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Cancer

Cover image for Cancer

15 March 2007

Volume 109, Issue 6

Pages 1003–1214

  1. Commentary

    1. Top of page
    2. Commentary
    3. Editorial
    4. Review Articles
    5. Original Articles
    6. Correspondence
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      Informing prospective research subjects of the influence of regulatory requirements for drug approval on the design of clinical trials in oncology (pages 1003–1006)

      Maurie Markman

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22491

      An established tenet of ethical clinical research stipulates that individuals considered for entry into therapeutic trials must be provided with all data that might influence their decision. However, discussion in the literature regarding the investigators' responsibility to inform possible participants about the nature and impact of regulatory requirements on the studies' design has been limited. Three examples are discussed, which illustrate the ethical concerns that might result from the failure of clinical researchers to fully inform patients.

  2. Editorial

    1. Top of page
    2. Commentary
    3. Editorial
    4. Review Articles
    5. Original Articles
    6. Correspondence
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      Therapy for elderly patients with acute myeloid leukemia : A problem in search of solutions (pages 1007–1010)

      Hagop M. Kantarjian

      Article first published online: 5 FEB 2007 | DOI: 10.1002/cncr.22502

      Elderly patients with acute myeloid leukemia (AML) have poor outcomes with standard intensive chemotherapy and are managed with supportive care, low-dose chemotherapy, or hospice care. In this Editorial, the topic is reviewed, and the author discusses the article in this issue of Cancer by Burnett et al concerning the use of low-dose cytarabine versus hydroxyurea in patients with AML who are considered unfit to receive intensive chemotherapy.

  3. Review Articles

    1. Top of page
    2. Commentary
    3. Editorial
    4. Review Articles
    5. Original Articles
    6. Correspondence
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      Impact of a 21-gene RT-PCR assay on treatment decisions in early-stage breast cancer : An economic analysis based on prognostic and predictive validation studies (pages 1011–1018)

      Gary H. Lyman, Leon E. Cosler, Nicole M. Kuderer and John Hornberger

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22506

      The prognostic and predictive accuracy for distant recurrence-free survival using a 21-gene reverse-transcriptase polymerase chain reaction assay has been validated in 668 lymph node-negative, estrogen receptor-positive women with early-stage breast cancer. A decision analysis based on the validation studies demonstrates that use of the assay to guide treatment is potentially more efficacious and less costly than routine treatment with either tamoxifen alone or chemotherapy and tamoxifen.

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      Multidisciplinary frontiers in breast cancer management : A surgeon's perspective (pages 1019–1029)

      S. Eva Singletary

      Article first published online: 12 FEB 2007 | DOI: 10.1002/cncr.22519

      The current paradigm of breast cancer management may be altered significantly in the future by the adoption of new treatment schema and devices outside of the surgical arena. Surgeons must strive to be true surgical oncologists, rather than merely surgical technicians, by staying abreast of these new developments.

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      Tyrosine kinase receptor RON in human pancreatic cancer : Expression, function, and validation as a target (pages 1030–1039)

      E. Ramsay Camp, Anthony Yang, Mike J. Gray, Fan Fan, Stanley R. Hamilton, Douglas B. Evans, Andrea T. Hooper, Daniel S. Pereira, Daniel J. Hicklin and Lee M. Ellis

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22490

      The tyrosine kinase receptor RON was shown to be expressed in human pancreatic adenocarcinomas and induced molecular and cellular alterations consistent with epithelial to mesenchymal transition in pancreatic cancer cells. Subsequent studies showed that inhibition of RON inhibited tumor growth in vivo.

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      Kaposi sarcoma of the musculoskeletal system : A review of 66 patients (pages 1040–1052)

      Gabriel Caponetti, Bruce J. Dezube, Carlos S. Restrepo and Liron Pantanowitz

      Article first published online: 30 JAN 2007 | DOI: 10.1002/cncr.22500

      Kaposi sarcoma (KS) of bone and skeletal muscle has been rare but occurred with all KS subtypes. Locally aggressive African and classic KS lesions involved the peripheral skeleton; whereas, in patients with acquired immunodeficiency syndrome, axial and/or maxillofacial bone involvement has been more common. Computed tomography scans and magnetic resonance images were better for detecting osseous KS lesions, which frequently went undetected on plain x-ray films or bone scans. Treatment options, including surgery, radiation, and/or chemotherapy, have had limited success.

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      What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion? (pages 1053–1059)

      Anne Han and Désireé Ratner

      Article first published online: 5 FEB 2007 | DOI: 10.1002/cncr.22509

      The authors investigated the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion. Although radiotherapy has been established as an adjuvant treatment for selected patients, the extent of nerve involvement by tumor, particularly in the setting of other high-risk features, may be helpful in defining its role.

  4. Original Articles

    1. Top of page
    2. Commentary
    3. Editorial
    4. Review Articles
    5. Original Articles
    6. Correspondence
    1. Disease Site

      Breast Disease
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      Switching to an aromatase inhibitor provides mortality benefit in early breast carcinoma : Pooled analysis of 2 consecutive trials (pages 1060–1067)

      Francesco Boccardo, Alessandra Rubagotti, Daniela Aldrighetti, Franco Buzzi, Giorgio Cruciani, Antonio Farris, Giorgio Mustacchi, Mauro Porpiglia, Giorgio Schieppati and Piero Sismondi

      Article first published online: 12 FEB 2007 | DOI: 10.1002/cncr.22513

      The superiority of new generation aromatase inhibitors over tamoxifen in the adjuvant treatment of early breast carcinoma has emerged from several randomized trials. However, until now not all previous studies have shown a mortality benefit.

    2. Discipline

      Diagnostic Imaging
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      Mediastinal nodal staging of nonsmall cell lung cancer using integrated 18F-FDG PET/CT in a tuberculosis-endemic country : Diagnostic efficacy in 674 patients (pages 1068–1077)

      Yoon Kyung Kim, Kyung Soo Lee, Byung-Tae Kim, Joon Young Choi, Hojoong Kim, O Jung Kwon, Young Mog Shim, Chin A Yi, Ha Young Kim and Myung Jin Chung

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22518

      Positron emission tomography / computed tomography (PET/CT) provides high specificity and reasonably high accuracy but relatively low sensitivity for mediastinal nodal staging of nonsmall-cell lung cancers. The high specificity is achieved at the expense of sensitivity by interpreting calcified nodes or nodes with high attenuation at CT, even with high fluorodeoxyglucose (FDG) uptake at PET, as benign in a tuberculosis endemic region.

    3. Disease Site

      Endocrine Disease
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      Patients with differentiated thyroid cancer have a venous gradient in thyroglobulin levels (pages 1078–1081)

      Electron Kebebew and Emily Reiff

      Article first published online: 5 FEB 2007 | DOI: 10.1002/cncr.22505

      In 14 of 15 patients who underwent thyroidectomy and/or lymph node dissection for primary differentiated thyroid cancer (DTC) (n = 10 patients) and recurrent or persistent DTC (n = 5 patients), the authors observed a venous gradient in thyroglobulin (Tg) protein levels. These findings suggested that venous sampling for Tg may be used to localize DTC in some patients who have high or increasing serum Tg levels but negative radioiodine scans or imaging studies.

    4. Gastrointestinal Tract
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      Cost-effectiveness analysis of oxaliplatin compared with 5-fluorouracil/leucovorin in adjuvant treatment of stage III colon cancer in the US (pages 1082–1089)

      Samuel Aballéa, Jeremy V.M. Chancellor, Maria Raikou, Michael F. Drummond, Milton C. Weinstein, Sophia Jourdan and John Bridgewater

      Article first published online: 30 JAN 2007 | DOI: 10.1002/cncr.22512

      Lifetime disease-related costs and overall survival were compared for patients with stage III colon cancer receiving adjuvant fluorouracil/leucovorin alone or with oxaliplatin. An improvement of life-expectancy by 1.35 years was predicted and the incremental cost of the oxaliplatin-based strategy was estimated at $22,800 per quality-adjusted life-year gained.

    5. Genitourinary Disease
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      The risk of renal impairment in hormone-refractory prostate cancer patients with bone metastases treated with zoledronic acid (pages 1090–1096)

      William K. Oh, Kevin Proctor, Mari Nakabayashi, Carolyn Evan, Lauren K. Tormey, Timothy Daskivich, Lucia Antràs, Michael Smith, Maureen P. Neary and Mei Sheng Duh

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22504

      For this observational study, the authors assessed the risk of renal impairment in patients with hormone-refractory prostate cancer who received zoledronic acid in an outpatient clinic setting. A significantly greater risk of renal impairment than was reported in previous clinical trials was found and was associated with increasing age at zoledronic acid initiation, prior pamidronate use, and a history of renal disease, hypertension, or smoking (P ≤ .05).

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      Predictive value of p53 and pRb expression in superficial bladder cancer patients treated with BCG and interferon-alpha (pages 1097–1105)

      Kesavan Esuvaranathan, Edmund Chiong, Thomas Paulraj Thamboo, Yiong Huak Chan, Revathi Kamaraj, Ratha Mahendran and Ming Teh

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22503

      A prospective immunohistochemical analysis of 80 intravesical bacille Calmette-Guerin (BCG)-treated, high-risk, superficial, bladder transitional-cell carcinoma patients showed that nuclear pRb underexpression may be predictive of nonresponse and cancer recurrence after intravesical BCG with interferon-alpha (IFN-α) therapy. Nuclear p53 expression, or its combination with pRb expression, is not significantly associated with post-BCG clinical outcome, and it should not be used to influence a decision for BCG alone or BCG with IFN-α therapy.

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      Survivin expression is associated with bladder cancer presence, stage, progression, and mortality (pages 1106–1113)

      Shahrokh F. Shariat, Raheela Ashfaq, Pierre I. Karakiewicz, Osamah Saeedi, Arthur I. Sagalowsky and Yair Lotan

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22521

      In this study, the authors showed that Survivin is expressed in urothelial cancer cells but not in normal urothelium. For patients treated with radical cystectomy and bilateral lymphadenectomy, Survivin expression was associated with features of biologically aggressive disease such as advanced pathologic stage, metastases to lymph nodes, lympho-vascular invasion, disease recurrence, and bladder cancer-specific mortality. These findings provide a rationale for further evaluation of Survivin and its downstream signaling pathways in bladder cancer, and raise the potential for Survivin-targeted therapy for bladder cancer.

    8. Hematologic Malignancies
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      A comparison of low-dose cytarabine and hydroxyurea with or without all-trans retinoic acid for acute myeloid leukemia and high-risk myelodysplastic syndrome in patients not considered fit for intensive treatment (pages 1114–1124)

      Alan K. Burnett, Donald Milligan, Archie G. Prentice, Anthony H. Goldstone, Mary F. McMullin, Robert K. Hills and Keith Wheatley

      Article first published online: 21 FEB 2007 | DOI: 10.1002/cncr.22496

      In this study, patients with acute myeloid leukemia or high-risk myelodysplastic syndrome who were unfit for intensive chemotherapy were randomized to receive either low-dose cytarabine (ara-C) or hydroxyurea with or without all-trans retinoic acid. The results indicted that low-dose ara-C was superior to best supportive care and hydroxyurea and may represent standard care against which new treatments are compared in this patient group.

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      A Decision analysis to determine the appropriate treatment for low-risk myelodysplastic syndromes (pages 1125–1132)

      Mikkael A. Sekeres, Alex Z. Fu, Jaroslaw P. Maciejewski, Ali-Reza Golshayan, Matt E. Kalaycio and Michael W. Kattan

      Article first published online: 30 JAN 2007 | DOI: 10.1002/cncr.22497

      Patients with low-risk myelodysplastic syndromes (MDS) are often treated with either growth factors (GF) or nongrowth factor (NGF) approaches. Modeling estimates suggest that patients who fall into a good GF predictive group of response should almost always receive GF initially, whereas those in intermediate and poor predictive groups should almost always be treated with NGF.

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      Survival advantage with decitabine versus intensive chemotherapy in patients with higher risk myelodysplastic syndrome : Comparison with historical experience (pages 1133–1137)

      Hagop M. Kantarjian, Susan O'Brien, Xuelin Huang, Guillermo Garcia-Manero, Farhad Ravandi, Jorge Cortes, Jianqin Shan, Jan Davisson, Carlos E. Bueso-Ramos and Jean-Pierre Issa

      Article first published online: 21 FEB 2007 | DOI: 10.1002/cncr.22508

      The authors compared the outcome of decitabine therapy in 115 patients with higher risk myelodysplastic syndrome with contemporary historic experience with intensive chemotherapy in similar patients. Complete response rates were comparable with the 2 strategies, but early mortality was significantly higher with intensive chemotherapy. Survival was significantly better with decitabine compared with intensive chemotherapy, whether matched historic controls were used, or whether the total experience was analyzed, with chemotherapy incorporated (decitabine vs intensive chemotherapy) in a multivariate analysis of factors for survival.

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      Treatment of chronic myeloid leukemia in the imatinib era : Perspective from a developing country (pages 1138–1145)

      Zeba Aziz, Javaid Iqbal, Mohammad Akram and Sarah Saeed

      Article first published online: 21 FEB 2007 | DOI: 10.1002/cncr.22498

      Two hundred seventy-five patients in all phases of chronic myeloid leukemia (CML) received treatment with imatinib. Impressive cytogenetic, hematologic, and molecular responses were noted with minimal toxicities and improved quality of life. The current results indicate that the biology of CML is not different in patients from developing countries.

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      Comparison of peripheral T-cell lymphomas and diffuse large B-cell lymphoma (pages 1146–1151)

      Naoto Tomita, Shigeki Motomura, Rie Hyo, Hirotaka Takasaki, Sachiya Takemura, Jun Taguchi, Shin Fujisawa, Koji Ogawa, Yoshiaki Ishigatsubo and Kengo Takeuchi

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22507

      The characteristics and outcome of patients with peripheral T-cell lymphomas (PTCLs) was compared with those of patients with diffuse large B-cell lymphoma. Although patients with PTCLs had a lower complete response rate and shorter survival, immunophenotype itself was not identified as an independent risk factor for response or survival.

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      Overexpression of CXCR4 predicts adverse overall and event-free survival in patients with unmutated FLT3 acute myeloid leukemia with normal karyotype (pages 1152–1156)

      Sergej Konoplev, Georgios Z. Rassidakis, Elihu Estey, Hagop Kantarjian, Chrysoula I. Liakou, Xuelin Huang, Lianchun Xiao, Michael Andreeff, Marina Konopleva and L. Jeffrey Medeiros

      Article first published online: 21 FEB 2007 | DOI: 10.1002/cncr.22510

      The prognostic significance of CXCR4 expression in 122 patients with acute myeloid leukemia (AML) that had a normal karyotype and no evidence of FLT3 gene mutations was examined using immunohistochemistry and archive paraffin-embedded bone marrow biopsy material. CXCR4 expression was associated with poor prognosis in AML patients with an unmutated FLT3 gene.

    14. Lung Disease
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      Irradiation-induced telomerase activity and the risk of lung cancer : A pilot case-control study (pages 1157–1163)

      Meng Chen, Jian Gu, Jinliang Xing, Margaret R. Spitz and Xifeng Wu

      Article first published online: 30 JAN 2007 | DOI: 10.1002/cncr.22493

      Telomerase activity is undetectable in most normal somatic cells, but is up-regulated by various mechanisms during tumorigenesis. Telomerase activation enables cells to overcome replicative senescence and maintain telomere stability during cell proliferation. The aim of the study was to evaluate the association between irradiation-induced telomerase activity and the risk of lung cancer.

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      Overexpressed Raf-1 and phosphorylated cyclic adenosine 3′-5′-monophosphatate response element-binding protein are early markers for lung adenocarcinoma (pages 1164–1173)

      Maria Cekanova, Mourad Majidy, Thomas Masi, Hussein A. N. Al-Wadei and Hildegard M. Schuller

      Article first published online: 21 FEB 2007 | DOI: 10.1002/cncr.22520

      The results from this study indicated that simultaneously overexpressed serine/threonine kinase Raf-1 and phosphorylated cyclic adenosine 3′–5′-monophosphatate response element-binding protein (P-CREB) are early markers for lung adenocarcinoma. RAF-1 and P-CREB may contribute to the development of a significant subset of human lung adenocarcinomas and may offer promising targets for early detection and treatment.

    16. Melanoma
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      Improvement of overall survival of patients with cutaneous melanoma in Germany, 1976–2001 : Which factors contributed? (pages 1174–1182)

      Konstantinos G. Lasithiotakis, Ulrike Leiter, Thomas Eigentler, Helmut Breuninger, Gisela Metzler, Friedegund Meier and Claus Garbe

      Article first published online: 30 JAN 2007 | DOI: 10.1002/cncr.22511

      Improvement of survival of patients diagnosed with cutaneous melanoma during 1976–2001 may not be entirely attributable to factors associated with early diagnosis and more favorable primary tumors. Factors of melanoma management, which changed during the study period, like sentinel node biopsy, adjuvant treatment, structured follow-up, and surgical interventions in distant metastasis have to be taken into account.

    17. Discipline

      Epidemiology
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      A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese (pages 1183–1191)

      Jeppe T. Friborg, Jian-Min Yuan, Renwei Wang, Woon-Puay Koh, Hin-Peng Lee and Mimi C. Yu

      Article first published online: 21 FEB 2007 | DOI: 10.1002/cncr.22501

      The results from this prospective study indicated that smoking and alcohol influence the risk of nasopharyngeal carcinoma (NPC) and other oropharyngeal carcinomas differently in a high-incidence NPC population. Long-term smoking was a risk factor for NPC, but alcohol consumption was not.

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      Obesity is associated with increased risks of prostate cancer metastasis and death after initial cancer diagnosis in middle-aged men (pages 1192–1202)

      Zhihong Gong, Ilir Agalliu, Daniel W. Lin, Janet L. Stanford and Alan R. Kristal

      Article first published online: 20 FEB 2007 | DOI: 10.1002/cncr.22534

      Obesity at the time of diagnosis was associated with increased risks of prostate cancer metastasis and death. The adverse effects of obesity differed little by initial treatment, Gleason score, stage at diagnosis, or primary treatment.

    19. Radiation Oncology
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      Fractionated stereotactic radiotherapy for acoustic neuroma : Single-institution experience at the princess margaret hospital (pages 1203–1210)

      Eng-Siew Koh, Barbara-Ann Millar, Cynthia Ménard, Howard Michaels, Mostafa Heydarian, Shenaz Ladak, Sharon McKinnon, John A. Rutka, Abhijit Guha, Gregory R. Pond and Normand J. Laperriere

      Article first published online: 22 FEB 2007 | DOI: 10.1002/cncr.22499

      A retrospective review of fractionated stereotactic radiotherapy (FSRT) for acoustic neuroma assessed the clinical outcome and toxicity in 60 consecutive patients. At a median follow-up of 31.9 months the 5-year actuarial local control rate was 96.2% (95% CI: 91.1%–100.0%). The overall hearing preservation was 77.3%, with no new cases of cranial nerve toxicity post-FSRT reported. FSRT remains a safe and effective alternative treatment modality for acoustic neuroma compared with either microsurgical resection or single fraction stereotactic radiosurgery.

  5. Correspondence

    1. Top of page
    2. Commentary
    3. Editorial
    4. Review Articles
    5. Original Articles
    6. Correspondence
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      Author reply (page 1212)

      Alvaro Moreno-Aspitia and Gerardo Colon-Otero

      Article first published online: 5 FEB 2007 | DOI: 10.1002/cncr.22517

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      Author reply (page 1214)

      Akseli Hemminki, Merja Särkioja and Jarmo Salo

      Article first published online: 5 FEB 2007 | DOI: 10.1002/cncr.22459

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