastatic prostate cancer requiring pTURP were included from January 2013 to December 2014. The baseline and operative data of patients recorded. They were evaluated for subjective parameters as International Prostatic Symptom Score (IPSS), Quality of Life (IPSS QoL) and objective parameters as maximum urinary flow rate (Qmax), Voided Volume (VV), PVR before and at 3 months after treatment. The criteria for poor functional outcome was defined as decrease in IPSS < 50%, increase in Qmax < 30% and need of pads for incontinence post-operatively. Results: Out of total 112, there were 10 cases of acute urinary retention. So comparison of parameters was feasible in only 102 subjects. A significant decrease in IPSS (-60.15%, p < 0.05) and increase in IPSS QoL (+74.73%, p < 0.05) was observed following treatment. A significant increase in Qmax, VV and decrease in PVR was also observed (+59.17%, p < 0.05), (+26.03%, p < 0.05) and (-61.61%, p < 0.05) respectively. As a secondary outcome, it was ascertained that 3 factors associated significantly (p < 0.05) with poor functional outcome (n = 20): Time interval between diagnosis of prostate cancer and pTURP ( > 8 mo), Gleason score ( > 7) and PSA at time of surgery ( > 22 ng/ml). Chemotherapy for CRPC was weakly associated (p = 0.085). There was no statistical significance of age, trigger of operation, prostate volume, stage, operative time, resection weight and hospital stay with poor functional outcome. Conclusions: It’s a unique prospective study emphasizing pTURP as effective procedure in both subjective and objective parameters. Poor functional outcome (19.60%) of surgery is associated with time interval between diagnosis of prostate cancer and pTURP, Gleason score and PSA at time of surgery.
SPARC expression in primary tumor and metastatic lymph node of resected pancreatic cancer patients and its impact on prognosis.
Authors: Yang Di, Xinzhe Yu, Ji Li, Feng Yang, Hengchao Li, Sijie Hao, Xiaoyi Wang, Lie Yao, Hang He, Qi Ouyang, Deliang Fu, Chen Jin
Journal: Journal of Clinical Oncology (2015)

e15231 Background: Previous researches in pancreatic cancer demonstrated a negative correlation between SPARC expression in the primary tumor and survival benefit, but not for lymph node SPARC expression. We aim to evaluate SPARC expression in various types of tissues and its impact on prognosis. Methods: The expression patterns of SPARC were examined by Immunohistochemistry in resected pancreatic cancer specimens. Kaplan-Meier analyses and Cox proportional hazards regression were used to assess the mortality risk associated with the presence or absence of SPARC status. Results: A total of 222 tissues samples from 73 patients were collected for the evaluation of SPARC expression, which included 73 primary tumor tissues, 73 adjacent normal tissues, 38 metastatic lymph nodes and 38 matched normal lymph nodes. SPARC was expressed in all types of tissues except normal lymph nodes. Positive SPARC expression in primary tumor cell was associated with significant decreased OS (p = 0.007) and DFS (p = 0.003), whereas in other type of tissue didn't show a predictive role for prognosis. Univariate and multivariate analyses both confirmed this significance. Conclusions: SPARC can serve a dual function role as both a predictor for bad prognosis and biomarker for metastatic lymph node in pancreatic cancer patients.
Abstract P103: Childhood- and Adult Neighborhood-Level Variation in Adult Metabolic Syndrome Measures
Authors: Todd R Sponholtz, Ramachandran S Vasan
Journal: Circulation (2019)

Objectives: Metabolic syndrome (MS) risk varies by residential neighborhood across the life-course. We compared the proportional variance of adult MS measures explained at the level of adult and childhood neighborhoods. Methods: We defined neighborhoods as groups of Framingham Offspring Cohort (OS) members whose examination 1 (1971-4) residences were geocoded to within 100 m of ≥1 other group member. We included neighborhoods whose residents had ≥5 children in the Generation 3 Cohort (Gen3) aged 0-19 years at the time of their parent’s first examination. Outcomes were measured from 1971-4 for OS and 2002-5 for Gen3; we analyzed residuals of log-transformed body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and serum high-density lipoprotein (HDL) and -triglycerides, regressed on age and sex. We estimated neighborhood-level intraclass correlations (ICCs) and 95% confidence intervals (95% CIs) of all outcomes using multilevel linear regression. Results: Among 598 Gen 3 participants (mean age 39.8 years, 49.8% men), parental-residence-defined childhood neighborhoods (n=58) explained 6.6% (95% CI: 2.3, 15.5%) and 6.0% (95% CI: 2.1, 15.9%) of the variance in HDL and triglyceride levels, respectively. The neighborhood-level ICC for BMI was 2.4% (95% CI: 0.5, 11.9%); ICCs for blood pressure measures were similar to BMI. Neighborhoods explained none of the variance in any outcome among 772 OS participants (mean age 38.0 years, 49.2% men). Conclusion: Childhood, but not adult, neighborhoods explained a modest percentage of the variance in adult MS measures.
Genomic profile and immune infiltrate in paired ovarian cancer (OC) samples pre- and post-neoadjuvant chemotherapy (NC).
Authors: Alexandra Leary, Catherine Genestie, Julien Adam, Audrey Le Formal, Patricia Pautier, Catherine Lhomme, Romy chen-Min-Tao, Aurelie Auguste
Journal: Journal of Clinical Oncology (2015)

5575 Background: Most studies of OC have analysed tumors at diagnosis, little is known about the evolution of the genomic or immune landscape of OC with NC. Profiling after NC may be informative as the residual tumor may be enriched for resistant clones. Aim: Compare matched post- vs pre-NC tumors to describe changes in immune infiltrate, genomic stability (GS) and characterize the chemo-resistant sub-populations by identifying SCNAs selectively enriched post-NC. Methods: 27 frozen OC samples (13 paired pre/post-NC and 1 subsequent relapse) were subjected to aCGH. GS was evaluated by the % altered genome and the number of altered segments > 15Mbp (N). Changes in copy number alterations (CNA) were considered relevant if log(2)ratio difference in matched post- vs pre-NC samples > 0.5. FFPE samples (N = 66; 33 paired) were scored for % stromal tumor infiltrating lymphocytes (sTILs) on whole sections. Results: Cellularity of frozen samples was high (70-90%) and included 12 high grade serous OC (HGSOC) and 1 low grade SOC. At baseline, HGSOC were unstable with 10 showing N> 10 (range 14-48) and 31%-70% altered genome. LGSOC showed 2% altered genome. GS increased in 8/12 HGSOC resulting in < 2% altered genome post-NC for 3; GS decreased in 2/12 and did not change in 3. CNAs enriched in paired post-vs pre-NC included gains in genes involved in p53 signalling (MDM4, TP53BP2), EMT/senescence (PKD1, ESRP1, RB1CC1), or epigenetic modification (CEBBP, SMARCB1, RBBP7) and changes in DNA repair genes implicated in chemoresponsiveness (PALB2, ERCC4, RAD54B or RAD21). In addition potentially actionable targets were upregulated post NC (AKT3, BRAF, RAS family or FGF6). For the case with 3 samples, the profile at relapse was different from pre-NC but identical to the post-NC. sTILs increased with NC in 48% (16/33) of paired cases, and 6 tumors had ≥ 60% sTILs post-NC. An evaluation of changes in PDL1 with NC is ongoing and will be presented. Conclusions: The immune and genomic landscape of OC changes with NC. Surprisingly a proportion showed increasing TILS and GS. Comparative profiling of post- vs pre-NC tumors could be used to select therapies such as immune or targeted therapies to eradicate the residual lethal clones driving relapse.
Prostate cancer (PCa) incidence and severity in 821 hypogonadal men with and without testosterone therapy (TTh) in a controlled, observational registry implying more than 7,000 patient-years.
Authors: Ahmad Haider, Karim Sultan Haider
Journal: Journal of Clinical Oncology (2019)

304 Background: Guidelines by AUA and EAU state that there is no evidence for an increased PCa risk for testosterone (T) treatment in hypogonadal men. Methods: In a registry study initiated in 2004 in a urology practice, 428 hypogonadal men (T≤350 ng/dL) received T undecanoate 1000 mg every 3 months following an initial 6-month interval for up to 13 years (T-group). 393 hypogonadal men (age range 51-74) opted against TTh (CTRL). Suspicion of or active PCa was excluded by transrectal ultrasound, digital rectal examination and PSA before treatment/observation initiation. Examinations were repeated between one and four times per year. Biopsies were performed when indicated according to EAU Guidelines. Results: In the T-group, 12 (2.8%) , in CTRL, 42 men (10.9%) were diagnosed with PCa. The mean baseline age of PCa patients was 64.9 years in the T-group and 64 in CTRL.In the T-group, the average time span between day of first injection and positive biopsy was 14.2 months (range: 5-18). No patient was diagnosed with PCa beyond 18 months of TTh. In CTRL, PCa was diagnosed at any time during the observation time. In the T-group, radical prostatectomy (RP) was performed in all men. All but 3 patients had Gleason score (GS) ≤6, and all but 1 had a primary GS of 3. Tumor grade was G2 in all 12 (100%), tumor stage T2a in 7 (58%), T2b in 3 (25%), and T2c in 2 (17%) patients. All but 2 patients are back on TTh after an average time of 25 months. In CTRL, RP was performed in all but 6 patients who received radiation therapy (RT). GS was ≤6 in 2 patients, 7 men had a GS of 7, 21 a GS of 8, and 12 a GS of 9. 4 men had a primary Gleason score of 3, 29 had 4, and 9 had 5. Tumor grade was G2 in 9 (21%) and G3 in 33 (79%) patients, tumor stage T2a in 2 (5%), T2c in 1 (2%), T3b in 15 (36%) and T3c in 24 (57%) patients. In CTRL, biochemical recurrence occurred in 11 (26%) patients. These patients received androgen deprivation therapy (ADT). 12 (34%) patients died of whom 7 were on ADT. In the T-group, no biochemical recurrences or deaths occurred during the observation time. Conclusions: Less PCa occurred and severity was lower in testosterone-treated hypogonadal patients compared to untreated hypogonadal controls.
Temozolomide (TMZ) and radiation therapy (RT) combination in elderly patients with glioblastoma: A multicenter retrospective study of AINO (Italian Association of Neuro-Oncology).
Authors: Giuseppe Lombardi, Andrea Pace, Francesco Pasqualetti, Simona Rizzato, Marina Faedi, Elena Anghileri, Elisa Nicolotto, Elena Bazzoli, Luisa Bellu, Veronica Villani, Alessandra Fabi, Patrizia Ferrazza, Lorena Gurrieri, Monia Dall'Agata, Marica Eoli, Alessandro Della Puppa, Ardi Pambuku, Domenico D'Avella, Roberta Ruda, Vittorina Zagonel
Journal: Journal of Clinical Oncology (2015)

e13003 Background: the efficacy of TMZ plus RT in elderly patients (PTS) with glioblastoma (GBM) is unclear. We performed a multicenter retrospective study to analyze prognostic factors and clinical outcome. Methods: inclusion criteria wereage ≥ 65, newly histologically confirmed GBM, ECOG PS 0-2, adjuvant treatment with RT (39.9 Gy/15fr or 60 Gy/30fr) plus TMZ (75mg/m2/die) followed by TMZ alone (150-200mg/m2/die for 5d/28d). Results: we enrolled 237 PTS, 129 M, 108 F; average age was 71 (range 65-84); ECOG PS was 0-1 in 196 PTS and 2 in 41 PTS; radical/subtotal surgery was performed in 108 PTS. MGMT was analyzed in 151 PTS and was methylated in 56%. 71 PTS were treated with RT 39.9Gy, 166 PTS with RT 60Gy. 123 PTS started concomitant therapy within 7 weeks from surgery. Median TMZ cycles was 6 (range 0-31). 3 PTS (1%) had complete response, 19 (8%) partial response, 142 (60%) stable disease, 73 (31%) progression disease. PFS and OS were 11.3 and 17.3 ms. OS was 19.4 vs 13.8 ms for PTS treated with RT 60Gy and 40Gy (p = 0.02); OS was 17.7 vs 16.1ms for PTS treated with radical/subtotal surgery vs partial surgery (p = 0.02); OS was 21.2 vs 13.6 ms for met and unmet MGMG (p < 0.01). No significant difference was showed for PS (0-1 vs 2), time from surgery to start of concomitant therapy ( ≤ or > 7wks), sex and age ( < or ≥ 75 ys). On multivariate analysis, radical/subtotal surgery (HR = 0.5; 95% CI 0.3-0.9), RT 60Gy (HR = 0.5; 95% CI 0.3-0.8), metMGMT (HR = 0.3; 95% CI 0.2-0.5), PS 0-1 (HR = 0.4; 95% CI 0.3-0.7) were independent predictors of longer OS. 54 PTS (23%) reduced/delayed TMZ during therapy. 25 PTS (10%) had grade 3-4 haematological toxicity (17 PTS had thrombocytopenia, 5 neutropenia, 2 pancytopenia, 1 anemia): 8 PTS treated with RT 40Gy and 17 PTS with 60Gy. 6 PTS (2%) showed grade 3-4 non-haematological toxicity: 2 PTS asthenia, 2 hypertransaminasemia, 1 nausea, 1 intestinal perforation. Conclusions: RT+TMZ is effective in elderly PTS with good performance status. Severe haematological toxicity was more frequent in PTS treated with RT 60Gy. Radical/subtotal surgery, RT 60Gy, metMGMT, ECOG PS 0-1 represent predictors of longer survival in elderly PTS with GBM
Hopes, Fears, and Deja Vu Regarding Germline Gene Editing
Authors: John D. Lantos
Journal: JAMA Pediatrics (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 Pediatrics 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 Pediatrics journal
A Novel Prognostic Model That Is Superior to FLIPI-1 and FLIPI-2 and Integrates Clinical and Treatment Factors to Predict Progression-Free Survival and Early Treatment Failure in Patients with Follicular Lymphoma in the GALLIUM Trial
Authors: Farheen Mir, Andrew Grigg, Michael Herold, Wolfgang Hiddemann, Robert Marcus, John F. Seymour, Christopher R Bolen, Andrea Knapp, Aino Launonen, Federico Mattiello, Tina Nielsen, Mikkel Z Oestergaard, Michael Wenger, Carla Casulo
Journal: Blood (2018)
Patient-reported symptoms and impacts of locally advanced or metastatic urothelial cancer (la/mUC) after chemotherapy followed by a PD-1/PD-L1 checkpoint inhibitor (CPI).
Authors: Manasee Shah, Jacob Devine, Sam Wang, Zsolt Hepp, Sonali Shah
Journal: Journal of Clinical Oncology (2019)

380 Background: Published literature on la/mUC patient burden is limited. Patient interviews can help better characterize the symptoms and impacts associated with disease and treatment management. Methods: Patients (pts) aged ≥18 yr with non-resected la/mUC treated with chemotherapy followed by a CPI were recruited. Semi-structured 60 min telephone interviews were conducted; transcripts were analyzed. In a follow-up survey, pts rated the bothersomeness of their symptoms and impacts on quality of life (QoL) on a 0–10 scale (0, not at all bothersome; 10 most bothersome). Results: Twenty-four pts (median age, 55 yrs [range 33–70]) were interviewed; most were female (67%), &lt; 65 yrs (79%) with stage IV mUC (63%). Due to recruitment limitations, this study was conducted in a unique non-resected advanced UC population who were generally younger and included more females than the broader la/mUC population. These pts experienced a range of signs/symptoms and overlap was reported between ongoing disease- and treatment-related symptoms. Fatigue, sexual dysfunction, and sleep disturbances were attributed to both disease and treatment; nausea/vomiting and hair loss were attributed to treatment alone. Common ongoing symptoms were fatigue (92%), hematuria (88%), pain (75%), and urinary symptoms (71%); most salient symptoms (defined as mean bothersome rating ≥5 in ≥50% of pts) were loss of hair, weight, and appetite, as well as fatigue, hematuria, pain, urinary symptoms, and nausea/vomiting. The most salient impacts were those on emotional functioning and family relationships. Most pts did not report significant difficulty with basic activities of daily living (ADLs). Some pts reported challenges with instrumental ADLs (eg, shopping, cooking); most pts reported ncreased reliance on friends and relatives for assistance. Conclusions: Patients with la/mUC treated with chemotherapy and CPI report that symptoms and impacts have profound effects on health-related QoL. The inclusion of instruments within a clinical trial that accurately capture pts’ experiences will enhance understanding of the disease course and the benefits of treatment.
Unintended Consequences of the Right to Try Act for Palliative Care in Pediatric Oncology
Authors: Ashley F. Lanzel, James V. Lavery
Journal: JAMA Oncology (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 Oncology 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 Oncology journal
Outcomes and predictors of life sustaining treatments in patients with metastatic cancer.
Authors: Kah Poh Loh, Meng-Shiou Shieh, Ankit J. Kansagra, Peter Lindenauer, Penelope Pekow, Mihaela Stefan, Tara Lagu
Journal: Journal of Clinical Oncology (2015)

6579 Background: Patients with metastatic cancer admitted to the ICU or requiring invasive mechanical ventilation (IMV) have historically had high mortality rates. However, little is known about how frequently these patients receive life-sustaining treatments (LSTs) or which characteristics are associated with receipt of LSTs. Methods: We used the 2010 California Healthcare Cost and Utilization Project - State Inpatient Database to identify metastatic cancer patients ( ≥ 18 years), focusing on patients with a medical DRGs. Using ICD-9-CM procedure codes, we examined use of LSTs. We stratified patients by the use of LSTs and cancer types and compared patient characteristics and outcomes via chi-square or Wilcoxon tests. We used multivariate logistic regression models to identify predictors for potential use of LSTs and IMV while accounting for the clustering of patients within hospitals. Results: We identified 68,890 admissions among metastatic cancer patients. Mean age was 65 years and 48% were male. Cancer types were divided into lung (18%), breast (8%), colorectal (8%), GU (11%) and others (29%). Approximately 8% of these received at least one LSTs, including IMV (4%), PEG (1%), acute dialysis (1%), and TPN (3%). Receipt of LSTs varied by cancer types. Compared to patients who did not receive these treatments, length of stay (LOS) was longer in patients receiving LSTs [11.0 days vs. 5.5 days; p-value < 0.001] and in-hospital mortality rate was higher (41% vs. 10%, p-value < 0.001). In multivariable models, predictors of receipt of LST included older age, non-white race and greater burden of comorbidities. Compared to lung cancer, breast (OR 0.82, 95% CI 0.71-0.88) and GU cancer (OR 0.75, 95% CI 0.66-0.80) were less likely to receive LSTs. DNR status were marginally associated with the receipt of LSTs (OR 0.95, 95% CI 0.88-0.99) and not associated with the receipt of IMV (OR 1.04, 95% CI 0.94-1.09). Conclusions: Nearly 8% of hospitalized metastatic cancer patients received LSTs. Patients receiving LSTs had a longer LOS and higher in-hospital mortality rates than all hospitalized metastatic cancer patients. Lung or colorectal cancers were associated with the patients receiving LSTs. DNR status was not associated with receiving IMV.
Abstract P184: 2017 ACC/AHA Blood Pressure Classification and Cardiovascular Risk by Sex and Age: a 10-year Follow-up of 17.7 Million Koreans
Authors: Hokyou Lee, Sungha Park, Hyeon Chang Kim
Journal: Circulation (2019)

Introduction: The ACC/AHA has lowered the definition of high blood pressure (BP) in 2017 with emphasis on individual risk assessment. However, in clinical settings without feasible risk calculation tools, it is unclear whether such BP classification alone can accurately stratify cardiovascular disease (CVD) risk across various demographic groups. Hypothesis: We hypothesized that CVD risks according to ACC/AHA BP categories differ by sex and age subgroups. Methods: We followed 17 714 343 persons, who underwent national health screening and had no prior CVD, for 10 years using the Korean National Health Insurance database. BP was classified by ACC/AHA definitions. Stage 1 and 2 hypertensions were further subcategorized into narrower systolic and diastolic BP (SBP/DBP) intervals. Outcome was the first CVD event (myocardial infarction and/or stroke). We used multivariable Cox proportional hazards model, stratified by sex and age subgroups, to calculate hazard ratios (HR) according to BP categories. Results: Effect of high BP on CVD risk varied significantly by sex and age, with greater relative hazards in women and in younger ages (figure). Elevated BP was associated with higher CVD risk, compared with normal BP, in both sexes of age 20-69, but the association was no longer significant after age 70. Among stage 1 or 2 hypertension, CVD risks significantly diverged when the ACC/AHA category was divided into narrower SBP/DBP intervals. For instance, in men of age 50-59, HRs for SBP/DBP &lt;120/80-89, 120-129/80-89, 130-139/&lt;80, and 130-139/80-89 mmHg—all of which are stage 1 hypertensions—were 1.09, 1.20, 1.41, and 1.43, respectively. Similar trends were seen for both sexes, but there was a greater divergence of HRs toward higher pulse pressure in men and in older ages. Conclusion: Effect of high BP on CVD risk varies significantly by sex and age, and heterogeneous risk groups may coexist in the same ACC/AHA BP category. Therefore, an individual-level risk calculation tool is crucial for precise risk assessment in persons with high BP.