http://www.ecancermedicalscience.com/ This RSS feed lets you know when new articles are added to the ecancermedicalscience website. dev@2cs.com;lowens@brandcastmedia.com;linda.cairns@ifom-ieo-campus.it;gordon.mcvie@ieo.it;jonathan@ecancermedicalscience.com; en http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2010.177 Tue, 26 Jan 2010 00:00:00 GMT ]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.174 Fri, 11 Dec 2009 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2010.164 Wed, 3 Feb 2010 00:00:00 GMT
The latest innovation in cancer treatments are targeted biological treatments, joining the current arsenal of surgery, radiotherapy and chemotherapy, particularly significant
in latter stage cancers associated with very poor survival.

Despite this latest breakthrough in cancer treatment, this has in fact only opened the door to beginning to understand the complexity of cancer on a molecular and genetic basis. Oncology research and development (R&D) has the highest failure rate for new molecular entities (NME) and significantly higher development costs. Although tremendous scientific and economic barriers exist, the oncology development market
has increased two-fold over the past five years.

This report aims to map current oncology R&D funding and management, primarily in Europe and the USA, to examine public-private relationships, current oncology R&D strategies and oncology innovation policies. Its objectives are:

- To map current funding and management of oncology R&D via questionnaire
surveys and interviews of oncology experts;
- To produce a high-resolution bibliometric analysis of oncology drug R&D in
order to better understand the public-private mix in research activity;
- To investigate the cumulative life-time funding of specific oncology drugs;
- To review current public policy affecting oncology drug R&D, specifically, public
R&D investment policies, transnational investment policies, regulatory policies,
and drug reimbursement policies; and
- To propose future oncology policies supporting the R&D process.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2010.162 Mon, 14 Dec 2009 00:00:00 GMT
Methods: We conducted a retrospective audit of patients with GIST treated with imatinib from 1st February 2002 to 31st March 2007. Information gathered included patient demographics, disease characteristics, and details of treatment administered, treatment response, toxicities and follow-up data. The primary objective was to record disease control rate (DCR), defined as a lack of progression on computed tomography (CT) at 3 months. Secondary end points of this audit were progression-free and overall survival. These were compared with published clinical trial results.

Results: Thirty six consecutive patients with a diagnosis of GIST treated with imatinib were identified. Median age of patients was 70.1 years. At the time of analysis, patients have been followed up for a median of 41.6 months. In total, patients were treated for a median of 15.8 months. Treatment was generally well tolerated with a small percentage of patients experiencing grade 3/4 toxicities. Disease control was observed in 30 patients (DCR, 83.3 %, 95% CI 67.2-93.6, intention to treat analysis). The median progression free survival (PFS) in this cohort was 23.7 months (95% CI 12.9-34.4); while the median overall survival (OS) was 39.7 months (95%CI 22.8-56.5).

Conclusion: Our data demonstrated that the treatment of unselected GIST patients within the NICE guidance compares favourably to previously published data of randomised registration studies of imatinib. Of note, the median age of this cohort is some 10 years older than that reported in the trials. Imatinib was well tolerated with acceptable treatment-related adverse events.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.161 Mon, 12 Oct 2009 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.160 Wed, 30 Sep 2009 00:00:00 GMT Background
Vitamin D and cancer: Calcitriol, the biologically active form of vitamin D (1,25(OH)D), exerts its effects mainly through binding to nuclear vitamin D receptor (VDR). Calcitriol has been shown to be an antiproliferative, prodifferentiation, proapoptotic agent and an inhibitor of cell migration. Animal and human in vitro studies strongly indicate that vitamin D may have benefits for many forms of cancer.� Inadequate levels of circulating 25-hydroxy-vitamin D (25(OH)D) are associated with an increased risk and poor prognosis of several types of cancer.
Vitamin D and melanoma: Cutaneous malignant melanoma (CMM) represents a major public health issue: rates in Italy have almost doubled in the last decade and CMM is frequent among young adults. For resected stage II melanoma no standard adjuvant treatment exists and 5-year overall survival is about 70%.
Cultured melanoma cells can synthesise calcitriol from 25(OH)D and express the VDR. Moreover, 1,25(OH)D has antiproliferative and prodifferentiation effects in human melanoma cells. 1,25(OH)D has been shown to induce apoptosis in human melanoma cell lines and has an inhibitory effect on the spreading of melanoma cells in vitro.
Preliminary results on Vitamin D: Epidemiological data indicate that vitamin D deficiency is relatively common in Europe. In an Italian study, we found that 85% of the participants had insufficient levels of 25(OH)D. We have shown through a meta-analysis of randomized trials that vitamin D supplementation is associated with a significant reduction (7%) in total mortality in healthy subjects and an association between VDR and 25(OH)D and CMM progression has also been demonstrated. We have also reported significant associations between VDR polymorphisms and incidence of skin cancer. In early supplementation trials, the lack of effect on cancer incidence has been attributed to insufficient vitamin D supplementation, stressing the need to better study vitamin D bioavailability.
In fact, a recent IARC report highlighted the need for new randomised trials, based on results from our meta-analyses on 25(OH)D serum levels and cancer risk.
Clinical trial and biomarkers studies
In order to assess whether vitamin D supplementation could improve prognosis of CMM, an Italian multicentre trial in stage II resected melanoma patients was planned to monitor changes in 25(OH)D. The study will address two important questions regarding the relationship between the biology of VDR and (i) vitamin D metabolism (ii) CMM prognosis. This will involve investigating the association between VDR polymorphisms and Breslow thickness, the most important prognostic factor of CMM, and between 25(OH)D serum level, vitamin D supplementation and VDR.
We will also evaluate at baseline whether VDR polymorphisms are associated with Breslow thickness and whether we obtain significant increase in 25(OH)D serum levels during the first year of supplementation. We will quantify the percentages of patients who have desirable levels of 25(OH)D and if not the mean time to reach that level. The findings from this study will be of large interest because Vitamin D could have anticancer benefits for a wide spectrum of cancers.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.159 Wed, 30 Sep 2009 00:00:00 GMT with modern techniques, some of the questions that were raised some 50 years ago shortly after Burkitt�s first description, as well as new questions that can be asked only in the light of modern understanding of the immune system and the molecular basis of tumor development. The African lymphoma has taught us much, but there is a great deal still to be learned.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.158 Tue, 29 Sep 2009 00:00:00 GMT At the European Institute of Oncology (IEO) a clinical study is ongoing to verify whether, during clinical practice, the patient is adequately informed to sign an �informed consent�, in a fully aware manner, that will allow the patient and doctor to share in the decisions regarding complex treatment strategies (Living Will). A further aim of the study is to verify if health workers, both in hospital and at home, respect the patients� will.
The observational study �Respecting the patient�s wishes: correlation between administered treatment and that accepted by the patient in their �Living Will�� was approved by the IEO Ethical Committee in April 2008.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.157 Thu, 29 Oct 2009 00:00:00 GMT The discovery of biomarkers strongly associated with breast carcinogenesis has an enormous potential especially for the selection of subjects at high-risk for developing breast cancer who may benefit from chemopreventive treatments.
Although the number of analyzed biomarkers continue to increase, an unique biomarker for breast cancer risk prediction has not been identified and it is more likely that a panel of biomarkers should be taken into account. Anyhow, further studies are needed to validate breast cancer biomarkers evaluation for individual risk assessment.
This review summarizes main biomarkers that have found to have significant roles at different stages of breast carcinogenesis with updates from the more recent literature.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2010.156 Tue, 19 Jan 2010 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.153 Thu, 24 Sep 2009 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.152 Wed, 19 Aug 2009 00:00:00 GMT
Myxomas, sarcomas, breast, lung, and renal cancer represent the commonest causes of primary benign, malignant and metastatic intra-cardiac masses respectively.

Recent studies have shown that cardiac involvement in malignant lymphoma is common but under-investigated.
Diagnostic imaging techniques for detection of cardiac masses include echocardiography, CT and MRI, with echocardiography having the highest sensitivity. We propose that 18-F-PET/CT may play an important role in the detection and evaluation of intra-cardiac masses.

]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.150 Fri, 18 Sep 2009 00:00:00 GMT Ultrasound revealed a well-vascularized right thyroid nodule that was identified as a cold area by 99mTc-sodium pertechnetate scan. Fine-needle aspiration showed a follicular lesion and blood tests revealed hypercalcemia and hyperparathyroidism.
A 99mTc-methoxyisobutylisonitrile (99mTc-Sestamibi) scan was subsequently performed revealing a focal area of increased uptake in the right thyroid lobe, within the cold area detected by the thyroid scan.
A right emithyroidectomy and right superior and inferior parathyroidectomy was performed and histopathological examination showed a parathyroid carcinoma (immunohistochemistry positive for PTH and chromogranin A, Ki-67 10%) associated with follicular hyperplasia.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.149 Wed, 21 Oct 2009 00:00:00 GMT
Material and methods: After a series of meetings with members of administrative, clinical, research and informatics departments, the TR was activated in March 2006 with the aim to collect data on all the individuals referring to the Institute, with or at risk of developing a tumour. It was implemented on an Oracle-based interface. A minimum data set of variables was defined and data collection was divided into four forms, which together gather all the relevant data on patients, tumors, treatments and subsequent events.

Results: After a 6-month pilot period, which involved the training of the tumour registrars, adjustments to the structure of the registry, development of data quality control procedure and finalization of the operative protocol, from September 2006 the data collection has been fully operative. Five registrars have been chronologically entering data of all individuals who visited the IEO for the first time since 1st January 2000. As of March 2009, data on 69,637 individuals and 43,567 tumours has been reviewed, recoded and registered in the TR. Twenty-two percent of the tumors (n=9,578) were first invasive primaries, diagnosed and treated at the IEO; the most common sites were breast (n=4,972), lung (n=627), intestines (n=479) and prostate (n=376).
Conclusion: The IEO TR has proven functional and reliable in monitoring the activity of the Hospital, allowing extraction of data from any subpopulation with characteristics of interest. The structured and centralized TR represents an important tool for our research-oriented Institution.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.148 Tue, 9 Jun 2009 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.147 Mon, 8 Jun 2009 00:00:00 GMT
The clinical manifestations of early cardiotoxicity commonly include: ventricular premature beats, supraventricular tachycardia, cardiomyopathy and sudden death.

This study confirms the necessity for close cardiac monitoring of patients undergoing anthracycline therapy. Such monitoring should not only comprise echocardiographic monitoring for left ventricular systo-diastolic dysfunction, but also electrocardiographic monitoring (QTc) in order to exclude electrophysiological changes possibly related to life threatening arrhythmias (10).

]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.146 Thu, 17 Sep 2009 00:00:00 GMT Material and methods: Semiautomatic image analysis system was used to measure a total of 8 nuclear parameters in 48 thyroid lesions including seven nodular goiter (NG), 14 follicular adenoma (FA), 14 follicular carcinoma (FC) and 13 follicular variant papillary carcinoma (FVPC).

Results: The parameters related to nuclear size (area, perimeter, MaxD, MinD, nuclear size) and shape (L/S ratio, Form_AR) were significantly higher in neoplastic group (FA, FC, FVPC) when compared to non-neoplastic group (NG) P<0.05. The perimeter was the most reliable parameter (area under the cure (AUC)=97%) followed by area, MaxD, and size (all have AUC= 96%) then form-AR (90%), LS ratio (86%) and the least reliable was Min D (79%). Within the neoplastic group, most parameters related to size and shape of the nuclei was significantly higher in FVPC than in FA and FC (p ≤ 0.05). Nuclear area and size (AUC 77%) were the most reliable parameters for differentiation between FVPC and FA. The best cut off values for diagnosing FVPC are nuclear area ≥39.9�m2 and nuclear size ≥27.7�m2. However, there was no quantitative difference between FC and FA.

Conclusion: Nuclear morphometric parameters may help in the differentiation between neoplastic and non-neoplastic thyroid lesions and between FVPC and follicular neoplasms (FC and FA) but they have no value in the differentiation between FC and FA.



]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.145 Thu, 6 Aug 2009 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.144 Wed, 5 Aug 2009 00:00:00 GMT
Aim of the study: Assessment of the toxicity of metronomic chemotherapy and the response and progression free survival of relapsed DLCBL patients.

Patients and methods: forty patients with the diagnosis of relapsed and / or refractory DLCBL. Patients included in this study may have received any number of preceding therapies (as long as one had included an Anthracycline) and were not candidates for BMT. They received Cyclophosphamide tab (50 mg p.o. q.d), Methotrexate tab (2.5 mg p.o 4 times/week) and high-dose Celecoxib tab (400 mg p.o. b.i.d.) until disease progression or toxicity.

Results: All of the 40 patients included (median age, 56 years) were evaluable for response, 52% had a high international prognostic index at relapse, with a median follow-up of 8.4 months (range 4-23 months),
32.5 % had a partial response and 50% has stable disease. Progression-free survival was 12 months. The median response duration was 9 months. Treatment protocol was well tolerated with no major toxicities. The most common toxicity was fatigue (57.5%), myelo-suppression and gastrointestinal side effects.

Conclusions: Low-dose Cyclophosphamide, Methotrexate and high-dose Celecoxib is well tolerated and active in pretreated diffuse large cell B lymphoma. Although thrombotic events were not observed during this study, Close surveillance for arterial and venous thrombotic events is recommended.

]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.143 Tue, 12 May 2009 00:00:00 GMT
Although further investigation is warranted in order to identify the optimal echogenic marker and to define its potential use for image-guided-radiotherapy in prostate cancer patients, we demonstrate the feasibility of the BAT system for the visualization of non US-dedicated markers.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.142 Tue, 12 May 2009 00:00:00 GMT
Each Italian Region has a Centre for the coordination of the screening program which employs a dedicated software that can trace the course of each citizen within the program.

The "Screening Centre" has a database that can provide a detailed, real-time situation of the program: it is therefore possible to compare the characteristics of screen-detected and non-screen-detected cancers.

The target population for the screening program includes all citizens aged 50 to 70, except "high-risk" subjects [family history; serious, persistent IBD; previous colorectal surgery; recent non-screen-related FOBT and/or colonoscopy; apparent digestive-tract symptoms (proctorrhagia; abdominal pain; bowel irregularities, etc.)].]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.141 Thu, 2 Apr 2009 00:00:00 GMT
Three main subtopics that could be possibly canvassed out of whole meeting, namely: a) apoptosis and signaling, b) cancer stem cells, c) cancer genome and epigenome profiling.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.140 Fri, 20 Mar 2009 00:00:00 GMT
Diagnosis and treatment of MBC is similar to that of female patients but men tend to be treated with mastectomy rather than breast conserving surgery. The mainstay of adjuvant therapy or palliative treatment for advanced disease is endocrine, mostly tamoxifen. Prognosis of male patients is equal to that of stage-matched women, but men tend to fare worse because of delay in presentation leading to a large proportion of patients presenting with stage III or IV disease. Increased input is needed for psychological support for male breast cancer patients. Specific therapeutic questions about MBC need international trials to obtain meaningful answers.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.137 Tue, 31 Mar 2009 00:00:00 GMT
Methods: An interdisciplinary team defined the alerts and the actions to be taken in response; recipients of the alert messages were identified and software was programmed. Program features were created so their employment would generate a prompt notification of clinically critical results. After a training period, the program was introduced in the hospital routine.

Results: There were a total of 150 generated alerts; the main alert related to microorganisms requiring prompt patient isolation and/or public notification. Clinical use of the program was relevant in detection and immediate notification of Cytomegalovirus active infection in stem cell recipients and central venous catheter � related candidemia: the prompt administration of adequate treatment was possible hours in advance compared to the previous approach.
Conclusions: A laboratory-based automated surveillance system is effective in facilitating the management of NIs; its clinical employment also leads to important clinical advantages in patient care.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.136 Thu, 4 Jun 2009 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.135 Wed, 11 Feb 2009 00:00:00 GMT
Using reflection on clinical practice, a pilot project was undertaken to look at staff perceptions of communication skills, best practice methods and training opportunities within a haemato-oncology unit in a cancer hospital in Italy. A questionnaire was distributed to medical and nursing staff members of the unit (n=32) and focused on communication practice, information giving, difficult situations and training. Forty-three percent of staff responded. The global perception of overall effectiveness of communication skills of the responders regarding communication of diagnosis, prognosis and condition was high. Practical aspects of giving information about disease, prognosis and treatment to patients and relatives, were highlighted in terms of the importance of environment - type and availability, having the personnel necessary for this type of communication and patient choice. Different methods and techniques for communication were reported, however this appeared independent of medical or nursing background, and time in clinical practice. The overall, the views of the team (stratified), showed no great difference between years of practice or profession. This projects has been fundamental in raising awareness of the issue of communication and encouragement of reflection on daily practice in order to give some direction for service development, in an area where the need for communication skills training is not currently seen as mandatory but may be beneficial not only for patients but staff well-being.

Areas for our future practice development include training, addressing environmental issues, team-working and developing written information to support verbal information.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.134 Wed, 18 Mar 2009 00:00:00 GMT
Methods An educational programme was developed, which included a review of current knowledge and baseline practice, development of competencies related to the role of research nurse, haemato-oncology and clinical trial education to support this advanced practice for nurses in clinical trials.

Results Overall, the feedback on the course by the nurses was very positive, and the nurses were able to undertake the role of research nurse within specified clinical trials

Conclusions The role of the research nurse is complex and varied. First level nurse training does not cover all aspects for the performance and skills required for this role. By assessing the practice environment and requirements of nurses working in clinical trials, it was possible to recognise previous education, skills and knowledge of the nurses and develop a programme to complement this. Job specific training and competencies have been helpful in clarifying and defining key areas of a previously poorly defined role, and have assisted these nurse in performing as research nurses within in clinical trials.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.131 Thu, 15 Jan 2009 00:00:00 GMT
Therefore, new diagnostic methods, for early detection based on a better understanding of the molecular biology of pancreatic cancer, are required.

We examin the methylation status of p16INK4A, RASSF 1A and MGMT genes considered to be inactivated by promoter methylation in several tumours.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.130 Mon, 12 Jan 2009 00:00:00 GMT
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.129 Fri, 9 Jan 2009 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.128 Mon, 23 Feb 2009 00:00:00 GMT
c-Myc protein, a regulator of a number of key cellular signaling pathways, plays a pivotal role in a number of malignancies. The present study was undertaken to evaluate expression of c-Myc protein in tumors of the oral cavity from the South Indian population,that are predominantly oral squamous cell carcinoma (OSCC). c-Myc protein was overexpressed in 80% of the cases studied.

Taking into account the pivotal role demonstrated for c-Myc in tumorigenesis as well as its potential as a therapeutic target, our observations suggest a key role in the genesis of OSCC in this population.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.126 Mon, 15 Dec 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.124 Thu, 15 Jan 2009 00:00:00 GMT Methods: From March 2007 to July 2008, 50 patients with a tumour less than 3cm with clinically negative axillary lymph nodes underwent sentinel lymph node biopsy (SLNB) followed by axillary lymph node dissection (ALND). Subareolar 99mTc sulphur colloid injection was performed the day before surgery and patent blue vital dye was also injected subareolarly at least 5 minutes before surgery. Sentinel lymph node was identified during the surgical procedure using a gamma probe and direct vision. All sentinel nodes underwent frozen section analysis. Later haematoxylin & eosin staining and immunohistochemical analysis were performed. Finally, SLNB was compared with standard ALND for its ability to accurately reflect the final pathological status of the axillary nodes.
Results: The sentinel lymph node (SLN) was identified in 48 of 50 patients (96%). The number of sentinel lymph nodes ranged from 1-4 (mean 1.48) and non sentinel nodes ranged from 7-27 (mean 14.33). Of the 48 patients with successfully identified SLNs, 29.17% (14/48) were histologically positive. Sensivity of the SLN to predict axilla was 93.75%; accuracy was 97.96%. The SLN was falsely negative in one patient � 6.25% (1/16).
Conclusions: This validation study proves the accuracy of the SLNB and its reasonable false negative rate. The SLNB represents a major advance in the surgical treatment of breast cancer as a minimally invasive procedure predicting the axillary lymph node status and can now be used as the standard method of staging in patients with early breast cancer at this institution.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.123 Mon, 16 Mar 2009 00:00:00 GMT
Methods: Following a detailed family and personal history intake and physical exam, each woman on their initial visit is categorized into low (standard) risk, high, and indeterminate risk groups. Women found to be at high risk of developing breast and/or ovarian cancer are referred for further testing, additional screening measures, or participation in chemoprevention trials. All other women are counseled concerning follow-up and life style issues.

Results: Between 2003 and 2007, 171 women for whom complete information was obtained, were analyzed. Thirty four of the women were Caucasians (19.8%) and 137 (80.2%) were ethnically diverse minority women. Sixty two (36.2%) were found to be at high risk with a median age of 42 years. The majority of the high risk women were referred to the clinic by medical professionals (58%), most of which were from within the BHC health care system. Trends in genetic testing results indicate fewer mutations among high risk Asians than among other ethnicities.

Conclusion: Accurate risk assessments and implementation of screening and prevention measures have been challenging during the first few years of operation. Nevertheless, the need for providing consultation from internal referrals, and the potential for genetic and psychosocial research in an ethnically diverse population are powerful incentives for continuing to evolve these services.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.121 Wed, 10 Dec 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.118 Mon, 8 Dec 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2009.116 Fri, 5 Jun 2009 00:00:00 GMT
Case Report: A case of nipple-areola sparing mastectomy double stage reconstruction with the use of stem cells enhanced fat graft is reported.

Conclusions: Fat grafting is growing like a new and promising tool in the reconstruction of nipple and areola sparing mastectomies in the way to restore a sufficient and reliable subcutaneous space in the mastectomy flap. This combined with an anatomical gel implant offer a integrated system to achieve a natural shaped breast.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.115 Tue, 2 Dec 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.114 Mon, 1 Dec 2008 00:00:00 GMT
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.111 Tue, 9 Dec 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.109 Tue, 25 Nov 2008 00:00:00 GMT The co-existence of breast and ovarian cancers in the same individual should raise suspicion of a hereditary process. Patients with either BRCA1 or BRCA2 germline mutations have an average risk of 39% and 11% respectively of developing ovarian cancer by the age of 70 they have a risk of 35-85% of developing breast cancer in their lifetime . We report here unusual pathologic features in a BRCA2 germ-line mutation carrier recently diagnosed with synchronous breast and ovarian cancers, and summarize the findings in 6 other women who were diagnosed with ovarian cancer either simultaneously with the diagnosis of breast cancer or at varying times after the diagnosis. While in most instances this may be a coincidental occurrence in highly susceptible individuals, the patient we highlight raises the provocative hypothesis that at times breast cancer metastasizes to the ovaries of mutation carriers and stimulates the development of an ovarian cancer as well as other cancers. In addition, these ovarian cancers may have different mechanisms of metastases predisposing them to travel to unusual sites.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.108 Wed, 12 Nov 2008 00:00:00 GMT
In the interim safety data analysis, we demonstrate that bevacizumab is a safe therapy in the adjuvant melanoma setting with no apparent increase in the surgical complication rate after either primary tumour resection and/or loco-regional lymphadenectomy.


]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.107 Wed, 12 Nov 2008 00:00:00 GMT
This question was posed by James Doroshow (National Cancer Institute, Bethesda, US) at the 20th EORT-NCI-AARC symposium on Molecular Targets and Cancer Therapeutics (Geneva, 21-24 October 2008). Together with E. Leo (Beerse, Belgium), James Doroshow - since 2004 Director of the Division of Cancer Treatment and Diagnosis at NCI- was co-chairing the workshop on Phase 0 clinical trials. In his introduction to the speakers, Doroshow raised six open questions, namely whether Phase 0 trials are useful, ethically acceptable, feasible, whether they speed up the drug development process and save money, and whether there is room for improvement.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.106 Tue, 11 Nov 2008 00:00:00 GMT
Methods: The hybrid system Siemens Symbia-T2 was used for the acquisition of a patient administered with 1.7 GBq of 90Y-DOTATATE. The following parameters were set for SPECT: 80(50%) keV and 120(30%) keV energy windows medium energy collimators 128�x128 matrix, 64 projections (40s/step). Low-dose CT was acquired (80mAs) for attenuation correction. Images were reconstructed with the OSEM 3D-Fast algorithm.

Results: Post-therapy SPECT-CT 90Y-Bremsstrahlung images of a patient undergoing receptor peptide radionuclide therapy are presented. 90Y-Bremsstrahlung images obtained are suitable for tumour and normal organ dosimetry, offering detailed information on biodistribution, comparable to 111In-diagnostic images.

Conclusions: The improvement on Bremsstrahlung images allows to address diagnostic examinations to patient recruitment and to restrict ample dosimetry evaluation only to treated patients. This could avoid the need of a different radionuclide or isotope to mimic therapy. The clinical impact might be notable, being dosimetry and toxicity information essential in radionuclide therapy especially in patients with risk factors.

]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.104 Thu, 9 Apr 2009 00:00:00 GMT
Patients and methods: This study included 34 cases of operable breast cancer that were given 4 cycles of neoadjuvant chemotherapy in the form of FEC100 then subjected to surgery. Surgery done was either breast conserving surgery (BCS) or modified radical mastectomy. All patients completed the treatment regimen and no patients were excluded from the study. All surgical specimens were studied pathologically for chemotherapy effect.

Results: An overall objective response was observed in 70.6% of the patients. Seven patients (20.6%) experienced a clinical complete response (cCR), seventeen patients (50.0%) had partial response , nine patients (26.5%) had no change of their disease, and only one patient had disease progression. Of the seven patients who had a cCR, only four patients (11.8%) had pathologic complete response (pCR), while pCR for the whole group was14.7 %( 5/34). Tumor size of more than 2 cm was observed in 28patients (82.4%) at time of presentation, while tumor size of 2 cm or less was seen in 6 patients (17.6%) only. After completion of the course of chemotherapy, twenty three patients (67.6%) were observed to have tumors of 2 cm or less that allowed for less extensive resections. Twenty three patients underwent breast conservative surgery (67.6%) while modified radical mastectomy was performed in 11 patients (32.4%).

Conclusion: : The use of neoadjuvant chemotherapy in operable breast cancer in this study was associated with tumor and axillary downstaging which increased the proportion of cases undergoing breast conservation, with acceptable side effects and reasonable cost. During the limited follow up time of this study no loco regional recurrences were observed and one distant treatment failure was recorded. Its impact, if any, on overall or disease-free survival is still ongoing.

]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.102 Mon, 24 Nov 2008 00:00:00 GMT
Case Report: We report a clinical case of a woman with advanced high grade uterine leiomyosarcoma refractory to ifosfamide, doxorubicin and trabectedin, who experienced a sustained and progressive response to GCB alone.

Conclusions: Gemcitabine also when given as a mono-chemotherapy can obtain a long lasting tumour control in heavy pre-treated patients with uterine LMS and should be considered as a possible option for this subset of patients.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.100 Wed, 12 Nov 2008 00:00:00 GMT
Chemoprevention describes the potential of chemicals to intervene and block multistage carcinogenesis. Aspirin (acetylsalicylate) is showing cancer chemopreventive potential and the medicine has public health potential given that low-doses also reduce the risk of cardiovascular events by up to 30%. Whilst recognising that aspirin has undesirable effects, perhaps the medicine may compliment other cancer control programmes such as screening and lifestyle measures. Furthermore, perhaps the cancer chemopreventive potential of aspirin might be mediated, at least in part, by salicylate which is present in fruits and vegetables. Salicylate might therefore be considered to be a nutraceutical. Furthermore, there are a number of matters that arise including the potential for the public health field to further advocate the self-care preventive agenda, which might include aspirin. Perhaps it is now timely for a conference on the public health potential of aspirin to be convened.

Key words :
aspirin, cancer control, salicylate, nutraceutical, public health
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.99 Wed, 19 Nov 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.98 Tue, 30 Sep 2008 00:00:00 GMT
Methods: Focus groups and individual interviews to 11 female participants aged 26-58 were conducted using a base-line questionnaire.

Result: Many participants possessed knowledge about mammography which was different from the facts of medical consensus. Various factors, including self beliefs, experience of breast cancer or being screened with a mammogram, and stories from friends and relatives, could influence intertwiningly on the participants� view about breast screening with a mammogram. Skeptical attitudes towards the media description of breast screening issues were revealed. The participants felt that the NHS pamphlets offered enough information about breast screening.

Conclusion: The women in this study showed that people may not be surrounded by the practical information sources to know about mammogram efficacy until they are invited to the breast screening. In order to achieve democratic discussion over breast screening including mammography, the NHS and mass media have a room for further cooperation to provide the full picture of breast screening to the public.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.96 Fri, 26 Sep 2008 00:00:00 GMT
Objectives and Methods: A prospective study was designed to assess the intra-operative (IO) tumor size in 29 patients of breast cancer presenting to a tertiary care center in Delhi, and to compare it with CE, USG, and PE.

Observations and Results: Twenty-nine patients (mean age: 47 years), presenting with invasive duct carcinoma (stage IIIA: 31%, stage IIB: 28%), were included in the study. Comparison with mean IO (4.2 cm) revealed that both USG and PE underestimated tumor size by a mean of 0.35 cm (8.4 %), and 0.45 cm (10.7%) respectively, in most patients. CE tended to overestimate size by 0.82 cm (19.8%). All 3 modalities showed statistically significant correlation with IO (maximum Pearson��s correlation co-efficient for PE=0.937, p<0.001 R2 =0.877, maximum for PE). Two-way analysis of variance revealed mean difference in size to be statistically significant (p=0.000) only between CE and IO.

Discussion: Formalin processing causes changes in tumor dimensions in the breast, causing reduction in tumor size. It may also have a bearing on the assessment of surgical margins in breast conservation surgery. Immediate postoperative measurement of the specimen is ideal. Protocol for specimen fixation should be standardized.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.95 Thu, 11 Sep 2008 00:00:00 GMT

]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.92 Thu, 21 Aug 2008 00:00:00 GMT
Salivary gland carcinomas displaying exclusively myoepithelial differentiation- myoepithelial carcinoma (EMC) are rare, less than 1% of all salivary gland tumours. MEC arises most commonly in the parotid gland and usually occurs in women. The histopathologic features, immuno- histochemical profile, and clinical behaviour remains controversial.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.91 Fri, 15 Aug 2008 00:00:00 GMT
METHODS: Between June 2004 and February 2007 patients with measurable metastatic melanoma in progression and PS < 1 received TMZ in a dose of 150 mg/m2 qd for 7 days, followed by 7 days off therapy and THA in 200 mg qd, both orally administered. Concomitant treatment with steroids was allowed. PBMCs were collected from the last 14 consecutive patients for evaluation of immune parameters.

RESULTS: 40 screened patients were eligible and evaluable for response and 39 were evaluable for toxicity. 25 patients had asymptomatic and 15 symptomatic brain metastases. The toxicity was primarily grade 1-2 with no grade 4 or treatment related deaths. Four patients had tromboembolic events grade 3. One pt obtained a CR and 5 PR in the CNS, while 2 had CR and 4 PR outside CNS. Overall response rate was 17.5%. We found a significant positive correlation between lymphopenia and objective response.

CONCLUSIONS: The combination treatment was well tolerated but with more frequent thromboembolic events compared to single drug TMZ or THA. The treatment demonstrated activity in CNS as well as outside CNS. The correlation between lymphopenia and objective response needs further investigation.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.88 Thu, 21 Aug 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.86 Thu, 5 Jun 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.84 Tue, 20 May 2008 00:00:00 GMT
This report summarises the key findings and conclusions of the Eurocan+Plus Project which ran between October 2005 and December 2007, and outlines proposals for action in the short and the longer term.

Participants in the Project represented themselves and not the institution where they work. The Project was in no way a formal collaboration between any governmental body, funding agency, research or medical institution of any of the 27 EU Member States. In this respect, proposals in this Summary Report and in other deliverables in no way represent a formal commitment ofany governmental or non-governmental institution for any idea proposed by the Project.

For more information on the topics developed in this report, interested readers are invited to consult the reports issued by the different Work Packages. These reports can be consulted on the Project website www.eurocanplus.eu.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.83 Thu, 21 Aug 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.81 Mon, 9 Jun 2008 00:00:00 GMT
Methods: We conducted a phase II prospective randomised study of short versus prolonged treatment with pentoxifylline (800 mg) and tocopherol (1000 IU) orally once daily in patients with grade 3 toxicity post radical radiotherapy. In addition, all 18 patients received inhaled carbogen (95% oxygen + 5% CO2) over 90 minutes, 5 days per, week for 3 weeks. The primary endpoint was improvement in maximum Lent-Soma toxicity scores.

Results: Maximum Lent-Soma scores improved in six of the eighteen patients (response rate 33%). The proportion of patients responding to treatment in the prolonged treatment arm B was more than double than in the shorter arm A, but this did not reach statistical significance (p 0.321). Two patients who had prolonged treatment (arm B) had complete resolution of their symptoms which was maintained at 2 and 3 years follow up.

Conclusions: We recommend prolonged treatment for 12 months, with PTX and tocopherol in combination with carbogen therapy, in the management of late radiation effects.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.80 Mon, 28 Jul 2008 00:00:00 GMT The successful treatment of cancer is a major health and political issue in England & Wales and also in the Major Developed Countries (MDC). All Malignancy deaths by age and gender are analysed to determine how successful the MDC were in reducing cancer deaths between 1979-2002 within the context of the each nations Gross-Domestic-Product-Expenditure-on-Health� (GDPEH) over the period.

Method
Incidence rates of new cancers in England & Wales are examined for 1979-80 to 2003-04 to highlight extent of the problem. Set in the context of GDREH for each MDC 1980-2002 as an indicator of how each nation has responded to the challenge of cancer. The changing cancer mortality rates for England & Wales are compared with each MDC by age and sex using WHO All Malignancies mortality rates over the period 1979-81 to 2000-02. Chi square tests are used to compare outcomes between England & Wales with each MDC.

Results
1] Men�s All Age malignancy incidence in England & Wales rose 48% and women�s 51% with notable rises for females aged 15-34 and 55-74years.
2] Every MDC increased GDPEH substantially UK up to 9.3% but remains 8th of ten MDC and still below the MDC average (9.85%).
3] England & Wales men�s average (15-74years) deaths were 3rd highest in 1979-81 but fell to 8th by 2000-02 declining significantly more than 7 other MDC.
England & Wales women�s average (15-74 years) rates were highest in 1979-81 and in 2000-02 but declined significantly more than most MDC in every age band from 35-74 years.
4] Most MDC countries men�s rates declined significantly more than their women�s except Japan and Spain but the improvements in men�s cancer death were not matched in women�s rates especially the 35-54�s.
Conclusions: Rising incidence poses problems for every MDC but especially for England & Wales as does the relatively low Anglo-Welsh GDPEH whilst poorer women�s results should be a matter of concern for most MDC. The reductions in cancer deaths reflects well on all front-line services indicating what can be achieved with improved GDDPEH but should not obscure the challenge of the rising incidence of cancer.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.79 Thu, 13 Mar 2008 00:00:00 GMT
Here we report the case of a patient affected by MALT NHL resistant to antibiotics chemotherapy and immunotherapy who achieved a durable complete remission after radio-immunotherapy treatment with Zevalin (90Y ibritumomab-tiuxetan) administered in a single standard dose. This observation must be confirmed on a larger series but suggests that radio-immunotherapy may be a valid approach in treating MALT NHL patients relapsing or those resistant to conventional therapies so avoiding more aggressive and toxic approaches.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.77 Mon, 7 Jul 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.75 Mon, 18 Feb 2008 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.74 Fri, 15 Feb 2008 00:00:00 GMT
This study compares sentinel lymph-node biopsy carried out at the time of removal of the primary breast tumour, under general anaesthetic, with sentinel lymph-node biopsy carried out under local anaesthetic prior to the main operation.

It compares the total cost of the two treatment approaches, in terms of average income and of their impact on the subsequent programming of operations and hence on waiting lists and income.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.67 Wed, 6 Feb 2008 00:00:00 GMT We have previously reported the favourable effect of transdermal estradiol (E2), relative to oral conjugated equine oestrogen (CEE), on ultrasensitive C-reactive protein after 12 months of treatment in a retinoid-placebo controlled two-by-two randomised breast cancer prevention trial (ref). Here we investigate the changes in lipids and clotting profile in patients of the same trial.

Methods and Results:
Recent postmenopausal women were randomised to either oral CEE 0.625 mg/d and placebo (n=55), CEE and fenretinide 200 mg/d (n=56), transdermal E2 50 �g/d and placebo (n=59), or E2 and fenretinide 200 mg/d (n=56). Sequential medroxyprogesterone acetate 10 mg/d was given in each group. After 12 months there was a statistically significant effect of the route of administration of hormone replacement therapy (HRT) on fibrinogen levels the median percent change being -5.7% with CEE and -1.1% with E2 (P=0.012). Total cholesterol decreased in all arms (P<0.0001). HDL-C decreased significantly with transdermal E2 (P=0.006) compared to oral CEE and with fenretinide relative to placebo (P<0.001). Triglycerides exhibited an opposite modulation by HRT route, with a 21.4% median increase with oral CEE and an 8.6% reduction with transdermal E2 (P<0.0001). Antithrombin-III showed a 4% borderline significant reduction in the fenretinide arm relative to placebo, irrespective of HRT administration route (P=0.055).

Conclusions:
Our data indicate that transdermal E2 may be preferable to oral CEE based on its safer cardiovascular risk profile. Fenretinide modified some cardiovascular risk biomarkers and confirmed a safer profile compared to other retinoids.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.66 Mon, 21 Jan 2008 00:00:00 GMT
This article discusses the ACGT's approach to collecting and dealing with genomic data. It also looks at the ACGT's ultimate objective providing a unified technological infrastructure which will facilitate the seamless and secure access and analysis of multi-level clinical and genomic data enriched with high-performing knowledge discovery operations and services.

By doing so it is expected that the influence of genetic variation in oncogenesis will be revealed the molecular classification of cancer and the development of individualised therapies will be promoted and finally the in-silico tumour growth and therapy response will be realistically and reliably modelled.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.65 Tue, 26 Feb 2008 00:00:00 GMT Background. Previous studies showed that after breast conserving surgery for breast cancer , Radiotherapy may be applied to the portion of the breast where the primary tumor was removed (partial breast irradiation - PBI) avoiding the irradiation of the whole breast. We developed a procedure of PBI consisting in a single high dose of radiotherapy of 21Gy with electrons equivalent to 58-60Gy in fractionated doses, delivered during the surgical session by a mobile linear accelerator, positioned close to the operating bed.
Patients and methods From July 1999 to December 2006, 1246 patients with primary carcinoma less than 2.5 cm in diameter mostly over 48 years were treated with Electron IntraOperative Radiotherapy (ELIOT) at a single dose of 21Gy.
Results. After a follow-up from 0.3 to 94.7 months (median 26), 24 patients (1.9 %) showed a local recurrence and 22 developed distant metastases. 16 patients died, 7 for breast carcinoma and 9 for others causes. The 5 years crude survival was 96.5%. Six cases (0.5%) developed serious breast fibrosis which resolved in two-three years. Other 40 patients suffered for mild fibrosis. Cosmetic results were good.
Conclusions. ELIOT is a safe method for treating conservatively operated breasts, avoids the long period of postoperative radiotherapy greatly improving the quality of life and reduces the cost of Radiotherapy. ELIOT reduces radiation to normal surrounding tissues and deep organs. Results on short-term and middle-term toxicity are good. Data on local control are encouraging.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.64 Fri, 2 May 2008 00:00:00 GMT An institutional task force on Upper Gastrointestinal Tumours is active at the European Institute of Oncology (EIO). Members decided to collect in a document the institutional guidelines on management of liver tumours (primary and metastatic). This article is aimed at presenting the current treatment guidelines as well as ongoing research protocols and trials in this field at EIO.

Methods:
A steering committee convened to assign tasks to individual members. Contributions from experts in each treatment area were collected in a single document, in order to produce a draft for subsequent review from the aforementioned committee. Six drafts have been discussed and the final version approved.

Results:
Surgical, Medical Oncology, Interventional Radiology, Nuclear Medicine and Radiation Therapy approaches, their roles in management of liver tumours and ongoing research trials are presented and discussed in this article.

Conclusions:
At the European Institute of Oncology a multi-disciplinary integrated approach to liver tumours is a standard and several research ongoing projects are currently active in this field.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2008.63 Tue, 8 Jul 2008 00:00:00 GMT
Patients and methods: Women with stage I-II breast cancer treated with adjuvant adriamycin and cyclophosphamide (AC) from 1990-1995 were identified in a provincial breast cancer database. Cases were classified into 4 cohorts 1: all cycles delivered at full dose and on time 2: one single dose reduction or dose delay 3: >1 dose reduction or dose delay 4: <2 cycles of chemotherapy delivered.

Results: 484 eligible cases were identified (cohort 1: n = 268 2: n= 88 3: n= 89 4: n= 39). Slight imbalances in lymph node status (p=0.05) and adjuvant hormonal therapy (p=0.05) were observed between the cohorts. 55% (267/484) of the patients had node-positive disease and 33% (158/484) were ER+. 45% of cases had a reduction in DI. With a median follow-up of 9.6 years, there were no significant differences in relapse-free survival (p=0.94), breast cancer-specific survival (p=0.87) or overall survival (p=0.86) between the 4 cohorts. Outcomes were independent of hormone receptor status.

Conclusions: Although toxicity related reductions in the DI of adjuvant AC chemotherapy for early stage breast cancer are common, they did not appear to significantly impact on clinical outcomes in this population-based cohort of women with stage I-II breast cancers.
]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/eCMS.2007.61 Thu, 29 Nov 2007 00:00:00 GMT Patients and Methods � This study is a prospective randomized controlled trial. 100 women with breast cancer who needed axillary dissection were randomized into the LigaSureTM or conventional axillary dissection group. Level I to III lymph node dissection was performed. A closed suction drain was always placed in the axilla and removed after 6-8 days or when fluid amount was < 60 cc in the previous 24 hours.
Results � There were no significant differences between the two groups when considering the duration of surgical procedure: average duration was 70.7 � 24.66 minutes for LigaSureTM patients, while in the conventional dissection group the mean was 70.6 � 22.47 minutes (p=0.98). Total amount of drained fluid was 624.49 cc in the LigaSureTM axillary dissection group and 792.96 in the conventional ALND group; this difference did not achieve statistical significance (p=0.09); the duration of draining was also similar with no statistical difference (p=0.15).
Conclusions � The present study did not show clear advantages in LigaSureTM use for ALND, although it represents a good haemostatic device, especially in abdominal surgery.

Keywords � breast carcinoma; breast cancer surgery; axillary dissection; seroma; drain; haemostasis; LigaSure.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.60 Thu, 15 Nov 2007 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.58 Tue, 16 Oct 2007 00:00:00 GMT
Sixteen patients (59%) had synchronous and 11 (41%) metachronous metastases. During pre-operative chemotherapy tumour regression occurred in 10 cases (37%); stable disease (SD) in a further 10 patients (37%) and progressive disease (PD) developed in 7 cases (26%). The 5 year overall survival for NACT responders was 64% and only 15% for non-responders (p=0.044).

The response to chemotherapy is likely to be a significant prognostic factor affecting survival after liver resection for cure.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.57 Thu, 17 Jan 2008 00:00:00 GMT
Methods: Mothers of 2668 children with solid tumours included in the Manchester Children�s Tumour Registry, 1954-1996 were traced and followed up to 31st December 2000 through the UK National Health Service Central Register. Standardised Incidence Ratio(SIR), P-values and 95% confidence intervals were calculated from age and calendar year-specific female breast cancer incidence rates for England and Wales.

Results: There was a significant excess of breast cancer in mothers overall(SIR=1.3,95%CI=1.0-1.5) mainly due to mothers of children with rhabdomyosarcoma (RMS) (SIR=2.2, 95%CI=1.0-4.0), skin cancer(SIR=7.9, 95%CI=2.9-17.1), and central nervous system tumours(SIR=1.2, 95%CI=0.9-1.8). Maternal breast cancer risk was associated with late age at birth of the index child and male sex and young age at diagnosis in the index child. Risk was highest in the 10 years following the birth of the index. The pattern was seen most strongly in mothers of children with embryonal RMS.

Conclusion: There are excesses of breast cancer in mothers of children with solid tumours in general and specifically in RMS, skin and CNS. There appears to be a temporal relationship between certain tumours in children and breast cancer in their mothers, suggesting a origin of their respective pregnancy. We propose a mother-fetal
interaction mechanism to explain this association.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecms.2007.56 Fri, 21 Sep 2007 00:00:00 GMT
This paper reports on original results of the ACGT integrated project focusing on the design and development of a European Biomedical Grid infrastructure in support of multicentric, post genomic clinical trials on Cancer. Post-Genomic clinical trials (CTs) use multilevel clinical and genomic data and advanced computational analysis and visualization tools to test hypothesis in trying to identify the molecular reasons for a disease and the stratification of patients in terms of treatment.

The paper provides a presentation of the needs of users involved in post-genomic CTs, and presents indicative scenarios which drive the requirements of the engineering phase of the project. Subsequently, the initial architecture specified by the project is presented and its services are classified and discussed. A range of such key services, including the Master Ontology on Cancer which lies at the heart of the integration architecture of the project, are presented. Special efforts have been taken to describe the methodological and technological framework of the project, enabling the creation of a legally compliant and trustful infrastructure.

Finally, a short discussion of the forthcoming work is included and the potential involvement of the cancer research community in further development or utilization of the infrastructure is described.]]> http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.55 Thu, 20 Sep 2007 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecancer.2008.53 Tue, 18 Sep 2007 00:00:00 GMT http://www.ecancermedicalscience.com/view-article.asp?type=abstract&doi=10.3332/ecms.2007.48 Wed, 15 Aug 2007 00:00:00 GMT
In human studies, FDG PET images, in either the fasting state or the glucose-loaded state, have demonstrated that [18F]FDG uptake is decreased,in the tumour, and thus the PET image quality is impaired when plasma glucose levels are increased. All these results suggest that patients should fast before FDG PET studies and their plasma glucose concentration needs to be considered when assessing tumour glucose metabolism. For lymphomatous disease, the data are contradictory and there are reports that insulin does not induce major changes in glucose uptake of lymphomatous tissue.

Here we report two cases of lymphoma in which [18F]FDG PET/Computed Tomography ([18F]FDG PET/CT) was used for chemotherapy response evaluation. in both cases initial [18F]FDG PET/CT scans were negative for neoplastic lesions but showed increased and diffuse FDG uptake in muscles. This led us to investigate better the importance of a fasting condition. A second [18F]FDG PET/CT performed 3-4 days later revealed pathological uptake in the lymphomatous lesions in both cases.

We demonstrate the importance of a euglycemic state before [18F]FDG administration, and that a fasting period of at least 6 hours is required prior to administration.]]>