tbuckley/cabot-search huggingface dataset:
Immunohistochemical study of tumor microinvasion in blood vessels at non-small cell lung cancer (NSCLC).
Authors: Pavel A. Anistratov, Yury N. Lazutin, Gennadiy Z. Sergostyants, Liubov Yu Vladimirova, Sergey P. Pyltsin, Igor A. Leyman, Anna P. Charitonova
Journal: Journal of Clinical Oncology (2014)

e18532 Background: Neoangiogenesis in the tumor tissue is an important factor of growth and metastasis of malignant neoplasms. Tumor vascular invasion is a prognostic factor for patients with NSCLC, identification of which in samples of tumor tissue with standard staining hematoxylin – eosin present offer from beyond to extensive necrosis foci, expressed inflammatory infiltration, preventing morphological evaluation of vascularization. Methods: The morphological examination of postoperative samples of tumor tissue obtained from 60 patients with NSCLC aged 51 to 73 years; men – 53 (88,4%), women- 7 (11,6%); adenocarcinoma-34 (56,6%), squamous cell carcinoma-26 (43,4)cases; 1B stage (st.)-35(58,3%), 2 st .-20 (33,3%), 3A st.-5 (8,4%) applied immunohistochemical staining of the marker of endothelial cells- CD34, marker of smooth muscle and mioepithelial cells- Muscle Actin and a marker of tumor cells- pan CK(clon AE1/AE3). Desease-free survival (DSF), in the term follow-up of 38 months, was studied in 35 patients with 1B st. of NSCLC. Results: Standard staining preparations hematoxylin -eosin revealed a tumor vascular microinvasion in 33% of patients with NSCLC, immunohistochemical staining of the marker pan CK in 38,3%, with Muscle Actin in 48,3%, with CD 34 in 58,3%. Tumor vascular microinvasion by means of colouring preparations marker CD 34 detected in 50% of patients with 1B-2 st. NSCLC and in 30% of patients with 1B st., at squamous cell carcinoma in 20%, and adenocarcinoma in 35% of cases. The median survival in the subgroup without vascular microinvasion not achieved, in the subgroup with vascular microinvasion amounted to about 37 months. 3 year DFS in the first subgroup amount to 51% in the second subgroup reaches 66% (p=, 0519), i.e. noted the change for the worse of the treatment results at 15%. Conclusions: Thus, immunohistochemical study using antibodies CD34 to endothelial cells significantly increases the frequency of detection of the tumor microinvasion in blood vessels, resulting in a tendency to worsening of the prognosis in patients with no involved in process regional lymph nodes.
Rectal cancer: Characteristics and survival rates of young versus old.
Authors: Shams Aziz Mistry, Harish Madala, Charles Chacko, Jill Gernand, AlMarie Logrono, Madan L. Arora, Radhika Kakarala
Journal: Journal of Clinical Oncology (2014)

e14517 Background: Rectal cancer is detected at a later stage in young patients (YP) (< 50). There has been an increased incidence of rectal cancer in YP. The aim of our study is to compare characteristics of rectal cancer and survival outcome in YP(18-49 years) vs older patients (50+) using the Surveillance, Epidemiology, and End Results (SEER) database Methods: We analyzed a retrospective cohort of patients > 18 years of age with rectal adenocarcinoma from 1991-2010. Continuous and categorical variables are reported using mean (SD), proportions, and percentages. Univariate analysis was done using T-test and Chi-square tests. Multivariate Cox regression analysis was used to evaluate risk adjusted outcomes and to predict the hazard of dying. Kaplan Meier method was used to estimate the survival function. Results: We included 102,167 patients in our study. YP with rectal carcinoma were more likely to be African American (11.9% vs 8.8%; p<0.001), Hispanic(13.3% vs 8.3%; p<0.001) and Asian (10.9% vs 8.3%; p<0.001) as compared to the older patients.YP were more likely to present with distant metastasis (16.7% vs 13.4%; p<0.001) and had more poorly differentiated tumors (13.3 % vs 12.1%; p< 0.001). YP also received more cancer directed surgery (84 % vs 80%; p<0.001) and post-operative radiation (52% vs 39.8; p<0.001) compared to older patients. In contrast to previous studies the five year survival was better for YP (74.3% vs 70.7%; p<0.001). (See table.) After controlling for gender, race, marital status, grade, stage, cancer specific surgery and post-operative radiation, multivariate Cox regression analysis revealed that age is an independent predictor of death, and YP with rectal cancer had a lower risk of dying (HR 0.693; p<0.001). Conclusions: In previous studies younger patients with rectal cancer were found to have poorer or equivalent survival compared to older patients. In contrast, our study shows that young patients less than 50 years of age, have advanced stage rectal cancer at diagnosis but have better survival. Five-year survival rate for rectal cancer patient. Stage of rectal cancer Young (< 50 yrs) N=12,268 Older (≥ 50 years) N=83,232 P-Value Localized 93.3% 87.7% <0.001 Regional 74.2% 66.6% <0.001 Distant 17.3% 13.4% <0.001 Overall 74.3% 70.7% <0.001
Predictors of Outcomes in Patients with Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia at First Relapse in the Era of Tyrosine Kinase Inhibitors
Authors: Iman Aboudalle, Hagop M. Kantarjian, Nicholas J Short, Marina Y. Konopleva, Nitin Jain, Guillermo Garcia-Manero, Rebecca E. Garris, Wei Qiao, Jorge E. Cortes, Susan M. O'Brien, Partow Kebriaei, Tapan M. Kadia, Elias J. Jabbour, Farhad Ravandi
Journal: Blood (2018)
Outcomes of pneumatic dilatation and Heller’s myotomy for achalasia in England between 2005 and 2016
Authors: Philip R Harvey, Ben Coupland, Jemma Mytton, Felicity Evison, Prashant Patel, Nigel J Trudgill
Journal: Gut (2019)

Introduction Achalasia is a disorder characterised by failed relaxation of the lower oesophageal sphincter. The aim of this study was to examine, at a national level, the long-term outcomes of achalasia therapies. Methods Hospital Episode Statistics include diagnostic and procedural data for all English National Health Service–funded hospital admissions. Subjects with a code for achalasia who had their initial treatment between January 2006 and December 2015 were grouped by treatment; pneumatic dilatation (PD) or surgical Heller’s myotomy (HM). Procedural failure was defined as time to a further episode of the same therapy or a change to a different therapy. Up to three PDs were permitted without being considered a therapy failure. Results 6938 subjects were included; 3619 (52.2%) were men and median age at diagnosis was 59 (IQR 43–75) years. 4748 (68.4%) initially received PD and 2190 (31.6%) HM. The perforation rate following PD was 1.6%. Mortality at 30 days was 0.0% for HM and 1.9% for PD, and &lt;8% after perforation following PD. Factors associated with increased mortality after PD included age quintile 66–77 (OR 4.55 (95% CI 2.00 to 10.38), p&lt;0.001), &gt;77 (9.78 (4.33 to 22.06), p&lt;0.001); Charlson comorbidity score &gt;4 (2.87 (2.08 to 3.95), p&lt;0.001); previous HM (2.47 (1.33 to 4.62), p&lt;0.001); and repeat PD 1–3 (1.58 (1.15 to 2.16), p=0.005), &gt;3 (1.97 (1.21 to 3.19), p=0.006). Durability of up to 3 PD and HM over 10 years of follow-up was 86.2% and 81.9%, respectively (p&lt;0.001). Discussion The efficacy of PD for achalasia appears to be greater than HM over 10 years. There was no mortality associated with HM, but 1.9% of subjects died within 30 days of PD. Mortality was associated with increasing age, comorbidity, previous HM and repeat PD.
The EXACT trial: An individualized treatment protocol for solid tumors.
Authors: Gerald Prager, Robert M Mader, Fritz Wrba, Christoph Zielinski
Journal: Journal of Clinical Oncology (2014)

e14002 Background: Currently approved novel targeted agents in the treatment of cancer are limited for certain subtypes of cancer and do not consider an individually expressed druggable target or for an activated signaling pathway. To improve existing therapeutic strategies, there is increasing evidence of benefit by extension of treatment protocols focusing at molecular profile-based treatment decisions. To generate a scientific rationale for an individualized treatment approach, the current protocol was designed. We aimto prospectively validate treatment benefit of an individualized treatment concept based on molecular profiling from paraffin-embedded tumor tissue sections obtained by real time biopsy. Methods: Patients with refractory metastatic cancer without any standard treatment options according to NCCN guidelines and/or ESMO guidelines are eligible for inclusion. Potential therapeutic targets in individual patients’ tumor sections are evaluated via a fully informative genomic tumor profile that analyses DNA via ultrahigh multiplex PCR. Suggested treatment benefit are evaluated to reject the null hypothesis, which is defined as follows: ≤ 40 % of this patient population have a progression free survival (PFS) ratio of ≥ 1.0. Thus, the individual patient serves as his own control for outcome parameters. The alternative proportion P1 (PFS ratio > 1.0) is set at least to 55% using a one-sided exact binomial test at a significance level of 0.0250. The null hypothesis, i.e. no benefit by using this strategy, can be rejected, if at least 30 out of 55 patients treated show a PFS ratio > 1.0. A potential correlation between overall response rate, PFS or overall survival will be assessed by RECIST criteria and evaluated as secondary end points. 10/55 patients have been included so far, allowing a first interim analysis. Results: We aimto prospectively validate treatment benefit of an individualized treatment concept based on molecular profiling from paraffin-embedded tumor tissue sections obtained by real time biopsy. Conclusions: This prospective translational study evaluates an individualized treatment concept based on prospective biomarkers assessed in a real-time biopsy for patients with treatment-refractory cancer.
The diagnostic, predictive, and prognostic role of serum cellular adhesion molecules (VCAM-1, EpCAM) levels in breast cancer patients.
Authors: Nuri Faruk Aykan, Senem Karabulut
Journal: Journal of Clinical Oncology (2014)

e22001 Background: Cellular adhesion molecules (CAMs) play important roles on invasion and metastasis steps of carcinogenesis. The purpose of this study was to determine the clinical significance of two molecules from the subgroup of CAMs, vascular cell adhesion molecule-1 (VCAM-1) and epithelial cell adhesion molecule (EpCAM) in breast cancer patients. Methods: A total of 96 patients with a pathologically confirmed diagnosis of breast cancer were enrolled into this study. Serum VCAM-1 and EpCAM levels were determined by the ELISA method. Age and sex matched 30 healthy controls were included in the analysis. Results: Median age of patients was 48 years old, range (29-80 years). Thirty-seven (39%) patients had metastatic disease. Median follow-up time was 22.6 ± 10.37 months. Twenty-nine (30%) patients had progression and 20 (21%) patients died during follow-up. Median progression-free (PFS) and overall survival (OS) were 8.6±1.7 (%95CI=5-12) month and 35.5±1.5 (%95CI=33-38) month, respectively. Baseline serum EpCAM levels of patients were significantly higher compared to control group (p<0.001) whereas no significant difference in the serum levels of VCAM-1 was observed between the two groups (p=0.47). Similarly, a significant correlation was not found in the serum levels of VCAM-1 and EpCAM (p=0.83).In addition, no significant correlation was detected between the serum VCAM-1 and EpCAM levels and other clinical parameters (p> 0.05). Patients with HER-2 positivite and triple-negative tumors had significantly poorer PFS while metastatic disease and chemotherapy unresponsiveness had significantly adverse effect on OS analysis (PFS p = 0.04 and p = 0.001; OS p<0.001 and p <0.001, respectively). Serum VCAM-1 and EpCAM levels were identified to have a prognostic role on neither PFS nor OS (VCAM-1 p = 0.76, p = 0.32 respectively; EpCAM p= 0.16, p = 0.69, respectively). Conclusions: To the best of our knowledge, this is the first study investigating serum EpCAM levels in breast cancer patients in the literature.Serum levels of EpCAM have diagnostic value in breast cancer patients. However, for both markers predictive and prognostic role could not be determined in these groups of patients.
Epigenetic and Single Cell Analyses Reveal Dual Fate Decision Points in Pre-Primed Hematopoietic Stem Cells during Erythro-Megakaryopoiesis
Authors: Elisabeth F Heuston, Cheryl A. Keller, Jens Lichtenberg, Belinda Giardine, Stacie M Anderson, Bethan Psaila, Nisc Comparative Sequencing Program, Ross C Hardison, David M. Bodine
Journal: Blood (2017)
Adrenomedullin in heart failure: pathophysiology and therapeutic application
Authors: Adriaan A. Voors, Daan Kremer, Christopher Geven, Jozine M. ter Maaten, Joachim Struck, Andreas Bergmann, Peter Pickkers, Marco Metra, Alexandre Mebazaa, Hans‐Dirk Düngen, Javed Butler
Journal: European Journal of Heart Failure (2018)

Adrenomedullin (ADM) is a peptide hormone first discovered in 1993 in pheochromocytoma. It is synthesized by endothelial and vascular smooth muscle cells and diffuses freely between blood and interstitium. Excretion of ADM is stimulated by volume overload to maintain endothelial barrier function. Disruption of the ADM system therefore results in vascular leakage and systemic and pulmonary oedema. In addition, ADM inhibits the renin–angiotensin–aldosterone system. ADM is strongly elevated in patients with sepsis and in patients with acute heart failure. Since hallmarks of both conditions are vascular leakage and tissue oedema, we hypothesize that ADM plays a compensatory role and may exert protective properties against fluid overload and tissue congestion. Recently, a new immunoassay that specifically measures the biologically active ADM (bio‐ADM) has been developed, and might become a biomarker for tissue congestion. As a consequence, measurement of bio‐ADM might potentially be used to guide diuretic therapy in patients with heart failure. In addition, ADM might be used to guide treatment of (pulmonary) oedema or even become a target for therapy. Adrecizumab is a humanized, monoclonal, non‐neutralizing ADM‐binding antibody with a half‐life of 15 days. Adrecizumab binds at the N‐terminal epitope of ADM, leaving the C‐terminal side intact to bind to its receptor. Due to its high molecular weight, the antibody adrecizumab cannot cross the endothelial barrier and consequently remains in the circulation. The observation that adrecizumab increases plasma concentrations of ADM indicates that ADM‐binding by adrecizumab is able to drain ADM from the interstitium into the circulation. We therefore hypothesize that administration of adrecizumab improves vascular integrity, leading to improvement of tissue congestion and thereby may improve clinical outcomes in patients with acute decompensated heart failure. A phase II study with adrecizumab in patients with sepsis is ongoing and a phase II study on the effects of adrecizumab in patients with acute decompensated heart failure with elevated ADM is currently in preparation.
Clinical impact of diverting ileostomy on the dose intensity of adjuvant chemotherapy for colorectal cancer.
Authors: Shusuke Yagi, Eiji Shinozaki, Keisho Chin, Mitsukuni Suenaga, Daisuke Takahari, Mariko Ogura, Takashi Ichimura, Takeru Wakatsuki, Masato Ozaka, Izuma Nakayama, TOMOHIRO MATSUSHIMA, Hiroki Osumi, Kensei Yamaguchi
Journal: Journal of Clinical Oncology (2018)

867 Background: CAPOX as adjuvant chemotherapy is a standard care option for stage III and high risk stage II colorectal cancer(CRC). And then chemotherapy induced diarrhea (CID) is known as one of the dose-limiting toxicities for CAPOX. Although diverting ileostomy is useful for preventing serious complications of high risk anastomosis, it is well recognized that high ileostomy output is hard to manage. Furthermore, the effect of diverting ileostomy on CID of adjuvant chemotherapy is unclear. In this study, we addressed the clinical impact of diverting ileostomy on the dose intensity of adjuvant chemotherapy for CRC. Methods: Patients who diagnosed with stage III colon cancer and stage II or III rectal cancer after curative surgery and received CAPOX as adjuvant chemotherapy during 2011- 2014 were reviewed retrospectively. We investigated the relationship between diverting ileostomy and dose intensity, toxicities and disease-free survival (DFS). Results: 112 patients (median age 60 years, 52% male, 69% colon cancer, 63% stage III, median follow-up 47 months) were enrolled in this study. Of 112 patients, 100 patients were received chemotherapy without ileostomy (non-ileostomy group: NIG) and 12 patients were received chemotherapy with ileostomy (ileostomy group: IG). 112 Patients received 870 chemotherapy cycles. All treatment related grade 3/4 adverse events were documented in 39% of patients in NIG and 33% of patients in IG (P = 0.77). Grade 3/4 of CID occurred in 8% of patients in NIG and 8% of patients in IG (P = 1). Grade 3/4 of neutropenia were recognized in 21% of patients in NIG and 17% of patients in IG (P = 1). Average relative dose intensity (RDI) in NIG were 75.7% and 85.8% for capecitabine and oxaliplatin, respectively. Average RDI of capecitabine and oxaliplatin in IG were 76.1% and 82.7%, respectively. Significant difference of RDI of capecitabine and oxaliplatin were not shown in comparison between NIG and IG (P = 0.93, P = 0.63). The 3-year DFS rate was 85.0% in NIG and 75.0% in IG. The HR for DFS for NIG compared to IG was 1.709 (95% CI, 0.49 to 5.95; P = 0.40). Conclusions: The presence of diverting ileostomy does not affect RDI of CAPOX as adjuvant chemotherapy.
Accelerating innovation in outcomes and quality-of-care research through integrating clinical databases: Pediatric oncology experience in Egypt.
Authors: Ahmad Samir AlFaar, Mohamed Sabry Bakry, Mohamed Kamal, Sameera Ezzat, Iman Zaky, Hala Taha, Amr Ismail, Sherif Abouelnaga
Journal: Journal of Clinical Oncology (2014)

e17573 Background: Children’s Cancer Hospital -Egypt was established to serve as the country major referral center. Within 6 years the hospital has received 13,865 patients with cancer among 19,744 screened ones. With this rapidly growing number the hospital looked for developing a reliable method for examining the quality of care and supporting health services research as an emerging field in the country. The aim of this paper is to describe the role of integrating several databases in providing a 360 view for healthcare picture. Methods: We have developed an online cancer registry database using RedCap data capture system to gather patients data from different sources. This database was integrated with the electronic medical records to share new patients data instantaneously. Two nurses were trained to curate the database daily and act as human quality control gateway. Cancer registry provided data about 19,927 patients were examined between 2007 and 2013. The second aspect was provided by digitizing and Optical Character Recognition of 12,573 pathology paper-based reports. Pathology reports were analysed electronically to extract dates, initial and final diagnoses, gross and microscopic pictures and markers used for diagnosis. A third aspect was added to the model by mining Radiology Information System database to extract 258,632 studies for all patients. Radiological studies were organized to show the type of investigation, time needed and outcome. Results: A unified comprehensive new database was developed showing uncountable number of quality of care indices and correlations between different initial and final timepoints. Those indicators included delay of diagnosis, reporting and difference in outcomes correlated with epidemiological aspects. The time used to develop this database was two weeks in the first time. A standard operating procedures was developed to decrease time during future updates. Conclusions: Accelerated pathway for research can be acquired in any settings including unprivileged low-middle income countries via structured reporting, integration between different databases and using simple information technology skills.
Pelvic sentinel lymph node status and risk of aortic nodal metastasis in patients with endometrial cancer.
Authors: Robert W. Holloway, Jeffrey A. James, Corinne N. Jeppson, Ajit Gubbi, Erica L. Takimoto, Nicole M. Stavitzski, Sarfraz Ahmad
Journal: Journal of Clinical Oncology (2014)

5597 Background: Pelvic sentinel lymph node (SLN) mapping is hypothesized to improve the accuracy of surgical staging. The clinical relevance of isolated tumor cell (ITC) metastasis compared to H&E micro- or macro-metastases in pelvic SLN are unknown. The purpose of this study was to evaluate aortic nodal status (infra-renal [IR] or infra-mesenteric IM]) in relation to pelvic SLN in patients with clinical stage I endometrial cancer (EC). Methods: 80 patients with EC underwent robotic-assisted laparoscopic hysterectomy and pelvic SLN mapping (isosulfan blue and/or indocyanine green with near-infrared imaging) from 4/11-8/13. A systematic pelvic and aortic lymphadenectomy to the left renal vein was performed and data were gathered prospectively. SLN were ultra-sectioned and evaluated with both H&E and IHC stains. The dataset was examined for peri-operative and clinico-pathologic factors including presence and type of lymph node (LN) metastasis (ITC vs. H&E). The disease status of pelvic SLN was compared to aortic nodal status. Results: Mean age was 65.9±12.0 yr, BMI 33.8±8.4 kg/m2, height 65.3±10.6 inches, operative time 178±33 min, and length of hospital stay 1.4±1.1 days. Histologies included: endometrioid G1 (18.8%), G2 (45%), G3 (12.5%), and type II cancers (23.8%). Mean depth of invasion (DOI) was 43.1±30.4% (39% cases >50% DOI) and lymphovascular space invasion was present in 46.3% of cases. Mean pelvic and aortic LN yields were 26.6±16.4 and 12.7±6.4, respectively. 34 (42.5%) patients had pelvic LN metastasis with 33 having (+) SLN [7 (21.2%) ITC vs. 26 (81.8%) H&E]. 15/80 (18.8%) patients had aortic LN metastasis [2 IR, 8 IR+IM, and 5 IM] and all cases had (+) SLN. 15/33 (45.5%) patients with SLN metastasis had aortic metastasis. The risk of aortic metastasis with ITC-SLN was 2/7 (28.6%) vs. 13/26 (50%) for micro- plus macro-metastasis SLN. There were no cases with isolated infra-renal or infra-mesenteric LN metastasis. Conclusions: These findings suggest that SLN metastasis whether identified by IHC isolated tumor cells or H&E pose a significant risk for aortic LN metastasis. The phenomenon of “isolated infra-renal metastasis” in EC appears uncommon with pelvic SLN mapping.
Atlas and Epitome of Ophthalmoscopy and Ophthalmoscopic Diagnosis
Journal: JAMA (1901)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal