Cancer

Patients with localized non-Hodgkin lymphoma involving the thyroid gland have an excellent prognosis after combined modality treatment with chemotherapy and radiation therapy. The International Prognostic Index is a significant prognostic indicator.

A newly diagnosed patient with low grade lymphoma presented with abnormal hemostatic assays and a bleeding disorder. Further studies demonstrated an acquired prothrombin deficiency due to a noninhibitory antibody.

Pediatric natural killer cell lymphomas are rare but rapidly can become fatal. High dose chemotherapy followed by stem cell rescue appears to be an effective treatment for pediatric patients with this very rare malignancy.

State-of-the-art mammography, tumor excision with 2 cm macroscopically free margins, and meticulous microscopic analysis of the margins supported by specimen X-rays are required to identify breast carcinomas of limited extent (BCLE), the proper tumor profile for conventional conserving treatment. The place of BCLE as the potential candidate for clinical trial on breast-conserving surgery alone without radiation therapy is postulated and discussed.

Although fixed schedule dose reduction is the conventional management for delivering chemotherapeutic agents to patients with hepatic dysfunction, the authors believe that an alternate strategy of dividing the dose over time represents an extension or complement to the current approach.

The combination of vinorelbine and paclitaxel without or with granulocyte colony-stimulating factor is a well tolerated regimen at the recommended doses and is biologically active in patients with metastatic breast carcinoma.

A highly significant association was found between polymorphism in both tumor necrosis factor-α and heat shock protein 70 (hsp70-2) genes and breast carcinoma in Tunisians. More noteworthy, these polymorphisms have been implicated in the prognosis of breast carcinoma.

The results of the current study did not support a role for personality in the early development of breast carcinoma in 2224 older, asymptomatic women attending a free community mammography screening program.

See also pages 686–97, this issue.

Highly threatening life stressors and social support interact to increase the risk of breast carcinoma in susceptible individuals.

See also pages 679–85, this issue.

A clinicopathologic study of 30 patients found macroscopic elevation and invasion of the submucosa to be characteristics of early-stage mucinous gastric carcinoma.. The frequency of lymph node metastasis and prognosis of patients, however, did not differ between mucinous and nonmucinous gastric carcinomas. In patients who had early-stage tumors, the mucinous histologic type did not appear to influence outcome adversely after gastrectomy.

Irinotecan (CPT-11; 350 mg/m² administered every 3 weeks) is an active and feasible first-line chemotherapy regimen for patients with colorectal carcinoma. The overall safety data confirmed CPT-11 as a well-tolerated treatment.

A Phase I study was carried out of irinotecan (CPT-11) plus chronomodulated infusion of 5-fluorouracil (5-FU) and folinic acid (FA) in the treatment of patients with advanced colorectal carcinoma. The recommended doses for Phase II trials is CPT-11 325 mg/m² on Day 1 followed by a chronomodulated infusion of 5-FU 700 mg/m² and FA 150 mg/m² from Day 1 to Day 5, with each course repeated every 3 weeks.

In comparative genomic hybridization, it was suggested that gain of 7q, 8q, 13q, 20q and loss of 17p, and 18q (and especially gain of 20q) in patients with primary colorectal carcinoma may be correlated with the spread of metastasis of the liver.

Patients with colorectal carcinoma who showed p53 mutations in their metastatic lesions had a better survival after undergoing liver resection compared with patients who had metastatic lesions with wild-type p53. The explanation for this finding remains unclear, and there may be several explanations, such as altered responsiveness to growth factor exposure or the presence of other critical genetic defects in patients with wild-type p53 metastases.

An analysis of 22 pair-matched benign and malignant prostate carcinoma tissue samples that were obtained from same patients demonstrated the overexpression of lipoxygenase-5 in prostate adenocarcinoma. It is suggested that inhibitors of the arachidonic acid pathway in general and selective lipoxygenase-5 inhibitors in particular may be useful for disease prevention or for therapy in patients with prostate carcinoma.

Long term repeated screening was important in the subjects with prostate specific antigen (PSA) levels of 4.0 ng/mL or lower. The risk for prostate carcinoma in individuals with PSA levels of 4.0 ng/mL or lower was shown.

Adjuvant whole abdominal radiotherapy given to 58 patients after total abdominal hysterectomy and bilateral salpingo-oophorectomy for Stages I–IIIa uterine papillary serous carcinoma appeared to result in improved survival compared with 20 patients who did not receive this treatment. In a multivariate analysis, the International Federation of Gynecology and Obstetrics (FIGO) stage, but not p53 over-expression or percent of papillary serous component in the tumor, was predictive of outcome.

There is a curative potential for interstitial brachytherapy in women with Stage I–III primary vaginal carcinoma.

Although allogeneic blood transfusion may have immunosuppressive effects, perioperative blood transfusions did not influence the cancer free survival rate in patients with hepatocellular carcinoma.

Biochemical and molecular analysis was performed on a newly diagnosed patient with primary pulmonary osteosarcoma. High overexpression of BCL-2 and cyclin D was demonstrated as well as a significant degree of genomic instability. This may contribute toward the unique tumor phenotype and relative chemoresistance of this rare malignancy.

Patterns of ganglioside biosynthesis differ strikingly between tumors from patients younger than 1 year of age (whether diagnosed clinically or by screening) and those older than 1 year of age. These findings support the view that alterations in ganglioside profiles may be linked to the pathogenesis of aggressive tumors.

The authors report on the analysis of clinicopathologic factors associated with disease specific and metastasis free survival in adult patients with rhabdomyosarcoma who were treated at a single institution.

Central venous device-related bloodstream infection and device-related thrombosis (DRT) are significant complications that can occur during moderate dose continuous-infusion interleukin-2 therapy. Low dose warfarin did not prevent DRT when started after device placement.

The similar pharmacokinetics of MitoExtra (ME) and mitomycin C (MMC) suggest complete release of MMC from the hydroxypropyl-B -cyclodextrin carrier contained in the ME formulation.

Epigallocatechin-3-gallate, the most prevalent flavanol of green tea, is a potent inhibitor of gelatinases. Epigallocatechin-3-gallate at micromolar concentrations inhibits in vitro invasion and proliferation of transformed cells and is an orally available pharmacologic agent that may confer the antiangiogenic and antimetastatic activity associated with green tea.

The rectal epithelial proliferation of adenoma patients who received 1-year supplementation of 3.75 g calcium carbonate/day was reduced significantly compared with nonintervened adenoma patients. This effect was influenced significantly by dietary intakes of fat, carbohydrate, and fiber.

The authors conducted a population-based matched cohort study examining the risks of developing cancer in patients with inflammatory bowel disease. The study found similar increased risks for developing colon carcinoma and hepatobiliary carcinoma among patients with Crohn disease and ulcerative colitis, an increased risk of developing rectal carcinoma among patients with ulcerative colitis, and an increased risk of developing lymphoma among males with Crohn disease.

Breast carcinoma presents 1 decade earlier in Mexican women than in Western European, Canadian, or American women, but at similar age to Japanese and Latin American women.

Survival among African-American women with cervical carcinoma is equal to that of their Caucasian counterparts when treatment is provided in an equal access health care system.

The association between cutaneous melanoma and other nonmelanoma carcinomas may provide insight into its pathogenesis. The authors report a statistically significant overrepresentation of non-Hodgkin lymphoma among cutaneous melanoma survivors and vice versa. These findings may provide insight into the pathogenesis of both malignancies.