MedWorm: Neoadjuvant Therapy

The Empowered Patient

Kidney Cancer Association — Fri, 03 Feb 2012 16:49:12 +0100

Members of the Kidney Cancer Association are attending the 2012 Genitourinary Cancers Symposium in San Francisco this week. Our Medical & Scientific Steering Committee meets here and we convened the first meeting of our new Neoadjuvant Group. We are currently studying the formation of a Kidney Cancer Association Clinical Trials Consortium that may address specific unmet needs in research. We encourage patients and their family members to invest the time necessary to evaluate information from this imporant Symposium that is freely available online from ASCO. If you have specific questions, we'll gladly refer these queries to medical experts. Generally speaking, it may not be wise for patients to rely on the judgment of those who lack a medical background ...

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Predicting platinum resistance in primary advanced ovarian cancer patients with an in vitro resistance index

Cancer Chemotherapy and Pharmacology — Thu, 02 Feb 2012 18:11:01 +0100

Conclusions This in vitro assay predicted primary platinum resistance, without misclassification of sensitive OC patients, and the results were significantly associated with PFS. We suggest that samples from primary tumor and metastatic samples have different responses to chemotherapy and that exposure to chemotherapy might induce in vitro platinum resistance. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00280-012-1835-9Authors Thea Eline Hetland, Departement of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, 0424 Oslo, NorwayJanne Kærn, Departement of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, 0424 Oslo, NorwayMartina Skrede, Departement of Pathology, Norwegian Radium Hospital...

Accuracy of transrectal ultrasound after preoperative radiochemotherapy compared to computed tomography and magnetic resonance in locally advanced rectal cancer

International Journal of Colorectal Disease — Thu, 02 Feb 2012 06:54:29 +0100

Conclusions Transrectal ultrasonography resulted as the most accurate method to determine neoplastic wall infiltration and lymph node involvement even after radiochemotherapy. In most cases, considering the poor correlation between the diagnostic procedures and the disagreement of the results, a restaging performed only with TRUS could be proposed, limiting the use of the other imaging methods to selected cases. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00384-012-1419-5Authors Jacopo Martellucci, Surgical Department, University of Siena, Siena, ItalyM. Scheiterle, Surgical Department, University of Siena, Siena, ItalyB. Lorenzi, Surgical Department, University of Siena, Siena, ItalyF. Roviello, Surgical Department, University of Sie...

[Comment] Don't pick the loser: lessons from the GeparQuinto trial

The Lancet Oncology — Wed, 01 Feb 2012 05:00:00 +0100

In The Lancet Oncology, Michael Untch and colleagues report the first efficacy results from the GeparQuinto (GBG 44) study, a randomised phase 3 trial of lapatinib versus trastuzumab in combination with neoadjuvant anthracycline-based and taxane-based chemotherapy. 620 women with HER2-positive operable or locally advanced breast cancer were randomly assigned to receive lapatinib (a tyrosine-kinase inhibitor of HER1 and HER2) or trastuzumab (a monoclonal antibody to the HER2 receptor), concurrent with a planned regimen of four cycles of an anthracycline (epirubicin 90 mg/m2 plus cyclophosphamide 600 mg/m2) followed by four cycles of a taxane (docetaxel 100 mg/m2). (Source: The Lancet Oncology)

[Articles] Lapatinib versus trastuzumab in combination with neoadjuvant anthracycline-taxane-based chemotherapy (GeparQuinto, GBG 44): a randomised phase 3 trial

The Lancet Oncology — Wed, 01 Feb 2012 05:00:00 +0100

This direct comparison of trastuzumab and lapatinib showed that pathological complete response rate with chemotherapy and lapatinib was significantly lower than that with chemotherapy and trastuzumab. Unless long-term outcome data show different results, lapatinib should not be used outside of clinical trials as single anti-HER2-treatment in combination with neoadjuvant chemotherapy. (Source: The Lancet Oncology)

Radical cystectomy for clinically muscle invasive bladder cancer: does prior non-invasive disease affect clinical outcomes?

World Journal of Urology — Tue, 31 Jan 2012 16:48:25 +0100

Conclusion Our retrospective study suggests that patients with non-invasive urothelial carcinoma of the bladder that progress to muscle invasion and require radical cystectomy appear to have better pathologic and clinical outcome than patients presenting with clinical muscle invasive disease de novo. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00345-012-0832-2Authors Ahmed F. Kotb, Department of Surgery (Urology), McGill University, Montreal, QC, CanadaEvan Kovac, Department of Surgery (Urology), McGill University, Montreal, QC, CanadaWassim Kassouf, Department of Surgery (Urology), McGill University, Montreal, QC, CanadaJoe Chin, Department of Surgery (Urology), University of Western Ontario, London, ON, CanadaYves Fradet, Department ...

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Comparison of ER/PR and HER2 statuses in primary and paired liver metastatic sites of breast carcinoma in patients with or without treatment

Journal of Cancer Research and Clinical Oncology — Tue, 31 Jan 2012 07:10:50 +0100

Conclusions ER/PR and HER2 statuses between primary and liver metastatic lesions of breast carcinoma can be modified after treatment but are stable in most cases during the natural metastatic process. Content Type Journal ArticleCategory Original PaperPages 1-6DOI 10.1007/s00432-012-1150-1Authors Jieqiong Liu, Department of Breast Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of ChinaHeran Deng, Department of Breast Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of ChinaWeijuan Jia, Department of Breast Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of ChinaYunjie Zeng, Department of Pathology, Sun Yat-Sen Memorial Hospital,...

HCC: current surgical treatment concepts

Langenbeck's Archives of Surgery — Tue, 31 Jan 2012 07:04:17 +0100

Conclusions The improvement of survival in HCC patients after surgical treatment results from refinements in surgical technique and better identification of adverse prognostic factors. Content Type Journal ArticleCategory Review ArticlePages 1-15DOI 10.1007/s00423-012-0911-2Authors F. Cauchy, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Clichy, France, University Denis Diderot-Paris 7, Paris, FranceD. Fuks, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Clichy, France, University Denis Diderot-Paris 7, Paris, FranceJ. Belghiti, Beaujon Hospital, Assistance Publique Hôpitaux de Paris, Clichy, France, University Denis Diderot-Paris 7, Paris, France Journal Langenbeck's Archives of SurgeryOnline ISSN 1435-2451Print ISSN 1435-2443 (Source:...

Neoadjuvant chemoradiation therapy is beneficial for clinical stage t2 n0 esophageal cancer patients due to inaccurate preoperative staging.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:22:39 +0100

CONCLUSIONS: For cT2 N0 esophageal cancer patients, the benefit of neoadjuvant therapy is still unclear. Induction therapy for cT2 N0 did not translate into a statistically significant improvement in survival. However, due to the significant understaging of T2 N0 patients, we recommend neoadjuvant therapy to all cT2N0 patients before operation. PMID: 22269708 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

In Regard to “Thymidylate Synthase Gene Polymorphism Affects the Response to Preoperative 5-Fluorouracil Chemoradiation Therapy in Patients With Rectal Cancer” (Int J Radiat Oncol Biol Phys 2011;81:669–676)

International Journal of Radiation Oncology * Biology * Physics — Mon, 30 Jan 2012 09:33:53 +0100

To the Editor: When preparing a manuscript addressing TS genetic polymorphisms in the context of neoadjuvant radiochemotherapy in patients with locally advanced rectal cancer, we read with great interest the study by Hur and colleagues . Of course, predictive markers for efficiency of the applied therapy regimen would be of high clinical value, which is documented by the high interest this issue has in the literature. In view of published data and our own data in this field, we would like to add some comments: (Source: International Journal of Radiation Oncology * Biology * Physics)

Castration Therapy of Prostate Cancer Results in Downregulation of HIF-1α Levels

International Journal of Radiation Oncology * Biology * Physics — Mon, 30 Jan 2012 09:33:53 +0100

Conclusions: Our data suggest that neoadjuvant castration decreases tumor cell hypoxia in prostate cancer, which may explain increased radiosensitivity after castration. (Source: International Journal of Radiation Oncology * Biology * Physics)

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Predictors of pre‐transplant dropout and post‐transplant recurrence in patients with perihilar cholangiocarcinoma

Hepatology — Mon, 30 Jan 2012 05:00:00 +0100

Conclusion: Outcome following neoadjuvant chemoradiation and liver transplantation for perihilar CCA is excellent. Risk of dropout is related to patient and tumor characteristics and this can be used to guide patient counseling prior to enrolment. Recurrence risk is mostly associated with presence of residual cancer on explant. PSC patients do not have an independent survival advantage over de‐novo patients, but present with more favorable tumor characteristics. (HEPATOLOGY 2012.) (Source: Hepatology)

Phase 2 study of neoadjuvant docetaxel plus bevacizumab in patients with high‐risk localized prostate cancer

Cancer — Sun, 29 Jan 2012 12:48:22 +0100

CONCLUSIONS:Neoadjuvant docetaxel and bevacizumab is safe, and results in reductions in both tumor volume and serum PSA, in men with high‐risk localized prostate cancer. The role of neoadjuvant chemotherapy in prostate cancer, and perioperative antiangiogenic therapy in general, requires further elucidation through ongoing and planned trials. Cancer 2012;. © 2012 American Cancer Society. (Source: Cancer)

Dose-dependent change in biomarkers during neoadjuvant endocrine therapy with fulvestrant: results from NEWEST, a randomized Phase II study

Breast Cancer Research and Treatment — Fri, 27 Jan 2012 17:55:30 +0100

Abstract NEWEST (Neoadjuvant Endocrine Therapy for Women with Estrogen-Sensitive Tumors) is the first study to compare biological and clinical activity of fulvestrant 500 versus 250 mg in the neoadjuvant breast cancer setting. We hypothesized that fulvestrant 500 mg may be superior to 250 mg in blocking estrogen receptor (ER) signaling and growth. A multicenter, randomized, open-label, Phase II study was performed to compare fulvestrant 500 mg (500 mg/month plus 500 mg on day 14 of month 1) versus fulvestrant 250 mg/month for 16 weeks prior to surgery in postmenopausal women with ER+ locally advanced breast cancer. Core biopsies at baseline, week 4, and surgery were assessed for biomarker changes. Primary endpoint: change in Ki67 labe...

Consensus Guidelines: Neoadjuvant Therapy in Breast CancerConsensus Guidelines: Neoadjuvant Therapy in Breast Cancer

Medscape Today Headlines — Fri, 27 Jan 2012 17:20:33 +0100

Key recommendations of an international consensus on neoadjuvant systemic therapy in primary breast cancer are discussed by Dr. Lidia Schapira. Medscape Hematology-Oncology (Source: Medscape Today Headlines)

Value of three‐dimensional power Doppler to predict clinical and histological response to neoadjuvant chemotherapy in locally advanced cervical carcinoma

Ultrasound in Obstetrics and Gynecology — Fri, 27 Jan 2012 08:35:23 +0100

ConclusionFI is a potential marker for predicting both clinical and histological responses to chemotherapy in patients with locally advanced cervical carcinoma. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. (Source: Ultrasound in Obstetrics and Gynecology)

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KRAS genotyping in rectal adenocarcinoma specimens with low tumor cellularity after neoadjuvant treatment

Modern Pathology AOP — Fri, 27 Jan 2012 05:00:00 +0100

Authors: Florence Boissière-Michot, Evelyne Lopez-Crapez, Hélène Frugier, Marie-Laurence Berthe, Alexandre Ho-Pun-Cheung, Eric Assenat, Thierry Maudelonde, Pierre-Jean Lamy & Frédéric Bibeau (Source: Modern Pathology AOP)

Controversies Concerning the Use of Neoadjuvant Systemic Therapy for Primary Breast Cancer

World Journal of Surgery — Thu, 26 Jan 2012 06:56:55 +0100

Abstract The major aim of neoadjuvant systemic therapy is to improve prognosis by individualizing treatment. The proven benefits of neoadjuvant systemic therapy include reducing tumor burden, higher breast-conserving surgery, and the possibility of in vivo monitoring of response to treatment. Other goals of neoadjuvant treatment are the detection of new prognostic and predictive biomarkers and the investigation of new drugs and imaging modalities. Although many prospective trials have answered important questions regarding neoadjuvant systemic therapy, several topics remain controversial. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-012-1424-4Authors Manfred Kaufmann, Department of Obstetrics and Gynecology and Breast Unit, Johann Wolfgang Goethe University...

RCTs: Neoadjuvant chemotherapy and bevacizumab for HER2-negative breast cancer

NeLM - News — Thu, 26 Jan 2012 05:00:00 +0100

Source: N Engl J Med Area: News The efficacy of neoadjuvant chemotherapy, as measured by the rate of pathological complete response varies according to breast-cancer subtype. When anthracyclines, taxanes, and agents directed against HER2 (if indicated) are used, approximately 30 to 40% of all breast cancers that are HER2-positive or triple-negative are completely eradicated locally at the time of surgery. Long-term follow-up studies have shown a consistent correlation between pathological complete response and low rates of relapse and death among patients with these two subtypes of breast cancer. Two RCTs of neoadjuvant chemotherapy and bevacizumab for HER2-negative breast cancer have been published in the New England Journal of Medicine (NEJM). The GeparQuinto phase...

Effects of ghrelin administration during chemotherapy with advanced esophageal cancer patients

Cancer — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSIONS:Short‐term administration of exogenous ghrelin at the start of cisplatin‐based chemotherapy stimulated food intake and minimized adverse events. Cancer 2012;. © 2012 American Cancer Society. (Source: Cancer)

[Liver transplantation for hilar cholangiocarcinoma.]

Der Chirurg — Thu, 26 Jan 2012 05:00:00 +0100

This article summarizes the current state, recommendations and results of liver transplantation for these patients. PMID: 22273852 [PubMed - as supplied by publisher] (Source: Der Chirurg)

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Bevacizumab Added to Neoadjuvant Chemotherapy for Breast Cancer

New England Journal of Medicine — Wed, 25 Jan 2012 22:00:16 +0100

New England Journal of Medicine, Volume 366, Issue 4, Page 310-320, January 2012. (Source: New England Journal of Medicine)

Neoadjuvant Chemotherapy and Bevacizumab for HER2-Negative Breast Cancer

New England Journal of Medicine — Wed, 25 Jan 2012 22:00:13 +0100

New England Journal of Medicine, Volume 366, Issue 4, Page 299-309, January 2012. (Source: New England Journal of Medicine)

Bevacizumab Shows Benefit in Nonmetastatic Breast CancerBevacizumab Shows Benefit in Nonmetastatic Breast Cancer

Medscape Today Headlines — Wed, 25 Jan 2012 22:00:00 +0100

Only months after the FDA revoked its metastatic breast cancer indication, the agent improved response in the neoadjuvant setting in 2 trials. Medscape Medical News (Source: Medscape Today Headlines)

Studies Reignite Debate over Avastin in Breast Cancer (CME/CE)

MedPage Today Public Health — Wed, 25 Jan 2012 21:06:05 +0100

(MedPage Today) -- Women with HER2-negative metastatic breast cancer had significantly higher rates of pathologic complete response when bevacizumab was added to neoadjuvant chemotherapy, two large clinical trials showed. (Source: MedPage Today Public Health)

Actinomyces infection mimicking tumor-progression in rectal cancer under neoadjuvant therapy.

Acta Oncologica — Wed, 25 Jan 2012 07:36:11 +0100

Authors: Petersen S, Würschmidt F, Gaul H, Caselitz J, Schwenk W PMID: 22263972 [PubMed - in process] (Source: Acta Oncologica)

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Prognostic value of metabolic response in breast cancer patients receiving neoadjuvant chemotherapy

BMC Cancer — Wed, 25 Jan 2012 05:00:00 +0100

Background: Today's clinical diagnostic tools are insufficient for giving accurate prognosis to breast cancer patients. The aim of our study was to examine the tumor metabolic changes in patients with locally advanced breast cancer caused by neoadjuvant chemotherapy (NAC), relating these changes to clinical treatment response and long-term survival. Methods: Patients (n=89) participating in a randomized open-label multicenter study were allocated to receive either NAC as epirubicin or paclitaxel monotherapy. Biopsies were excised pre- and post-treatment, and analyzed by high resolution magic angle spinning magnetic resonance spectroscopy (HR MAS MRS). The metabolite profiles were examined by paired and unpaired multivariate methods and findings of important metabolites were confirmed by sp...

Partial Pathologic Response and Nodal Status as Most Significant Prognostic Factors for Advanced Rectal Cancer Treated With Preoperative Chemoradiotherapy

World Journal of Surgery — Tue, 24 Jan 2012 07:55:25 +0100

Conclusion Partial pathologic response ≥25% was a superior predictor compared to pCR for improved survival after preoperative CRT. CSS and RFS were adversely affected by the presence of lymph node metastases. Content Type Journal ArticlePages 1-9DOI 10.1007/s00268-011-1409-8Authors Marianne Huebner, Division of Health Sciences Research, Mayo Clinic, Rochester, MN, USABruce G. Wolff, Division of Colorectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USAThomas C. Smyrk, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USAJeremiah Aakre, Division of Health Sciences Research, Mayo Clinic, Rochester, MN, USADavid W. Larson, Division of Colorectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA Journal Wo...

Long-term PSA-free survival and castration-free survival with delayed antiandrogen therapy in patients with one versus two or more positive nodes at prostatectomy

World Journal of Urology — Tue, 24 Jan 2012 07:29:22 +0100

Conclusions The prognosis of patients with positive nodes after RRP and ePNLD is good in terms of BCR- and ADT-free survival. After 8 years, 29.7% were still free from BCR, and 39% did not receive ADT. The number of positive nodes was the most important predictor of BCR- and ADT-free survival. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00345-012-0827-zAuthors Michele Lodde, Department of Urology l’Hotel Dieu de Quebec, Centre de Recherche-CHUQ, Université Laval Québec, 11, Cote du Palais, Québec, QC G1R2J6, CanadaLouis Lacombe, Department of Urology l’Hotel Dieu de Quebec, Centre de Recherche-CHUQ, Université Laval Québec, 11, Cote du Palais, Québec, QC G1R2J6, CanadaAngelo Naselli, Istituto Nazionale per la Ricerca sul...

Response to neoadjuvant therapy in locally advanced rectal cancer: assessment with diffusion-weighted MR imaging and 18FDG PET/CT

Abdominal Imaging — Tue, 24 Jan 2012 07:26:01 +0100

Abstract The aim of this study was to evaluate the correlation between the changes of SUVmax and of apparent diffusion coefficient (ADC) before and after neoadjuvant therapy, to enable us predict the therapy response, in patients with locally advanced rectal cancer (LARC). A total of 30 patients with LARC who underwent CRT were recruited for our study. All the patients underwent a whole body 18F-FDG-PET/CT scan and a pelvic MR examination including DW imaging for staging (PET/CT1 and RM1), and after the chemoradiation therapy (PET/CT2, and RM2). Histopathologic analysis of rectal specimen, according to tumor regression grade (Mandard’s criteria) was used as the standard reference. MR and PET-CT images were analyzed, and measurements of ADC values and SUVmax were taken. Di...

Neoadjuvant Chemoradiation Therapy Is Beneficial for Clinical Stage T2 N0 Esophageal Cancer Patients Due to Inaccurate Preoperative Staging [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions For cT2 N0 esophageal cancer patients, the benefit of neoadjuvant therapy is still unclear. Induction therapy for cT2 N0 did not translate into a statistically significant improvement in survival. However, due to the significant understaging of T2 N0 patients, we recommend neoadjuvant therapy to all cT2N0 patients before operation. (Source: The Annals of Thoracic Surgery)

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Atypical presentation and transabdominal treatment of chylothorax complicating esophagectomy for cancer

Journal of Cardiothoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

We report a case of a young adult male who underwent neoadjuvant chemoradiationtherapy followed by Ivor-Lewis esophagectomy for a squamous-cell carcinoma of the distal esophagus. During the postoperative course the patient presented recurrent episodes of hemodynamic instability mimicking cardiac tamponade, secondary to compression of the left pulmonary vein and the left atrium by a mediastinal chylocele. Mediastinal drainage and ligation of the cisterna chyli and the thoracic duct was successfully performed through a transhiatal approach. (Source: Journal of Cardiothoracic Surgery)

The differences in the histological types of breast cancer and the response to neoadjuvant chemotherapy: The relationship between the outcome and the clinicopathological characteristics.

Breast — Mon, 23 Jan 2012 05:00:00 +0100

CONCLUSIONS: The response to standardized NAC and prognosis varies for each histological type. For some types, the prognosis was not associated with the clinicopathological response to NAC. Innovative regimens should therefore be investigated for each histological type to achieve the best response. PMID: 22277312 [PubMed - as supplied by publisher] (Source: Breast)

Advances in the management of high‐risk localised and metastatic prostate cancer

BJU International — Sat, 21 Jan 2012 12:44:16 +0100

• At the third annual Interactive Genitourinary Cancer Conference, held in Budapest from 30 April to 1 May 2011, the latest developments in the management of patients with high‐risk localised and metastatic prostate cancer were discussed.• Prostate cancer is the most common cancer in Western men and, for advanced disease, no curative agents are available.• For men with high‐risk localised disease there is debate about the best treatment approaches, with both radical prostatectomy and radiation therapy shown to improve outcomes.• These approaches have started to be augmented as new techniques and therapies are developed. For instance, radiation therapy combined with androgen deprivation therapy has been shown to be more efficacious than radiation therapy alone, and there...

Laparoscopy to predict the result of primary cytoreductive surgery in advanced ovarian cancer patients (LapOvCa-trial): a multicentre randomized controlled study

BMC Cancer — Fri, 20 Jan 2012 05:00:00 +0100

In this study we aim to assess whether adding laparoscopy to the diagnostic work-up of patients suspected of advanced ovarian carcinoma may prevent unsuccessful PDS for ovarian cancer. Methods: Multicentre randomized controlled trial, including all gynaecologic oncologic centres in the Netherlands and their affiliated hospitals. Patients are eligible when they are planned for PDS after conventional staging. Participants are randomized between direct PDS or additional diagnostic laparoscopy. Depending on the result of laparoscopy patients are treated by PDS within three weeks, followed by six courses of platinum based chemotherapy or with NACT and IDS 3-4 weeks after three courses of chemotherapy, followed by another three courses of chemotherapy. Primary outcome measure is the proportion o...

Neoadjuvant anastrozole vs. tamoxifen in patients receiving goserelin for premenopausal breast cancer (STAGE): RCT

NeLM - News — Fri, 20 Jan 2012 05:00:00 +0100

Source: Lancet Oncology Area: News Aromatase inhibitors have shown increased efficacy compared with tamoxifen in postmenopausal early breast cancer. This RCT assessed the efficacy and safety of anastrozole versus tamoxifen in premenopausal women (ER-positive, HER2-negative, operable disease with WHO performance status ?2) receiving goserelin for early breast cancer in the neoadjuvant setting. The study randomised 197 patients to goserelin 3.6 mg/month plus either anastrozole 1mg per day and tamoxifen placebo (n= 98) or tamoxifen 20mg per day and anastrozole placebo (n= 99) for 24 weeks before surgery. The primary endpoint was best overall tumour response (complete response or partial response), assessed by callipers, during the 24-week neoadjuvant treatment period for the inten...

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Pathologic Complete Response of HER-2 Neu-Positive Invasive Ductal Carcinoma and Ductal Carcinoma In Situ following Neoadjuvant Chemotherapy plus Trastuzumab: A Case Report and Review of Literature

Journal of Nanomaterials — Thu, 19 Jan 2012 15:27:25 +0100

We report a case of pCR of DCIS associated with invasive carcinoma in an HER-2 + tumor after NC plus trastuzumab despite persistence of malignant-appearing microcalcifications mammographically. A 41-year-old Caucasian female presented with a 4×4 cm mass in the right breast and a 2.5 cm right axillary node. Mammogram showed a 2.5 cm mass and a 12 cm area of linear pleomorphic, suspicious calcifications in the upper part of the breast. Core biopsy revealed invasive ductal carcinoma and DCIS associated with calcifications (ER 85%, PR 6%, Her2neu 3+ by IHC). Axillary node FNA was positive for malignancy. The patient received doxorubicin/cyclophosphamide (AC) → paclitaxel plus T with complete clinical and radiologic response but no significant cha...

Defined Clinical Classifications Are Associated with Outcome of Patients with Anatomically Resectable Pancreatic Adenocarcinoma Treated with Neoadjuvant Therapy

Annals of Surgical Oncology — Thu, 19 Jan 2012 07:00:34 +0100

Conclusions This system describes discrete clinical subgroups of patients with pancreatic cancer who have similar, potentially resectable tumor anatomy but heterogeneous physiology and cancer biology. It may be used with neoadjuvant therapy to predict outcomes, individualize treatment algorithms, and optimize survival. Content Type Journal ArticleCategory Pancreatic TumorsPages 1-9DOI 10.1245/s10434-011-2211-4Authors Ching-Wei D. Tzeng, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USAJason B. Fleming, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USAJeffrey E. Lee, Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USAL...

A observational study of the efficacy and safety of capecitabine versus bolus infusional 5-fluorouracil in pre-operative chemoradiotherapy for locally advanced rectal cancer

International Journal of Colorectal Disease — Thu, 19 Jan 2012 06:59:00 +0100

Conclusions In consideration of the better ypT0-2 downstaging rate, less severe toxicities, and no need for indwelling intravenous device on oral capecitabine regimen, the administration of oral capecitabine with RT may be a more favorable option in the neoadjuvant treatment for LARC. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00384-011-1377-3Authors Chin-Fan Chen, Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanMing-Yii Huang, Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, TaiwanChih-Jen Huang, Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, ...

Epithelial Malignant Pleural Mesothelioma After Extrapleural Pneumonectomy: Stratification of Survival With CT-Derived Tumor Volume

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION. With control of prognostic covariates, CT-derived tumor volume can be used to stratify survival of patients with epithelial mesothelioma after extrapleural pneumonectomy and should be included in prognostic evaluation of patients for whom resection is being considered. (Source: American Journal of Roentgenology)

Adjuvant and neoadjuvant therapy for renal cell carcinoma: A survey of the Society of Urologic Oncology.

Urologic Oncology — Thu, 19 Jan 2012 05:00:00 +0100

CONCLUSION: Urologic cancer specialists surveyed in late 2010 demonstrated nearly universal support for trials to investigate the role of neoadjuvant and adjuvant therapies for RCC of all stages. With appropriate patient selection and outcome assessment, this widespread support indicates great potential for future clinical trials which will require the participation of urologic surgeons. PMID: 22264501 [PubMed - as supplied by publisher] (Source: Urologic Oncology)

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Unresectable colorectal cancer liver metastases treated by intraoperative radiofrequency ablation with or without resection

British Journal of Surgery — Wed, 18 Jan 2012 12:02:50 +0100

Conclusion:IRFA, either with or without resection, is a promising treatment option for patients with unresectable CRLM. Registration number: NTC00210106 (http://www.clinicaltrials.gov). Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Hepatoblastoma: recent developments in research and treatment

Seminars in Pediatric Surgery — Wed, 18 Jan 2012 06:36:29 +0100

Hepatoblastoma is the most common liver tumor of early childhood. According to recent studies its incidence seems to be increasing in North America and Europe. Since new histological variants have been described recently the formerly clear-cut distinction of hepatoblastoma and hepatocellular carcinoma may not be valid anymore and a new histological classification will be inaugurated by an international working group. Recent research identified prognostically relevant gene signatures as well as potential molecular targets for therapy of hepatoblastoma. The multicentric study groups in the USA, Europe and Japan recommend cisplatin based chemotherapy for neoadjuvant and adjuvant treatment. However, their risk stratification systems and general treatment strategies differ substantially. Theref...

Pediatric germ cell tumors

Seminars in Pediatric Surgery — Wed, 18 Jan 2012 06:36:29 +0100

represent a diverse group of tumors that present from in utero through adolescence at many nongonadal locations, from the neck to the sacrococcygeal region. Surgical resection remains the central element of management, and accurate surgical staging is essential to properly ascertain the correct risk-based treatment. The management for all benign tumors (mature and immature teratomas) and select completely resectable malignant tumors is surgery alone. Modern-day chemotherapy is extremely effective in infants and children with unresectable and metastatic disease and these children have a very high survival rate. The use of neoadjuvant chemotherapy allows vital organ preservation and there is no role for resection of vital structures at the time of initial presentation. (Source: Seminars in ...

The role of neoadjuvant chemotherapy in children with malignant solid tumors

Seminars in Pediatric Surgery — Wed, 18 Jan 2012 06:36:29 +0100

Pediatric surgeons play a critical role in diagnosing, staging, and treating malignant solid tumors in children. Over the years, the surgical management of the primary tumor site has evolved from an aggressive en-bloc resection at diagnosis to a more tailored surgical approach, often affecting definitive local control after the delivery of neoadjuvant therapy, as currently directed by many solid tumor protocols. In fact, inappropriate upfront resection can lead to unnecessary short- and long-term morbidity, an incomplete resection, and may be associated with a delay in the initiation of the systemic chemotherapy that is critical to the treatment of gross or occult metastatic disease. Therefore, it is important for the pediatric surgeon, as a member of the multidisciplinary team involved in...

Extensive nodal involvement increases the positivity of blue nodes in the axillary reverse mapping procedure in patients with breast cancer

Journal of Surgical Oncology — Wed, 18 Jan 2012 05:00:00 +0100

ConclusionsThe ARM technique is feasible in patients undergoing NAC. Patients with extensive nodal involvement have increased risk of having positive blue nodes. More studies are needed to assess the subgroup of patients with positive axilla that may have the blue node spared without compromising the oncological treatment. J. Surg. Oncol © 2012 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

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A Phase II Study of Gefitinib for Aggressive Cutaneous Squamous Cell Carcinoma of the Head and Neck.

Clinical Cancer Research — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSIONS: Gefitinib, in the neoadjuvant setting, was active and well-tolerated in patients with aggressive CSCC, and did not interfere with definitive treatment. In view of the 18% CR rate we observed, EGFR TKIs should be further explored in the treatment of aggressive CSCC. PMID: 22261807 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Adenosquamous carcinoma of the lung: surgical results as compared with squamous cell and adenocarcinoma cases [THORACIC]

European Journal of Cardio-Thoracic Surgery — Wed, 18 Jan 2012 05:00:00 +0100

CONCLUSION ASC of the lung is more aggressive than AC and SC. The decreased survival of patients with ASC as compared with either of those single histology tumors suggests the need for a clinical trial of adjuvant chemotherapy that includes early-stage patients. (Source: European Journal of Cardio-Thoracic Surgery)

Occurrence of neutropenia in women with breast cancer during chemotherapy treatment

Acta Paulista de Enfermagem — Wed, 18 Jan 2012 03:24:10 +0100

CONCLUSION: Neutropenia in both the adjuvant and neoadjuvant therapy occurred beginning with the second cycle and was maintained during treatment, and was statistically significant when compared women who had to those who did not have this occurrence.OBJETIVO: Analizar la ocurrencia de neutropenia inducida por drogas utilizadas en el tratamiento quimioterápico de mujeres con cáncer de mama. MÉTODOS: Estudio retrospectivo, realizado con la evaluación de 72 historias clínicas, durante loa años 2003-2006. RESULTADOS: De los 558 ciclos de quimioterapia realizados, fueron registrados 152 eventos adversos en los períodos de neoadyuvante y adyuvante, totalizando 43 casos por toxicidad hematológica. En cuanto a la ocurrencia de neutropenia, el 43% presentaron, por lo menos, un episodio dur...

Current Management of Vulvar Cancer

Hematology/Oncology Clinics of North America — Tue, 17 Jan 2012 12:47:50 +0100

Vulvar cancer is surgically staged and is categorized by the pathologic evaluation of the vulvar tumor and the inguinofemoral lymph nodes. All tumors more invasive than 1 mm and larger than 2 cm require pathologic assessment of inguinofemoral lymph nodes. Sentinel node biopsy is an alternative to inguinofemoral lymphadenectomy in many cases that require a lymphadenectomy. Radical local excision with inguinofemoral lymph node assessment is the preferred procedure for early-stage disease. Primary neoadjuvant chemoradiation is used for most advanced-stage tumors. (Source: Hematology/Oncology Clinics of North America)

Neoadjuvant Therapy for HER2-Positive Early-Stage Breast Cancer: The Future Is Almost Here

Cancer Network — Tue, 17 Jan 2012 12:00:00 +0100

It may not be appropriate, nor always considered standard, to recommend neoadjuvant chemotherapy for all patients for whom adjuvant therapy was recommended before surgery. Indeed, tumor size and nodal status play a role, as do hormone receptors, in determining the appropriate extent of adjuvant therapy. (Source: Cancer Network)

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What Is the Current Standard of Care for Anti-HER2 Neoadjuvant Therapy in Breast Cancer?

Cancer Network — Tue, 17 Jan 2012 12:00:00 +0100

This article provides a comprehensive summary of the knowledge gained from recent neoadjuvant trials conducted with agents targeting HER2, and will put them into perspective with current treatment recommendations from American and European guidelines. (Source: Cancer Network)

Improving Therapy for HER2-Positive Cancers Through Neoadjuvant Studies

Cancer Network — Tue, 17 Jan 2012 12:00:00 +0100

Treatment of HER2-positive cancers has improved rapidly over the past decade, and the pace of progress continues to accelerate. The advances have been fueled in part by the conduct of neoadjuvant studies, which have aided in the development of novel therapies and more effective combination regimens. (Source: Cancer Network)

Dual HER2 blockade with lapatinib and trastuzumab may improve response in HER2-positive early breast cancer

NeLM - News — Tue, 17 Jan 2012 05:00:00 +0100

Source: Lancet Area: News According to the results of a Phase III study published early online in the Lancet, dual inhibition of the human epidermal growth factor receptor 2 (HER2) with lapatinib and trastuzumab may improve response when used in the neoadjuvant treatment of HER2-positive breast cancer. The authors note that around 20% of breast tumours over-express the HER2 receptor, and that this is associated with a poor outcome. Trastuzumab is a humanised monoclonal antibody that targets the HER2 receptor, as does the tyrosine kinase inhibitor lapatinib; both have been shown to improve disease-free/progression-free survival in HER2-positive breast cancer. The purpose of the current study was to determine whether use of both agents together would be better than si...

Lapatinib versus trastuzumab in combination with neoadjuvant chemotherapy for HER2-positive breast cancer

NeLM - News — Tue, 17 Jan 2012 05:00:00 +0100

Source: Lancet Oncology Area: News According to the findings of a Phase III study published early online in the Lancet Oncology, trastuzumab is superior to lapatinib when used in combination with chemotherapy for the neoadjuvant treatment of HER2-positive primary breast cancer. The authors note that the tyrosine kinase inhibitor lapatinib, which targets EGFR and HER2, has been shown to improve outcomes when used in the treatment of metastatic breast cancer. The purpose of the current study was to evaluate its efficacy in the early breast cancer setting. The Phase III GeparQuinto study randomised patients with primary breast cancer to neoadjuvant therapy within three groups - the current report looks at the HER2-positive group. This included 62...

Ipsilateral breast tumor recurrence (IBTR) in patients with operable breast cancer who undergo breast‐conserving treatment after receiving neoadjuvant chemotherapy

Cancer — Tue, 17 Jan 2012 05:00:00 +0100

CONCLUSIONS:ER status and multifocality of the residual tumor after NAC were independent predictors of IBTR after BCT. The MDAPI was barely adaptable to the study patients in terms of predicting IBTR. Patients with ER‐positive and HER2‐negative tumors had a favorable prognosis, whereas patients who developed IBTR after NAC had significantly worse overall survival. The authors propose a new IBTR prognostic index using the 2 factors that were identified as predictive of IBTR: ER status and multifocality of the residual tumor. Cancer 2012. © 2012 American Cancer Society. (Source: Cancer)

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Standardization of cytoreductive surgery is a precondition for clinical trials of ovarian cancer including cytoreductive surgery and/or neoadjuvant chemotherapy.

Gynecologic Oncology — Tue, 17 Jan 2012 05:00:00 +0100

Authors: Lim MC, Park SY PMID: 22266549 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

Dual HER2 Blockade Better than One as Neoadjuvant Tx (CME/CE)

MedPage Today Hematology/Oncology — Mon, 16 Jan 2012 22:30:00 +0100

(MedPage Today) -- Significantly more women with HER2-positive breast cancer achieved complete tumor resolution when they received two targeted agents before surgery instead of one, results of a large European study showed. (Source: MedPage Today Hematology/Oncology)

Influence of Surgical Technique on Mastectomy and Reexcision Rates in Breast-Conserving Therapy for Cancer

Computational Intelligence and Neuroscience — Mon, 16 Jan 2012 15:14:21 +0100

Conclusions. CSM is a technique that reduces reexcisions and mastectomy rates. (Source: Computational Intelligence and Neuroscience)

JNM: PET has predictive value for triple-negative breast cancer

Health Imaging News — Mon, 16 Jan 2012 14:47:36 +0100

An interim 18F-FDG PET/CT exam after two cycles of neoadjuvant chemotherapy was predictive of pathologic response and disease-free survival in patients with triple-negative breast cancer, an aggressive subtype of breast cancer, according to a prospective study published online Jan. 12 in the Journal of Nuclear Medicine. (Source: Health Imaging News)

Neoadjuvant Therapy of Pancreatic Cancer: The Emerging Paradigm?

The Oncologist — Mon, 16 Jan 2012 05:00:00 +0100

Authors: Lim KH, Chung E, Khan A, Cao D, Linehan D, Ben-Josef E, Wang-Gillam A Abstract AbstractPancreatic cancer remains one of the deadliest cancers due to difficulty in early diagnosis and its high resistance to chemotherapy and radiation. It is now clear that even patients with potentially resectable disease require multimodality treatment including chemotherapy and/or radiation to improve resectability and reduce recurrence. Tremendous efforts are currently being invested in refining preoperative staging to identify optimal surgical candidates, and also in developing various neoadjuvant or adjuvant regimens to improve surgical outcome. Although at present no studies have been done to directly compare the benefit of neoadjuvant versus adjuvant approaches, accumulating evidence ...

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Association of HER2/ErbB2 Expression and Gene Amplification with Pathologic Features and Prognosis in Esophageal Adenocarcinomas.

Clinical Cancer Research — Sun, 15 Jan 2012 05:00:00 +0100

CONCLUSIONS: HER2 positivity was shown in 17% of resected EACs and associated with reduced tumor aggressiveness. EACs with BE had nearly twice the odds of being HER2 positive and, within this subgroup, HER2 positivity was independently associated with improved survival. Clin Cancer Res; 18(2); 546-54. ©2012 AACR. PMID: 22252257 [PubMed - in process] (Source: Clinical Cancer Research)

Which Imaging Modality Is Superior for Prediction of Response to Neoadjuvant Chemotherapy in Patients With Triple Negative Breast Cancer?

Journal of Surgical Research — Sat, 14 Jan 2012 22:30:05 +0100

(Source: Journal of Surgical Research)

Detection of KRAS Codon 12 Mutations is not Associated with Concurrent Detection of TP53 Mutations in Patients With Rectal Cancer

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:55 +0100

Conclusions: Our study confirms that tumors with both KRAS and TP53 mutations are less likely to respond to CRT. in addition, our data suggests that tumors with KRAS codon 12 mutation are less likely to occur with TP53 gene mutation. the association of select genetic alterations may affect tumor response to neoadjuvant therapy. (Source: Journal of Surgical Research)

Accuracy of Histological Classification of Needle Biopsy/Aspirate Specimens in Patients With Non-Small Cell Lung Cancer (NSCLC)

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:22 +0100

Conclusions: Histological subclassification is important to guide therapy in NSCLC. Even in a tertiary referral cancer center, the rate of inaccuracy of histological subclassification based on limited biopsy material is significant, especially when neoadjuvant therapy is used. Clinicians managing patients with NSCLC need to recognize this discordance. Further research is needed to develop new biomarkers capable of using limited biopsy material to subclassify NSCLC accurately. (Source: Journal of Surgical Research)

The Impact of Neoadjuvant Chemotherapy on Wound Complication Risk After Breast Cancer Resection and Reconstruction - A Multi-Institutional Assessment

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:04 +0100

Conclusions: in this multi-institutional analysis, neoadjuvant chemotherapy was not associated with post-operative wound complication, regardless of the type of breast surgery performed. Patients and providers can be assured that receipt of neoadjuvant therapy does not increase the risk of post-operative wound complication. (Source: Journal of Surgical Research)

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Invasive Lobular Carcinoma Predicts Micrometastatic Disease in Stage I-III Breast Cancer

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:04 +0100

Conclusions: ILC was an independent predictor of the presence of DTCs and CTCs. Since most late recurrences are ER positive this raises the question of whether DTCs and CTCs are indeed responsible for late breast cancer recurrence. We are currently assessing DTCs and CTCs for ER status to determine discordance rates between these cells and the primary tumor. (Source: Journal of Surgical Research)

Indications for Sentinel Lymph Node Biopsy in Multifocal and Multicentric Breast Cancer

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:04 +0100

Conclusions: in conclusion, in a select subset of patients with multifocal and multicentric breast cancer, sentinel lymph node biopsy can accurately predict lymph node status with false-negative rates comparable to that of patients with unifocal breast cancer. However, when a multifocal or multicentric breast cancer has an additional relative contraindication to performing sentinel lymph node biopsy, such as neoadjuvant chemotherapy or T>5cm, the false-negative rate increases. (Source: Journal of Surgical Research)

Does Complete Pathologic Response to Neoadjuvant Radiotherapy Predict Oncologic Outcome in Patients With Soft Tissue Sarcoma?

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:56 +0100

(Source: Journal of Surgical Research)

Recurrence Patterns and Predictors of Recurrence After Neoadjuvant Chemoradiation (CRT) Followed by Surgery for Esophageal Cancer

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:55 +0100

(Source: Journal of Surgical Research)

Perioperative Outcomes of Patients With Less Than Clinical N2 NSCLC Receiving Neoadjuvant Vs. Adjuvant Therapy

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:53 +0100

(Source: Journal of Surgical Research)

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Color Doppler Ultrasonography Evaluation for Chemotherapy Treatment Response of Osteogenic Sarcoma

Ultrasound in Medicine and Biology — Sat, 14 Jan 2012 19:41:40 +0100

Abstract: The aim of this study was to evaluate the vascular parameters of the proximal peripheral arteries of limbs by color Doppler ultrasonography (CDUS) in individuals with osteogenic sarcoma (OGS) after neoadjuvant chemotherapy and their relation to the tumor necrosis rate. We recruited 50 individuals with osteogenic sarcoma who were scheduled for neoadjuvant chemotherapy before elective surgery from 2003 to 2010. Once enrolled, we evaluated these 50 subjects using color Doppler sonography to identify vascular parameters of tumor vessels before and after neoadjuvant therapy. The vascular parameters of the proximal peripheral arteries of limbs (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistive index [RI]) and tumor neovascularity were compared before and after neoad...

[Nondetectable prostate cancer in radical prostatectomy specimens].

Orvosi Hetilap — Fri, 13 Jan 2012 21:00:24 +0100

Conclusion: The rate of pT0 staging was higher in the hormonally treated group. Because of biochemical and clinical relapse despite vanishing prostate cancer phenomenon, these cases are considered not to be true pT0. On the basis of present study and other reports the rate of pT0 staging is about one percentage in non-hormonally treated patients. Prognosis of these patients is excellent. Orv. Hetil., 2012, 153, 113-117. PMID: 22236417 [PubMed - in process] (Source: Orvosi Hetilap)

Neoadjuvant Clinical Trials for the Treatment of Primary Breast Cancer: The Experience of the German Study Groups

Current Oncology Reports — Fri, 13 Jan 2012 17:15:39 +0100

This article summarizes the results of the neoadjuvant trials that have been conducted by the German study groups, outlines ongoing clinical research projects, and discusses concepts for future clinical trials. Content Type Journal ArticleCategory Breast Cancer (KR Fox, Section Editor)Pages 1-8DOI 10.1007/s11912-011-0212-xAuthors Michael Untch, Department of Gynecology, Helios Klinikum Berlin-Buch, Berlin, GermanySibylle Loibl, German Breast Group c/o GBG Forschungs GmbH, Neu Isenburg, GermanyGottfried E. Konecny, Division of Hematology Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USAGunter von Minckwitz, German Breast Group c/o GBG Forschungs GmbH, Neu Isenburg, Germany Journal Current Oncology ReportsOnline ISSN 1534-6269Print ISSN...

Patterns of operative mortality following esophagectomy

Diseases of the Esophagus — Fri, 13 Jan 2012 05:00:00 +0100

SUMMARYEsophagectomy has one of the highest mortality rates among all surgical procedures. We investigated the type and frequency of complications associated with perioperative mortality after esophagectomy. We performed a retrospective review of all perioperative deaths following esophagectomy for esophageal cancer at the Mayo Clinic, Rochester from 1993 through 2009. Of 1522 esophagectomies, perioperative mortality occurred in 45 (3.0%). The majority who died were male (82%); median age was 72 years (range 46–92). The median age‐adjusted Charlson comorbidity score was 6. Twenty‐three (51%) underwent neoadjuvant chemoradiotherapy. The type of esophagectomy was transthoracic in 27 patients (60%), transhiatal in eight (18%), tri‐incisional in seven (16%), left thoracoabdominal in on...

ChEST Trial: Provocative, but Likely Too Little, Too LateChEST Trial: Provocative, but Likely Too Little, Too Late

Medscape Today Headlines — Thu, 12 Jan 2012 19:54:05 +0100

Neoadjuvant therapy may be as effective as adjuvant therapy in early-stage NSCLC, according to a new study, but Dr. H. Jack West says the information comes a little too late. Medscape Hematology-Oncology (Source: Medscape Today Headlines)

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A multi-centre pathologist survey on pathological processing and regression grading of colorectal cancer resection specimens treated by neoadjuvant chemoradiation

Virchows Archiv — Thu, 12 Jan 2012 16:48:09 +0100

Abstract To ascertain the approach and degree of consensus of pathologists in the handling and regression grading of colorectal cancer resection specimens treated with neoadjuvant chemoradiation, a ten-part questionnaire was circulated to 18 gastrointestinal pathologists in eight countries. The questions were specific and addressed pertinent issues related to colorectal cancer with neoadjuvant chemoradiation. There is a lack of consensus on how to handle the specimen, number of sections taken, correlation with pre- and post-operative radiological imaging, and especially, regression grading schema employed. Consensus in the form of guidelines is required so that the pathological assessment of these specimens will provide clinically relevant information for patient managemen...

Thymoma and thymic carcinoma

General Thoracic and Cardiovascular Surgery — Thu, 12 Jan 2012 06:43:57 +0100

Abstract Thymic tumors comprise a heterogeneous group of neoplasms with a wide spectrum of clinical presentations. The evolution of the disease is often unpredictable, ranging from an indolent attitude to the possibility of intra- and extrathoracic spread. From the histological point of view, thymoma and thymic carcinoma are the most frequent subtypes and arise only from thymic epithelial cells. Other histological types are even more rare and are usually considered separately. A number of prognostic factors have been validated as predictors of outcome: staging, World Health Organization histological classification, diameter of the tumor, associated paraneoplastic syndromes, completeness of resection, and early onset of recurrence. Complete surgical resection is the key fac...

The prognostic factors of resected non-small cell lung cancer with chest wall invasion: a retrospective study

World Journal of Surgical Oncology — Thu, 12 Jan 2012 05:00:00 +0100

Conclusions: Completeness of resection, nodal status, depth of invasion, tumor size, and adjuvant chemotherapy were prognostic factors for long-term survival in NSCLC patients with chest wall invasion. Because of poor prognosis in cases with chest wall invasion that have N2 positive LN, that is difficult to achieve complete resection and that need pneumonectomy, definite chemoradiotherapy or neoadjuvant chemoradiotherapy should be considered first in these cases. (Source: World Journal of Surgical Oncology)

Bilateral wilms tumors (WT) treated with the SIOP 93 protocol in France: Epidemiological survey and patient outcome

Pediatric Blood and Cancer — Wed, 11 Jan 2012 05:00:00 +0100

ConclusionsResults of this study demonstrate a favorable outcome of patients with bilateral WT receiving an individual treatment program. With a tailored approach to treatment according to the tumor response, 77% of our patients were operated before the third month of preoperative chemotherapy. In spite of good survival, 14% of our patients have ESRD. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc. (Source: Pediatric Blood and Cancer)

Current status of molecular markers for prognostication and outcome in invasive bladder cancer

BJU International — Wed, 11 Jan 2012 05:00:00 +0100

CONCLUSIONS• Different molecular markers have the potential to improve prognostication of patients with invasive BC and provide improved evidence for targeted therapy in the neoadjuvant, adjuvant and metastatic setting.• However, in order to advocate their routine clinical use on a sound scientific basis prospective data are still necessary. (Source: BJU International)

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Molecular insights on basal-like breast cancer

Breast Cancer Research and Treatment — Tue, 10 Jan 2012 16:49:30 +0100

Abstract Molecular classification of breast cancer (BC) identified diverse subgroups that encompass distinct biological behavior and clinical implications, in particular in relation to prognosis, spread, and incidence of recurrence. Basal-like breast cancers (BLBC) compose up to 15% of BC and are characterized by lack of estrogen receptor (ER), progesterone receptor (PR), and HER-2 amplification with expression of basal cytokeratins 5/6, 14, 17, epidermal growth factor receptor (EGFR), and/or c-KIT. There is an overlap in definition between triple-negative BC and BLBC due to the triple-negative profile of BLBC. Also, most BRCA1-associated BCs are BLBC, triple negative, and express basal cytokeratins (5/6, 14, 17) and EGFR. There is a link between sporadic BLBC (occurring i...

Curative Strategies for Liver Metastases from Colorectal Cancer: A Review.

The Oncologist — Tue, 10 Jan 2012 05:00:00 +0100

Authors: Zdenkowski N, Chen S, van der Westhuizen A, Ackland S Abstract AbstractColorectal cancer is a very common malignancy and frequently manifests with liver metastases, often without other systemic disease. Margin-negative (R0) resection of limited metastatic disease, in conjunction with systemic antineoplastic agents, is the primary treatment strategy, leading to long survival times for appropriately selected patients. There is debate over whether the primary tumor and secondaries should be removed at the same time or in a staged manner. Chemotherapy is effective in converting some unresectable liver metastases into resectable disease, with a correspondingly better survival outcome. However, the ideal chemotherapy with or without biological agents and when it should be admini...

Gene expression, molecular class changes and pathway analysis after neoadjuvant systemic therapy for breast cancer.

Clinical Cancer Research — Tue, 10 Jan 2012 05:00:00 +0100

CONCLUSIONS: Our data indicates that energy metabolism related processes are up-regulated and immune related signals are depleted in residual cancers. Targeting these biological processes may represent promising adjuvant treatment strategies for patients with residual cancer. PMID: 22235097 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Evaluation of overall tumor cellularity after neoadjuvant chemotherapy in patient with locally advanced hypopharyngeal cancer

European Archives of Oto-Rhino-Laryngology — Mon, 09 Jan 2012 19:37:51 +0100

Abstract The aim of this study is to clarify the prognostic value of the pathological overall tumor cellularity after neoadjuvant chemotherapy for locally advanced hypopharyngeal cancer. In consecutive series of 45 operable patients with locally advanced hypopharyngeal cancer, neoadjuvant chemotherapy by cisplatin and 5-fluorouracil was administered. Pathological image analysis was performed in 30 patients using the large cross-section specimen after total resection to evaluate the overall tumor cellularity. The chemotherapeutic responses were classified according to the pathological grading scale by dividing into four categories; more than 70% overall tumor cellularity in Grade 1, between an estimated 10 and 70% in Grade 2, less than 10% in Grade 3, and no identifiable ma...

Comparison of different treatment regimens for IB2 and IIA2 cervical cancer

The Chinese-German Journal of Clinical Oncology — Mon, 09 Jan 2012 19:27:47 +0100

Conclusion neoadjuvant treatment using for patients with IB2, IIA2 cervical cancer is effective in reducing risk factors of pathological, but it could not improve the long-term survival. The indications of adjuvant therapy after surgery should be reconsidered. Those tumors of diameter 5.5 cm or less response poor to neoadjuvant treatment, and no improvement of survival was found, so direct surgical treatment is suggested for these patients. Radiotherapy is a better choice of preoperative treatment. Content Type Journal ArticlePages 37-42DOI 10.1007/s10330-011-0889-1Authors Dongxia Liang, State Key Laboratory of Oncology in Southern China, Guangzhou, 510060 ChinaYanna Zhang, State Key Laboratory of Oncology in Southern China, Guangzhou, 510060 ChinaXueming Sun, Stat...

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Perineal reconstruction after abdominoperineal excision using inferior gluteal artery perforator flaps

British Journal of Surgery — Mon, 09 Jan 2012 05:00:00 +0100

Conclusion:Although operating times are long, the IGAP flap is robust, with no flap necrosis observed in this series. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Perineal reconstruction after abdominoperineal excision using inferior gluteal artery perforator flaps.

The British Journal of Surgery — Mon, 09 Jan 2012 05:00:00 +0100

CONCLUSION: Although operating times are long, the IGAP flap is robust, with no flap necrosis observed in this series. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 22231559 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)

Quality of life issues in men undergoing androgen deprivation therapy: a review.

Asian Journal of Andrology — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Casey RG, Corcoran NM, Larry Goldenberg S Abstract Androgen deprivation therapy (ADT) has been an essential treatment option for treating prostate cancer (PCa). The role for hormonal treatment initially was restricted to men with metastatic and inoperable, locally advanced disease. Now it has been extended to neoadjuvant or adjuvant therapy for surgery and radiotherapy, for biochemical relapse after surgery or radiation, and even as primary therapy for non-metastatic disease. Fifty percent of PCa patients treated will receive ADT at some point. There is growing concern about the adverse effects and costs associated with more widespread ADT use. The adverse effects on quality of life (QoL), including physical, social and psychological well-being when men are androgen-depriv...

The Neoadjuvant Net: A patient- and surgeon-friendly device to facilitate safe breast-conserving surgery in patients who underwent neoadjuvant treatment.

Breast — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Taffurelli M, Montroni I, Santini D, Zamagni C, Fiacchi M, Zanotti S, Pellegrini A, Ugolini G Abstract The primary goal of the study was to describe an innovative and helpful tool in defining the minimal surgical margins necessary during breast-conserving surgery (BCS) after neoadjuvant treatment: the Neoadjuvant Net (NN). The secondary endpoint was to assess its usefulness in achieving postoperative disease-free margins and reducing Ipsilateral Breast Tumor Recurrences (IBRTs). The breast-conserving surgical technique together with the use of the Neoadjuvant Net is herein reported. Age, stage at diagnosis, clinical and pathological response, lymph node status, type of surgery, margin status, and incidence of local and distant recurrence were retrospectively analyzed. Seve...

Multi-modality treatment of colorectal liver metastases.

World Journal of Gastroenterology : WJG — Sat, 07 Jan 2012 05:00:00 +0100

Authors: Cai GX, Cai SJ Abstract Liver metastases synchronously or metachronously occur in approximately 50% of colorectal cancer patients. Multimodality comprehensive treatment is the best therapeutic strategy for these patients. However, the optimal pattern of multimodality therapy is still controversial, and it raises several significant concerns. Liver resection is the most important treatment for colorectal liver metastases. The definition of resectability has shifted to focus on the completion of R0 resection and normal liver function maintenance. The role of neoadjuvant and adjuvant chemotherapy still needs to be clarified. The management of either progression or complete remission during neoadjuvant chemotherapy is challenging. The optimal sequencing of surgery and chemothe...

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Correlation Between the Pretherapeutic Neutrophil to Lymphocyte Ratio and the Pathologic Response to Neoadjuvant Chemotherapy in Patients With Advanced Esophageal Cancer

World Journal of Surgery — Fri, 06 Jan 2012 06:45:03 +0100

Conclusions Our study is the first to demonstrate that the pretherapeutic NLR can be used as a predictor for chemosensitivity of thoracic esophageal cancer. Preoperative evaluation based on the clinical N stage and NLR may be easily used in routine clinical practice. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-011-1411-1Authors Hiroshi Sato, Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Shizuoka, 411-8777 JapanYasuhiro Tsubosa, Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Shizuoka, 411-8777 JapanTatsuyuki Kawano, Department of Esophago-Gastric Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan Journal World...

Estrogen receptor alpha deletion enhances the metastatic phenotype of Ron overexpressing mammary tumors in mice

Molecular Cancer — Fri, 06 Jan 2012 05:00:00 +0100

Conclusions: Ron receptor overexpression is associated with ERalpha-positive human and murine breast tumors. In addition, loss of ERalpha on a Ron overexpressing background in mice leads to the development of breast tumors which grow slower but which exhibit more metastasis and suggests that targeting of ERalpha, as in the case of tamoxifen therapy, may reduce the growth of Ron overexpressing breast cancers but may cause these tumors to be more metastatic. (Source: Molecular Cancer)

Laparoscopic surgery for rectal cancer: preoperative radiochemotherapy versus surgery alone

Surgical Endoscopy — Thu, 05 Jan 2012 06:49:56 +0100

Conclusion Long-course radiochemotherapy does not have an impact on the feasibility or short-term outcome of laparoscopic conservative rectal excision for rectal cancer Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2119-xAuthors Quentin Denost, Department of Digestive Surgery, CHU Bordeaux, Saint André Hospital, Bordeaux, 33075 FranceChristophe Laurent, Department of Digestive Surgery, CHU Bordeaux, Saint André Hospital, Bordeaux, 33075 FranceThomas Paumet, Department of Digestive Surgery, CHU Bordeaux, Saint André Hospital, Bordeaux, 33075 FranceLaurence Quintane, Department of Digestive Surgery, CHU Bordeaux, Saint André Hospital, Bordeaux, 33075 FranceMathieu Martenot, Department of Digestive Surgery, CHU Bordeaux, Saint André Hospital, Bordeaux...

Salvage radiotherapy in patients with recurrent esophageal carcinoma

Strahlentherapie und Onkologie — Wed, 04 Jan 2012 16:50:43 +0100

Conclusion RT is feasible and effective in the management of recurrent esophageal carcinoma, especially for relief of symptoms. Toxicity is in an acceptable range. The outcome of REC is poor; however, long-term survival of patients with recurrent esophageal carcinoma after radiochemotherpy might be possible, even with a previous history of radiotherapy in the initial treatment. If re-irradiation of esophageal carcinoma is contemplated, three-dimensional conformal techniques and a minimum total dose of 45 Gy are recommended. Content Type Journal ArticleCategory Original articlePages 1-7DOI 10.1007/s00066-011-0023-xAuthors K. Fakhrian, Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, GermanyN. Gami...

HIF-1 activation induces doxorubicin resistance in MCF7 3-D spheroids via P-glycoprotein expression: a potential model of the chemo-resistance of invasive micropapillary carcinoma of the breast

BMC Cancer — Wed, 04 Jan 2012 05:00:00 +0100

Conclusions: MCF7 breast cancer cells cultured as 3-D spheroids are resistant to doxorubicin and this resistance is associated with an increased Pgp expression in the plasma membrane via activation of HIF-1. The same mechanism may be suggested for IMPC drug resistance. (Source: BMC Cancer)

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Short-term clinicopathological outcome of neoadjuvant chemohormonal therapy comprising complete androgen blockade, followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy in Japanese patients with high-risk localized prostate cancer

World Journal of Surgical Oncology — Wed, 04 Jan 2012 05:00:00 +0100

Conclusion: We found that neoadjuvant chemohormonal therapy with complete androgen blockade followed by treatment with docetaxel and estramustine phosphate before radical prostatectomy was safe, feasible, and associated with favorable pathological outcomes in patients with a high risk of localized PCa. (Source: World Journal of Surgical Oncology)

Accelerated methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) as neoadjuvant chemotherapy for patients with muscle‐invasive transitional cell carcinoma of the bladder

Cancer — Tue, 03 Jan 2012 05:00:00 +0100

CONCLUSIONS:AMVAC is safe and appears to be a well‐tolerated and effective NAC regimen for MIBC. It minimizes delays to definitive treatment and produces excellent pathological and radiological response rates. It is an appropriate comparator for future randomized trials. Cancer 2011;. © 2011 American Cancer Society. (Source: Cancer)

Updates on the multimodality management of desmoplastic small round cell tumor

Journal of Surgical Oncology — Tue, 03 Jan 2012 05:00:00 +0100

AbstractDesmoplastic Small Round Cell Tumor (DSRCT) is a rare and an aggressive malignancy with poor outcome. This tumor can co‐express epithelial, neural, and mesenchymal markers. The molecular hallmark of DSRCT is the EWS–WT1 fusion protein. Despite the diversities in treatment modality, the best results have been seen with radical surgery and adjuvant or neoadjuvant chemotherapy. J. Surg. Oncol © 2011 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

Radiation Sensitivity of Esophageal Adenocarcinoma: The Contribution of the RNA-Binding Protein RNPC1 and p21-Mediated Cell Cycle Arrest to Radioresistance.

Radiation Research — Tue, 03 Jan 2012 05:00:00 +0100

Authors: Hötte GJ, Lennon NL, Reynolds JV, Maher SG Abstract Radiation combined with chemotherapy (neo-CRT) is increasingly the standard of care for the treatment of esophageal cancer either as neoadjuvant therapy in multimodal protocols or as primary therapy. Unfortunately, ∼60% of patients demonstrate little or no response to neo-CRT. Accordingly, understanding the molecular mechanisms of resistance to therapy may underpin significant advances through the identification of nonresponders either before or early in treatment. We previously identified the RNPC1 gene, which is important in stabilizing p21, as being upregulated in the tumors of esophageal cancer patients who had a poor response to neo-CRT. We hypothesize that RNPC1 contributes to resistance to radiation therapy thro...

A phase II study of neoadjuvant bevacizumab plus capecitabine and concomitant radiotherapy in patients with locally advanced rectal cancer

Angiogenesis — Mon, 02 Jan 2012 16:46:32 +0100

Conclusions The schedule of neoadjuvant therapy tested was safe and active. Pre-treatment vessel density by the panendothelial marker anti CD-34 antibody, post-treatment Ki-67 labeling index and VEGFR-2 expression were significantly associated to residual tumor area. The biomarkers correlations warrant further evaluation in prospective clinical trials. Content Type Journal ArticleCategory Original PaperPages 1-10DOI 10.1007/s10456-011-9250-0Authors Giampietro Gasparini, Unità Operativa Complessa di Oncologia Medica, Azienda Complesso Ospedaliero di Rilevanza Nazionale “S. Filippo Neri”, Via G. Martinotti, 20, 00135 Rome, ItalyFrancesco Torino, Unità Operativa Complessa di Oncologia Medica, Azienda Complesso Ospedaliero di Rilevanza Nazionale “S. Filippo Neri...

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Locally advanced esophageal adenocarcinoma: Response to neoadjuvant chemotherapy and survival predicted by ([18F])FDG-PET/CT.

Acta Oncologica — Mon, 02 Jan 2012 05:00:00 +0100

Conclusion. Our results support previous results showing that ([18F])FDG-PET/CT can distinguish a group of patients with worse prognosis after neoadjuvant chemotherapy in adenocarcinoma of the esophagus or esophagogastric junction. This information could offer a new independent preoperative marker of prognosis. PMID: 22208782 [PubMed - as supplied by publisher] (Source: Acta Oncologica)

Jennerex Announces First Patient Treated In Phase 2a Clinical Trial Of JX-594 As A Neoadjuvant Therapy In Colorectal Cancer

Health News from Medical News Today — Sun, 01 Jan 2012 08:00:00 +0100

Jennerex, Inc., a private clinical-stage biotherapeutics company focused on the development and commercialization of first-in-class targeted oncolytic virus products for cancer, announced that the first patient has been treated in a Phase 2a clinical trial of JX-594 as a neoadjuvant therapy in patients who are undergoing surgery to treat colorectal cancer that has spread to the liver. The study is being led by Rebecca Auer, M.D... (Source: Health News from Medical News Today)

[Articles] Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

SummaryBackgroundStudies with pertuzumab, a novel anti-HER2 antibody, show improved efficacy when combined with the established HER2-directed antibody trastuzumab in breast cancer therapy. We investigated the combination of pertuzumab or trastuzumab, or both, with docetaxel and the combination of pertuzumab and trastuzumab without chemotherapy in the neoadjuvant setting.MethodsIn this multicentre, open-label, phase 2 study, treatment-naive women with HER2-positive breast cancer were randomly assigned (1:1:1:1) centrally and stratified by operable, locally advanced, and inflammatory breast cancer, and by hormone receptor expression to receive four neoadjuvant cycles of: trastuzumab (8 mg/kg loading dose, followed by 6 mg/kg every 3 weeks) plus docetaxel (75 mg/m2, escalating, if tolerated, ...

[Articles] Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: preliminary safety results from the CHHiP randomised controlled trial

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

We present a pre-planned preliminary safety analysis of side-effects in stages 1 and 2 of a randomised trial comparing standard and hypofractionated radiotherapy.MethodsWe did a multicentre, randomised study and recruited men with localised prostate cancer between Oct 18, 2002, and Aug 12, 2006, at 11 UK centres. Patients were randomly assigned in a 1:1:1 ratio to receive conventional or hypofractionated high-dose intensity-modulated radiotherapy, and all were given with 3–6 months of neoadjuvant androgen suppression. (Source: The Lancet Oncology)

Assessing treatment effect in pancreatic cancer.

Archives of Pathology and Laboratory Medicine — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions.-Assessment of treatment effect in pancreatic cancer is difficult. Pathologists need to be aware that some histologic features of treatment effect overlap with histologic features seen in untreated pancreatic cancer, such as tumor cell anaplasia, necrosis, and fibrosis. Careful assessment of pancreatic resections, including detailed gross examination and thorough histologic sampling, is important in accurately assessing treatment effect and improving patient outcomes. PMID: 22208494 [PubMed - in process] (Source: Archives of Pathology and Laboratory Medicine)

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Prognostic Assessment of Polymorphisms of the MDR‐1 and GSTP1 Genes in Patients with Stage II and III Breast Cancer Submitted to Neoadjuvant Chemotherapy

The Breast Journal — Sun, 01 Jan 2012 05:00:00 +0100

(Source: The Breast Journal)

Factors Affecting Lymph Node Yield in Patients Undergoing Axillary Node Dissection for Primary Breast Cancer: A Single-Institution Review

Annals of Surgical Oncology — Wed, 28 Dec 2011 06:52:26 +0100

Conclusions Age, type of breast surgery, body mass index, and clinical stage have no effect on yield of lymph nodes at axillary lymph node dissection. Neoadjuvant chemotherapy, however, is associated with a far fewer nodes at axillary dissection, and alteration of the guidelines should be considered for this population of patients. Content Type Journal ArticleCategory Breast OncologyPages 1-7DOI 10.1245/s10434-011-2199-9Authors Marie Catherine Lee, Surgical Oncology, Comprehensive Breast Program, Moffitt Cancer Center, Tampa, FL, USARobert Plews, Department of General Surgery, The Ohio State University Medical Center, Columbus, OH, USABhupendra Rawal, Biostatistics Core, Moffitt Cancer Center, Tampa, FL, USAJohn V. Kiluk, Surgical Oncology, Comprehensive Breast Prog...

Phase II Trial of Neoadjuvant/adjuvant Imatinib Mesylate for Advanced Primary and Metastatic/recurrent Operable Gastrointestinal Stromal Tumors: Long-term Follow-up Results of Radiation Therapy Oncology Group 0132

Annals of Surgical Oncology — Wed, 28 Dec 2011 06:52:23 +0100

Conclusions This long-term analysis suggests a high percentage of patients experienced disease progression after discontinuation of 2-year maintenance imatinib therapy after surgery. Consideration should be given to studying longer treatment durations in intermediate- to high-risk GIST patients. Content Type Journal ArticleCategory Bone and Soft Tissue SarcomasPages 1-7DOI 10.1245/s10434-011-2190-5Authors Dian Wang, Medical College of Wisconsin, Milwaukee, WI, USAQiang Zhang, Radiation Therapy Oncology Group Statistical Center, Philadelphia, PA, USACharles D. Blanke, University of British Columbia and British Columbia Cancer Agency, Vancouver, BC, CanadaGeorge D. Demetri, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USAMichael C. Heinrich, Po...

Comparison of Outcomes and the Use of Multimodality Therapy in Young and Elderly People Undergoing Surgical Resection of Pancreatic Cancer

Journal of the American Geriatrics Society — Wed, 28 Dec 2011 05:00:00 +0100

ConclusionCarefully selected elderly individuals experience similar perioperative outcomes and overall survival to those of younger individuals after resection of pancreatic cancer. There appears to be a significant disparity in the use of adjuvant therapy between young and elderly individuals. (Source: Journal of the American Geriatrics Society)

T cells localized to the androgen‐deprived prostate are TH1 and TH17 biased

The Prostate — Tue, 27 Dec 2011 05:00:00 +0100

CONCLUSIONSThese observations suggest castration elicits a time‐dependent prostate‐specific T‐cell infiltration, and this infiltration is likely mediated by effects of castration on prostate tissue rather than T‐cells. These findings have implications for the timing of immunotherapies combined with androgen deprivation as treatments for prostate cancer. Prostate © 2011 Wiley Periodicals, Inc. (Source: The Prostate)

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7. Accuracy of FDG-PET in pre-operative staging of oesophageal cancer.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Conclusion: The accuracy of FDG-PET in predicting oesophageal cancer stage was lower than expected in our institution. This may have been due to factors such as neoadjuvant chemotherapy, time delay before surgery and concurrent infection/inflammation. FDG-PET staging was more accurate than CT staging. PMID: 22186293 [PubMed - in process] (Source: Cancer Imaging)

16. Axillary ultrasound accuracy in assessing nodal metastases in a breast screening service.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Conclusion: 39.1% of patients with surgically proven axillary metastatic disease were diagnosed pre-operatively. This exceeds the target rate (20%) suggested by the UK BIG 18 committee. Further investigation with larger cohorts and data from other screening centres is essential for validation of these findings. PMID: 22186006 [PubMed - in process] (Source: Cancer Imaging)

Breast MR with special focus on DW-MRI and DCE-MRI.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Authors: Petralia G, Bonello L, Priolo F, Summers P, Bellomi M Abstract The use of magnetic resonance imaging (MRI) for the assessment of breast lesions was first described in the 1970s; however, its wide application in clinical routine is relatively recent. The basic principles for diagnosis of a breast lesion rely on the evaluation of signal intensity in T2-weighted sequences, on morphologic assessment and on the evaluation of contrast enhancement behaviour. The quantification of dynamic contrast behaviour by dynamic contrast-enhanced (DCE) MRI and evaluation of the diffusivity of water molecules by means of diffusion-weighted MRI (DW-MRI) have shown promise in the work-up of breast lesions. Therefore, breast MRI has gained a role for all indications that could benefit from its h...

Accuracy of water enema-MDCT in colon cancer staging: a prospective study.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Conclusion: WE-MDCT allows good staging of colon cancer based on objective features. PMID: 22185708 [PubMed - in process] (Source: Cancer Imaging)

Difficult adnexal masses: learn from my mistakes.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Authors: Spencer JA Abstract The aim of imaging an adnexal mass is to determine its site of origin and to assess whether it is likely to be benign or malignant. For a malignant mass there needs to be consideration of whether it is a primary or could reflect metastatic disease from another site and evaluation of the extent of tumor spread. An additional role of the radiologist is in providing a tissue diagnosis when there is doubt about the diagnosis and before embarking on neoadjuvant chemotherapy. I have made all of the mistakes possible in the narrow field of imaging suspected adnexal masses, some more than once. In this workshop, I will share some of these with you in a friendly interactive session. PMID: 22185700 [PubMed - in process] (Source: Cancer Imaging)

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Advanced endometrial carcinoma: primary debulking surgery or neoadjuvant chemotherapy?

Bulletin du Cancer — Mon, 26 Dec 2011 05:00:00 +0100

Authors: Guyon F, Stoeckle E, Thomas L, Petit A, Sire M, Floquet A Abstract Endometrial cancers with peritoneal spread are stage IVB of FIGO classification. Their pattern is similar to that of ovarian cancer. Optimal debulking surgery and chemotherapy are predictor of better overall and disease free survival. Despite the poor outcome, there is a need for new treatment options. Recommended management for this group of patients should consist of surgical cytoreduction followed by chemotherapy. There may be a role for neoadjuvant chemotherapy followed by interval surgery in selected subgroups of patients. PMID: 22198346 [PubMed - as supplied by publisher] (Source: Bulletin du Cancer)

Effect of hospital volume on processes of care and 5-year survival after breast cancer: A population-based study on 25 000 women.

Breast — Mon, 26 Dec 2011 05:00:00 +0100

CONCLUSION: Survival benefits reported in high-volume hospitals suggest a better application of recommended processes of care, justifying the centralization of breast cancer care in such hospitals. PMID: 22204930 [PubMed - as supplied by publisher] (Source: Breast)

Chemotherapy response and recurrence-free survival in neoadjuvant breast cancer depends on biomarker profiles: results from the I-SPY 1 TRIAL (CALGB 150007/150012; ACRIN 6657)

Breast Cancer Research and Treatment — Sat, 24 Dec 2011 16:42:11 +0100

Abstract Neoadjuvant chemotherapy for breast cancer allows individual tumor response to be assessed depending on molecular subtype, and to judge the impact of response to therapy on recurrence-free survival (RFS). The multicenter I-SPY 1 TRIAL evaluated patients with ≥3 cm tumors by using early imaging and molecular signatures, with outcomes of pathologic complete response (pCR) and RFS. The current analysis was performed using data from patients who had molecular profiles and did not receive trastuzumab. The various molecular classifiers tested were highly correlated. Categorization of breast cancer by molecular signatures enhanced the ability of pCR to predict improvement in RFS compared to the population as a whole. In multivariate analysis, the molecular signatu...

Primary surgery or neoadjuvant chemotherapy in ovarian cancer: What is the value of comparing apples with oranges?

Gynecologic Oncology — Sat, 24 Dec 2011 14:52:04 +0100

Authors: Vergote I, Leunen K, Amant F PMID: 22153125 [PubMed - in process] (Source: Gynecologic Oncology)

Med Sci Monit 2012; 18(1):BR60-67 "Apoptosis – associated genes and their role in predicting responses to neoadjuvant breast cancer treatment"

Medical Science Monitor — Thu, 22 Dec 2011 19:17:00 +0100

Conclusions: Gene expression profiling using real-time PCR assay is a valuable research tool for the investigation of molecular markers, which reflect tumor biology and treatment response. (Source: Medical Science Monitor)

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An unusual case of metaplastic breast carcinoma following neoadjuvant chemotherapy

Pathology International — Thu, 22 Dec 2011 17:25:15 +0100

(Source: Pathology International)

Recommendations from an International Consensus Conference on the Current Status and Future of Neoadjuvant Systemic Therapy in Primary Breast Cancer

Annals of Surgical Oncology — Thu, 22 Dec 2011 16:37:01 +0100

Abstract The use of neoadjuvant systemic therapy (NST) for the treatment of primary breast cancer has constantly increased, especially in trials of new therapeutic regimens. In the 1980 s, NST was shown to substantially improve breast-conserving surgery rates and was first typically used for patients with inoperable locally advanced or inflammatory breast cancer. Investigators have since also used NST as an in vivo test for chemosensitivity by assessing pathologic complete response. Today, by using pathologic response and other biomarkers as intermediate end points, results from trials of new regimens and therapies that use NST are aimed to precede and anticipate the results from larger adjuvant trials. In 2003, a panel of representatives from various breast cancer cl...

A Comparison of Multimodality Treatment: Two and Four Courses of Neoadjuvant Chemotherapy Using S-1/CDDP or S-1/CDDP/Docetaxel Followed by Surgery and S-1 Adjuvant Chemotherapy for Macroscopically Resectable Serosa-positive Gastric Cancer: A Randomized Phase II Trial (COMPASS-D Trial)

Japanese Journal of Clinical Oncology — Thu, 22 Dec 2011 05:00:00 +0100

This randomized Phase II trial will compare the outcome of neoadjuvant chemotherapy using two and four courses of S-1 plus cisplatin or S-1 plus cisplatin plus docetaxel by a two-by-two factorial design for patients with macroscopically resectable serosa-positive gastric cancer. After neoadjuvant chemotherapy, patients will receive D2 gastrectomy followed by S-1 chemotherapy for 1 year postoperatively. The primary endpoint is the 3-year overall survival. The sample size is 120 for the two hypotheses: the superiority of four courses compared with two courses and the superiority of S-1 plus cisplatin plus docetaxel compared with S-1 plus cisplatin. This trial will be able to define the more suitable number of cycles and better regimen of neoadjuvant chemotherapy for gastric cancer. (Source: ...

Jennerex treats first patient in Phase IIa study of cancer drug

Drug Development Technology — Thu, 22 Dec 2011 00:00:00 +0100

Jennerex, a private clinical-stage biotherapeutics company, has treated the first patient in a Phase IIa clinical trial of JX-594, as a neoadjuvant therapy in patients who are undergoing surgery to treat colorectal cancer. (Source: Drug Development Technology)

Posttherapy Nodal Status, Not Graded Histologic Response, Predicts Survival after Neoadjuvant Chemotherapy for Advanced Gastric Cancer

Annals of Surgical Oncology — Wed, 21 Dec 2011 19:46:04 +0100

Conclusions Posttherapy nodal status, not graded histologic response, predicts survival after NAC for AGC and could serve as a reliable surrogate marker for OS in the course of exploring the most promising regimen for NAC. Content Type Journal ArticleCategory Gastrointestinal OncologyPages 1-8DOI 10.1245/s10434-011-2165-6Authors Kazumasa Fujitani, Department of Surgery, Osaka National Hospital, Osaka, JapanMasayuki Mano, Department of Pathology, Osaka National Hospital, Osaka, JapanMotohiro Hirao, Department of Surgery, Osaka National Hospital, Osaka, JapanYoshinori Kodama, Department of Pathology, Osaka National Hospital, Osaka, JapanToshimasa Tsujinaka, Department of Surgery, Osaka National Hospital, Osaka, Japan Journal Annals of Surgical OncologyOnline ISS...

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Does the Timing of Esophagectomy After Chemoradiation Affect Outcome? [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Wed, 21 Dec 2011 05:00:00 +0100

Conclusions The timing of esophagectomy after neoadjuvant CXRT is not associated with perioperative complication, pathologic response, or overall survival. It may be reasonable to delay esophagectomy beyond 8 weeks for patients who have not yet recovered from chemoradiation. (Source: The Annals of Thoracic Surgery)

Potential Contribution of Preoperative Neoadjuvant Concurrent Chemoradiation Therapy on Margin-Negative Resection in Borderline Resectable Pancreatic Cancer

Journal of Gastrointestinal Surgery — Tue, 20 Dec 2011 06:42:47 +0100

Conclusion Pancreatectomy following preoperative neoadjuvant CCRT can be a potential strategy for margin-negative resection in BRPCa patients. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s11605-011-1784-3Authors Chang Moo Kang, Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 South KoreaYong Eun Chung, Department of Radiology, Yonsei University College of Medicine, Seoul, South KoreaJeong Youp Park, Division of Gastroenterology, Yonsei University College of Medicine, Seoul, South KoreaJin Sil Sung, Department of Radiologic Oncology, Yonsei University College of Medicine, Seoul, South KoreaHo Kyoung Hwang, Division of Hepatobiliary and Pancreas...

Neoadjuvant chemotherapy with FOLFOX: Improved outcomes in Chinese patients with locally advanced gastric cancer

Journal of Surgical Oncology — Tue, 20 Dec 2011 05:00:00 +0100

ConclusionPeri‐operative treatment with FOLFOX shows promise in patients with resectable locally advanced gastric cancer. It warrants further evaluation and should be considered an alternative to peri‐operative ECF. J. Surg. Oncol © 2011 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

[Pelvic exenteration: State-of-the-art and perspectives.]

Gynecologie, Obstetrique et Fertilite — Tue, 20 Dec 2011 05:00:00 +0100

Authors: Ferron G, Pomel C, Martinez A, Narducci F, Lambaudie E, Marchal F, Rouanet P, Querleu D Abstract Criteria for patient selection prior to undergo pelvic exenteration have strongly diminished due to improvement in local control of locally advanced tumors treated with chemo-radiotherapy. Preoperative study with current image techniques improves the definition of tumor extension to better adapt surgical resection. New haemostatic devices have lead to a reduction in peroperative blood loss. Latero-pelvic extension requires a specific surgical approach with latero-endopelvic résection including vascular and nervous structures and/or intraoperative radiotherapy techniques. Laparoscopic approach is an alternative for selected patients presenting with central tumor. Reconstruction...

Adjuvant therapy

Medicine — Tue, 20 Dec 2011 02:10:11 +0100

Abstract: Adjuvant therapy is used to reduce the risk of cancer recurrence and improve survival. It is usually given after patients have had radical (i.e. potentially curative) treatment targeting the primary tumour, but there are some circumstances where treatment is given beforehand (termed ‘neoadjuvant’). The aim of therapy is either to improve local tumour control, or to reduce the risk of distant relapse. Selecting patients who benefit from treatment can be difficult, and decisions must take into account both the patient and tumour characteristics. In this article we review the basic principles of adjuvant and neoadjuvant therapy, focussing on breast and colorectal cancer. We also discuss the potential adverse effects of therapy and conclude by looking at potential future developm...

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Bladder cancer

Medicine — Tue, 20 Dec 2011 02:10:11 +0100

Abstract: Bladder cancer is the most frequently occurring tumour of the urinary tract and the eighth-most common cause of cancer death in the UK. Urothelial cell carcinoma of the bladder is characterized by high recurrence rate, pathological progression and poor survival in advanced metastatic disease. Due to the long follow-up period and associated expenses of disease monitoring it is one of the most expensive cancers to manage. Local therapy and surveillance are the mainstays of management of early disease, whilst neoadjuvant chemotherapy, radical surgery and radiotherapy are effective in advanced disease. There remains a great need for effective tumour markers to aid diagnosis, staging, monitoring and predicting prognosis. Novel therapies for advanced metastatic bladder cancer are under...

Neoadjuvant Chemo Improves Breast Cancer OutcomesNeoadjuvant Chemo Improves Breast Cancer Outcomes

Medscape Today Headlines — Mon, 19 Dec 2011 23:17:08 +0100

The expected -- and the unexpected --results of GeparTrio and GeparQuinto are discussed at SABCS. Medscape Hematology-Oncology (Source: Medscape Today Headlines)

Re: International Phase III Trial Assessing Neoadjuvant Cisplatin, Methotrexate, and Vinblastine Chemotherapy for Muscle-Invasive Bladder Cancer: Long-Term Results of the BA06 30894 Trial

The Journal of Urology — Mon, 19 Dec 2011 05:00:00 +0100

International Collaboration of Trialists; Medical Research Council Advanced Bladder Cancer Working Party (now the National Cancer Research Institute Bladder Cancer Clinical Studies Group); European Organisation for Research and Treatment of Cancer Genito-Urinary Tract Cancer Group; Australian Bladder Cancer Study Group; National Cancer Institute of Canada Clinical Trials Group; Finnbladder; Norwegian Bladder Cancer Study Group, and Club Urologico Espanol de Tratamiento Oncologico Group; G. Griffiths, R. Hall, R. Sylvester, D. Raghavan and M. K. Parmar (Source: The Journal of Urology)

Antioxidant Therapy Alleviates Oxidative Stress by Androgen Deprivation and Prevents Conversion From Androgen Dependent to Castration Resistant Prostate Cancer

The Journal of Urology — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions: Androgen deprivation therapy induced oxidative stress in in vitro and human prostate cancer. Antioxidant therapy using N-acetyl-cysteine appears to be a promising therapeutic modality for prostate cancer. (Source: The Journal of Urology)

Plasma miR-221 as a Predictive Biomarker for Chemoresistance in Breast Cancer Patients who Previously Received Neoadjuvant Chemotherapy.

Onkologie — Sun, 18 Dec 2011 22:24:02 +0100

Conclusion: Our results indicate that plasma miR-221 may be a predictive biomarker for sensitivity to NAC in breast cancer patients. PMID: 22156446 [PubMed - in process] (Source: Onkologie)

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Neoadjuvant Chemotherapy in 29 Patients with Locally Advanced Follicular or Hürthle Cell Thyroid Carcinoma: A Phase 2 Study

Thyroid — Fri, 16 Dec 2011 19:49:33 +0100

Thyroid , Vol. 0, No. 0. (Source: Thyroid)

Neoadjuvant and adjuvant chemotherapy with modified mesna, adriamycin, ifosfamide, and decarbazine (MAID) regimen for adult high-grade non-small round cell soft tissue sarcomas

International Journal of Clinical Oncology — Fri, 16 Dec 2011 16:55:24 +0100

Conclusion The modified MAID regimen achieved a better outcome with less serious adverse events than previously reported and is a potential option in the management of NSRCSTSs. Further evaluation with long-term follow-up is required. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s10147-011-0360-xAuthors Koichi Ogura, Department of Orthopaedic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanTakahiro Goto, Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, JapanJungo Imanishi, Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hosp...

Long‐term follow‐up of patients treated with neoadjuvant chemotherapy and radiotherapy for large, extremity soft tissue sarcomas

Cancer — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS:For patients with high‐risk, extremity STS, the significant survival benefits conferred by an intense regimen of neoadjuvant chemoradiotherapy and surgery are sustained even with long‐term follow‐up. Cancer 2012;. © 2011 American Cancer Society. (Source: Cancer)

Dynamic contrast‐enhanced magnetic resonance imaging as a prognostic factor in predicting event‐free and overall survival in pediatric patients with osteosarcoma

Cancer — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS:DCE‐MRI was identified as a prognostic factor for EFS and overall survival before treatment on this trial and was indicative of a histologic response to neoadjuvant therapy. Further studies are needed to verify these findings with other treatment regimens and establish the potential role of DCE‐MRI in the development of risk‐adapted therapy for osteosarcoma. Cancer 2012;. © 2011 American Cancer Society. (Source: Cancer)

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Histologic tumor involvement of superior mesenteric vein/portal vein predicts poor prognosis in patients with stage II pancreatic adenocarcinoma treated with neoadjuvant chemoradiation

Cancer — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS:Histologic tumor involvement of the SMV/PV is an independent predictor of both DFS and OS in patients with stage II PAC treated with neoadjuvant therapy and PD. Complete histologic evaluation of the resected SMV/PV is important for the prognosis in patients with PAC who received neoadjuvant therapy and PD. Cancer 2012;. © 2011 American Cancer Society. (Source: Cancer)

Aldehyde dehydrogenase 1‐positive cells in axillary lymph node metastases after chemotherapy as a prognostic factor in patients with lymph node‐positive breast cancer

Cancer — Fri, 16 Dec 2011 05:00:00 +0100

CONCLUSIONS:The responsiveness of ALDH1‐positive cells to chemotherapy in primary and metastatic lesions and its prognostic significance were clarified in patients with breast cancer. The authors concluded that ALDH1‐positive status may represent a surrogate marker as a new concept in patients with lymph node‐positive breast cancer. Cancer 2012;. © 2011 American Cancer Society. (Source: Cancer)

The biological features and prognosis of breast cancer diagnosed during pregnancy: A case-control study.

Acta Oncologica — Fri, 16 Dec 2011 05:00:00 +0100

Conclusions. While we did not observe any differences in tumor features, BCP patients have poorer prognosis compared to age and stage-matched control. Further studies should try to elucidate reasons for such poor outcome. PMID: 22171586 [PubMed - as supplied by publisher] (Source: Acta Oncologica)

Neoadjuvant Treatment of Breast Cancer

Breast Care : Last 20 articles — Thu, 15 Dec 2011 23:00:00 +0100

Breast Care 2011;6:417 (DOI:10.1159/000335444) (Source: Breast Care : Last 20 articles)

Outcomes and toxicities for the treatment of stage IVB cervical cancer

Archives of Gynecology and Obstetrics — Thu, 15 Dec 2011 16:49:53 +0100

Conclusions CCRT using combination chemotherapeutic agents may not have survival advantage over single agent cisplatin-based CCRT. Further improvement in treatment is needed to increase survival outcomes and to decrease treatment-related toxicities in patients with stage IVB cervical cancer. Content Type Journal ArticleCategory Gynecologic OncologyPages 1-9DOI 10.1007/s00404-011-2173-6Authors Jong Ha Hwang, Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 323 Illsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769 KoreaMyong Cheol Lim, Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 323 Illsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769 KoreaSang-Soo Seo, Center for Uterine Cancer, Researc...

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The CARTS study: Chemoradiation therapy for rectal cancer in the distal rectum followed by organ-sparing transanal endoscopic microsurgery

BMC Surgery — Thu, 15 Dec 2011 05:00:00 +0100

DiscussionThe CARTS-study is one of the first prospective multicentre trials to investigate the role of a rectum saving treatment modality using chemoradiation therapy and local excision. The CARTS study is registered at clinicaltrials.gov (NCT01273051) (Source: BMC Surgery)

Neoadjuvant chemoradiotherapy followed by surgery for esophageal adenocarcinoma: Significance of microscopically positive circumferential radial margins

The Journal of Thoracic and Cardiovascular Surgery — Thu, 15 Dec 2011 05:00:00 +0100

Objectives: The incidence and consequence of an isolated involved circumferential radial margin (CRM) after resection for esophageal adenocarcinoma in the setting of neoadjuvant chemoradiotherapy (CRT) has not been reported. We aimed to determine the frequency and significance of a close ( (Source: The Journal of Thoracic and Cardiovascular Surgery)

Neoadjuvant Therapy – What Have We Achieved in the Last 20 Years

Breast Care : Last 20 articles — Wed, 14 Dec 2011 23:00:00 +0100

Breast Care 2011;6:6 (DOI:10.1159/000335347) (Source: Breast Care : Last 20 articles)

Trends and Novel Approaches in Neoadjuvant Treatment of Breast Cancer

Breast Care : Last 20 articles — Wed, 14 Dec 2011 23:00:00 +0100

Breast Care 2011;6:3 (DOI:10.1159/000335331) (Source: Breast Care : Last 20 articles)