Biomedical subjects

F L Moffat

Publications and source records attributed to F L Moffat.

57 records · Page 4Linked to original sources

PubMedDate not supplied

Increased thymidylate synthase gene expression in liver metastases from colorectal carcinoma: implications for chemotherapeutic options and survival.

OBJECTIVES: To determine the association of intratumoral thymidylate synthase (TS) gene expression with resistance to fluoropyrimidines and to study the association of TS gene expression with outcome in patients with liver metastases from colorectal cancer. METHODS: Intratumoral TS gene expression was measured by reverse transcriptase and polymerase chain reaction in 33 patients with liver metastases from colorectal carcinoma. Fifteen patients underwent resection, and 18 were treated with chemotherapy only. Patients with high levels of TS gene expression were compared to those with low levels of TS gene expression. RESULTS: All patients with a high level of TS gene expression were nonresponders to fluoropyrimidine chemotherapy. Median survival in patients with unresectable disease was shorter in those who had high levels of TS gene expression (7 months vs 15 months, P = 0.02). After hepatic resection, median disease-free interval was shorter in patients with high levels of TS gene expression (5 months vs 18 months; P = 0.004). Similarly, survival was shorter after resection in those with high TS gene expression (17 months vs 43 months, P = 0.0002). DISCUSSION: Increased TS gene expression is associated with a poor outcome in patients with liver metastases from colorectal carcinoma, whether resected or treated by chemotherapy only. This is related in part to reduced responsiveness to chemotherapeutic agents, but it also reflects inherently more aggressive behavior of metastases.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Sentinel node biopsy for breast cancer: showtime or dress rehearsal?

INTRODUCTION: Sentinel lymph node biopsy (SLNB) may prove superior to axillary node dissection (AND) for breast cancer staging. At issue is whether existing clinical data support performance of SLNB without AND at this time. DISCUSSION: The various methods of SLNB are discussed in detail. SLNB using radiocolloids and surgical probes (with or without blue dye) yields superior SLN localization rates as compared to blue dye alone. However, the incidence of false-negative SLNB is variable with all methods and frequently 10% or higher (11.4% in the only published multicenter study). CONCLUSIONS: Outside of a clinical trial, SLNB should be performed in addition to, not instead of, AND. The sensitivity of pathological staging is enhanced and nonaxillary SLNs are identified, while concomitant AND apprehends all false-negative SLNBs. Two prospective randomized cooperative trials provide excellent educational, training and research opportunities for North American breast surgeons as they gain experience with this new, promising staging procedure.

Biopsy↗

PubMedDate not supplied

Breast-conserving surgery and selective adjuvant radiation therapy for stage I and II breast cancer.

In this report we update our experience with selective adjuvant radiotherapy (XRT) following breast-conserving surgery (BCS) for early breast cancer. Of 150 evaluable private breast cancer patients treated by BCS since 1975, 83 were offered the option of foregoing adjuvant XRT because their primary disease met four pathological criteria: primary tumor less than or equal to 2.5 cm; adequate resection margins; no intramammary vascular, lymphatic, or perineural invasion by tumor; and minimal or no associated in situ cancer. Of the 67 patients who chose not to have XRT, four have developed local (breast) tumour recurrence at 80 months' median follow-up (5-year local recurrence rate 6.4% by Kaplan-Meier analysis). These findings are discussed in light of other series in which patients were carefully selected for BCS without XRT, and the observations of large randomized trials and unselected series of patients. We conclude that adjuvant XRT is not always necessary following BCS. The most valuable contribution of XRT to breast-conserving therapy is that a much larger proportion of breast cancer patients can be considered for conservative locoregional surgery than would otherwise be reasonable.

Adult↗