tbuckley/cabot-search huggingface dataset:
CT-guided percutaneous nephrostomy and ureteroscopic holmium laser lithotripsy in treatment of complex renal calculi: a report of 32 cases
Authors: Yu-liang Chen, Hai-bin Yu, Xing-hua Luo, Huai-jun Tang, Tian-yi Xie, Ai-jun Sun
Journal: BMJ (2010)

From August 2007 to January 2009 a total of 95 patients with complex renal calculi were treated with CT ( n = 32 ), X-ray ( n = 33 ) or ultrasound ( n = 30 ) guided percutaneous nephrostomy and ureteroscopic holmium laser lithotripsy respectively. The CT guided procedure had lower positioning time,positioning failure rate, complication rate and residual stone rate than those of X-ray and ultrasound localization, particularly had advantages in the stone clearance rate and complications rate ( all P ＜ 0. 05 ).CT guided localization can be chosen in the following conditions: higher kidney position, large staghorn calculi or renal pelvis stones without hydronephrosis, with congenital renal malformations or failure of ultrasound or X-ray localization.

Key words: 
Kidney calculi;  Tomography,X-ray computed
Reference value in normal adult echocardiography: a retrospective study
Authors: Peihua Wu, Chao Yu
Journal: BMJ (2016)

Objective
To observe normal range based on normal adult echocardiography with data mining retrospectively.


Methods
Analyzed the echocardiography data of 15 553 patients who came to Peking university People's Hospital from Nov 2012 to Nov 2014 without obvious abnormalities of cardiac structure and function.The reference range of 15 parameters were calculated and analyzed in correlation with gender, age and other factors for each group.


Results
The reference ranges of basic measurement parameters in two-dimensional echocardiography: main pulmonary artery diameter(MPA) (2.14±0.22)cm, diameter of ascending aorta(asc Aorta)(2.87±0.35)cm; The reference ranges of basic measurement parameters in M-mode echocardiography: aortic root diameter(Ao root diam)(2.82±0.35)cm, left atrial dimension(LA dimension)(3.14±0.37)cm, interventricular septal end-diastole thickness (IVsd) (0.86±0.12)cm, left ventricular internal diameter at end-diastole(LVIDd)(4.67±0.41)cm, left ventricular internal diameter at end-systole (LVIDs)(2.83±0.34)cm, left ventricular posterior wall end-diastolic thickness(LVPWd)(0.85±0.12)cm, end diastolic volume(EDV)(101.21±19.83)ml, end-systole volume(ESV)(31.09±9.07)ml, ejection fraction(EF)(69.55±5.70)%; The reference ranges of basic measurement parameters in pulsed doppler echocardiography: mitral A wave velocity (MVA)(73.14±16.42)cm/s, mitral E wave velocity(MVE)(84.18±16.17)cm/s, E/A(1.21±0.35), aortic peak velocity(Ao V2 max)(124.95±19.87)cm/s.The measured parameters of males were higher than those of females and value of measured was increased with age for example measured parameters in LVIDd(r=0.225, P=0.00), IVSd(r=0.216, P=0.00), LA dimension(r=0.231, P=0.00) and E/A(r=0.212, P=0.00), with age were positive correlated.The range of 15 parameters in this study and the ASE 2015 guide are similar but have slightly different, such as this research shows that men's left ventricular end-diastolic diameter (4.77±0.41) cm, the ASE recommend (5.02±0.41) cm which is smaller than the result of this study. And this study for women (4.60+ 0.40) cm is higher than the ASE recommended (4.50+ 0.36) cm.


Conclusions
Based on preliminary analysis of large data from normal adult echocardiography, the rang of measured values could be used as a normal reference value of echocardiographyfor routine practice in China.


Key words: 
Echocardiography; Data Interpretation, Statistical; Reference Values
Cancer diagnoses and survival rise as 65-year-olds become Medicare eligible.
Authors: Deven C. Patel, Hao He, Mark F. Berry, Chi-Fu Jeffrey Yang, Winston Trope, Natalie Lui, Douglas Z. Liou, Leah Monique Backhus, Joseph B Shrager
Journal: Journal of Clinical Oncology (2020)

2015 Background: A “Medicare effect” has been described to account for increased health care utilization occurring at the age of 65, when individuals become eligible for government-sponsored health care. The existence of such an effect in cancer care, where it would be most likely to reduce mortality, has been unclear. Methods: Patients aged 61-69 diagnosed with lung, breast, colon, or prostate cancer from 2004-2016 were identified using the Surveillance, Epidemiology, and End Results database and dichotomized based on eligibility for Medicare (age 61-64 vs 65-69). Using age-over-age percent change calculations, trends in cancer diagnosis, AJCC staging, and survival were characterized. Results: 134,991 patients were identified with lung cancer; 175,558 with breast; 62,721 with colon; and 238,823 with prostate. The age-over-age growth in the number of cancer diagnoses was highest at age 65 when compared to all other ages within the decade, for all four cancers (Table: p&lt;0.01, p&lt;0.001, p&lt;0.01, p&lt;0.001 respectively). Comparing age 65 diagnoses to the 61-64 year old cohort, the greatest difference for all four cancers was seen in stage I (lung p&lt;0.001; breast p&lt;0.002; colon p&lt;0.001; prostate p&lt;0.02). The older (65-69), Medicare-eligible cohort had higher cancer specific 5-year survival than the 61-64 aged cohort for lung (22.0% vs 21.0%, p&lt;0.01) and colon cancer (66.2% vs 63.2%, p&lt;0.01). Conclusions: The 65 age threshold for Medicare eligibility is associated with more cancer diagnoses, particularly in stage I, resulting in improved cancer-specific survival for some cancers. Near-elderly individuals may be delaying care until the age of 65. A Medicare-for-all system would thus be likely to reduce cancer mortality. [Table: see text]
Combined use of albumin and neutrophil-to-lymphocyte ratio as new prognostic and predictive factor in patients with poorly differentiated neuroendocrine carcinomas.
Authors: Elena Colombo, Paolo Manca, Marta Bini, Achille Bottiglieri, Giacomo Massa, Natalie Prinzi, Martina Torchio, Monica Niger, Francesca Corti, Michele Prisciandaro, Emma Zattarin, Claudia Proto, Marina Chiara Garassino, Massimo Milione, Laura Cattaneo, Maria Di Bartolomeo, Marco Platania, Filippo G. De Braud, Giuseppe Lo Russo, Sara Pusceddu
Journal: Journal of Clinical Oncology (2020)

e15543 Background: Outcomes of patients affected by advanced neuroendocrine carcinomas (NEC) with Ki-67 labeling index &gt; 55% are heterogeneous regardless of the primary tumor site. We explored baseline inflammatory indexes and serum albumin levels to identify markers of response to standard first line chemotherapy. Methods: We retrospectively identified patients with advanced NEC treated with cisplatin (CP) or carboplatin (CB) and etoposide between 2015 and 2019 at the National Cancer Institute of Milan. Linear and Cox regressions were used to investigate, respectively, numeric and time-to-event outcomes. Maximization of log-rank statistics was used for optimal cutoffs finding. An artificial intelligence algorithm, random forest, was used to rank the impact of different clinical features on OS and PFS. Results: A total of 81 consecutive patients with different primary tumors (53 small cell lung carcinoma, 12 large cell neuroendocrine carcinoma, 10 gastrointestinal neuroendocrine carcinoma and 6 Merkel cell carcinoma) either treated with CP (n = 39) or CB (n = 42) were analyzed. Overall response rate (ORR), median progression free survival (PFS) and median overall survival (OS) were, respectively, 50.6%, 5.5 months (m) and 9.1m. Considered together, high serum albumin (SA &gt; 3.5 g/dl) and low neutrophile-to-lymphocyte ratio (NLR &lt; 3.59) identified a group of patients (n = 42) with longer median PFS and OS compared to the rest of the cohort (8.3m vs 1.5m, HR 3.58, CI 2.14-6.02, p &lt; 0.001 for PFS and 12.6m vs 4.4m, HR 3.11, CI 1.88-5.18, p &lt; 0.001 for OS); within this group a higher ORR (74% vs 36%, OR 5.01, CI 1.83-14.64, p = 0.002) was observed. Two multivariate models showed statistically significant associations of SA and NLR with PFS ( p = 0.017 and p = 0.005) and OS ( p = 0.016 and p = 0.036), independent of baseline ECOG performance status, age, sex, body mass index, smoking status, stage, hepatic tumor burden, primary site, histology, lactate dehydrogenase (LDH) serum levels, type of platinating agent and number of cycles. Two random forest models ranked SA, NLR and LDH as the most important factors for PFS and OS prediction. Conclusions: In the setting of advanced NEC with Ki-67 &gt; 55% the combined use of SA and NLR identified two groups of patients with remarkably different outcomes, suggesting that these serum markers at baseline may have prognostic implications and be predictive of response to platinating agents. Prospective studies should validate these preliminary findings.
Recruiting patients with advanced cancer to participate in a non-opioid intervention for chronic pain management.
Authors: Preethi Selvan, Katherine Myers-Coffman, Karolina Bryl, Jasmine Tenpa Lama, Brigette Sutton, Jacelyn Biondo, Carrie Cottone, Clarissa Lacson, Allison Millstein, Joshua Banks, Brooke Worster, Amy Leader, Joke Bradt
Journal: Journal of Clinical Oncology (2020)

e14085 Background: Chronic pain related to advanced cancer is difficult to treat. In addition to traditional analgesics, non-pharmacological interventions, such as music therapy, may help alleviate pain in this population. Research studies to test the efficacy of these non-pharmacological interventions are necessary and important. However, recruiting patients with advanced cancer to participate in such interventions can be challenging. Identifying effective sources of referrals and barriers to participation may help increase recruitment rates in the future. Methods: We recruited patients with advanced cancer (stage III or IV) with chronic pain from two major hospital systems to participate in a pain management interventional study. The experimental group received individualized music therapy, while the control group received talk therapy. Participants attended six weekly sessions at the hospital and were compensated for time and travel. Recruitment methods included referrals from care teams, advertisement through flyers and posters, EMR chart reviews, and in-person recruitment at multiple infusion centers. Missing data was excluded from analyses. Chi-square tests assessed significant differences between groups. Results: Of 594 patients that were referred to the study, 7% enrolled (n = 40), 35% declined (n = 208), and 58% were ineligible (n = 346). Forty-seven percent (n = 19) of enrolled participants were female; race/ethnic distributions were the following: African American/Black (55%; n = 22), Caucasian/White (28%; n = 11), or other (17%; n = 7). The most effective recruitment method was through self-referral; of the 40 patients enrolled in the study, 9 (23%) were enrolled through this method. There were no statistically significant differences between referral source and enrollment. The top three reasons patients declined to participate included lack of interest (32%; n = 67), lack of time and/or energy (28%; n = 59), and lack of transportation (16%, n = 34). Conclusions: Although there were no differences in referral sources, more patients were enrolled through self-referral or in-person recruitment, showing the power of personal motivation and personal touch. While lack of participation due to interest, time, or energy are hard to overcome, future research should consider campaigns to reach patients who are motivated to participate. In addition to referrals, resources for in-person recruitment and transportation to help alleviate barriers to research participation should be considered.
CT appearances of pulmonary cryptococcosis: a report of 4 cases
Authors: 屈艳娟, 廖美焱, 田志雄, 胡浩, 汪必成
Journal: BMJ (2010)

The X-ray computed tomography (CT) appearance of 4 cases with pulmonary cryptococcosis (PC) diagnosed by pathological examination in our hospital was retrospectively analyzed. The appearances of PC on CT were various: solitary lesion in 1 case, multiple lesions in single lobe in 2, and multiple lesions in multiple lobes in 1. There were total 52 lesions in 4 cases; the diameter of nodules or masses was 3 - 75 mm. Cavitations were found in 1 case; lesions appeared obviously enhanced and one lesion showed central necrosis. Two cases underwent pulmonary lobectomy; and 2 cases received core cutting needle biopsies, after antifungal therapy for 3 months to 1 year the lesions showed being absorbed. In summary, the CT appearance of PC is non-specific with various modes and forms. PC should be considered when multiple nodules or masses scattered in subpleural zone, accompanied with ground-glass opacity and obviously enhanced. The examination of pathogen and pathology at the beginning is crucial for improving diagnostic accuracy.

Key words: 
Cryptococcosis ;  Tomography,X-ray computed ;
Specific organ metastases and survival of advanced non-small cell lung cancer (NSCLC) patients with EGFR mutation.
Authors: Tiantian Shi, Long Wang, Zhisong Fan, Li Feng, Jing Han, Yu Su, Xinliang Zhou, Jing Zuo, Fengling Liu, Da Jiang, Xiaoli Xu, Yudong Wang
Journal: Journal of Clinical Oncology (2020)

e21527 Background: The retrospective study was performed to evaluate the clinicopathological characteristics and survival associated with distant metastasis from advanced NSCLC with EGFR mutation. Methods: The records of metastasis NSCLC patients with EGFR mutation at the time of diagnosis between 2012 and 2018 were reviewed. The Kaplan-Meier method was used to assess survival curves and the log-rank test was used in the univariate analysis. The multivariate survival analysis were performed using the Cox proportional hazards model to investigate the effects of clinicopathological factors on survival. All the statistical analyses were performed using SPSS 23.0 statistical software and a statistically significant difference was determined as P &lt; 0.05. Results: A total of 258 NSCLC patients with EGFR mutation were enrolled in this study, including 146 cases of female (56.6%), 241 cases of adenocarcinoma (93.4%) and 212 cases of non-smokers (82.2%). Among these patients, 65(25.2%), 111(43.0%), 22(8.5%), 107 (41.5%), 11(4.3%), 87 (33.7%), 65 (25.2%) had brain, bone, liver, lung, adrenal gland, pleural metastasis and extrathoracic lymph node metastases, respectively. The median OS of total patients was 32.9 months (95% CI: 29.8-36.0). In the univariate analysis, patients with metastases to the bone (p = 0.001), liver (p = 0.012), extrathoracic lymph node(p = 0.006), and pleural(p = 0.008) exhibited a poorer survival compared to those without metastases to these regions. Abdominal metastases (p = 0.005) and extremity metastases (p = 0.002) were statistically independent prognostic factors. Association between metastatic region and the response to TKI treatment, liver metastases (p = 0.033), extrathoracic lymph node metastases (p = 0.000) and bone metastases (p = 0.009) were correlated with the poor response of TKI treatment, and the abdominal metastasis ( p= 0.029) and extremity metastases ( p= 0.016) were correlated with the poor response of TKI treatment. Conclusions: Bone metastases, liver metastases, extrathoracic lymph node metastases and pleural metastases were independent prognostic factors of NSCLC patients with EGFR mutation. Liver metastases, extrathoracic lymph node metastases, and bone metastases were correlated with the poor response of TKI treatment.
Update of NGS analysis of Italian survey of second tumors in patients with diagnosis of GIST (gastrointestinal stromal tumor).
Authors: Silvia Gasperoni, Francesca Castiglione, Margherita Vannucchi, Laura Papi, Elena Fumagalli, Sara Manglaviti, Bruno Vincenzi, Alessandro Mazzocca, Margherita Nannini, Giovanni Vancheri, Tommaso Adragna, Margaret Ottaviano, Giovannella Palmieri, Giulia Meoni, Angela Stefania Ribecco, Giovanni Grignani, Francesco Tolomeo, Lorenzo Tofani, Agnese Paderi, Enrico Mini
Journal: Journal of Clinical Oncology (2020)

e23518 Background: In patients with GIST, literature reports a risk of second primary tumors between 4.5% and 33% with different distribution in the worldwide. The network of 7 italian EURACAN centers has collected clinical and molecular features of GIST patients with second primary tumors. Methods: We reviewed the clinical characteristics of 201 patients with GIST and second primary tumors in order to evaluate association between risk of dead and each possible factor, using Kaplan meier curve, log-rank test and Cox model for Hazard Ratio and it’s interval Confidence 95% estimation. Furthermore, NGS analysis ( 56 gene onco panel) in 72 patients with GIST was performed. Results: On the basis of the significant correlation previously observed between the Miettinen risk criteria of GIST (low/very low) and the incidence of second primary tumors (gastrointestinal tumors),P &lt; 0.001 (Abstr 11032 ASCO 2019), we observed in these patients a median age of diagnosis of GIST of 68, with prevalent gastric site localization ( KIT exon 11 mutation), NF1 and Lynch (kit/pdgfra WT) syndromes in the low risk subgroup. The more frequent site of second epithelial tumor in gastrointestinal tract was the colon followed by gastric, pancreatic and biliary tract. In patients with GIST with low-very low risk according Miettinen classification, after a median follow-up period of 25 years, we have observed that the gastroenteric site of second tumors occurrence is significantly related to the survival (p &lt; .0003). In the NGS analysis of the GIST we observed the pathogenetic somatic mutations in the following genes: BRCA 2 (p.Thr2125fs), but germline test negative, TP53 (p.Arg192*,p.Gly244Ser,p.His168Leu), RET (p.Lys120Asn, p.His168Leu, p.Thr930Met ), NRAS (p.Gly134Asp), CTNNB1 (p.Ser45Phe), MSH6 (P.Ala164Val), SMARCB1 (p.Arg192), VHL (p.Gly93Val), PTEN(p.Val158Ile, p.Asn323fs), STK1I (p.Arg40Cys), SMO (p.Glu194Lys), EGFR (p.Gly721Asp), ATM (p.Asp2708Asn), ERBB4 (p.Asn181Ile). Conclusions: In our analysis patients with GIST (low-very low classes according to Miettinen) have significant risk to death because of second primary tumors in gastrointestinal tract. Specific attention to gastrointestinal screening during the follow-up of GIST (low and very low risk) is required.
Clinical and patho-genomic characteristics of concomitant mutated status of TP53, EGFR, KRAS genes in Chinese patients with resected lung adenocarcinoma.
Authors: Qiu Yuan, Haihong Yang, Hanzhang Chen, Qiuhua Deng, Liping Liu, Dakai Xiao, Yongping Lin, Jianxing He, Changbin Zhu, Weiwei Li, Di Shao, Wenxi Jiang
Journal: Journal of Clinical Oncology (2020)

e21024 Background: Alterations of TP53, EGFR, KRAS genes are of importance in LUAD etiology, vital prognostic markers as well as therapeutic targets as recently reported. In addition, in advanced or metastatic NSCLC, concomitant mutations of TP53 with EGFR or KRAS closely associated with prognosis and TKIs’ efficacy. While, distribution of concomitant mutations of TP53, EGFR and KRAS in early stage or resectable LUAD remained to be elucidated. Methods: 434 patients with defined pathological diagnosis of LUAD were recruited from 1 st .Jan.2019-31 st .Dec.2019, which made 468 FFPE blocks for the study. Histology and composition were given by authorized by pathologist. Genomic DNA from FFPE samples and peripheral blood was extracted. 636 cancer-related genes were specifically captured and sequenced by MGI-seq 2000. Association of concomitant status with clinical and genomic characteristics was further analyzed. Results: Generally, TP53, EGFR and KRAS mutation rate is 26.7%, 60.9% and 10% respectively. Among these samples, Subtypes of EGFR mutations significantly differed in between tumors rising in left and right lung (P = 0.048). Tumors with KRAS mutations occurred more easily in right lung than those with TP53 or EGFR mutations (P = 0.012, P = 0.043 respectively). In addition, histology subtype and clinical stage were closely associated with TP53, EGFR and KRAS mutation status (P &lt; 0.001). 90 samples (19.2%) carried concomitant TP53 and EGFR mutation, 14 samples (3%) were TP53/KRAS co-mutated. LUAD samples with EGFR amplification had higher rate of concomitant TP53/EGFR mutations (RR:1.1,95%CI: 1.032 to 1.159,P = 0.0009). Moreover, KRAS G13 mutated samples more easily co-mutated with TP53 mutations compared with those with mutations in G12 loci (RR:1.33,95%CI: 1.24 to 1.37,P = 0.024). Further, samples with non-concomitant TP53 mutations had highest level of tumor mutation burden (muts/Mb) (median TMB = 9.74 vs 2.05 for TP53/EGFR/KRAS wild type, P &lt; 0.0001). Samples with concomitant TP53/EGFR mutations and TP53/KRAS mutations displayed higher TMB level than their non-concomitant compartment (P &lt; 0.001 and P = 0.05 respectively). Conclusions: TP53,EGFR and KRAS mutations and their concomitant mutation status displayed diverse correlation with spatial, clinical and genomic characteristics in resectable LUAD patients. This correlation may indicate complex biological heterogeneity of LUAD which may need further exploration.
Postoperative XELOX therapy for patients with curatively resected high-risk stage II and stage III rectal cancer without preoperative chemoradiation: A prospective, multicenter, open-label, single arm phase II study.
Authors: Takeshi Kato, Masataka Ikeda, Atsuyo Ikeda, Junichi Hasegawa, Hirofumi Ota, Tatsushi Shingai, Masayoshi Yasui, Hitoshi Fujii, Yasuhiro Miyake, Mamoru Uemura, Chu Matsuda, Taroh Satoh, Tsunekazu Mizushima, Yuichiro Doki, Hidetoshi Eguchi
Journal: Journal of Clinical Oncology (2020)

e16039 Background: Preoperative 5-FU-based chemoradiation is currently a standard treatment for advanced rectal cancer, particularly in Western countries. Although it reduced the local recurrence, it could not necessarily improve overall survival. Furthermore, it can also produce adverse effects and long-term sphincter function deficiency. Adjuvant oxaliplatin plus capecitabine (XELOX) is a recommended regimen for patients with curatively resected colon cancer. However, the efficacy of postoperative adjuvant therapy for rectal cancer patients who have not undergone preoperative chemoradiation remains unknown. We aimed to evaluate the efficacy of surgery and postoperative XELOX without preoperative chemoradiation for treating rectal cancer. Methods: We performed a prospective, multicenter, open-label, single arm phase II study. Patients with curatively resected high-risk stages II and III rectal cancer who had not undergone preoperative therapy were treated with a 120 min intravenous infusion of oxaliplatin (130 mg/m 2 ) on day 1 and capecitabine (2,000 mg/m 2 /day) in 2 divided doses for 14 days of a 3-week cycle, for a total of 8 cycles (24 weeks). The primary endpoint was 3-year disease-free survival (DFS). Results: Between August 2012 and June 2015, 60 men and 47 women with a median age was 63 years (range: 29–77 years) were enrolled. Ninety-three patients had Eastern Cooperative Oncology Group performance status scores of ‘0’ and 14 had scores of ‘1’. Tumors were located in the upper and lower rectums in 54 and 48 patients, respectively; 8 patients had stage II disease and 99 had stage III. The 3-year DFS was 70.1% (95% confidence interval, 60.8–78.0%) and 33 patients (31%) experienced recurrence, most commonly in the lung (16 patients) followed by local recurrence (9) and hepatic recurrence (7). Conclusions: Postoperative XELOX without preoperative chemoradiation is effective for rectal cancer and provides good 3-year DFS prospects.And this is probably the first and last report in the world for such cases. Trial registration: This clinical trial was registered in the University Hospital Medical Information Network registry system as UMIN000008634 at Aug 06, 2012.