Cancer

The biologic effect of continuing hormone replacement therapy (HRT) after a diagnosis of breast carcinoma is unclear. The goal of the current study was to determine the short-term effect of HRT withdrawal on invasive breast carcinoma using biologic surrogate markers of tumor response.

In 923 patients with primary breast carcinoma, HER-2/neu status was correlated significantly with hormone receptor status and tumor grade. The assessment of HER-2/neu status may be considered unnecessary in patients with hormone-responsive and Grade 1/2 breast tumors.

In the current study, p53 and Bcl-2 expression in primary breast tumor tissue specimens and corresponding metastatic lymph node specimens was analyzed in 60 patients with breast carcinoma. p53 and Bcl-2 expression in primary tumor tissue specimens was found to be correlated with p53 and Bcl-2 expression in corresponding metastatic lymph node specimens. The predictive and prognostic significance of the expression of p53 and Bcl-2 in metastatic lymph nodes needs to be evaluated in larger prospective trials.

Primary Gleason pattern was a clinically relevant predictor of outcome in patients with Gleason score 7 prostate carcinoma undergoing radical prostatectomy.

There have been recent studies suggesting that nephrectomy and immunotherapy can improve survival of patients with metastatic renal cell carcinoma (RCC). Multivariate analysis of patients with metastatic RCC who were treated with nephrectomy and high-dose interleukin-2 indicated that regional lymph node status, constitutional symptoms, location of metastases, sarcomatoid histology, and thyroid-stimulating hormone levels were associated with survival. The authors present a scoring algorithm based on these features that can be used to predict survival in patients who present with metastatic RCC and to stratify such patients for prospective clinical trials.

Prostate-specific antigen (PSA) levels alone for screening for prostate carcinoma was compromised by the variations in the amount of PSA produced by benign prostatic tissue specimens. Using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry, the authors identified a protein with an average mass-to-charge ratio (m/Z) of 24,782.56 ± 107.27 that was correlated with the presence of prostate carcinoma. In addition, this protein was not expressed in any of the 12 benign prostatic hyperplasia specimens that were assayed. Therefore, this protein may be useful a marker for prostate carcinoma.

Quantitative nuclear grade (QNG) solutions derived from sets of nuclear morphometric descriptors of size, shape, DNA content, and chromatin texture independently predicted which men with biochemical recurrence after radical prostatectomy were likely to experience more rapid progression to distant metastasis and/or death. Therefore, the QNG biomarker may allow a more reliable prediction at the time of surgery of which patients may benefit from immediate adjuvant therapy.

In a Phase II multicenter, cooperative group trial of men with hormone-refractory prostate carcinoma, estramustine, docetaxel, and carboplatin with granulocyte–colony-stimulating factor support resulted in a ≥ 50% decline in prostate-specific antigen in 68% of patients, as well as measurable responses in 52% of patients.

Prophylactically removed ovaries were compared with normal ovaries and papillary serous ovarian carcinomas regarding morphologic features and expression of neoplasia-associated markers. Findings suggest the existence of preneoplastic changes in ovarian surface epithelium.

An increase in cyclooxygenase-2 staining was found to be correlated with the loss of epithelial basement membrane in ovarian surface epithelia from prophylactic oophorectomies.

Follow-up in patients with vulvar carcinoma has been routine for many years, although to the authors' knowledge its value has never been demonstrated. The data from the current study indicate that routinely scheduled follow-up meetings for patients with carcinoma of the vulva result in the detection of smaller recurrences in a substantial proportion of patients compared with self-reported recurrences.

Mantle cell lymphoma (MCL) is a discrete entity characterized by generalized lymphadenopathy with frequent involvement of the bone marrow, spleen, and gastrointestinal tract. The reported outcome in patients with MCL treated with conventional therapy alone has been poor. In 1994, the authors began to examine the efficacy of high-dose cyclophosphamide and total body irradiation followed by autologous stem cell transplantation (ASCT) in patients with MCL in first disease remission. The current study was conducted to analyze the long-term results of ASCT in patients with diffuse MCL in first disease remission.

The authors compared the outcome of 187 patients with Philadelphia chromosome-positive chronic myelogenous leukemia in early chronic phase with a historic group of 650 patients receiving interferon-alpha regimens (1982–1997). Multivariate analysis indicated a significant survival advantage for imatinib therapy.

Imatinib mesylate currently is included in the treatment of adult patients with Philadelphia chromosome-positive chronic myelogenous leukemia (CML). However, few data are available regarding its use in pediatric patients with CML. In the current study, the authors examined the use of imatinib mesylate in the treatment of pediatric patients with CML and evaluated response using cytogenetics, fluorescent in situ hybridization, and reverse transcriptase-polymerase chain reaction.

Elderly patients with diffuse large B-cell lymphoma who received doxorubicin at dose intensities ≥ 10 mg/m² per week had treatment outcomes comparable to those of young patients. Although a reduction in doxorubicin dose was unavoidable for 36% of the elderly patients in the current series, 29% of elderly patients experienced inappropriate dose reductions, which stemmed from physician bias in response to patient age; this bias resulted in poor treatment outcomes.

The authors investigated the efficacy and safety of the humanized anti-CD52 monoclonal antibody, alemtuzumab, in patients with B-cell chronic lymphocytic leukemia and residual disease. Alemtuzumab produced significant responses in patients with residual disease after chemotherapy. Bone marrow disease was eradicated more frequently than lymph node disease, and molecular disease remissions were achieved.

Gemcitabine plus oxaliplatin is tolerated relatively well and has a certain efficacy in patients with advanced hepatocellular carcinoma.

The des-γ-carboxy prothrombin (CDP) Index is a new prognostic indicator in patients with hepatocellular carcinoma who had small, solitary tumors and a child A classification at the time of diagnosis.

The current article addressed reintervention strategies for patients with glioblastoma. The authors demonstrated that it is possible to select patients with glioblastoma who are good candidates for an aggressive reintervention strategy at the time of first disease recurrence. They also showed that these patients improved their overall survival without compromising their quality of life.

Multimodality treatment has been reported to dramatically improve the outcome of patients with Ewing sarcoma. However, little information concerning treatment-related complications in patients who are long-term survivors is available. In the current study, 41 patients with Ewing sarcoma who survived the disease by at least 20 years were included and, in a retrospective analysis, all complications related to the multimodality treatment of Ewing sarcoma were assessed.

Soft tissue sarcomas (STSs) are a heterogeneous group of diseases comprised of numerous histologic subtypes that display a wide range of natural histories and responses to systemic therapies. For example, gastrointestinal stromal tumors (GISTs) usually are refractory to the chemotherapeutic agents doxorubicin and ifosfamide, whereas leiomyosarcomas of the extremities, uterus, and retroperitoneum are sensitive to these agents. An oral alkylating agent derived from imidazotetrazine, temozolomide, has been reported to exhibit broad-spectrum antitumor activity against murine tumors. In the current study, the authors conducted a two-arm Phase II study of temozolomide to determine its efficacy and toxicity in patients with STSs who had received, had refused, or were not eligible for standard chemotherapy with doxorubicin and ifosfamide (Arm 1) and in patients with GISTs (Arm 2).

To evaluate the utility of molecular testing for the diagnosis of synovial sarcoma (SS), the detection of SYT-SSX transcripts was systematically performed using the real-time polymerase chain reaction on 204 fixed, embedded tissue specimens of possible synovial sarcomas. Molecular testing proved to be very helpful or necessary when the diagnosis of SS was suspected, but was challenged by other tumor types, mainly other spindle cell sarcomas, round cell sarcomas, carcinomas, myoepitheliomas, and epithelioid fibrosarcomas.

The current retrospective study demonstrates that basal cell carcinomas (BCCs) of the sclerosing subtype are a risk factor for recurrence after patients receive radiotherapy. Expression of p53 and Bcl-2 is associated with the aggressiveness in BCC subtypes.

The authors performed a retrospective analysis of children with acute lymphoblastic leukemia and hypodiploidy treated at a single institution. They corroborated findings that hypodiploidy with fewer than 45 chromosomes is a high-risk feature and suggested that patients in this category are reasonable candidates for allogeneic stem cell transplantation. In contrast, hypodiploidy with 45 chromosomes was associated with a good outcome.

Patients undergoing high-dose therapy with autologous stem cell transplantation have been reported to experience significant psychological distress during the long inpatient stay. In a randomized trial, music therapy provided by trained therapists lowered mood disturbance compared with standard care.

In 91 patients with neoplastic disease, significantly increased free circulating interferon-α/β type 1 receptors were found compared with 25 healthy individuals. The highest levels were noted in patients with various types of adenocarcinomas.