Cancer

The impact of breast carcinoma on survivors' adjustment is minimal 20 years after initial treatment. However, there is a higher prevalence than anticipated of treatment-related lymphedema and numbness in the hands, feet, or chest, both of which were correlated significantly with posttraumatic stress disorder symptoms related to treatment. These findings were indicative of continuing psychologic sequelae in response to having been treated for cancer long after treatment completion. The long-term impact of treatment side effects on adjustment may be underrecognized.

Significant short-term treatment-related upper-limb morbidity exists after sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). There is no significant difference in short-term treatment-related morbidity between SLNB and ALND.

Breast conservation therapy (BCT) (comprised of lumpectomy, evaluation of axillary lymph nodes, and adjuvant radiotherapy) is a well defined alternative to mastectomy (MT) in appropriate patients with early-stage breast carcinoma, and several randomized studies worldwide have demonstrated that BCT and MT offer comparable survival. Nevertheless, long-term randomized data remain relatively scarce. Between 1979–1987, the National Cancer Institute conducted a randomized, prospective study of MT versus BCT in the treatment of patients with early-stage breast carcinoma. In the current study, the authors present the updated results after a median potential follow-up of 18.4 years.

Androgen receptors (AR) frequently are present in ductal carcinoma in situ and in invasive breast carcinomas. Furthermore, a significant number of poorly differentiated carcinomas are AR-positive but are negative for estrogen and progesterone receptors.

In multivariate analysis of cases of thyroid malignancy stratified by type (follicular, papillary, or medullary), extrathyroidal extension consistently evolved as the key risk factor for both lymph node metastasis and distant metastasis. Screening for both local residual disease and distant metastases should be intensified, particularly in the high-risk population of patients whose primary tumors exhibit extrathyroidal growth.

The authors report the expression of the novel vascular endothelial growth factor receptor neuropilin-1 in human pancreatic adenocarcinoma. The results show that epidermal growth factor is an important regulator of neuropilin production.

Thymidine phosphorylase (TP) activity in patients with renal cell carcinoma (RCC) was greater compared with TP activity in normal kidney. TP levels were correlated with both disease stage and tumor grade, and elevated levels of TP in patients with RCC predicted a poor prognosis.

Fibroblast growth factor receptor 3 (FGFR3) mutations frequently are found in superficial bladder carcinoma and in urine sediment DNA samples. The identification of FGFR3 mutations, along with cytologic evaluation, significantly increased the detection of tumors in a noninvasive assay.

First-line, cisplatin-based chemotherapy yielded a complete response rate of approximately 90% in patients with Stage IIC and Stage IIIA/B seminoma (American Joint Committee on Cancer-International Union Against Cancer classification) and in patients with primary extragonadal seminoma. The presence, initially or at recurrence, of liver and/or central nervous system metastases was a major, adverse prognostic factor, with 5-year overall survival rates of 48% (95% confidence interval, 22–74%) and 7% (95% confidence interval, 1–32%), respectively. These patients may be candidates for more aggressive first-line or salvage chemotherapy regimens.

Sex cord-stromal tumors exhibit potentially aggressive malignant behavior that is difficult to predict based on clinical and pathologic features. Retroperitoneal lymph node dissection remains a treatment option, especially for patients with malignant features and/or small-volume metastatic disease.

The immunohistochemical expression of c-ABL, platelet-derived growth factor receptor-β, and c-KIT tyrosine kinases was evaluated in ovarian serous carcinoma. The majority of serous epithelial ovarian tumors express one or more of these kinases targeted by the tyrosine kinase inhibitor, imatinib mesylate.

The authors investigated prognostic factors in patients with T1–T2 glottic carcinoma who were treated with radical radiotherapy. They concluded that promoting a healthier lifestyle and checking at regular intervals for possible second primary tumors may have a favorable impact on the survival of patients with T1–T2 squamous cell carcinoma of the glottis.

Alemtuzumab induced sustained responses in patients with refractory lymphoproliferative disorders. Infectious complications, despite prophylactic treatment, are common.

The optimal treatment strategy for elderly patients with advanced nonsmall cell lung carcinoma has not yet been defined. The current analysis demonstrated that carboplatin and paclitaxel exhibited similar toxicity profiles in patients age 70 years and older and patients younger than age 70 years, with comparable survival rates and progression of quality-of-life outcomes between patients in the two age groups

Vascular endothelial growth factor-C (VEGF-C) expression was detected both in vitro and in vivo in the majority of human melanoma metastases localized in the lymph nodes, whereas a lower percentage of cutaneous metastases expressed this growth factor. These findings point to VEGF-C as a possible mediator of melanoma metastasis to the lymph nodes, and could lead to a better understanding of the metastatic process.

Families with CDKN2A mutations are at increased risk for atypical nevi, melanomas, and pancreatic carcinomas. These phenotypes appear to be inherited as an autosomal-dominant trait within certain families.

The results of the current study found that myoid differentiation in adult pleomorphic soft tissue sarcomas of the extremity is independently associated with an adverse prognosis as measured by patient survival.

Hormone levels may be influenced by obesity, and hormones may play a more prominent role in adenocarcinoma compared with squamous cell carcinoma of the uterine cervix. The authors investigated the possible correlation between obesity and type of cervical carcinoma and found that obesity and body fat distribution were associated more strongly with adenocarcinoma than with squamous cell carcinoma.

The Functional Assessment of Cancer Therapy (FACT) Taxane subscale possesses strong psychometric properties, including excellent internal consistency, concurrent validity, and sensitivity to change over time. Examination of the relative importance of patient-reported treatment toxicity versus relief of disease symptoms demonstrated that each factor makes a relatively equal contribution to total, multidimensional quality of life (QOL); symptom status appears to play a stronger role than toxicity in patient reports of global QOL.

Ecteinascidin 743 (ET-743) is a new agent that appeared to be well tolerated but was found to have limited activity as a single agent in the current Phase II study in heavily pretreated patients with recurrent osteosarcoma.

N-myc oncogene activation strongly predicts a poor outcome in patients with childhood neuroblastoma. Because the transforming properties of Myc are mediated through the expression of target genes, the authors used cDNA arrays as tools to identify potential N-Myc targets. A number of new targets of potential biologic interest were identified, the expression of which may possess prognostic significance for patients with childhood neuroblastoma in the future.

An intent-to-treat analysis demonstrated that a brief cognitive-behavioral intervention was capable of reducing anxiety and improving mental health, vitality, and general overall quality of life for up to 6 months after the end of the intervention in patients with melanoma. An intervention analysis revealed additional improvements in overall distress and reduction in bodily pain after 2 months, with some improvement maintained at 6 months postintervention. The results suggest that brief interventions may be applied to a broader oncology population.

Radiotherapy offered excellent local control with a prolonged clinical course for patients with mucosa-associated lymphoid tissue lymphoma in the ocular adnexa. The initial response to radiotherapy had a marginal impact on the development of subsequent disease recurrence.

The current study was conducted to determine the prevalence of genetic polymorphisms in UGT1A10 and their association with risk for orolaryngeal carcinoma. UGT1A10 is an enzyme that is involved in the detoxification of several tobacco carcinogens and is expressed in aerodigestive tract tissues. The results of the current study showed that the UGT1A10 gene has several low-frequency missense polymorphisms and that the codon 139 polymorphism is an independent risk factor for orolaryngeal carcinoma in blacks.