Cancer

To validate the observation that ethnicity is associated with presentation and outcome of patients with gastric adenocarcinoma, the authors used a large U.S. hospital-based database, the National Cancer Data Base. The findings indicated that ethnicity has a significant impact on presentation, treatment, and prognosis in patients with gastric adenocarcinoma.

Histologic downgrading of dysplasia after photodynamic therapy has been associated with the loss of biomarkers which, in turn, have been associated with the progression of neoplasia in Barrett esophagus. In this study, patients with persistently positive biomarkers appeared to be at a higher risk of recurrent high-grade dysplasia.

Determination of the percentage of primary renal cell carcinoma that is 0%, 1% to 50%, or 51% to 100% high Fuhrman grade 3 or 4 is a simple and powerful measurement of patient outcome after surgery that provides additional prognostic information beyond stage, primary tumor size, and conventional Fuhrman grade. This prognostic information could be useful in the stratification of patients into prognostic groups for the development of more individualized follow-up schedules and for enrollment into clinical trials.

The current study sought to determine whether an index based on symptoms commonly reported by women with ovarian cancer could be used in combination with CA 125 and transvaginal sonography (TVS) to screen women for ovarian cancer. The addition of a symptom index to CA 125 created a composite index that identified >80% of women with early-stage disease. A composite marker such as this could be of value as a first step in a multistep screening program in which false-positive results are identified via TVS before referral for surgery.

Consolidation intraperitoneal topotecan therapy was tolerable in women with advanced ovarian and primary peritoneal cancers in this phase 2 pilot study.

Intensity-modulated radiotherapy and concurrent chemotherapy without prior surgical resection resulted in excellent local and regional control in 71 patients with stage III and IV oropharyngeal carcinoma. There was significant sparing of the parotid glands and other critical normal tissues, with moderate acute toxicities and minimal severe late effects.

In this trial by the North Central Cancer Treatment Group, a low dose (25 mg weekly) of the mammalian target of rapamycin kinase inhibitor temsirolimus was tested in patients with relapsed mantle cell lymphoma (MCL). The dose level retained the antitumor activity of the 250-mg dose with less myelosuppression. The current results indicate that further studies of temsirolimus in combination with other active drugs for MCL and other lymphoid malignancies are warranted.

The presenting features and treatment outcome of 120 patients with Down syndrome (DS) and childhood acute lymphoblastic leukemia (ALL) were compared with 6237 non-DS patients treated in the same years. Presenting features of childhood ALL in DS differ from those in non-DS patients. They are almost invariably characterized by BCP phenotype, and are often TEL/AML1 negative. Treatment results, although not as good as for non-DS patients, improved progressively, with modern therapy and support allowing 75% to survive.

Acute myeloid leukemia (AML) with hyperleukocytosis often is associated with early complications because of leukostasis, which was more prevalent in patients with AML M4 and M5 French-American-British subtypes and higher initial leukocyte counts in the current study. Although early mortality in such patients has remarkably decreased in the more recent period of study, with improvement of management including supportive care, they still had a lower postremission event-free survival rate.

CD40 expression in lung cancer cells is associated with a poor prognosis in immunohistochemical analysis. A juxtacrine interaction of CD40–CD154 among cancer cells facilitates the development of malignant potential in nonsmall cell lung cancer.

Efficacy was similar between a weekly regimen and a standard regimen of carboplatin and paclitaxel for elderly patients with advanced NSCLC. Elderly patients on the weekly regimen exhibited better tolerance than those on the standard regimen. Thus, the weekly regimen offers an advantageous tolerability profile to this patient population.

There appears to be a frequent association between bronchogenic carcinoma and secondary aspergillosis, and invasive pulmonary aspergillosis is a common clinical problem in patients with nonsmall cell lung cancer. In this study, the authors investigated bronchoalveolar lavage polymerase chain reaction, and the results indicated that it seems promising for making an early diagnosis, especially in patients with possible invasive and noninvasive pulmonary aspergillosis.

The Southwest Oncology Group evaluated carmustine and cisplatin in combination with external beam radiotherapy for the treatment of patients with high‒grade gliomas. Despite the presence of a cohort of long‒term survivors, the current study results do not suggest an improvement over treatment with radiotherapy and carmustine alone.

Although the survival of children with diffuse pontine glioma remains abysmal, a few prognostic factors have been associated with an improved outcome in the minority of patients. In this study, the authors demonstrated that the outcome of children aged <3 years with diffuse pontine glioma may be better than that of older children with this same tumor. The findings suggested that the biology of diffuse pontine glioma in young children differ from the biology of tumors that affect older patients.

The study is an updated meta-analysis of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. Chemotherapy improves recurrence-free survival and overall survival with small but statistically significant absolute benefits.

The results from this study of 13,598 individuals in 7 U.S. states indicated that low socioeconomic status is a substantial risk factor for mortality after a diagnosis of cancer. Much of this association was because of a later disease stage at diagnosis and less aggressive cancer treatment.

In this study, the authors estimated personal costs incurred per woman participating in a national breast cancer screening program for medically underserved, low-income woman in the U.S.

Disparities in healthcare access, timely diagnosis, and treatment adherence in African-American women are associated with excess mortality due to breast cancer. Implementation of Patient Navigators and Community Health Advocates significantly increased the proportion of stage 0 breast cancer diagnoses and decreased the proportion of stage IV breast cancer diagnoses in an urban healthcare setting.

A disparate proportion of breast cancer deaths occur among young women and those of African-American ancestry. In the authors' cancer center, which provides care to a multiracial, underserved population, despite similarity in age at diagnosis, African-American women presented with a significantly higher prevalence of triple-negative tumors, which was found to be predictive of the poorest recurrence and mortality outcomes.

On the basis of unprecedented numbers of cases, relative survival and incidence rates of cutaneous soft tissue sarcomas (CSTS) varied over time by race, sex, age, and histologic type, supporting previous findings that the histologic variants of CSTS are etiologically distinct. In particular, the rates of leiomyosarcoma (LS) and angiosarcoma (AS) increased exponentially among whites from 1980 through 2004. Both Kaposi sarcoma and dermatofibrosarcoma protuberans rates were highest among blacks, whereas LS and AS rates were highest among whites.

Incorporating standardized health-related quality of life (HRQL) assessments in daily clinical oncology nursing practice facilitates the discussion of HRQL issues and increases nurses' awareness. Additional efforts are needed to enhance the effect of routine HRQL assessments on patient management and HRQL.

In this 5-year longitudinal study, patients with breast cancer who received taxane-based adjuvant chemotherapy were compared with patients who received other regimens. The results indicated that receipt of taxanes was associated with delays of 6 to 12 months in patients' emotional recovery, including higher rates of depressive symptoms.

Radiotherapy (RT) in the setting of collagen vascular disease is generally well tolerated, but may carry a higher risk of late toxicity. RT to the pelvis or in the setting of systemic lupus erythematosus or scleroderma may predispose patients to an even greater risk of severe toxicity.

First-time chemotherapy patients' expectancies regarding nausea influence their actual experience of nausea after treatment and this nausea detracts from the patients' quality of life. Interventions that reduce strong expectancies for nausea are likely to decrease both the occurrence and severity of chemotherapy-induced nausea and may also improve quality of life.