Clinical medicine. Oncology最新文献

{"title":"Adjuvant Chemotherapy for Patients with Stage III Colon Cancer: Results from a CDC-NPCR Patterns of Care Study.","authors":"Rosemary D Cress,&nbsp;Susan A Sabatino,&nbsp;Xiao-Cheng Wu,&nbsp;Maria J Schymura,&nbsp;Randi Rycroft,&nbsp;Erik Stuckart,&nbsp;John Fulton,&nbsp;Tiefu Shen","doi":"10.4137/cmo.s2316","DOIUrl":"https://doi.org/10.4137/cmo.s2316","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate adjuvant chemotherapy use for Stage III colon cancer.</p><p><strong>Methods: </strong>This analysis included 973 patients with surgically treated stage III colon cancer. Socioeconomic information from the 2000 census was linked to patients' residential census tracts. Vital status through 12/31/02 was obtained from medical records and linkage to state vital statistics files and the National Death Index.</p><p><strong>Results: </strong>Adjuvant chemotherapy was received by 67%. Treatment varied by state of residence, with Colorado, Rhode Island and New York residents more likely to receive chemotherapy than Louisiana residents. Older age, increasing comorbidities, divorced/widowed marital status, and residence in lower education areas or non-working class neighborhoods were associated with lower chemotherapy use. Survival varied by state but after adjustment for sex, sociodemographic and health factors, was significantly higher only for California and Rhode Island. Older age and lower educational attainment were associated with lower survival. Chemotherapy was protective for all comorbidity groups.</p><p><strong>Conclusion: </strong>Although adjuvant chemotherapy for Stage III colon cancer improves survival, some patients did not receive standard of care, demonstrating the need for cancer treatment surveillance. Interstate differences likely resulted from differences in local practice patterns, acceptance of treatment, and access.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"107-19"},"PeriodicalIF":0.0,"publicationDate":"2009-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s2316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29171991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The metastasectomy and timing of pulmonary metastases on the outcome of osteosarcoma patients.","authors":"Yu-Min Huang,&nbsp;Chun-Han Hou,&nbsp;Sheng-Mou Hou,&nbsp;Rong-Sen Yang","doi":"10.4137/cmo.s531","DOIUrl":"https://doi.org/10.4137/cmo.s531","url":null,"abstract":"<p><strong>Background: </strong>The author intended to clarify the therapeutic effect and prognostic factors of metastasectomy and timing of pulmonary metastases in osteosarcoma patents.</p><p><strong>Methods: </strong>Data was obtained retrospectively on all consecutive osteosarcoma patients from 1985 to 2005 in author's institute. Fifty-two patients with pulmonary nodules were identified, including 24 patients undergoing pulmonary metastasectomy treatment. These patients were categorized into four groups: group 1, patients with lung metastases at the initial presentation; group 2, lung metastases identified during the period of pre-operative chemotherapy; group 3, lung metastases identified during period of the post-operative che motherapy; group 4, lung metastases identified after therapy for the primary osteosarcoma completed.</p><p><strong>Results: </strong>In our study, the 2-, 3-, and 5-year overall survival rates for 52 patients were 49%, 39% and 20%. The 2-year overall survival rates were 18% for group 1, 32% for group 3, and 70% for group 4 (p < 0.001). The 5-year overall survival rate was 34% for group 4. Patients who underwent metastesectomy showed a better survival outcome as compared with the patients not undergoing metastasectomy (p = 0.003). The 2-year and 5-year overall survival rates of only one lung metastatic nodule were 62% and 50%, and for initially multiple lung metastatic nodules, 45% and 5%, respectively. In addition, the patients presented with lung metastases had a worse prognosis as compared with those without initial lung metastases (p = 0.0001).</p><p><strong>Conclusions: </strong>The patients having single metastatic nodule showed a better prognosis than those with multiple lung nodules. Furthermore, those patients who underwent metastasectomy survived longer than those not undergoing metastasectomy. Patients who had late metastases after complete chemotherapy had a better prognosis; whereas those who had metastases identified at the initial presentation predicted a poor prognosis.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"99-105"},"PeriodicalIF":0.0,"publicationDate":"2009-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29171990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A commentary on \"risk factors for renal cell cancer in a Japanese population\".","authors":"Esther Uña Cidon","doi":"10.4137/cmo.s2926","DOIUrl":"https://doi.org/10.4137/cmo.s2926","url":null,"abstract":"<p><p>The well-written and researched article reported in Clinical Medicine: Oncology by Dr. Washio and Dr. Mori entitled \"Risk factors for renal cell cancer in a Japanese population\"1 makes evident the differences in incidence and mortality rates from renal cell carcinoma (RCC) between different populations and highlights the relevance of carrying out epidemiological studies, investigating additional risk factors which may explain the differences.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"87-90"},"PeriodicalIF":0.0,"publicationDate":"2009-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s2926","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29171988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric Adenocarcinoma: Is Computed Tomography (CT) Useful in Preoperative Staging?","authors":"Esther Uña Cidón,&nbsp;Isabel Jiménez Cuenca","doi":"10.4137/cmo.s2641","DOIUrl":"https://doi.org/10.4137/cmo.s2641","url":null,"abstract":"<p><strong>Background and purpose: </strong>Although multiple studies testing the accuracy of CT in the preoperative staging of gastric adenocarcinoma have been carried out, their results are controversial. Whilst some authors claim that CT is an accurate method for preoperatively staging gastric cancer, others have advocated the contrary. Because of this discrepancy we have retrospectively reviewed preoperative CT findings compared with histopathological results in patients with gastric adenocarcinoma.</p><p><strong>Patients and methods: </strong>Seventy-two patients diagnosed with gastric cancer who underwent potentially curative surgery and preoperative staging CT of quality were included in the study. The size, gastric wall thickening, presence of lymphadenopathy, adjacent organ invasion and location of the gastric mass was recorded. Early tumors (T1 and T2) and more advanced tumors (T3 and T4) were grouped together. CT staging was correlated with the final histopathological stage (TNM). The global results were expressed as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).</p><p><strong>Results: </strong>Seventy-two cases were included with fifty-five being male and a median age of 67 years (range 33-91). CT correctly identified the location of the tumor in 56 (53% antropyloric, 18% subcardial). Median time from CT scan to surgery was fourteen days (range 2-49). In T detection: T1/T2 and T3/T4 with sensitivity of 70% and 61%. Lymph node involvement: Sensitivity 49%. Overstaged in 47% Understaged in 75%. Specificity of 53%. Nine patients with colon-mesocolon (5 patients) and pancreas (4 patients) invasion. Sensitivity 44% and specificity 96%.</p><p><strong>Conclusion: </strong>Spiral CT is not an accurate method in predicting preoperative stages in gastric cancer.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"91-7"},"PeriodicalIF":0.0,"publicationDate":"2009-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s2641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29171989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic heterogeneity of breast tumor pathogenesis.","authors":"Rachel E Ellsworth,&nbsp;Jeffrey A Hooke,&nbsp;Craig D Shriver,&nbsp;Darrell L Ellsworth","doi":"10.4137/cmo.s2946","DOIUrl":"https://doi.org/10.4137/cmo.s2946","url":null,"abstract":"<p><p>Pathological grade is a useful prognostic factor for stratifying breast cancer patients into favorable (low-grade, well-differentiated tumors) and less favorable (high-grade, poorly-differentiated tumors) outcome groups. Under the current system of tumor grading, however, a large proportion of tumors are characterized as intermediate-grade, making determination of optimal treatments difficult. In an effort to increase objectivity in the pathological assessment of tumor grade, differences in chromosomal alterations and gene expression patterns have been characterized in low-grade, intermediate-grade, and high-grade disease. In this review, we outline molecular data supporting a linear model of progression from low-grade to high-grade carcinomas, as well as contradicting genetic data suggesting that low-grade and high-grade tumors develop independently. While debate regarding specific pathways of development continues, molecular data suggest that intermediate-grade tumors do not comprise an independent disease subtype, but represent clinical and molecular hybrids between low-grade and high-grade tumors. Finally, we discuss the clinical implications associated with different pathways of development, including a new clinical test to assign grade and guide treatment options.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"77-85"},"PeriodicalIF":0.0,"publicationDate":"2009-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s2946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29171987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for renal cell cancer in a Japanese population.","authors":"Masakazu Washio,&nbsp;Mitsuru Mori","doi":"10.4137/cmo.s2669","DOIUrl":"https://doi.org/10.4137/cmo.s2669","url":null,"abstract":"<p><p>The incidence of renal cell cancer has been increasing worldwide. Although the incidence of renal cell cancer in Japan is lower than the rates in the other industrialized countries, there is no doubt that it is increasing. In this paper, we would like to introduce the result of our studies, which evaluate the risk factors for renal cell cancer in Japan. Hypertension, diabetes mellitus, kidney diseases, fondness for fatty food and black tea showed an increased risk of renal cell carcinoma while an intake of starchy roots such as taro, sweet potato and potato reduced the risk of renal cell carcinoma. In Japan, however, drinking black tea may be a surrogate for westernized dietary habits while eating starchy roots may be a surrogate for traditional Japanese dietary habits. Further studies may be needed to evaluate risk factors for renal cell cancer because the number of renal cancer cases was small in our studies in spite of a large population-based cohort study.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"71-5"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s2669","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29171986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of advanced non small cell lung cancer in routine care: a retrospective analysis of 212 consecutive patients treated in a community based oncology group practice.","authors":"Hubert Koeppler,&nbsp;Jochen Heymanns,&nbsp;Joerg Thomalla,&nbsp;Kristina Kleboth,&nbsp;Ulrike Mergenthaler,&nbsp;Rudolf Weide","doi":"10.4137/cmo.s2199","DOIUrl":"https://doi.org/10.4137/cmo.s2199","url":null,"abstract":"<p><p>Treatment outcome data generated in prospective trials are intrinsically biased due to necessary selection criteria. Therefore the results obtained may not reflect the actual impact of current treatment options for an unselected general population. We analysed the treatment modalities and the outcome in 212 consecutive patients with non small cell lung cancer stages IIIB and IV who were seen in a community based oncology group practice between 6/1995 and 6/2006. 93 presented with stage IIIB and 119 with stage IV. Chemotherapy was given to 194/212 patients (92%), 114 patients (54%) received palliative radiation at one point during treatment. Treatment consisted of chemotherapy only in 86 patients (40%) and radiation only in 6 patients. 12 patients received best supportive care only. Patients with stage IIIB have survival rates at 12, 24 and 36 months of 64%, 27% and 21% respectively and for patients with stage IV the survival rates at 12, 24 and 36 months are 40%, 19% and 11% respectively. The median survival for stages IIIB and IV is 16 and 11 months respectively. In a multivariate analysis incorporating the factors stage (IIIB vs. IV), age (<70 vs. >/=70 years) and performance status (WHO 0/1 vs. 2/3) only stage and performance status were independent factors for survival. These retrospective data concerning analysis of survival, response rates and toxicity in a community setting confirm published results of phase II-III studies and indicate that results generated in prospective trials can be transferred into routine care.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"63-70"},"PeriodicalIF":0.0,"publicationDate":"2009-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s2199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29171985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photodynamic diagnosis for superficial bladder cancer: do all risk-groups profit equally from oncological and economic long-term results?","authors":"Wolfgang Otto, Maximilian Burger, Hans-Martin Fritsche, Andreas Blana, Wolfgang Roessler, Ruth Knuechel, Wolf F Wieland, Stefan Denzinger","doi":"10.4137/cmo.s1012","DOIUrl":"10.4137/cmo.s1012","url":null,"abstract":"<p><strong>Objective: </strong>Photodynamic diagnosis (PDD) of superficial bladder cancer decreases recurrence rates. We present oncological results of a randomized, prospective study, comparing transurethral resection (TUR) performed under conventional white light (WL) with PDD. The follow-up period is the longest reported to date. As costs might be reimbursed by prolonged recurrence-free survival in certain patients cost analysis in regard to risk-groups was performed.</p><p><strong>Material and methods: </strong>Using chi-square test and log-rank test we compared recurrence rates of 103 patients after WL-TUR and of 88 patients after PDD-TUR. Cost analysis was performed according to risk-groups of recurrence.</p><p><strong>Results: </strong>Mean follow-up was 99 months. Recurrence rate was 57% in WL vs. 28% in PDD (p < 0.001). Costs incurred by subsequent TUR averaged euro 2310 per WL patient vs. euro 713 per PDD patient. Savings per patient by PDD amounted to euro 1597. PDD costs were reimbursed in low, intermediate and high risk patients, respectively.</p><p><strong>Conclusions: </strong>PDD-TUR is significantly superior to conventional WL-TUR in terms of recurrence rate. While economic benefit is most prominent in intermediate risk patients, PDD related costs are reimbursed in all risk-groups.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"53-8"},"PeriodicalIF":0.0,"publicationDate":"2009-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29174096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) Diagnosis of Recurrent Anal Cancer After Chemoradiation and Negative Forceps Biopsies: A Case Report.","authors":"Julia Leblanc,&nbsp;Pradermchai Kongkam","doi":"10.4137/cmo.s993","DOIUrl":"https://doi.org/10.4137/cmo.s993","url":null,"abstract":"<p><p>A 69-year-old woman with a history of uT2 N0 post-treated anal squamous cell cancer (SCC) presented for EUS for perianal pain. Two months prior, a digital rectal examination was significant for an indurated lesion on the left lateral rectal wall just proximal to the dentate line. A sigmoidoscopy revealed mild narrowing of the anal canal and an ulcerated friable mucosa in the same area. A biopsy demonstrated ulceration without malignancy. EUS showed a hypoechoic, non-circumferential, left-sided distal rectal mass. EUS-FNA was performed. Cytology demonstrated poorly differentiated SCC. This was confirmed by subsequent surgical resection. While endoscopic biopsy of suspected anal recurrences is usually sufficient, histologic or cytologic confirmation are necessary, as radiation-induced changes are difficult to differentiate from tumor recurrence. This case demonstrates that EUS-FNA is useful in surveillance of anal SCC when there is a high clinical suspicion of recurrence.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":"3 ","pages":"59-62"},"PeriodicalIF":0.0,"publicationDate":"2009-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s993","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29174097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glioblastoma Multiforme Oncogenomics and Signaling Pathways.","authors":"Okezie O Kanu,&nbsp;Betsy Hughes,&nbsp;Chunhui Di,&nbsp;Ningjing Lin,&nbsp;Jinrong Fu,&nbsp;Darell D Bigner,&nbsp;Hai Yan,&nbsp;Cory Adamson","doi":"10.4137/cmo.s1008","DOIUrl":"https://doi.org/10.4137/cmo.s1008","url":null,"abstract":"<p><p>In the adult population, glioblastoma multiforme is one of the most common primary brain tumors encountered. Unfortunately, this highly malignant tumor represents over 50% of all types of primary central nervous system gliomas. The vast majority of GBMs develops quite rapidly without clinical, radiological, or morphologic evidence of a less malignant precursor lesion (primary or de novo GBMs), as compared to secondary GBMs that develop slowly by progression from diffuse low-grade astrocytomas. These GBM subtypes must be kept in mind because they may constitute distinct disease entities. Even though they look histologically quite similar, they likely involve different genetic alterations and signaling pathways. Decades of surgical therapy, radiotherapy, and chemotherapy have failed to drastically change survival. Clearly, we do not fully understand this tumor; however, the exciting genetic revolution in glioma research over the past decade is providing a promising outlook for exploring this tumor at the genetic level. Science has begun to elucidate the numerous genetic alterations and critical signaling pathways, and it has opened new exciting areas of research such as glioma stem cell biology and neoangiogenesis. This work has already begun to improve our understanding of GBM cell proliferation, migration, and invasion. Indeed, exciting novel targeted therapies are making their way to clinical trials based on this increased knowledge. This review provides the current understanding of GBM oncogenomics, signaling pathways, and glioma stem cell biology and discusses the potential new therapeutic targets on the horizon.</p>","PeriodicalId":88451,"journal":{"name":"Clinical medicine. Oncology","volume":" ","pages":"39-52"},"PeriodicalIF":0.0,"publicationDate":"2009-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/cmo.s1008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40032404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}