Cancer

Invasive lobular carcinoma (ILC) can be subdivided into classic (57%) and nonclassic types (43%). Histopathologic subtyping of these tumors, in addition to traditional clinicopathologic features, is a prognostic parameter that indicates a more favorable outcome for the classic type of ILC.

In this population-based, case–control study, associations between reproductive factors and breast cancer risk were estimated for subtypes of breast cancer distinguished by estrogen receptor (ER), progesterone receptor (PR), and HER-2 status. Prolonged breastfeeding was found to be associated with a significantly reduced risk of both luminal (ER–positive) and triple-negative (ER-negative [-]/PR-/HER-2-) breast cancers, and heterogeneity between subtype-specific associations was pronounced for many risk factors.

Sentinel lymph node (SLN) biopsy was performed in 50 patients who had papillary thyroid carcinoma with no suspicious lymph nodes. Biopsy identified SLN in 46 patients (92%) and detected metastatic lymph nodes in 14 of 18 patients (78%). Intraoperative SLN biopsy was found to be a safe and feasible method for highly accurate detection of central lymph node metastases.

Patients with prostate cancer and a serum prostate-specific antigen level ≥50 ng/mL have very high-risk prostate cancer that carries a high likelihood of being pathologically advanced. Although the probability of realizing long-term survival in these high-risk patients is less than in patients with more favorable disease, 10-year survival outcomes remain excellent and argue for aggressive management of these cases.

In a randomized, phase 3 trial, sunitinib demonstrated superior efficacy over interferon-alfa as first-line therapy in patients with metastatic renal cell carcinoma (RCC) with clear-cell histology. By analyzing the 375 patients who received sunitinib in this trial, a nomogram was developed from pretreatment clinical features to predict the probability of achieving 12-month progression-free survival with sunitinib therapy for metastatic RCC.

Positive predictive values of right and left needle biopsy were high at 97.3% and 96.7%; however, the negative predictive values were low at 24.7% and 31.3%. Contemporary extended pattern prostate biopsies, although able to diagnose cancers, fail to provide reliable localization of tumors to specific areas of the prostate.

The authors examined the etiology of and prognostic potential of E-cadherin (ECAD) methylation in population-based case series of patients with head and neck squamous cell carcinoma. The results indicated that ECAD methylation occurs more often in low smokers or never smokers and that it is a marker of better overall patient survival.

The authors investigated the prevalence and relevance of prognostic comorbidity grade according to the Adult Comorbidity Evaluation-27 comorbidity index in patients with salivary gland cancer. Compared with other studies that investigated the effects of comorbidity on patients with head and neck cancer, the current results indicated that patients with salivary gland cancer have less comorbidity and that their comorbidity status is comparable to that among patients with other nonsmoking- and nonalcohol-related cancers.

In this study, the authors identified a subpopulation of patients who underwent hematopoietic cell transplantation and were at increased risk for chronic kidney disease. These findings set the stage for appropriate long-term follow-up of vulnerable patients.

A randomized clinical trial comparing 1-year administration of zoledronic acid versus simple observation was conducted in 163 patients with asymptomatic myeloma. The results of this study indicate that the use of zoledronic acid in these patients reduces the development of skeletal events at the time of disease progression but does not influence the rate of or time to transformation into symptomatic myeloma.

New therapies are needed for patients with myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) despite recent advances. In this study, low-dose 5-azacytidine combined with thalidomide was found to be well-tolerated and was highly effective for the treatment of patients with MDS and AML arising from prior MDS.

Serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1 receptor antagonist, IL-6, IL-10, and endostatin were measured in patients with untreated acute myeloid leukemia or high-risk myelodysplastic syndromes. TNF-α levels <10 pg/mL were associated with higher rates of complete remission (P = .003), survival (P = .0003), and event-free survival (P = .0009), but the other cytokines were not predictive of clinical outcomes.

Hepatic intra-arterial chemotherapy is well tolerated and may be effective at prolonging survival of patients with unresectable intrahepatic cholangiocarcinoma. Tumor vascularity is significantly associated with radiographic response. From the results of the current study, we can predict that patients with small or intermediate (<8 cm) tumor size, hypervascular tumors on angiography, and Child-Pugh class A, transcatheter arterial chemoembolization may be of benefit for treating cholangiocarcinoma.

The role of amifostine and epoetin-α to reduce severe toxicities during concurrent chemo-hyperfractionated radiotherapy (CCRT) was investigated for limited-disease small cell lung cancer (LD-SCLC). A total of 76 chemotherapy-naive patients with LD-SCLC were randomly assigned at registration to either amifostine or epoetin-α. Although amifostine during CCRT did not significantly reduce severe toxicities, epoetin-α was found to be effective in preventing severe anemia during CCRT in patients with LD-SCLC. Other radioprotectvie strategies to minimize severe toxicities should be investigated.

In a phase 2 study, the authors tested a new approach of single-agent chemotherapy with temozolomide administered in an extended schedule followed by high-dose interleukin 2 (HD IL-2) to evaluate its safety and efficacy in patients with advanced metastatic melanoma. Although the sequential combination was safe and had lower toxicity than previously used biochemotherapy regimens, the overall response rate and the number of durable responses induced by this combination did not exceed the results obtained with single-agent HD IL-2.

Patients with renal cell carcinoma brain metastases are frequently excluded from trials and to the authors' knowledge no guidelines currently exist regarding central nervous system surveillance or treatment. The objective of the current study was to assist in the creation of guidelines.

Well-differentiated liposarcomas rarely recur, despite intralesional or marginal surgical margins and lack of treatment with postoperative radiotherapy. According to Scandinavian Sarcoma Group guidelines, postoperative radiotherapy for high-grade liposarcomas with nonwide surgery was recommended, but compliance in this study was poor and local recurrence rate without radiotherapy was high.

A series of patients with well differentiated or dedifferentiated (DD) retroperitoneal liposarcoma (RLS) was studied to evaluate the prognostic value of the presence, extension, and grade of the DD component. The results indicated that the presence of a DD component was the main independent prognostic factor both for local recurrence and survival in patients with RLS, whereas no difference was observed with regard to the rate of metastasis.

E75, a HER-2/neu-derived peptide, was administered as a preventive vaccine with granulocyte-macrophage–colony-stimulating factor in disease-free lymph node-positive and lymph node-negative breast cancer patients. Compared with suboptimally dosed patients, the optimally dosed E75 vaccine in disease-free breast cancer patients had similar toxicity but enhanced HER-2/neu-specific immunity that may lead to decreased recurrences with additional follow-up.

The relation between incense use and the risk of carcinoma of the respiratory tract was investigated in a prospective cohort of 61,320 Singapore Chinese. Long-term use of incense was associated with an increased risk of squamous cell carcinoma of the respiratory tract.

Low-molecular-weight heparin most likely is superior to unfractionated heparin in reducing mortality in the initial treatment of venous thromboembolism in patients with cancer. The current study indicated that there is a need for more and better designed trials to confirm these findings.

The exact mechanisms underlying the loss of fat mass in cancer cachexia are not known. In this report, the authors provided evidence that increased lipolysis, not reduced lipogenesis or increased adipocyte cell death and inflammation, was the primary factor for adipose tissue loss in gastrointestinal cancer, thereby constituting a possible future therapeutic target.

Data annotation is a critical need for translational research projects. In this report, the authors describe an institutional review board-approved, Health Insurance Portability and Accountability Act-compliant model honest broker system that encompassed multiple data sources in a large tertiary healthcare system.