Cancer

Allogeneic hematopoietic cell transplantation utilizing a peripheral blood allograft manipulated via low-density enrichment with a Percoll class gradient was feasible and safe, resulting in rapid engraftment and no occurrence of graft failure in examinable patients. However, the anticipated benefit of enrichment for a CD4−/CD8− double-negative cell population, which in preclinical studies suppressed graft versus host disease (GVHD), was observed in only a few patients, and there was no reduction in the expected incidence of GVHD.

Anemia is a predictor of survival for patients with cancer independent of the type of malignancy involved, and it must be considered in planning the treatment of these patients.

Gene methylation of p15 and p16 was found to lack prognostic significance in adult acute leukemias.

Dynamic magnetic resonance imaging estimates of regional contrast access in patients with resectable primary nonmetastatic osteosarcoma after preoperative chemotherapy, when combined with tumor size, holds promise for the identification of patients at risk of recurrence. The availability of such imaging-based response predictors could facilitate the development of risk-adapted treatment approaches.

In this study, the authors demonstrate that many men with prostate carcinoma and no history of androgen-deprivation therapy have low bone mineral density. Risk factors for osteoporosis, including low dietary calcium intake, hypogonadism, and hypovitaminosis D, are common.

A review of 680 patients receiving adjuvant chemotherapy for the treatment of breast carcinoma between 1980 and 1990 suggests a better prognosis for patients experiencing myelosuppression and for those included in a clinical trial.

A recent report suggested that the number of lymph nodes examined was a strong independent predictor of survival in patients with lymph node-negative breast carcinoma. However, in the larger study population used in the current report, there was no evidence that survival was related to the number of lymph nodes examined.

The three-dimensional anatomic characteristics of ductal anastomoses in an entire breast were studied using a computer-assisted complete reconstruction of all mammary ductal/lobular systems in a surgical specimen.

In 185 women who were diagnosed with Stage 0–II breast carcinoma from 3 months to 18 years previously and who underwent breast-conserving surgical treatment and radiotherapy, self-reported functional status (e.g., arm stiffness), and particularly breast specific pain, was related more consistently to quality-of-life indicators than was self-reported cosmetic status.

See accompanying article on pages 2282–7, this issue.

In 54 women who were diagnosed with Stage 0–II breast carcinoma from 9 months to 18 years previously and who underwent breast-conserving surgical treatment and radiotherapy, objectively rated arm edema was related significantly to quality-of-life (QOL) indicators. This functional outcome of treatment evidenced stronger relations with QOL indicators compared with an objective index of breast cosmesis.

See accompanying article on pages 2273–81, this issue.

Epirubicin, cisplatin, uracil and tegafur, and leucovorin combination chemotherapy is highly active in the treatment of advanced gastric carcinoma.

Concurrent hypermethylation of multiple tumor-related genes was detected frequently in gastric carcinoma and its adjacent normal tissues, which suggested the early involvement of aberrant methylation in the gastric carcinogenesis pathway.

This article defines the outcomes of treatment for patients with nonmetastatic prostate carcinoma who were diagnosed in the era before the advent of prostate specific antigen screening and were treated with watchful waiting, radiotherapy, or radical prostatectomy. However, comparisons of outcomes for patients in different treatment groups are treacherous given the bias due to patient selection.

Human papillomavirus DNA presence does not seem to influence disease evolution and prognosis in invasive penile carcinoma.

With the aid of advanced computational tools, quantitative pathology information extracted from biopsy specimens has been shown to enhance the prediction of organ-confined prostate carcinoma. Ordinal logistic regression and artificial neural network methodologies were used to train patient-specific statistical models to predict disease stage within a well-characterized set of patients. When challenged with an independent testing set, these trained computational models were able to predict with accuracy an organ-confined prostate carcinoma.

Neoadjuvant chemotherapy in ovarian carcinoma help to select patients for feasible and less aggressive interval debulking.

Previous experience has shown that most patients with anaplastic thyroid cancer present with advanced disease and die soon after diagnosis. However, selected patients who had localized tumors were found to live for an extended period after they were treated with complete surgical resection plus postoperative adjuvant chemotherapy and irradiation.

By dividing patients with angiocentric lymphoma of the head and neck into two groups according to whether their tumors were positive or negative for the cytotoxic granule-associated protein, granzyme B, and comparing their clinicopathologic and immunohistochemical findings, patterns of disease failure, and survival data, it was found that granzyme B may be useful as an additional marker for identifying patients with natural killer/T-cell lymphoma and as a prognostic indicator for risk assessment in patients with angiocentric lymphoma of the head and neck.

Women seem to have a better prognosis than men after undergoing irradiation. Accelerated hyperfractionated irradiation in women did not provide significantly better treatment outcomes compared with conventional fractionation.

Treatment with radiotherapy did not cause negative short-term effects on attentional and memory functions in patients with brain tumors who received a radiation dose of 54.5 grays. The cognitive deficits found in these patients were evident at baseline before radiotherapy.

The authors performed a pharmacokinetic study of direct intralesional injection of cisplatin/epinephrine/bovine collagen gel into hepatocellular carcinoma. The results showed that this novel technology is capable of delaying cisplatin release from the tumor into systemic circulation.

The efficacy of postoperative epirubicin and 5-FU was evaluated in patients with hepatocellular carcinoma that had been treated by radical resection. Metaanalysis of the results of three randomized control trials showed that these regimens were detrimental to disease-free and overall survival rates in cirrhotic patients.

Increased levels of insulin-like growth factor-2 (IGF-2) after transcatheter arterial chemoembolization (TACE), a common occurrence in patients with large-sized tumors and high serum α-fetoprotein levels, are reported to be associated with the development of metastatic hepatocellular carcinoma after TACE.

Preoperative chemotherapy was shown to decrease the risk of visceral metastasis in N2 nonsmall-cell lung carcinoma patients but was associated with a high rate of brain metastasis. It was concluded that prophylactic cranial irradiation should be reinvestigated in future clinical trials.

The sentinel lymph node (SLN) status has a strong additional value in predicting a minimum disease free period of 3 years after the SLN procedure. Patients with a positive SLN have a poorer prognosis than those with a negative SLN.

Regional tumor recurrences of melanoma were detected earlier with ultrasound B-scan than with physical examination. Better overall survival was noted in patients who had smaller metastases and a lower number of metastases.

Colorectal carcinomas with microsatellite instability have distinct molecular etiology and clinicopathologic features. Tumor-infiltrating lymphocytes may provide an economical indicator of colorectal carcinomas to test for microsatellite instability.

Patients who have undergone resection for lymph node positive esophageal carcinoma are at high risk of disease recurrence and early death. The results of this study indicate that postoperative chemoradiation therapy appears to prolong survival in this patient population.

Substantial dose escalation with minimal toxicity was permitted by weekly dosing with oral calcitriol. Peak serum calcitriol levels in the range required for antiproliferative effects in vitro were achievable with weekly dosing.

More than one extranodal site of disease, bulky disease, and an at least 1.1-fold elevation in the serum lactate dehydrogenase (LDH) level were found to constitute independent, adverse prognostic factors for progression-free survival in patients with aggressive lymphoma treated with a chemotherapy regimen comprised of cyclophosphamide, doxorubicin, vincristine, and prednisone with or without consolidated radiotherapy. Age > 60 years, bulky disease, and an at least 1.1-fold elevation in the serum LDH level also were found to be adverse prognostic factors for overall survival. Involved-field radiotherapy should be considered in patients with bulky lymphomas.

Myocutaneous inflammatory reactions caused by intra-arterial chemotherapy should be prevented, if possible, to obtain good limb function and chemotherapeutic effects in patients who undergo this type of chemotherapy. Resection of necrotic tissue is mandatory to relieve pain.

Females with localized rhabdomyosarcoma (RMS) of the genital tract are reported to have a 5-year survival of 87%. RMS at this site should be treated with combination chemotherapy, a conservative surgical approach, and the use of radiotherapy in selected patients. The best outcome is observed in patients ages 1–9 years, in whom the 5-year survival is reported to be 98% with multimodal therapy.

Untreated cancer was found to follow the inverse of a Gompertz growth curve. Findings were derived from statistical modeling of archival data. Increased survival rates were dependent on stage at initial treatment thus demonstrating the need for screening and early treatment.

Lung carcinoma disproportionately affects the African-American community. The current work examines issues germane to lung carcinoma in the African-American community including incidence, survival, tobacco exposure, occupational exposure, susceptibility to carcinogens, and disparities in treatment.