Cancer

Although patients with nonbreast malignancies treated with higher doses to the carotid arteries have been shown to have an increased risk of carotid injury, no evidence was found that radiation to the carotid artery delivered during supraclavicular irradiation for breast cancer increases the risk of hospitalization for stroke.

Patients with lobular carcinoma do not require conversion from lumpectomy to mastectomy more often than those with ductal carcinoma, nor do they require a greater number of operations to obtain negative margins.

Breast carcinoma with noninflammatory skin involvement (T4b/Stage IIIB) is a heterogeneous clinicopathologic entity and, thus, does not fulfill the formal criteria of a tumor category or stage within the TNM classification. A revision of the T4 category, i.e., not classifying these tumors according to their component skin involvement but, rather, according to tumor size and lymph node involvement, leads to a more precise assessment of Stage III breast cancer while eliminating up to 18% of patients with limited disease extent (similar to Stage I and II) from the entire group currently classified with noninflammatory Stage III.

Because the optimal sequencing of aromatase inhibitors (AI) and tamoxifen as adjuvant therapy is not known, and may differ for biological subsets of cancers, the authors developed Markov models to simulate disease-free survival (DFS) separately among postmenopausal women with ER+PR+ cancers and those with ER+PR− cancers. Their models suggest that patients with ER+PR+ tumors achieve optimal 10-year DFS estimates with starting with tamoxifen and then crossing over to an AI after two years, while those with ER+PR− tumors fare best with AI monotherapy.

Patients with cancer often have low levels of bioavailable or free testosterone; however, the decrease in total testosterone levels may be masked by an increase in sex hormone-binding globulin. The results of this study indicated that bioavailable testosterone levels were correlated directly with appetite, insulin-like growth factor 1, and ghrelin and inversely with interleukin 6 levels in the study population.

In 126 thyroid tissues it was found that a reverse-transcriptase polymerase chain reaction multigene assay of 6 novel candidate gene markers when used in combination was an excellent diagnostic and extent of disease indicator in differentiated thyroid cancer.

When stratified by prognostic variables, younger patients do not appear to have worse overall survival, freedom from biochemical recurrence, or distant metastasis-free survival when treated with external beam radiation therapy compared with older patients treated with external beam radiation therapy. External beam radiation is a viable treatment option for young men with early-stage prostate cancer.

The objective of this study was to compare the survival of patients with clinical Stage T4 (cT4) prostate cancer who underwent radical prostatectomy (RP) with the survival of patients who received other types of treatment or no treatment at all. The results indicated that patients who underwent RP for cT4 prostate cancer had increased survival compared with patients who received RT or HT alone and had a survival comparable to that of patients who received combined RT and HT.

Estrogen receptor (ER) β is the dominant ER expressed in bladder cancer cell lines and in the majority of human bladder tumors. Moreover, the degree of ERβ expression increases with increasing stage and grade of differentiation. Studies of the effects of pharmacologic agents that positively and negatively regulate ERβ function should provide insight into the biologic importance of this receptor in human bladder cancer.

Oral vinorelbine at doses of 70 mg/m² may be safely combined with estramustine. The combination appears to have modest activity in men with advanced prostate cancer.

In the current study, arsenic trioxide in the dose regimen and schedule employed was found to have no activity in men with refractory germ cell malignancies.

The authors found an increase in Gleason grade 3 and a decrease in Gleason grade 2 on prostate biopsies and radical retropubic prostatectomy (RRP) specimens between 1989 and 2001, with concomitant evolution in the prognostic implications of Gleason grades. These chronological changes, which may reflect changes in tumor biology, pathologic interpretation or both, need to be accounted for in comparing outcomes from different eras.

The objective of this study was to evaluate the effects (singly and jointly) of polymorphisms in 2 genes in the glutathione S-transferase (GST) family and the mutagen-sensitivity phenotype (based on an in vitro lymphocyte assay) on the risk of second primary tumors in a chemoprevention trial for patients with previously diagnosed early-stage head and neck squamous cell carcinoma. The GST-M1 null genotype was associated with an increased risk for any second primary tumor (hazard ratio [HR], 1.99; 95% confidence interval [95% CI], 1.11-3.56) and tobacco-related second primary tumors (HR, 2.16; 95% CI, 1.01-4.62) after adjusting for treatment arm, age at diagnosis, smoking status, alcohol use, index tumor site, and stage.

Alemtuzumab is a humanized monoclonal antibody that is directed against the cell surface antigen CD52. It has demonstrated activity in patients with chronic lymphocytic leukemia and other CD52-positive lymphoproliferative disorders. Because CD52 is also expressed on acute leukemic blasts, the authors investigated the safety and efficacy of alemtuzumab in patients with acute myeloid leukemia and acute lymphoblastic leukemia.

Patients with primary bone lymphomas treated with combined modality versus single-modality therapy had a superior outcome, with a significantly better survival.

The results of this metaanalysis demonstrated that allogeneic hematopoietic stem cell transplantation improves overall survival for adults with high-risk acute lymphoblastic leukemia.

Interferon γ1b immune enhancement in patients who received high-dose, donor-derived granulocyte transfusions was safe and appeared to improve or stabilize refractory, systemic fungal infections in high-risk patients with leukemia or myelodysplastic syndrome, including those who underwent hematopoietic stem cell transplantation.

The results of this histopathologic study suggest that high-dose irradiation evokes acute-type, subacute-type, and chronic-type tissue responses accompanied by an inflammatory cell reaction in a variety of cerebral metastases with different histologic subtypes. Among 24 cerebral metastases that recurred after radiosurgery and required craniotomy, histopathologic responses were observed within the irradiated tumor volume, and immunohistochemistry revealed a preponderance of CD68-positive macrophages and CD3-positive T lymphocytes in the inflammatory cell infiltrate that developed in late recurrences. This same inflammatory response was absent in neoplasms that recurred soon after radiosurgery.

Dedifferentiated central chondrosarcoma is a rare lesion and is associated with a poor prognosis. In this study, metastatic disease at diagnosis, malignant fibrous histiocytoma dedifferentiation, and a high percentage of dedifferentiated component in the lesion were related to a poorer outcome in patients with dedifferentiated central chondrosarcomas, and there was no statistical evidence of any beneficial effect from adjuvant chemotherapy.

In a small percentage of patients with soft-tissue sarcoma, bone resection may be required to obtain an adequate surgical margin, thereby limiting the risk of local tumor recurrence. Histologic bone invasion portends a poorer prognosis in terms of overall survival.

A retrospective analysis of management and outcome of 44 patients who developed local recurrence (LR) after treatment of extremity osteosarcoma confirmed that patients with LR had a very significant high risk of developing metastatic disease and dying of the tumor.

Breast cancer risk was elevated significantly in female radiologic technologists who experienced daily low-dose radiation exposures over several years that potentially resulted in appreciable cumulative exposure. In analyses that were stratified on birth cohort and adjusted for established breast cancer risk factors, breast cancer risk was increased significantly in women who began working as radiologic technologists before 1940 (vs. 1970 or later), rose significantly with increasing number of years worked before 1940, and was elevated significantly in those who had the highest observed (vs. minimal) proxy index for cumulative radiation exposure.

The Rho Guanine Nucleotide Exchange Factors (RhoGEFs) are key regulators of mitogenic and transforming pathways; One family member, PDZ-RhoGEF, also integrates signaling between monomeric Rho G proteins and heterotrimeric G proteins via a so-called regulator of G-protein signaling (RGS) domain. The results from this lung cancer case-control study showed that a non-synonymous SNP (rs868188, Ser1416Gly) in PDZ-RhoGEF was associated with a significantly reduced risk for lung cancer in Mexican Americans and that there was a joint effect between Ser141Gly and three other RGS geneSNPs, supporting this family of proteins as key regulators of tumorigenesis.

The incidence of dedifferentiated liposarcomas (DDLs) is largely underestimated and most retroperitoneal liposarcomas and malignant fibrous histiocytomas are in fact DDLs. The crucial importance of avoiding misdiagnosis of DDLs was stressed because these tumors present poorer outcome than well-differentiated liposarcomas.

In a population-based setting, the authors studied the influence of age and comorbidity on the administration of radiotherapy (RT) among 33,369 patients who were diagnosed with cancer between 1995 and 2002. In general, elderly patients and patients with comorbid conditions were treated less aggressively compared with patients who received standard treatment. Patients with lung cancer or non-Hodgkin lymphoma more often received RT alone instead of surgery or RT combined with chemotherapy, and patients with rectal cancer or breast cancer often had adjuvant RT withheld before or after surgery.

The results of the current study demonstrated that dutasteride had differential effects on the induction of apoptosis in a range of prostate cell lines and primary prostate cancer epithelial cells.