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Survival Differences (survival + difference)
Selected AbstractsFactors influencing long-term survival following salvage total laryngectomy after initial radiotherapy or conservative surgery,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2006B. Zach Fowler MD Abstract Background. This retrospective study investigated survival outcomes of salvage total laryngectomy (STL) after initial radiation therapy (RT) or larynx conservation surgery (CS) at an academic center. Methods. A chart review yielded 64 patients with STL: 53 with RT failures, six with CS failures, and five after RT + CS. Median potential follow-up after STL was 9.4 years (mean, 9.2 years; range, 0.3,17.4 years). Results. Five- and 10-year actuarial overall survival (OS) after STL was 65.2% and 37.7%, respectively. Mean survival after STL was 7.2 years (median, 6.8 years; range, 0.2,17.4 years). No significant survival difference was found between the three treatment groups (p = .50). For 21 patients with nodes assessed at STL, 9-year OS was 45.4% for patients with N0 disease versus 26.7% for patients with N+ disease (p = .25). Conclusion. These data suggest that STL after radiation failure is associated with equivalent long-term survival as STL after RT + CS or after failure of CS alone. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Survival in Danish patients with breast cancer and inflammatory bowel disease: A nationwide cohort study,INFLAMMATORY BOWEL DISEASES, Issue 4 2008Kirstine Kobberøe Søgaard BA Abstract Background: Incidences of inflammatory bowel disease (IBD) and of breast cancer have increased over the last decades. The influence of IBD on breast cancer prognosis, however, is unknown. We therefore examined the impact of IBD on treatment receipt and survival in breast cancer patients. Methods: Information on breast cancer patients (stage and treatment) diagnosed between 1980 and 2004 was sourced from the Danish Cancer Registry. Data on IBD and potential confounders were extracted from the Danish National Registry of Patients covering all Danish hospitals. Cox regression was used to compute mortality rate ratios (MRRs) among breast cancer patients with IBD, compared to their non-IBD counterparts, adjusting for age, stage, comorbidity measured by the Charlson Index, and calendar year. Results: We identified 71,148 breast cancer cases; 67 also had Crohn's disease (CD) and 216 had ulcerative colitis (UC). Patients with CD had more advanced stage and received radiotherapy less, and chemotherapy more, frequently than patients without IBD. In the adjusted analyses there was no substantial survival difference in breast cancer patients with and without IBD (MRRCD = 1.22; 95% confidence interval [CI] = 0.85,1.75; MRRUC = 1.09; 95% CI = 0.86,1.38). In a stratified analysis, chemotherapy was associated with poorer survival in patients with CD (MRRCD = 1.93; 95% CI = 1.00,3.72). Conclusions: Breast cancer patients with UC receive the same treatment and have similar survival to breast cancer without IBD. In contrast, breast cancer patients with CD are treated with radiotherapy less often. Survival of breast cancer in patients with CD treated with chemotherapy is poorer compared to survival in patients without IBD. (Inflamm Bowel Dis 2007) [source] Evaluation of acute congestive heart failure in dogs and cats: 145 cases (2007,2008)JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2010Caroline M. Goutal DVM Abstract Objective , To characterize the clinical presentation, management, and in-hospital outcomes of dogs and cats diagnosed with acute congestive heart failure (CHF). Design , Retrospective study of animals seen between January 2007 and May 2008. Setting , Emergency service at a university teaching hospital. Animals , Ninety dogs and 55 cats with CHF. Measurements and Main Results , Patient characteristics, including age, clinical signs, clinicopathologic abnormalities, diagnostic testing, and outcome were recorded. Forty-eight of the animals already were receiving cardiac medications at the time of presentation. The most common diseases represented were chronic valvular disease and cardiomyopathies. Cats had significantly lower median body temperature at admission compared with dogs (P<0.001). The most common abnormalities were elevated lactate (64%), elevated BUN (52%), hypochloremia (31%), hyperglycemia (27%), and elevated liver enzymes (26%). Many of these became even more prevalent during hospitalization. One hundred and sixteen animals were discharged from the hospital, for a survival rate of 80%. There was no survival difference between dogs and cats (P=0.39). Dogs that developed hypokalemia during hospital stay (P=0.04) were more likely to survive compared with those without hypokalemia and initial body temperature was lower for those cats that did not survive (P=0.02). Of those that did not survive, the majority were euthanized (n=25), while 4 dogs died. Conclusions , Dogs and cats presented to the emergency service with CHF had a high survival rate. In cats, initial body temperature was lower for those cats that did not survive. Although clinicopathologic abnormalities were common in both species, only dogs with hypokalemia had improved survival to hospital discharge. [source] Glut3 Expression in Biopsy Specimens of Laryngeal Carcinoma Is Associated With Poor Survival,THE LARYNGOSCOPE, Issue 2 2002Susan Baer MD Abstract Objectives/Hypothesis The aim of the study was to determine the clinical significance of the expression of Glut1 and Glut3 proteins in biopsy specimens of squamous cell carcinoma (SCC) of the larynx. Study Design A retrospective study. Methods Using immunohistochemistry, we immunostained sections of formalin-fixed, paraffin-embedded tissues from 48 biopsies of invasive SCC of the larynx for Glut1 and Glut3. The percentages of positive cells were recorded, then correlated with overall patient survival using the Kaplan-Meier method and the Breslow-Gehan-Wilcoxon test for statistical significance. Results All cases were positive for Glut1, and Glut1 expression was not associated with survival difference at any cut-off value. Eighteen (38%) of the cases were Glut3-negative and 30 (62%) were Glut3-positive. Glut3-positive cases were associated with poorer survival than Glut3-negative cases (P = .0336). No significant difference was found between Glut3-negative and Glut3-positive groups in respect to sex, tumor site (glottic vs. supraglottic), nodal or distant metastasis, or treatment modality. However, there were significantly more poorly differentiated tumors in the Glut3-positive group than in the Glut3-negative group (27% vs. 0%, respectively;P = .0182, Fisher's Exact Test). After poorly differentiated tumors were excluded from the survival analysis, Glut3 immunoreactivity remained a significant marker of poor prognosis (P = .0385). Conclusion Immunohistochemical detection of Glut3 in biopsy specimens of SCC of the larynx is a marker of poorer prognosis. [source] Estimating population parameters in a threatened arctic fox population using molecular tracking and traditional field methodsANIMAL CONSERVATION, Issue 4 2008T. Meijer Abstract Comprehensive population parameter data are useful for assessing effective conservation actions. The Fennoscandian arctic fox Alopex lagopus is critically endangered and the population size is estimated at 120 individuals that are fragmented into four isolated populations. Here, we use molecular tracking and visual observations to estimate population size and survival in one of the populations on the Swedish mountain tundra during a year of low food availability. We collected 98 arctic fox faecal samples during the winter of 2006 and recorded visual observations of ear-tagged individuals during the summer of 2005 and 2006. The faecal samples were analysed for variation in nine microsatellite loci and matched to the genetic profiles of previously ear-tagged individuals from 2001 to 2005. During winter 2006, the minimum number alive was 12 individuals using visual observations, 30 using molecular tracking and 36 by combining the datasets. Population size was estimated through mark,recapture for the molecular tracking and visual observation datasets and through rarefaction analyses for molecular tracking data. The mark,recapture estimate for visual observations was uninformative due to the large confidence interval (CI) (i.e. 6,212 individuals). Based on the molecular tracking dataset combined with the minimum number alive for visual observations and molecular tracking, we concluded a consensus population size of 36,55 individuals. We also estimated the age-specific finite survival rate during 1 year (July 2005 to July 2006) by combining molecular tracking with visual observations. Juvenile survival on a yearly basis was 0.08 (95% CI 0.02,0.18) while adults had a survival of 0.59 (95% CI 0.39,0.82). Juveniles displayed a lower survival than the adults during autumn (P<0.01) whereas no age-specific survival difference during spring was found. The risk of negative effects due to the small population size and low juvenile survival is accordingly considerable. [source] Missed lesions in synchronous multiple gastric cancerANZ JOURNAL OF SURGERY, Issue 4 2010Tae Kyung Ha Abstract Background:, The aims of this study were to define differences between synchronous multiple gastric cancer (MGC) and solitary gastric cancer (SGC) and to evaluate the characteristics of missed lesions in MGC so as to improve the detection rate of missed lesions during perioperative procedure. Methods:, The authors retrospectively analysed data on 9157 gastric cancer patients who underwent gastrectomy for gastric cancer in a single hospital. The characteristics of 8893 SGC and 264 MGC patients were evaluated. The characteristics of missed lesions in MGC were compared with those of diagnosed lesions found in preoperative endoscopy. Results:, Of the 9157 gastric patients, 264 patients with MGC showed a total of 565 cancer lesions, 70 of which were missed at endoscopy. The patients with MGC demonstrated different characteristics compared with those with SGC in terms of sex, age, type of operation, depth of tumour, lymph node metastasis, tumour size, tumour location and curability (P < 0.05). The characteristics of the missed lesions (n= 70) were a small size (P < 0.05), a middle one-third location (P < 0.001) and a flat type by macroscopic examination (P < 0.05) as compared with detected lesions (n= 495). No survival difference was detected between patients with and without missed lesions over a mean follow-up of 36.0 ± 22.7 month. Conclusions:, Preoperative gastroscopy should be performed meticulously in the entire stomach, especially in older men, in order to identify the presence and locations of cancer lesions that might otherwise be missed. [source] Estrogen receptor ,, an independent prognostic marker in estrogen receptor , and progesterone receptor-positive breast cancer?APMIS, Issue 9 2009BJØRN O. MÆHLE Both subtypes of estrogen receptor (ER), ER, and ER,, are normally present in the mammary gland. The role of ER, as a prognostic marker in breast cancer is well established due to the beneficial effect of providing tamoxifen as adjuvant therapy. The role of ER,, however, is less clear. To gain insight into the importance of ER, in breast cancer, 145 primary breast cancers were examined by immunohistochemistry for ER,, and the expression level was compared with ER, and progesterone receptor (PR) status. Especially, we wanted to examine the significance of ER, in the contrasting ER,+/PR+ and ER,,/PR, subgroups. In the ER,+/PR+ subgroup (dual positive), the survival difference between patients with low, medium and high ER , level was statistically significant (p = 0.004), with more than 70% of patients with medium and high ER, levels surviving 100 months, compared with less than 30% in the group with low ER, level. Further, for ER,+/PR+ patients there was a reduced risk of fatal outcome by multivariate analysis with increasing ER, levels (p(trend) < 0.01 [univariate analysis]; p(trend) = 0.05 [multivariate analysis]). The risk was 31% and 27% for medium and high ER, levels, respectively, compared with low ER, level, adjusting for standard prognostic factors such as tumor diameter, nuclear tumor grade (quantified by mean nuclear area), lymph node status, and patient age at operation. For patients with ER,,/PR, tumors (dual negative), however, there was no association between ER, levels and patient outcome. Our findings indicate that ER, expression provides independent prognostic information for breast cancers with ER,/PR-positive status, a feature typical among screen-detected breast cancers. The role of ER, needs to be further evaluated especially in this group of breast cancers. [source] Echogenicity of liver metastases from colorectal carcinoma is an independent prognostic factor in patients treated with regional chemotherapyCANCER, Issue 6 2002Thomas Gruenberger M.D. Abstract BACKGROUND Echogenicity of liver metastases was found to be a predictive biologic factor influencing long-term outcome after curative liver resection. The current analysis focuses on the influence of echogenicity on survival in patients treated with intraarterial chemotherapy for unresectable colorectal carcinoma liver metastases. METHODS A retrospective analysis of prospectively collected data at the Department of Surgery at the University of New South Wales-affiliated St. George Hospital was performed. Two hundred twelve consecutive patients with unresectable hepatic metastases from colorectal carcinoma treated between May 1992 and September 2000 were analyzed. Echogenicity of metastases was measured intraoperatively using a 5 MHz probe. Overall survival difference was compared between hyper- and hypoechoic metastases on an intention-to-treat basis. RESULTS At a median followup of 15.1 months, 47 patients (22%) were alive and 165 (78%) had died. A significant survival benefit was observed in patients having hyperechoic lesions (median survival 16.2 months, 95% confidence interval [CI] 13.9,18.5) compared to hypoechoic lesions (median survival 11.6 months, 95% CI 8,15.2), P < 0.01. Other prognostic factors were differentiation of the primary tumor (P < 0.02), percentage hepatic replacement (P < 0.05) and carcinoembryonic antigen decrease (P < 0.03). Echogenicity was identified as an independent prognostic factor in multivariate analysis (P < 0.009). CONCLUSIONS Echogenicity is an important prognostic survival parameter. Cancer 2002;94:1753,9. © 2002 American Cancer Society. DOI 10.1002/cncr.10386 [source] Numeracy and the shortcomings of utility assessment in head and neck cancer patients,,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2004Seth R. Schwartz MD Abstract Background. Because survival differences between surgical and nonsurgical treatment for head and neck cancer (HNC) are hard to detect, increasing focus has been placed on quality of life (QOL) differences after treatment. Utility assessment provides insight into QOL. Evidence suggests that a patient's comfort with numerical concepts ("numeracy") may influence utility measures. We hypothesize that patients who are nonnumerate provide inconsistent utility data in QOL studies. Methods. New HNC (n = 18) patients were recruited to participate. Patients completed a numeracy questionnaire, a utility assessment, and a global QOL questionnaire. Higher scores reflect better function. Interviewers rated the functional level of each patient. For both numerate and nonnumerate patients, utility scores were compared with global QOL (good vs poor) and observer-rated function. Results. Half of the patients were numerate. Numerate patients who rated their QOL as good had significantly higher utility scores than did patients with poor global QOL (0.95 vs 0.43, p = .03). In contrast, nonnumerate patients with good QOL had lower utility scores than did patients with poor QOL (0.45 vs 0.77, NS). Utility scores for numerate patients correlated well with observer-rated function (r = 0.41 to r = 0.57), whereas those of nonnumerate patients did not (r = ,0.16 to r = 0.06). Conclusions. QOL evaluation through utility assessment may provide inaccurate and contradictory data about patient functioning for nonnumerate patients. This may confound QOL assessment when interpreting utility data. © 2004 Wiley Periodicals, Inc. Head Neck26: 401,407, 2004 [source] Cancer survival in Germany and the United States at the beginning of the 21st century: An up-to-date comparison by period analysisINTERNATIONAL JOURNAL OF CANCER, Issue 2 2007Adam Gondos Abstract Transatlantic cancer survival comparisons are scarce and involve mostly aggregate European data from the late 1980s. We compare the levels of cancer patient survival achieved in Germany and the United States (US) by the beginning of the 21st century, using data from the Cancer Registry of Saarland/Germany and the SEER Program of the US. Age-adjusted 5- and 10-year relative survival for 23 common forms of cancer derived by period analysis for the 2000,2002 period were calculated, with additional detailed age- and stage-specific analyses for cancers with the highest incidence. Among the 23 cancer sites, 5 (10) year relative survival was significantly higher for 1 (2) and 8 (5) cancers in Germany and the US, respectively. In Germany, survival was significantly higher for patients with stomach cancer, whereas survival was higher in the US for patients with breast, cervical, prostate, colorectal and oral cavity cancer. Among the most common cancers, age-specific survival differences were particularly pronounced for older patients with breast, colorectal and prostate cancer. Survival advantages of breast cancer patients in the US were mainly due to more favorable stage distributions. This comprehensive survival comparison between Germany and the US suggests that although survival was similar for the majority of the compared cancer sites, long-term prognosis of patients continues to be better in the US for many of the most common forms of cancer. Among these, differences between patients with breast and prostate cancer are probably due to more intensive screening activities. © 2007 Wiley-Liss, Inc. [source] Independent predictors of contralateral metachronous upper urinary tract transitional cell carcinoma after nephroureterectomy: Multi-institutional dataset from three European centersINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2009Giacomo Novara Objectives: To identify the variables predictive of contralateral metachronous upper urinary tract transitional cell carcinoma (UUT-TCC) after nephroureterectomy (NFU) for non-metastatic UUT-TCC. Methods: Clinical and pathological data of 234 patients who had undergone NFU for UUT-TCC from 1989 to 2005 in three European urological centers were retrospectively collected and analyzed. Results: The median follow-up duration for the whole cohort was 34 months. Contralateral metachronous UUT-TCC was detected in 14 patients (6%). Three patients were treated by NFU, while seven patients underwent ureterectomy and reimplantation and four patients were treated by endoscopic resection plus bacillus Calmette,Guérin instillations within the UUT through a nephrostomic tube. On univariate analysis, a prior history of bladder TCC before NFU was the only factor predictive of the occurrence of contralateral UUT-TCC. Specifically, the 5-year probabilities of being free from contralateral UUT-TCC were 96.6% for the patients with de novo UUT-TCC, and 91.1% and 55.3% for those having non-muscle-invasive and muscle invasive bladder TCC before the UUT cancer, respectively. All survival differences were statistically significant (no history of bladder TCC vs history of non-muscle-invasive bladder TCC, log rank P value 0.015; history of non-muscle-invasive bladder TCC vs history of muscle-invasive bladder TCC, log rank P value 0.035). Conclusions: In our multicenter dataset of patients who had undergone NFU for UUT-TCC, contralateral metachronous UUT-TCC occurred in 6% of the patients. A prior history of bladder TCC before NFU was the only variable predictive of UUT recurrence at univariate analysis. [source] Dynamic heterogeneity and life history variability in the kittiwakeJOURNAL OF ANIMAL ECOLOGY, Issue 2 2010Ulrich K. Steiner Summary 1. Understanding the evolution of life histories requires an assessment of the process that generates variation in life histories. Within-population heterogeneity of life histories can be dynamically generated by stochastic variation of reproduction and survival or be generated by individual differences that are fixed at birth. 2. We show for the kittiwake that dynamic heterogeneity is a sufficient explanation of observed variation of life histories. 3. The total heterogeneity in life histories has a small contribution from reproductive stage dynamics and a large contribution from survival differences. We quantify the diversity in life histories by metrics computed from the generating stochastic process. 4. We show how dynamic heterogeneity can be used as a null model and also how it can lead to positive associations between reproduction and survival across the life span. 5. We believe our approach to identifying the nature of among-individual heterogeneity yields important insights into the forces that generate within-population variation of life-history traits. It provides an alternative to claims that fixed individual differences are a major determinant of heterogeneity in life histories. [source] Spatial patterns of recruitment in Mediterranean plant species: linking the fate of seeds, seedlings and saplings in heterogeneous landscapes at different scalesJOURNAL OF ECOLOGY, Issue 6 2008Lorena Gómez-Aparicio Summary 1Plant recruitment is a multiphase process that takes place in environments that are heterogeneous in space and time. In this work, I analyse how environmental heterogeneity in Mediterranean forests affects dynamics of early recruitment at different scales, using the wind-dispersed tree Acer opalus subsp. granatense as a case study. 2Seed dispersal and viability, post-dispersal predation, seedling emergence and seedling and sapling survival were evaluated in different habitats (regional scale) and microhabitats (local scale). Simultaneously, a review of the literature on spatial dynamics of plant recruitment in Mediterranean systems was conducted to look for general patterns and investigate their fit to the Acer system. Nineteen woody and herbaceous species were included in the review. 3At the regional scale, Acer recruitment dynamics strongly converged among sites of the same habitat. This was mainly due to large seedling emergence and survival differences among habitats. Although most of the studies reviewed analyzed only one site per habitat type, they also support strong regional variation (either site- or habitat-specific) in recruitment patterns. 4At the local scale, Acer recruitment was microhabitat-specific, a result shared by almost all the reviewed species independently of their life form and dispersal syndrome. This was mostly due to spatial differences in seed arrival (higher under conspecifics) and seedling survival (higher under nurse shrubs). 5Spatial discordance among seed rain and recruitment was found in 60% of the reviewed species at the regional scale, and in 67% at the local scale. Acer results supported this predominant lack of concordance. Discordance among seed rain and recruitment suggests that regeneration is largely limited by safe sites than by seed availability. Because seedling survival was the limiting process with a larger impact on the magnitude and spatial pattern of recruitment, safe sites might be defined as those where seedlings have a higher survival probability. 6Synthesis: This study indicates that the influence of seed dispersal on the spatial patterns and demography of plant species could be limited in heterogeneous and stressful environments (as are found in the Mediterranean), where recruitment is restricted to a small fraction of the landscape. If we are to preserve the distribution and abundance of Mediterranean species in the face of environmental changes, we need to explicitly consider the strong patch-specificity that characterizes their recruitment process at all scales. [source] Female common lizards (Lacerta vivipara) do not adjust their sex-biased investment in relation to the adult sex ratioJOURNAL OF EVOLUTIONARY BIOLOGY, Issue 6 2005J.-F. LE GALLIARD Abstract Sex allocation theory predicts that facultative maternal investment in the rare sex should be favoured by natural selection when breeders experience predictable variation in adult sex ratios (ASRs). We found significant spatial and predictable interannual changes in local ASRs within a natural population of the common lizard where the mean ASR is female-biased, thus validating the key assumptions of adaptive sex ratio models. We tested for facultative maternal investment in the rare sex during and after an experimental perturbation of the ASR by creating populations with female-biased or male-biased ASR. Mothers did not adjust their clutch sex ratio during or after the ASR perturbation, but produced sons with a higher body condition in male-biased populations. However, this differential sex allocation did not result in growth or survival differences in offspring. Our results thus contradict the predictions of adaptive models and challenge the idea that facultative investment in the rare sex might be a mechanism regulating the population sex ratio. [source] Impact of patient age on the outcome of primary breast carcinoma,JOURNAL OF SURGICAL ONCOLOGY, Issue 1 2002Byeong-Woo Park MD Abstract Background and Objectives The poorer outcome amongst younger breast cancer patients continues to be an issue of debate. In order to clarify the prognostic value of patient age, we retrospectively analyzed the data of 1098 breast cancer patients. Methods Patients were divided into two groups based on the age 35 (Group I, women aged 35 or younger, and Group II, women aged over 35). Clinico-pathological parameters, 10-year loco-regional recurrence-free (10LRRFS), distant relapse-free (10DRFS), and overall (10OS) survival estimates were determined. Results Among the 1098 patients, approximately 16.7% (183) were allocated to Group I and the other 83.3% (915) to Group II. There were no significant differences between the two groups in terms of histopathologic features or mean follow-up. Group I had a poorer 10LRRFS of 86.8% (P,=,0.036), 10DRFS of 57.7% (P,<,0.0001), and 10OS of 68.3% (P,=,0.0001), compared with 93.9, 76.2, and 81.4% for Group II, respectively. Group I also showed a poorer 10DRFS when matched for stage and lymph node status as well. With lymph node status and tumor size, a patient age of younger than 35 was determined to be an independent prognostic factor by multivariate analysis. Conclusions These results indicate that patient age (younger than 35) shows an independent prognostic value and that survival differences by age may reflect differences in the tumor biology. J. Surg. Oncol. 2002;80:12,18. © 2002 Wiley-Liss, Inc. [source] Fluorouracil, Doxorubicin, and Cyclophosphamide Followed by Tamoxifen as Adjuvant Treatment for Patients with Stage IV Breast Cancer with No Evidence of DiseaseTHE BREAST JOURNAL, Issue 1 2002Edgardo Rivera MD We conducted a single-institution study to determine whether local therapy plus six cycles of chemotherapy with 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC) followed by 5 years of tamoxifen is superior to local treatment alone in terms of disease-free survival (DFS) and overall survival (OS) in patients with stage IV breast cancer with no evidence of disease (stage IV-NED breast cancer). Patients with breast cancer were eligible if they had histologic proof of a locoregional or distant recurrence that had been curatively resected, irradiated, or both and had no other evidence of disease. Patients who had received prior anthracycline therapy were not eligible. All patients received six cycles of intravenous FAC, with cycles repeated every 3 weeks. After completion of chemotherapy, patients whose tumors had not previously demonstrated resistance to tamoxifen and had positive or unknown estrogen receptor status received tamoxifen 20 mg by mouth daily for 5 years. Patients in this study were compared with a historical control population (patients with stage IV-NED breast cancer who never received systemic therapy) as well as with the patients in two previously reported trials of chemotherapy for stage IV-NED disease. Forty-seven patients were registered, but only 45 were evaluable. There was a highly statistically significant difference ( p < 0.001) in OS and DFS among the four groups, with patients in our most recent study having the best OS and DFS at 3 years compared with the control group (84% vs. 55% and 66% vs. 11%, respectively). When patients in all four groups were analyzed together in search of prognostic factors, we found that patients whose primary tumors had negative axillary lymph nodes had a statistically significant improvement in OS and DFS ( p < 0.01) compared with patients with positive axillary lymph nodes. No survival differences were found between patients with positive and those with negative hormone receptor status. This study demonstrates a benefit in terms of OS and DFS for patients with stage IV-NED breast cancer who receive doxorubicin-based adjuvant chemotherapy. The benefit was greater on patients with node-negative primary tumors. In patients with stage IV-NED disease, doxorubicin-based chemotherapy should be considered standard treatment after adequate local control is achieved. [source] Clinical trial enrollment, patient characteristics, and survival differences in prospectively registered metastatic colorectal cancer patientsCANCER, Issue 20 2009Halfdan Sorbye MD Abstract BACKGROUND: Trial accrual patterns were examined to determine whether metastatic colorectal cancer (mCRC) patients enrolled in trials are representative of a general cancer population concerning patient characteristics and survival. METHODS: A total of 760 mCRC patients referred for their first oncological consideration at 3 hospitals in Scandinavia covering defined populations were registered consecutively during 2003 to 2006. Clinical trial enrollment, patient characteristics, and treatment were recorded prospectively, and the follow-up was complete. RESULTS: Palliative chemotherapy was initiated in 61% of the patients. Approximately one,third (36%) of patients receiving chemotherapy were included in a trial. The main reason for nonparticipation was failed eligibility criteria (69%). The median survival after chemotherapy was 15.8 months for all patients, and 18 months after combination chemotherapy. Trial patients had better prognostic characteristics and significantly longer survival than nontrial patients: 21.3 months versus 15.2 months when receiving combination chemotherapy. Poor performance status was the main reason for giving best supportive care only, and the median survival was then only 2.1 months. The median survival for all 760 nonresectable mCRC patients was 10.7 months. CONCLUSIONS: mCRC patients enrolled into clinical trials differ in characteristics from patients receiving chemotherapy outside protocol and have better survival, even when given the same treatment. Although trial patients have a median survival close to 2 years, survival is lower for all patients receiving chemotherapy and much lower for all patients diagnosed with mCRC. Studies that better accept the heterogeneity of the population with mCRC are needed. Cancer 2009. © 2009 American Cancer Society. [source] Hypermethylation of FHIT as a prognostic marker in nonsmall cell lung carcinomaCANCER, Issue 7 2004Riichiroh Maruyama M.D. Abstract BACKGROUND Methylation of CpG islands in the promoter and upstream coding regions has been identified as a mechanism for transcriptional inactivation of tumor suppressor genes. The purpose of the current study was to determine the correlation between the aberrant promoter methylation of multiple genes and survival in patients with nonsmall cell lung carcinoma (NSCLC). METHODS The methylation status of nine genes was determined in 124 surgically resected NSCLC cases using methylation-specific polymerase chain reaction. RESULTS The methylation frequencies of the genes tested in NSCLC specimens were 52% for E-cadherin (CDH1), 41% for RAS association domain family protein (RASSF1A), 38% for fragile histidine triad (FHIT) and adenomatous polyposis coli (APC), 27% for retinoic acid receptor beta (RAR,) and H-cadherin (CDH13), 20% for p16INK4A, 0.8% for O6 -methylguanine-DNA-methyltransferase (MGMT), and 0% for glutathione S-transferase P1 (GSTP1). The survival of the patients with FHIT methylation-positive tumors was found to be significantly shorter than that for those patients with methylation-negative tumors (P = 0.03), even in those patients with International Union Against Cancer TNM Stage I or Stage II disease (P = 0.007). In contrast, there were no significant survival differences noted between the methylation-positive and methylation-negative tumors for the other genes tested. In addition, based on multivariate analyses, FHIT methylation-positive status was found to be independently associated with poor survival (P = 0.046) and disease stage (P < 0.0001). CONCLUSIONS The results of the current study suggest that methylation of FHIT is a useful biomarker of biologically aggressive disease in patients with NSCLC. Cancer 2004;100:1472,7. © 2004 American Cancer Society. [source] | |||||||||||||||||||||||||