Cancer

Hepatic arterial administration of paclitaxel at doses of 200 mg/m² as 24-hour, continuous infusions every month to treat patients with metastatic breast carcinoma that involved the liver was safe and well tolerated. This approach may result in substantial tumor reduction, allowing for surgical resection of residual disease. Previous systemic taxane therapy did not hamper the potential efficacy of this approach.

In postmenopausal women with breast cancer who were receiving adjuvant tamoxifen therapy, lymph node status and modified Scarff-Bloom-Richardson grade 3 were the only significant predictive factors of early recurrence. In a low-risk subset of patients with lymph node-negative and/or grade 1 tumors, a sequential strategy with tamoxifen for 2 or 3 years followed by an aromatase inhibitor seemed to be the preferable option.

Screening has significantly and substantially reduced the rates of larger tumors and lymph node-positive breast cancer in Sweden, and the magnitude of the reduction is consistent with the reduction in breast cancer mortality.

Prior cost-effectiveness models analyzing computed tomography colonography (CTC) screening have assumed that patients with lesions measuring ≤5 mm will be referred to optical colonoscopy for polypectomy. However, consensus guidelines for CTC recommend reporting only those polyps that are ≥6 mm in size. The purpose of the current study was to assess the potential harms, benefits, and cost-effectiveness of CTC screening without the reporting of diminutive lesions compared with other screening strategies.

Endoscopic surveillance is recommended and widely practiced after definitive treatment for localized colorectal cancer, yet there is little evidence supporting its benefit. In a retrospective case–control study using Surveillance, Epidemiology, and End Results program–Medicare records, the authors found that surveillance endoscopy does not appear to influence colorectal cancer–specific mortality in patients age >65 years who are diagnosed with localized and regionalized colorectal cancer.

Racial and ethnic variation in patient-reported outcomes such as health-related quality of life (HRQoL) and satisfaction with care are understudied in elderly prostate cancer patients. Our prospective cohort study of 214 elderly (aged ≥65 years) men with newly diagnosed prostate cancer showed that African-American elderly had poorer outcomes and took longer to return to baseline HRQoL.

Quality of life domains are differentially affected by various treatments for localized prostate cancer. This prospective, longitudinal cohort study illustrates that urinary control and sexual function are better after radiation, although nerve-sparing surgery diminishes these differences among potent men undergoing prostatectomy. Brachytherapy causes more urinary obstructive and irritative symptoms, whereas both forms of radiation cause more bowel dysfunction than surgery.

Evidence-based guidelines for the follow-up schedule for each management strategy following orchiectomy for stage 1 seminoma have been developed from a systematic review of the literature. These recommendations are based on the risk of relapse and offer the possibility of maximal patient convenience and optimal healthcare resource allocation without compromising disease control.

Components of the mTOR pathway (PTEN, pAkt, p27, and pS6) were significantly associated with pathological features and survival of patients with renal cell carcinoma. Not all types of renal cell carcinoma seem to be equally amenable to mTOR targeted therapy.

Transcutaneous ultrasound-guided Tru-Cut biopsy performed under local anesthesia was found to successfully diagnose bulky/recurrent laryngopharyngeal masses in 9 of 10 patients, with no morbidity noted. This diagnostic method is promising for patients who are contraindicated for general anesthesia.

Although high-dose therapy is considered a standard therapy for younger patients with multiple myeloma (MM), the advantages of performing a second transplant remain debated. Taking into account the limited advantage of double transplants observed, the complexity of the program, the high percentage of dropouts, and the additional costs of a second transplant, the study favors single transplant programs for the treatment of younger MM patients.

Allele-specific, quantitative polymerase chain reaction analysis for JAK2V617F was performed in 176 patients with essential thrombocythemia using genomic DNA from archived bone marrow. JAK2V617F was detected in 96 patients (55%), in whom mutant allele burden ranged from 1% to 100% (median, 6.3%). The presence of JAK2V617F was significantly associated with higher hemoglobin level, lower platelet count, higher leukocyte count, increased incidence of venous thrombosis occurring after diagnosis, and older age at diagnosis. All but age retained significance in multivariable analysis. In addition, JAK2V617F allele burden was shown to impart additional phenotypic effects.

Bortezomib induced an overall response rate of 92% in 12 patients with plasma cell leukemia (PCL). The median progression-free survival was 8 months (range, 5 to >21 months) and toxicity was acceptable. Bortezomib, employed alone or in combination with other drugs, could contribute toward improving the usually poor prognosis of patients with PCL.

The pentostatin, cyclophosphamide, and rituximab regimen was well tolerated and efficacious for elder patients and individuals with a creatinine clearance ≤70. These findings suggest pentostatin, cyclophosphamide, and rituximab may be a good therapeutic option for elderly patients and those with modestly decreased renal function.

In this study, the presence of molecular changes in selected chromosomal regions in comparison with the histological appearance was determined. One hundred twenty-two bronchial biopsies were obtained by a combination of white-light and autofluorescence bronchoscopy from heavy smokers with COPD. Findings indicated that presence of LOH and expression of hTERT mRNA represent early events in lung carcinogenesis, as both were detected in precancerous lesions and in normal epithelium of heavy smokers.

Long-term outcome of fractionated stereotactic radiotherapy for craniopharyngiomas is excellent with regard to local control as well as treatment-related side effects, with an overall survival of 89% reported at 10 years. No severe treatment-related toxicity was observed.

An assessment of ifosfamide pharmacokinetics, toxicity, and relation to CYP3A4 activity as measured by the erythromycin breath test in patients with sarcoma is presented.

p53 protein stabilization and p53 mutations frequently occur in soft tissue sarcoma; both correlate with worse outcome for soft tissue sarcoma patients. However, increased p53 protein expression is not necessarily due to p53 mutation and should, therefore, not be used clinically as the sole assay of p53 mutation. Better outcome prediction is achieved from combining p53 immunohistochemistry and p53 direct sequencing and, therefore, they should become the basis for these assessments.

It is estimated that metastatic bone disease (MBD) affects 4,861,987 individuals annually in the U.S. This results in a national cost burden of 17% of the total direct medical costs incurred by oncology treatment, indicating the enormous impact of MBD on expenditures.

The objective of the study was to evaluate the diagnostic and ablative role of minimally invasive surgery (MIS) for pediatric cancer according to current tumor protocols. The results indicated that MIS is a reliable diagnostic tool for pediatric abdominal and thoracic malignancy. The role of ablative MIS in pediatric cancer remains limited.

The role of biallelic germline mutations in mismatch-repair genes was investigated in a cohort of pediatric oncology patients with multiple tumors. Of 15 patients, 2 possibly affected children could be identified.

Despite the attenuated immune response of cancer patients to influenza vaccination, the inactivated influenza vaccine is cost-effective for working-age (ages 20–64 years) cancer patients diagnosed within the previous 5 years who have a life expectancy of ≥3 months. All working-age cancer patients who are within 5 years of cancer diagnosis and have a life expectancy of ≥3 months should be vaccinated against influenza.

Delirium is a highly prevalent psychiatric condition in oncology. Exposure to opioids during hospitalization is associated significantly with an increased longitudinal risk of delirium in hospitalized cancer patients.

An investigation of the interaction between aPPD and estrogen receptors (ER) in human breast adenocarcinoma MCF-7 cells found that aPPD inhibits estrogen-stimulated gene expression and cell proliferation in ER-positive breast cancer cells. In addition, aPPD synergistically enhances cytotoxicity of tamoxifen in an ER-independent fashion, probably by down-regulating Akt activity.