Advanced Age is Not a Contraindication for Treatment With Curative Intent in Esophageal Cancer
Conclusions: Long-term outcomes of older esophageal cancer patients (70 y and above) selected for treatment with neoadjuvant chemoradiotherapy followed by surgery or definitive chemoradiotherapy were comparable with the outcomes of their younger counterparts. Advanced age alone should not be a contraindication for potentially curative chemoradiotherapy-based treatment in esophageal cancer patients. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Thoracic Source Type: research

Prevention of Trastuzumab and Anthracycline-induced Cardiotoxicity Using Angiotensin-converting Enzyme Inhibitors or β-blockers in Older Adults With Breast Cancer
Purpose: Although clinical trials have provided some data on the benefit of angiotensin-converting enzyme inhibitors (ACEIs) or β-blockers (BBs) in patients with chemotherapy-induced cardiotoxicity, evidence of ACEIs/BBs on prevention of trastuzumab and/or anthracycline-induced cardiotoxicity outside trials is limited. Materials and Methods: A cohort study of 142,990 women (66 y and above) newly diagnosed with breast cancer from 2001 to 2009 was conducted using the Surveillance, Epidemiology, and End Results-Medicare–linked database. The ACEI/BB exposure was defined as filled prescription(s) before or after...
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Treatment and Outcomes of Primary Urethra Cancer
Background: Urethral cancer is a rare malignancy, representing (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Impact of the Primary Information Source Used for Decision Making on Treatment Perceptions and Regret in Prostate Cancer
Objective: To assess the impact of the primary source of information used by prostate cancer patients to select a radiation treatment on their overall treatment experience and on treatment regret. Methods: Patients with low to favorable intermediate-risk prostate cancer treated with stereotactic body radiation therapy, intensity-modulated radiation therapy, or high-dose rate brachytherapy were surveyed. The questionnaire explored the decision-making experience, treatment experience, and treatment regret. Results: In total, 322 consecutive patients were surveyed with an 86% (n=276) response rate. In total, 48% (n=13...
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Radiotherapy Alone or With Chemotherapy in the Management of Carcinoma of the Supraglottic Larynx: A 25-Year Community Hospital Experience
Conclusions: Our outcomes are similar to those reported in the literature. Neither hyperfractionation nor chemotherapy appeared to confer a benefit for disease control or OS possibly owing to small sample size and the inherent bias of a retrospective review. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Head and Neck Source Type: research

Concurrent Chemoradiotherapy in the Adjuvant Treatment of High-risk Primary Salivary Gland Malignancies
Conclusions: Use of chemoradiotherapy for adjuvant treatment of salivary gland malignancies was well-tolerated, but no improvement in survival was seen with the use of chemoradiotherapy in both the overall study population and a subset with high-risk features. Caution should be used when using this modality until randomized evidence becomes available. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Head and Neck Source Type: research

Surgical Intervention in Gastric Carcinoid is Associated With Improved Survival in Local and Regional Disease
This study aims to determine if surgical intervention in patients with local, regional, and metastatic gastric carcinoid is associated with prolonged survival. Materials and Methods: The California Cancer Registry merged with the California Office of Statewide Health Planning and Development was queried for patients with a diagnosis of gastric carcinoid (2000 to 2011). Clinicopathologic characteristics, management, and outcomes were evaluated. Results: There were 1012 patients with a diagnosis of gastric carcinoid identified. The median age was 63 (range, 18 to 99) and the majority of patients were women (615, 60.7%)...
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Obesity is Independently Associated With Increased Risk of Hepatocellular Cancer–related Mortality: A Systematic Review and Meta-Analysis
Conclusions: On the basis of this meta-analysis, premorbid obesity may be independently associated with a 2-fold risk of HCC-related mortality. This association was more pronounced in men and western populations. Strategies targeting obesity-associated metabolic abnormalities may provide novel pathways for HCC therapy. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Predictive Impact of Clinical Benefit in Chemotherapy-treated Advanced Pancreatic Cancer Patients in Northern Alberta
Objectives: Patients with advanced pancreatic cancer (APC) have a poor prognosis and experience a large burden of disease-related symptoms. Despite advancements in the treatment of APC, survival is dismal and controlling disease-related symptoms and maintaining quality of life is paramount. We hypothesize that an improvement in disease-related symptoms, and therefore, a clinical benefit, while on chemotherapy is a predictive marker in APC. Materials and Methods: Patients 18 and older with APC diagnosed between January 1, 2005 and December 31, 2010 and treated at the Cross Cancer Institute were identified using the pro...
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Assessment of the Albumin-Bilirubin (ALBI) Grade as a Prognostic Indicator for Hepatocellular Carcinoma Patients Treated With Radioembolization
Objective: As the utility of Child-Pugh (C-P) class is limited by the subjectivity of ascites and encephalopathy, we evaluated a previously established objective method, the albumin-bilirubin (ALBI) grade, as a prognosticator for yttrium-90 radioembolization (RE) treatment for patients with hepatocellular carcinoma (HCC). Materials and Methods: A total of 117 patients who received RE for HCC from 2 academic centers were reviewed and stratified by ALBI grade, C-P class, and Barcelona Clinic Liver Cancer stage. The overall survival (OS) according to these 3 criteria was evaluated by Kaplan-Meier survival analysis. The u...
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Efficacy of Modified Dose-dense Paclitaxel in Recurrent Cervical Cancer
Conclusion: Our results suggested that MDDP monotherapy is a tolerable and relatively effective regimen for recurrent cervical cancer. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Survival Benefit of Adjuvant Radiation Therapy in Node-positive Vulvar Cancer
Background: Adjuvant radiation therapy improves overall survival in patients with vulvar cancer with 2+ positive lymph nodes, but its benefit remains uncertain for 1 positive lymph node. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified node-positive, American Joint Committee on Cancer version 6-staged women with squamous cell vulvar carcinoma treated with and without radiation following surgery. The Kaplan-Meier approach assessed overall and cause-specific survival. Propensity score-based, multiply imputed Cox modeling accounted for missing data and selection bias. Results...
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Clinical Use and Optimal Cutoff Value of Ca15-3 in Evaluation of Adnexal Mass: Retrospective Cohort Study and Review of the Literature
Conclusions: As Ca15-3 assessment allowed detection of significantly more malignancy cases, we believe that measurement of this marker in combination with Ca125 is worthwhile in patients presenting with adnexal masses. The cutoff of 21 U/mL seems to be the optimal value in this specific population. High Ca15-3 levels (above 44.5 U/mL) strongly direct to a diagnosis of malignancy, mostly of primary ovarian tumors rather than breast malignancy. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Extraskeletal Osteosarcoma: Outcomes and the Role of Chemotherapy
Conclusions: Our results suggest a clinical benefit when platinum-based chemotherapy is incorporated in the management of patients with EO. We plan to validate this further with an expanded multicenter analysis. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft tissue Source Type: research

Predictors of Local Recurrence in Patients With Myxofibrosarcoma
Conclusions: In this institutional series of MFS older age and positive/close margins were significantly associated with a higher risk of LR. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - August 24, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft tissue Source Type: research

Influence of Extent of Lymph Node Evaluation on Survival for Pathologically Lymph Node Negative Non–Small Cell Lung Cancer
Conclusions: There was a consistently increasing survival benefit associated with a more extensive lymph node evaluation at lung cancer resection, up to 16 to 18 lymph nodes removed. The median number of nodes evaluated was, however, only 7, suggesting that setting a goal of ≥16 examined lymph nodes may lead to improved survival outcomes, and reduce disparities in care. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Thoracic Source Type: research

Outcomes for Anaplastic Glioma Treated With Radiation Therapy With or Without Concurrent Temozolomide
Conclusions: These findings support the use of RT+TMZ in the postoperative management of grade III glioma, and suggest that there is a benefit to concurrent RT+TMZ that is independent of adjuvant monthly TMZ. Further investigation is warranted, both to prospectively validate the benefit of RT+TMZ, as well as to determine if an additional benefit truly exists for adjuvant TMZ following concurrent RT+TMZ. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Central Nervous System Source Type: research

The Role of Definitive Radiotherapy in Craniopharyngioma: A SEER Analysis
Objective: Assess patterns of care in the management of craniopharyngioma, especially with respect to the use of radiation therapy (RT) alone (which has been understudied to date) as compared with gross total resection (GTR) and subtotal resection (STR) with adjuvant RT. Materials and Methods: The epidemiology, treatment modalities, and outcomes of patients with craniopharyngioma were studied using the Surveillance Epidemiology and End Results (SEER) database from 2004 to 2012. Survival was compared between treatment groups using Kaplan-Meier analysis and log-rank tests. Results: In total, 1218 patients with cranio...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Central Nervous System Source Type: research

The Role of Radiotherapy in Early-stage Primary Diffuse Large B-Cell Lymphoma of the Waldeyer Ring: A Retrospective Cohort Study
Conclusions: RT was associated with improved OS and EFS in stage I to II DLBCL of the WR. Future prospective studies are required to confirm these findings. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Hematopoietic Source Type: research

Third-line Salvage Chemotherapy for Recurrent Carcinoma of the Cervix is Associated With Minimal Response Rate and High Toxicity
Conclusions: Patients eligible to receive third-line chemotherapy for metastatic and recurrent cervical cancer can expect minimal benefit at the cost of significant toxicity. Quality of life considerations should be of paramount importance when counseling regarding the risks and benefits of further cytotoxic therapy. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Adjuvant External Radiation Impacts Outcome of Pelvis-limited Stage III Endometrial Carcinoma: A Multi-institutional Study
Background: Adjuvant therapy choice for women with FIGO stage III endometrial carcinoma (EC) is controversial. We investigate the comparative benefit of adjuvant chemotherapy (CT) alone, radiation therapy alone (RT) or in combination (chemotherapy and radiation therapy [CRT]) with respect to recurrence-free survival (RFS) and overall survival (OS) in women with pelvis-limited (PL) EC (stage IIIA, IIIB, and IIIC1). Materials and Methods: A multi-institutional database of 270 surgically staged women with PLEC was analyzed. Univariate log-rank analyses and Cox regression multivariate analyses (MVA) were performed to iden...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Chemoradiation Versus Chemotherapy in Uterine Carcinosarcoma: Patterns of Care and Impact on Overall Survival
Objectives: Uterine carcinosarcoma (UCS) is a rare and aggressive cancer with poor survival. Our purpose was to evaluate the patterns-of-care and overall survival (OS) benefit of adjuvant chemoradiation (aCRT) compared with adjuvant chemotherapy (aCT) among UCS patients. Methods: A query was made in the National Cancer Database to identify patients with UCS diagnosed between 2004 and 2012. Factors predictive of OS were determined using univariate and multivariate Cox regression analysis, as well as Kaplan-Meier and log-rank analysis. Propensity-score matching was employed to decrease the potential influence of selecti...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Gynecologic Source Type: research

Appendix-derived Pseudomyxoma Peritonei (PMP): Molecular Profiling Toward Treatment of a Rare Malignancy
Conclusions: Molecular profiling by multiple platforms identified potential therapies for the nontargetable KRAS-mutated population. The role of cMET-targeted therapeutics and immune checkpoint inhibitors merits further investigation. Biomarker-guided selection of cytotoxic chemotherapies may facilitate efficacy to systemic treatment. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

A Phase II Study of Ganetespib as Second-line or Third-line Therapy for Metastatic Pancreatic Cancer
Conclusions: Single-agent ganetespib was tolerable with only modest disease control in rMPC. This disease is resistant to chemotherapy, and given the emerging data in lung and rectal cancers, as well as in pancreatic cancer cell lines, suggesting improved activity of ganetespib in combination with cytotoxic agents, studies combining this agent with chemotherapy in rMPC are more likely to yield success. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Impact of Concurrent Medication Use on Pancreatic Cancer Survival—SEER-Medicare Analysis
We examined the association of several medication classes on pancreatic cancer survival in a large medical claims database. Materials and Methods: Histologically confirmed pancreatic adenocarcinoma diagnosed between 2006 and 2009 were analyzed from the Surveillance, Epidemiology, and End Results-Medicare database with available part D data. Drug use was defined as having 2 prescriptions filled within 12 months of pancreatic cancer diagnosis. The following medication classes/combinations were analyzed: β-blocker, statin, insulin, metformin, thiazolidinedione, warfarin, heparin, β-blocker/statin, metformin/stati...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Hepatotoxicity After Immune Checkpoint Inhibitor Therapy in Melanoma: Natural Progression and Management
Conclusions: Melanoma patients treated with immune checkpoint inhibitors should be monitored regularly for hepatotoxicity. Treatment with discontinuation of therapy and initiation of corticosteroids is indicated with grade 3 or 4 hepatotoxicity. Cyclosporine may be beneficial in steroid-refractory hepatotoxicity. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Cutaneous Source Type: research

Suboptimal Compliance With National Comprehensive Cancer Network Melanoma Guidelines: Who Is at Risk?
Background: National Comprehensive Cancer Network (NCCN) melanoma treatment guidelines are based on best available literature. We evaluated NCCN excision margin and sentinel lymph node biopsy (SLNB) guideline adherence to identify patient populations at risk for suboptimal care. Methods: Retrospective review of prospectively maintained database of all patients who underwent operation for invasive melanoma from January 2005 to 2015. Results: In total, 865 patients underwent operation for 522 thin (60.3%), 268 intermediate-thickness (31.0%), and 75 thick (8.7%) melanomas. Tumor location was 349 extremity (40.4%), 348...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Cutaneous Source Type: research

Hepatic Progression-free and Overall Survival After Regional Therapy to the Liver for Metastatic Melanoma
Conclusions: HPFS and PFS were significantly prolonged in patients treated with PHP versus CE or Y90. Median OS in PHP patients was over double that seen in Y90 or CE patients but was significant only between PHP and Y90. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Cutaneous Source Type: research

Discord Among Radiation Oncologists and Urologists in the Postoperative Management of High-Risk Prostate Cancer
Objective: To query specialty-specific differences regarding postoperative radiotherapy (RT) for high-risk prostate cancer. Materials and Methods: Electronic mail survey of radiation oncologists (ROs) and urologists. We sought to maximize absolute response number to capture contemporary practice ethos. The outcome of interest was association between response and specialty. Training level/expertise, practice setting, percentage of consultation caseload consisting of high-risk prostate cancer, and nationality were set as effect modifiers for multivariate logistic regression. Results: In total, 846 ROs and 407 urologi...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Adjuvant Radiotherapy Versus Wait-and-See Strategy for Pathologic T3 or Margin-Positive Prostate Cancer: A Meta-Analysis
Objective: To conduct a meta-analysis of the randomized controlled trials (RCTs) comparing adjuvant radiotherapy (ART) to wait-and-see (WS) strategy in pathologic T3 or margin-positive prostate cancer. Methods: A comprehensive EMBASE, MEDLINE, http://www.clinicaltrails.gov, and Cochrane Library search for RCTs of ART versus WS was done. Results were synthesized for metastasis-free, biochemical progression-free, clinical progression-free, hormone-free, and overall survival as well as gastrointestinal (GI) and genitourinary (GU) toxicities. Either random-effects model or fixed-effects model were used based on the test o...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Location and Grade of Prostate Cancer Diagnosed by Transperineal Template-guided Mapping Biopsy After Negative Transrectal Ultrasound-guided Biopsy
Objectives: To determine the location and grade of prostate cancer diagnosed by transperineal template-guided mapping (TTMB) after negative transrectal ultrasound-guided (TRUS) biopsy. Materials and Methods: This analysis consisted of 1118 consecutive patients who underwent TTMB from January 2005 to August 2015. Eight hundred thirty-five underwent TTMB after at least 1 negative TRUS biopsy and 283 underwent TTMB as the first biopsy procedure. The study population was divided into cohorts based on the number of prior TRUS biopsy sessions (0, 1, 2, and ≥3). No patient underwent multiparametric magnetic resonance imag...
Source: American Journal of Clinical Oncology - July 26, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Safety and Outcome Measures of First-in-Human Intraperitoneal α Radioimmunotherapy With 212Pb-TCMC-Trastuzumab
Purpose: One-year monitoring of patients receiving intraperitoneal (IP) 212Pb-TCMC-trastuzumab to provide long-term safety and outcome data. A secondary objective was to study 7 tumor markers for correlation with outcome. Methods: Eighteen patients with relapsed intra-abdominal human epidermal growth factor receptor-2 expressing peritoneal metastases were treated with a single IP infusion of 212Pb-TCMC-trastuzumab, delivered (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Experimental Therapeutics Source Type: research

The Association Between Out-of-Pocket Costs and Adherence to Adjuvant Endocrine Therapy Among Newly Diagnosed Breast Cancer Patients
We examined medical and pharmacy claims for the 1-year period after initiating AET using the Truven Health Analytics MarketScan database. Adherence was defined as ≥80% proportion of days covered. Mean out-of-pocket costs for AET fill were measured as the sum of copayments, coinsurance, and deductibles and adjusted to 30-day amounts. Using a multivariable logistic regression model we calculated adjusted risk ratios controlling for age, comorbidities, type of surgery, use of chemotherapy and/or radiation therapy, average out-of-pocket costs for other services, and pharmacy use characteristics. Results: Of the 6863 wome...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Axillary Ultrasound Fine Needle Aspiration Biopsy: Is There a Role in the Post Z-0011 Era?
Objectives: Axillary ultrasound with fine needle aspiration (AXUSFNA) in early-stage breast cancer has required reappraisal. ACOSOG Z-0011 and after mapping of the axilla: radiotherapy or surgery have shown that women with limited nodal disease at sentinel lymph node biopsy got no survival advantage with completion axillary node dissection. We hypothesize that AXUSFNA may be sufficiently accurate for staging for some patients and sentinel lymph node biopsy need not be performed. We define the false negative rate (FNR) of AXUSFNA in different subsets of patients. Materials and Methods: This retrospective cohort study i...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Breast Source Type: research

Clinical Outcomes After Lung Stereotactic Body Radiation Therapy in Patients With or Without a Prior Lung Resection
Objectives: Tumor control (TC), toxicity and survival, following stereotactic body radiation therapy (SBRT) were compared between patients with and without a prior lung resection (PLR). Materials and Methods: The study is comprised of 130 patients with 141 peripheral tumors treated with SBRT at our institution from 2009 to 2013. Primary TC and lobar control (LC) were defined per RTOG 0236. Toxicity was scored using Common Terminology Criteria for Adverse Events version 4.0. Survival/TC and toxicity were compared between patients with and without PLR using the Kaplan-Meier method and cumulative incidence, respectively....
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Thoracic Source Type: research

A Review of the Surgical Management of Extrathoracic Solitary Fibrous Tumors
Conclusions: Routine long-term follow-up is essential for benign and malignant disease to enable early detection and treatment of recurrent disease. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft Tissue Source Type: research

Outcome After Surgery for Extremity Soft Tissue Sarcoma in Patients Presenting With Metastasis at Diagnosis
Conclusions: Extremity STS patients who present with metastasis at diagnosis have a poor prognosis. Patients who undergo metastasectomy have a better chance for prolonged survival. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft Tissue Source Type: research

Benefit of Radiotherapy in Extraskeletal Myxoid Chondrosarcoma: A Propensity Score Weighted Population-based Analysis of the SEER Database
Conclusions: The receipt of EBRT is associated with a CSS benefit in localized EMC. Aggressive local therapy, including EBRT, should be considered in these patients. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Soft Tissue Source Type: research

Impact of Androgen Deprivation Therapy on Overall Mortality in Prostate Brachytherapy Patients With Low Pretreatment Testosterone Levels
Objectives: To evaluate whether the use of androgen deprivation therapy (ADT) in prostate brachytherapy patients impacts overall mortality (OM) in patients with lower pretreatment serum testosterone levels compared with those with normal or high baseline serum testosterone. Materials and Methods: From October 2001 to May 2014, 1916 patients underwent brachytherapy and had a pretreatment serum testosterone. Baseline serum testosterone values were collected prospectively before initiation of therapy. Median follow-up was 7.2 years. In total, 26% of the patients received ADT, primarily men with higher risk disease. OM an...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Genitourinary Source Type: research

Challenges in Management of Squamous Cell Carcinoma of the Anus in New England and Across the United States: A Review of the National Cancer Data Base
Background: Management of squamous cell carcinoma of the anus (SCCA) is becoming more relevant, as its incidence continues to increase. The purpose of this study was to evaluate regional and national data to assess trends in epidemiology, access to cancer center care, and overall management strategies in SCCA. Study Design: A review of available data from the American College of Surgeons Committee on Cancer National Cancer Data Base focused on incidence, sex, age, stage at diagnosis, distance traveled for care, and utilization of therapy as first course of treatment (FCT). The analysis included 40,817 patients treated...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Tolerability and Long-term Outcomes of Dose-Painted Neoadjuvant Chemoradiation to Regions of Vessel Involvement in Borderline or Locally Advanced Pancreatic Cancer
Conclusions: We found that DP-neoadjuvant chemoradiation to regions of vessel involvement is both feasible and well tolerated. In addition, we demonstrated that over one third of patients with initially deemed unresectable disease were able to undergo surgical resection after receiving neoadjuvant therapy including DP-chemoradiation. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

A Multicenter Phase II Study of Gemcitabine, Capecitabine, and Bevacizumab for Locally Advanced or Metastatic Biliary Tract Cancer
Conclusions: Addition of bevacizumab to gemcitabine/capecitabine did not improve outcome in an unselected group of patients with advanced BTC compared with historical controls. The selective benefit of vascular endothelial growth factor inhibition in BTC remains to be explored. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Impact of Postoperative Adjuvant Chemotherapy Following Long-course Chemoradiotherapy in Stage II Rectal Cancer
Objectives: Use of adjuvant chemotherapy (AC) following neoadjuvant chemoradiation (nCRT) is controversial in rectal cancer (RC). We assessed a multi-institutional database to determine if there was benefit from AC for pathologic stage II RC patients and whether the addition of oxaliplatin to fluoropyrimidine (OXAC) therapy impacted outcomes. Materials and Methods: We included patients who underwent nCRT and had pathologic stage II (ypT3/4 ypN0) tumors. Disease-free survival and overall survival were assessed. Multivariate Cox models adjusting for age, sex, Eastern Cooperative Oncology Group, high-risk features (pT4, ...
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Programmed Cell Death-Ligand 1 (PD-L1) Expression in Anal Cancer
Conclusions: PD-L1 positivity was associated with worse CRR and CER, and marginally worse CMR. The effect on progression-free and overall survival needs to be validated in a study with a larger sample size. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Hyperfractionated Accelerated Reirradiation for Patients With Recurrent Anal Cancer Previously Treated With Definitive Chemoradiation
Conclusions: Hyperfractionated accelerated re-RT was well-tolerated in patients with previously irradiated anal cancer. Patients treated with either definitive re-RT or re-RT followed by surgical resection had excellent rates of overall survival and freedom from local progression. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Clinical and Economic Evaluation of Treatment Strategies for T1N0 Anal Canal Cancer
Conclusions: There was no statistically significant difference in survival among the treatment alternatives for T1N0 anal canal cancer. Given that surgery/ablation costs less than RT or CRT and might be cost-effective compared with RT and CRT, it is crucial to explore this finding further in this era of limited health care resources. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Phase II Study of Adjuvant Chemoradiotherapy Using Docetaxel/Cisplatin/5-Fluorouracil Before and After Intensity-modulated Radiotherapy With Concurrent Docetaxel in Patients With Completely (R0) Resected Gastric Carcinoma
Conclusions: These results demonstrate that this adjuvant regimen is active with an acceptable toxicity profile. A randomized phase 3 trial comparing the Intergroup 0116 chemoradiotherapy regimen with this regimen is underway. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - June 21, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Molecular Predictors of Response to Neoadjuvant Chemoradiation for Rectal Cancer
Objectives: To determine whether the expression of specific molecular markers in the rectal cancer biopsies prior to treatment, can correlate with complete tumor response to chemoradiotherapy (CRT) as determined by the pathology of the surgical specimen. Methods: We retrospectively examined pretreatment rectal biopsies of patients aged 18 years or older with locally advanced rectal cancer who had been treated with neoadjuvant CRT and surgical resection in our tertiary-care, university-affiliated medical center, between January 2001 and December 2011. Samples were analyzed for expression of B-cell lymphoma 2, P53, Ki67...
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Intraoperative Radiotherapy in the Era of Intensive Neoadjuvant Chemotherapy and Chemoradiotherapy for Pancreatic Adenocarcinoma
Conclusions: IORT in addition to intensive neoadjuvant chemotherapy and chemoradiotherapy was not associated with increased toxicity when used with resection or exploratory laparotomy, and was associated with encouraging survival rates in patients with close/positive margins and patients with unresectable disease. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research

Pretreatment Tumor Thickness as a Predictor of Pathologic Complete Response to Neoadjuvant Chemoradiation Therapy for Stage II/III Rectal Adenocarcinoma
Conclusions: We concluded that pretreatment tumor thickness is an independent predictor for pCR of stage II/III rectal adenocarcinoma to the neoadjuvant CRT. (Source: American Journal of Clinical Oncology)
Source: American Journal of Clinical Oncology - May 22, 2018 Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research