Cancer

Most breast cancer information that consumers are likely to encounter online is accurate. However, commonly cited quality criteria do not identify inaccurate information.

Occult cancer was identified in 5% of prophylactic mastectomies (PMs); PM with sentinel lymph node biopsy (SLNB) spared 4 of 393 patients (1%) from having to undergo axillary lymph node dissection. When performed, the negative predictive value of magnetic resonance imaging (MRI) for invasive cancer was found to be 100%, suggesting MRI can be used to select patients for PM without SLNB.

After adjusting for factors known to affect cancer mortality, colorectal cancer patients with a history of colorectal cancer in a first-degree relative had increased risk of mortality when compared with those without a family history. The deleterious effect of family history was principally limited to patients with 2 or more affected relatives, stage IV disease at diagnosis, and cancers originating in the colon.

Two independent telephone surveys were conducted in 2000 and 2003 to examine trends and predictors of colorectal cancer (CRC) screening in patients age ≥50 years; it was found that even though screening rates increased during this time interval, there was ongoing underutilization of CRC screening. The 2 strongest determinants of obtaining CRC screening were provider influence and patient barriers to CRC screening, indicating the need for multilevel interventions that target both the provider and patient.

The results of the current study found that disease-specific survival rates after resection for lymph node-negative esophageal cancer were increased in patients with a higher number of negative lymph nodes. These data suggest that patients undergoing surgical resection for esophageal cancer should have at least 18 lymph nodes removed.

In patients with prostate cancer being treated with androgen deprivation therapy (ADT), the efficacy of ADT is dependent on whether or not metastases were present at the initiation of ADT. The median time to progression in patients with metastases was 15.9 months, versus 33.2 months for those without metastases. Factors associated with outcome differed between these 2 groups.

Because men who undergo radical prostatectomy (RP) are at long-term risk of biochemical recurrence (BCR), the authors developed and internally validated a novel nomogram predicting the individual probability of BCR up to 20 years after RP. Within an external validation cohort, their nomogram accurately predicted the conditional probability of BCR up to at least 15 years after surgery.

Racial differences in cervical cancer survival can be attributed at least in part to late disease stage at presentation and sociodemographic factors that impact access to medical care. In this study, factors that affected access to medical care appeared to have a more important influence than race on the long-term survival of women with invasive cervical cancer.

The objective of this study was to identify biomarkers that reflect the clinical course of squamous cell carcinoma of the tongue (TSCC). Expression levels of the integrin genes α3 (ITGA3), β4 (ITGB4), and ITGB5 with functional normalization by desmosomal or cytoskeletal molecule genes were selected as candidate biomarkers for cervical lymph node metastasis or for the outcome of death in patients with TSCC.

The authors studied 2 lipid formulations of amphotericin B (AMB) that are used for the treatment of invasive aspergillosis (IA) in patients with hematologic malignancies: amphotericin B (AMB) lipid complex (ABLC) and liposomal AMB (L-AMB). In 381 consecutive patients, response to primary or salvage therapy was equally poor with both AMB formulations regardless of treatment modality; however, in the primary therapy group, ABLC was associated with significantly greater nephrotoxicity than L-AMB (P < .001).

Forty-one patients with previously untreated chronic lymphocytic leukemia or small lymphocytic lymphoma received 4 courses of the combination of fludarabine and rituximab followed by 4 weeks of alemtuzumab. The complete response rate improved from 13% to 21% after alemtuzumab, but this intravenous schedule was poorly tolerated, and only 49% of patients completed treatment.

A number of genomic abnormalities, including deletions, duplications, and uniparental disomy, were detected in 56 patients with early-stage chronic lymphocytic leukemia (CLL) by single nucleotide polymorphism (SNP) genomic array (SNP-chip) analysis. Genetic abnormalities are very common events in early-stage CLL.

In light of the current understanding of the ubiquitin-proteasome pathway in the pathophysiology of chronic lymphocytic leukemia (CLL), the authors developed fluorogenic assays to measure proteasome peptidase activity selectively in plasma from patients with CLL; in this study, they retrospectively assessed the associations of these activities with survival. The results indicated that proteasome activity in plasma is a powerful biomarker in patients with CLL and can be used in disease management.

Central nervous system diagnostics is a promising tool for detection of neurological disorders, including brain metastases. This article provides compelling evidence that the serum protein marker, proApolipoprotein A1 may be used in conjunction with S100β for MRI-independent diagnosis of metastatic brain tumors.

A 3-dimensional, polyacrylamide gel-based DNA microarray was developed to detect CpG islands hypermethylation of multiple genes in primary nonsmall cell lung cancers. Methylation frequencies were detected in all of the interrogated genes and were correlated with some clinicopathologic patient characteristics.

The cost-effectiveness of concomitant and adjuvant temozolomide for the treatment of newly diagnosed glioblastoma multiforme compared with initial radiotherapy alone amounted to €37,361 per life-year gained. We concluded that despite the high temozolomide acquisition costs the costs per life-year gained are comparable to accepted first-line treatment with chemotherapy in patients with cancer.

One approach that has been advocated by some for the treatment of children with recurrent or refractory central nervous system (CNS) tumors has been the use of high-dose chemotherapy and autologous stem cell rescue. However, the authors' institutional experience demonstrates that this is not an effective salvage strategy for older children with recurrent CNS malignancies who received previously radiotherapy.

Patients with cancer may die from their cancer or with their cancer. Particularly in elderly cancer patients, these comorbid deaths can have a major influence on management strategies and public health policy.

A prospective study of 1822 colorectal cancer survivors found a low prevalence of global psychological distress at 6 (8.3%) and 12 months (6.7%) postdiagnosis. Psychological distress at 6 months most strongly predicted distress prospectively at 12 months.

Development of hypothyroidism is fairly common in older breast cancer survivors, exceeding the incidence found in the general population. However, treatment with irradiation does not appear to contribute significantly to hypothyroidism risk in breast cancer patients.

The authors used a population-based survey of individuals who had activity limitations caused by cancer to examine the health-related quality of life (HRQOL) of cancer survivors between ages 20 and 64 years. Survey respondents who reported activity limitations because of cancer had severe HRQOL limitations for all healthy day measures that were examined.

Genetic variation in the catechol-O-methyltransferase and multidrug resistance genes were associated independently with morphine-related central side effects in cancer patients.

The mechanisms of growth inhibitory effects of 2 cytotoxic-conjugated peptides and 2 novel antagonist peptides were examined on 3 neuroendocrine tumor (NET) cell lines that expressed respective peptide receptors. Our results demonstrate that growth hormone-releasing hormone antagonists or peptide-linked antineoplastic agents such as AN-152 and AN-238 are effective inhibitors of NET proliferation in vitro. The development of antineoplastic agents targeted to specific tumor receptors may provide a more efficacious strategy than systemic chemotherapeutic agents currently in use.