Ipsilateral breast tumor recurrence after lumpectomy: is it time to take the bull by the horns?
Adult; Female; Prognosis; Combined Modality Therapy; Neoadjuvant Therapy; Neoplasm Metastasis; Neoplasm Recurrence; Lumpectomy; Breast Neoplasms – Pathology; Breast Neoplasms – Surgery; Breast Neoplasms – Therapy; Local – Pathology; Local – Surgery; Local – Therapy
Mamounas Eleftherios P; Mamounas E P
Journal of Clinical Oncology
2001
2001-09-15
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1200/jco.2001.19.18.3798" target="_blank" rel="noreferrer noopener">10.1200/jco.2001.19.18.3798</a>
Carboplatin and paclitaxel for the treatment of advanced or recurrent endometrial cancer.
Adult; Aged; Survival; Drug Administration Schedule; Human; Middle Age; Retrospective Design; Neoplasm Recurrence; Antineoplastic Agents; Combined; Kaplan-Meier Estimator; Drug Toxicity; Severity of Illness; Carboplatin – Administration and Dosage; Endometrial Neoplasms – Drug Therapy; Local – Drug Therapy; Paclitaxel – Administration and Dosage
OBJECTIVE: The purpose of this study was to determine the activity and toxicity of carboplatin and paclitaxel (taxol) in the treatment of advanced or recurrent endometrial cancer. STUDY DESIGN: This was a retrospective review of 18 consecutive patients with advanced (stage 4) or recurrent endometrial adenocarcinoma that had been treated with outpatient carboplatin and taxol. Taxol was delivered at 135 mg/m 2 over 3 hours, and carboplatin was delivery at an area under the curve of 5 over 1 hour. Cycles were repeated every 21 days. RESULTS: The overall response rate was 63% with 28% of patients who had a partial response and 35% of patients who had a complete response. Kaplan-Meier test was used to estimate the median survival time of 27 months and the median progression free survival time of 24 months. No patient had neutropenia, thrombocytopenia or grade 3 vomiting, neurosensory toxicity, or renal toxicity. CONCLUSION: Carboplatin and taxol for the treatment of advanced or recurrent endometrial cancer appear to be active regimens with minimal toxicity.
Akram T; Maseelall P; Fanning J
American Journal of Obstetrics & Gynecology
2005
2005-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ajog.2004.12.032" target="_blank" rel="noreferrer noopener">10.1016/j.ajog.2004.12.032</a>
Generation of "virtual" control groups for single arm prostate cancer adjuvant trials.
Humans; Male; Middle Aged; Aged; Treatment Outcome; Disease-Free Survival; *Nomograms; *Prostatectomy; Antineoplastic Agents/therapeutic use; Control Groups; Controlled Clinical Trials as Topic; Prostate/drug effects/pathology/surgery; Prostatic Neoplasms/*drug therapy/mortality/pathology/surgery; Neoplasm Recurrence; Chemotherapy; Adjuvant/*methods; Local/*drug therapy/mortality/pathology/surgery
It is difficult to construct a control group for trials of adjuvant therapy (Rx) of prostate cancer after radical prostatectomy (RP) due to ethical issues and patient acceptance. We utilized 8 curve-fitting models to estimate the time to 60%, 65%, ... 95% chance of progression free survival (PFS) based on the data derived from Kattan post-RP nomogram. The 8 models were systematically applied to a training set of 153 post-RP cases without adjuvant Rx to develop 8 subsets of cases (reference case sets) whose observed PFS times were most accurately predicted by each model. To prepare a virtual control group for a single-arm adjuvant Rx trial, we first select the optimal model for the trial cases based on the minimum weighted Euclidean distance between the trial case set and the reference case set in terms of clinical features, and then compare the virtual PFS times calculated by the optimum model with the observed PFSs of the trial cases by the logrank test. The method was validated using an independent dataset of 155 post-RP patients without adjuvant Rx. We then applied the method to patients on a Phase II trial of adjuvant chemo-hormonal Rx post RP, which indicated that the adjuvant Rx is highly effective in prolonging PFS after RP in patients at high risk for prostate cancer recurrence. The method can accurately generate control groups for single-arm, post-RP adjuvant Rx trials for prostate cancer, facilitating development of new therapeutic strategies.
Jia Zhenyu; Lilly Michael B; Koziol James A; Chen Xin; Xia Xiao-Qin; Wang Yipeng; Skarecky Douglas; Sutton Manuel; Sawyers Anne; Ruckle Herbert; Carpenter Philip M; Wang-Rodriguez Jessica; Jiang Jun; Deng Mingsen; Pan Cong; Zhu Jian-Guo; McLaren Christine E; Gurley Michael J; Lee Chung; McClelland Michael; Ahlering Thomas; Kattan Michael W; Mercola Dan
PloS one
2014
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1371/journal.pone.0085010" target="_blank" rel="noreferrer noopener">10.1371/journal.pone.0085010</a>
Facilitating breast-conserving surgery and preventing recurrence: aromatase inhibitors in the neoadjuvant and adjuvant settings.
Female; Humans; Neoadjuvant Therapy; Antineoplastic Agents/*administration & dosage; Aromatase Inhibitors/*administration & dosage; Breast Neoplasms/*drug therapy/*surgery; Neoplasm Recurrence; Segmental; *Mastectomy; Adjuvant; Chemotherapy; Local/*prevention & control
Breast-conserving surgery (BCS) is an attractive option for many patients with early-stage breast cancer, because it provides a better cosmetic outcome than modified radical mastectomy, while reducing surgical morbidity. In patients with large, operable breast tumors who are ineligible for BCS, neoadjuvant therapy is a useful option for reducing the tumor size and for increasing the proportion of candidates for BCS. In patients with endocrine-responsive tumors, neoadjuvant endocrine therapy with either tamoxifen or an aromatase inhibitor (AI; anastrozole, letrozole, or exemestane) provides an alternative to neoadjuvant chemotherapy. Clinical trials have demonstrated the superiority of neoadjuvant AIs over tamoxifen in achieving a clinical response and increasing the frequency of BCS. In addition, adjuvant endocrine therapy with AIs, whether used as initial therapy instead of tamoxifen, in a switching strategy after 2-3 years of tamoxifen, or as extended adjuvant therapy after 5 years of adjuvant tamoxifen, has been shown in several randomized clinical trials to improve disease-free survival, reduce distant metastases and, in some cases, improve overall survival. The availability of the AIs for effective and well-tolerated neoadjuvant and/or adjuvant endocrine therapy represents an important advance in breast cancer treatment, and surgeons should be familiar with these new therapeutic options.
Mamounas Eleftherios P
Annals of surgical oncology
2008
2008-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1245/s10434-007-9702-3" target="_blank" rel="noreferrer noopener">10.1245/s10434-007-9702-3</a>
The Role of MRI in the Follow-up of Women Undergoing Breast-conserving Therapy.
*Magnetic Resonance Imaging; Aftercare; Breast Neoplasms/*diagnostic imaging/*surgery; Female; Humans; Local/*diagnostic imaging; Mammography; Mastectomy; Neoplasm Recurrence; Population Surveillance/*methods; Segmental
OBJECTIVES: Breast-conserving therapy (BCT) represents a standard of care in the management of breast cancer. However, unlike mastectomy, women treated with BCT require follow-up imaging of the treated breast as well as the contralateral breast as part of posttreatment surveillance. Traditionally, surveillance has consisted of clinical exams and mammograms. However, magnetic resonance imaging (MRI) has emerged as a breast imaging technique utilized as part of high-risk screening programs as well as part of the initial diagnosis and workup of women considered for BCT. At this time, the role of MRI as part of follow-up for women treated with BCT remains unclear. METHODS: A systematic review was performed to evaluate the role of MRI following BCT. RESULTS: Although there is no randomized evidence supporting the routine use of MRI in surveillance post-BCT, a review of the literature demonstrates that MRI (1) has increased sensitivity as compared with mammography to detect recurrences, and (2) can help evaluate mammographic abnormalities before biopsy and/or surgery. CONCLUSIONS: In patients with higher risk of local recurrence, surveillance with MRI may represent an effective surveillance strategy though subgroups benefiting have not been identified nor has the impact on quality of life and cost been evaluated.
Shah Chirag; Ahlawat Stuti; Khan Atif; Tendulkar Rahul D; Wazer David E; Shah Shilpi S; Vicini Frank
American journal of clinical oncology
2016
2016-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/COC.0000000000000290" target="_blank" rel="noreferrer noopener">10.1097/COC.0000000000000290</a>
Selective lateral compartment neck dissection for thyroid cancer.
80 and over; Adenocarcinoma; Adult; Aged; Carcinoma; Female; Follicular/mortality/secondary/surgery; Follow-Up Studies; Humans; Local/mortality/pathology/surgery; Lymph Node Excision/*methods; Lymph Nodes/anatomy & histology/surgery; Lymphatic Metastasis; Male; Medullary/mortality/secondary/*surgery; Middle Aged; Morbidity; Neck Dissection/*methods; Neck Muscles/anatomy & histology/surgery; Neoplasm Recurrence; Papillary/mortality/secondary/surgery; Retrospective Studies; Selective lateral compartment neck dissection; Thyroid cancer; Thyroid Neoplasms/mortality/pathology/*surgery; Thyroidectomy/*methods; Young Adult
BACKGROUND: Compartment-oriented lymph node dissection in patients with thyroid cancer and macroscopic lymph node metastases reduces recurrence and improves survival. However, the extent of lymph node dissection remains controversial. The purpose of this study was to examine the results of selective lateral compartment neck dissection (LCND) for thyroid cancer. METHODS: We completed a retrospective review of patients with thyroid cancer who underwent selective LCND from
Welch Kellen; McHenry Christopher R
The Journal of surgical research
2013
2013-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.jss.2013.04.084" target="_blank" rel="noreferrer noopener">10.1016/j.jss.2013.04.084</a>
Carboplatin and paclitaxel for the treatment of advanced or recurrent endometrial cancer.
Adult; Aged; Antineoplastic Agents; Antineoplastic Agents/administration & dosage; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use; Carboplatin/administration & dosage; Drug Administration Schedule; Endometrial Neoplasms/*drug therapy; Female; Humans; Local/drug therapy; Middle Aged; Neoplasm Recurrence; Paclitaxel/administration & dosage; Phytogenic/administration & dosage; Survival Analysis; Treatment Outcome
OBJECTIVE: The purpose of this study was to determine the activity and toxicity of carboplatin and paclitaxel (taxol) in the treatment of advanced or recurrent endometrial cancer. STUDY DESIGN: This was a retrospective review of 18 consecutive patients with advanced (stage 4) or recurrent endometrial adenocarcinoma that had been treated with outpatient carboplatin and taxol. Taxol was delivered at 135 mg/m 2 over 3 hours, and carboplatin was delivery at an area under the curve of 5 over 1 hour. Cycles were repeated every 21 days. RESULTS: The overall response rate was 63% with 28% of patients who had a partial response and 35% of patients who had a complete response. Kaplan-Meier test was used to estimate the median survival time of 27 months and the median progression free survival time of 24 months. No patient had neutropenia, thrombocytopenia or grade 3 vomiting, neurosensory toxicity, or renal toxicity. CONCLUSION: Carboplatin and taxol for the treatment of advanced or recurrent endometrial cancer appear to be active regimens with minimal toxicity.
Akram Tahira; Maseelall Priya; Fanning James
American journal of obstetrics and gynecology
2005
2005-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ajog.2004.12.032" target="_blank" rel="noreferrer noopener">10.1016/j.ajog.2004.12.032</a>
Phase II study of gefitinib in patients with advanced salivary gland cancers.
80 and over; Adenocarcinoma/drug therapy/mortality/pathology; adenoid cystic carcinoma; Adenoid Cystic/*drug therapy/mortality/pathology; Adult; Aged; Antineoplastic Agents/*therapeutic use; Carcinoma; Disease-Free Survival; Dose-Response Relationship; Drug; Drug Administration Schedule; Female; gefitinib; Gefitinib; Humans; Local/*drug therapy/mortality/pathology; Male; Maximum Tolerated Dose; Middle Aged; Neoplasm Invasiveness/pathology; Neoplasm Recurrence; Neoplasm Staging; non-adenoid cystic carcinoma; Prognosis; Quinazolines/*therapeutic use; Remission Induction; response to therapy; salivary gland cancer; Salivary Gland Neoplasms/*drug therapy/mortality/pathology; Survival Analysis; Treatment Outcome
BACKGROUND: The purpose of this study was to determine the antitumor activity of the epidermal growth factor receptor (EGFR) inhibitor gefitinib in patients with recurrent/metastatic salivary gland cancer. METHODS: We conducted a phase II study in adenoid cystic carcinoma (ACC) and non-ACC. Gefitinib was administered 250 mg orally daily. The primary endpoint was tumor response. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and disease control rates. EGFR and human epidermal growth factor receptor 2 (HER2) expression were evaluated and correlated with outcomes. RESULTS: Thirty-seven patients were enrolled in this study, and 36 were evaluable (18 with ACC and 18 with non-ACC). No responses were observed. Median PFS was 4.3 months and 2.1 months, and median OS was 25.9 months and 16 months for patients with ACC and non-ACC, respectively. The disease control rate at 8 weeks was higher in patients with ACC. No unexpected toxicities occurred. EGFR and HER2 overexpression did not correlate with outcomes. CONCLUSION: We did not observe significant clinical activity of gefitinib in advanced salivary gland cancer. NCT00509002.
Jakob John A; Kies Merrill S; Glisson Bonnie S; Kupferman Michael E; Liu Diane D; Lee J Jack; El-Naggar Adel K; Gonzalez-Angulo Ana M; Blumenschein George R Jr
Head & neck
2015
2015-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/hed.23647" target="_blank" rel="noreferrer noopener">10.1002/hed.23647</a>