Cancer

In this investigation of racial disparities in breast cancer treatment, the authors conducted a comprehensive review of medical records and used multivariable logistic regression analyses controlled for sociodemographic factors, tumor characteristics, comorbidities, and health insurance status to assess whether there were differences between white American women and African-American women in the receipt of breast-conserving surgery, radiation, tamoxifen, and chemotherapy. The results indicated that white American women were more likely to receive tamoxifen and/or chemotherapy for regional-stage disease than African-American women and that married women with regional disease were more likely to receive chemotherapy than nonmarried women.

Patients with advanced gastric cancer have a median survival (MS) of <9 months. It is unclear whether the MS of patients who have advanced cancer at the time of diagnosis (synchronous, Group A) is different from that of patients who develop advanced cancer after curative surgery (metachronous, Group B). It was hypothesized that survival would be similar.

By using the Surveillance, Epidemiology, and End Results Registry database, the authors identified patients with adenocarcinoma of the pancreas who underwent surgical resection with or without radiation therapy. Radiation therapy was associated with improved survival.

Despite presenting with an earlier clinical stage of disease and similar pathologic features at the time of radical prostatectomy, black men were found to be at a slightly increased risk for biochemical disease recurrence. However, these recurrences appear to be no more aggressive than those in white men, as depicted by similar prostate–specific antigen doubling time.

The optimal therapy for localized prostate cancer depends not only on clinical features, but also on patient preferences. Our decision model and patient survey show that variations in individual preferences are critically important in selecting treatment for older patients and for patients with low-risk tumors.

Because not all prostate cancers deserve immediate treatment, it has become more important to risk-stratify cases. With the help of a nomogram for screen-detected cancers substantial groups of cancers can be identified that are likely indolent and can therefore be considered for active surveillance.

The study provides the first quantitative evidence of the impact of chemotherapy on ovarian infrastructure and shows that, although alkylating agents can significantly reduce ovarian reserve, both alkylating and nonalkylating regimens may affect ovarian stromal function.

Although the cyclin D1 gene (CCND1) numerical aberration is a good predictor of aggressive tumors, recurrence, and poor prognosis in patients with oral squamous cell carcinomas, in the current study, the authors were able to identify subgroups of patients with early recurrences and poor prognosis more efficiently by assessment of p16 deletion in addition to CCND1 status using fluorescence in situ hybridization on fine-needle aspiration biopsy samples compared with the analysis of either alteration alone.

The current study provided evidence that the combination of a purine analog with rituximab is safe and effective for patients with recurrent and/or refractory hairy cell leukemia. Moreover, the results suggest an added benefit compared with standard treatment.

Pleural biopsy performed using thoracoscopy is the cornerstone of the diagnosis and pleural staging of patients with malignant pleural mesothelioma. However, this procedure is less efficient in distinguishing the histologic subtype as either epithelial or biphasic.

Mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC) are uncommon tumors of the chest that, if they are resected completely, carry a good prognosis. The survival rate of patients with MEC who achieved complete surgical resection was 94% at 3 years and 87% at 5 years and 10 years. For patients with ACC, the survival rate was 73% at 3 years, 57% at 5 years, and 45% at 10 years.

Serum Hp and 2 of its glycoforms, SAHp and FHp, are potentially useful in the clinical diagnosis of nonsmall cell lung cancer. The markers increase with stage, suggesting they may also be useful in stratifying patients at presentation and in following patients after treatment.

In a phase 2 study, investigators observed that a regimen of interferon alpha-2b combined with thalidomide demonstrated a lack of response and excess toxicity in poor-prognosis patients with disseminated malignant melanoma. On the basis of these findings, there is no indication for further study within this study's trial parameters.

Retrospective analysis of 13 patients with central neurocytoma revealed that gamma knife stereotactic radiosurgery could be recommended as a primary or an adjuvant therapy.

In a series of 186 patients in recursive partitioning analysis (RPA) Classes 1 and 2 who had between 1 and 3 brain metastases, 91 patients who received 30 to 40 grays (Gy) of whole-brain radiotherapy (WBRT) alone were compared with 95 patients who received 18 to 25 Gy of stereotactic radiosurgery (SRS) alone with regard to overall survival (OS), control within the entire brain (BC), local control of treated metastases (LC), and brain control distant from treated metastases (DC). SRS alone was associated with improved BC and LC, whereas OS and DC were not significantly different in either group. Similar results were observed in the subgroup analyses of patients in RPA Classes 1 and 2.

Rhabdomyosarcoma (RMS) is a rare mesenchymal tumor with few treatment options after the failure of first-line therapy. Understanding the expression of kinases and apoptotic molecules in RMS tumors may lead to elucidation of mechanisms of resistance to chemotherapy and development of new therapies.

The findings do not support anecdotal reports that patients have been affected by changes in reimbursement to oncologists for chemotherapy as a result of the Medicare Modernization Act. Further research is needed to examine the effects of the legislation on vulnerable populations.

In this longitudinal study, contemporary childhood survivors of acute lymphoblastic leukemia were found to remain at an increased risk of obesity and hypertension after therapy despite reductions in the usage of cranial radiotherapy. Higher exposure to corticosteroids was found to be a significant risk factor.

The objectives of the current study were to evaluate a percutaneous radiologic arm port device (PRAPD) in a large set of 1000 consecutive cancer patients undergoing chemotherapy in terms of safety, efficacy, complications, and quality of life and to propose future recommendations. The results indicated that PRAPD is a safe, effective, and well-tolerated technique in oncology patients. PRAPD could be recommended in selected patients rather than a surgical port device.

Venous thromboembolism is increasingly frequent in hospitalized cancer patients. Risk factors for venous thromboembolism include older age, female sex, black ethnicity, chemotherapy, cancer type, and comorbidities.

Vascular stabilization leads to a remodeling of tumor vasculature accompanied by a reduction of vascular density because of partial regression of blood vessels and an extensive necrosis of tumor tissue. Thus, a better understanding of tumor vascular remodeling might optimize the assessment of the efficiency of tumor therapeutics via imaging and open additional strategies in tumor therapy.