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Biomedical subjects

S S Lo

Publications and source records attributed to S S Lo.

83 records · Page 5Linked to original sources
PubMedDate not supplied

Future prospects of neoadjuvant chemotherapy in treatment of primary breast cancer.

Neoadjuvant chemotherapy in breast cancer was developed in the 1970s and is now used in patients with locally advanced or early resectable breast cancer. Early administration of systemic chemotherapy before local treatment in locally advanced breast cancer and early resectable breast cancer is intended to downstage the primary tumor to make subsequent local treatment (surgery/or radiotherapy) easier and, it is hoped, to eliminate occult distant micrometastases to prolong survival. Despite the theoretical and experimental data indicating the survival superiority of neoadjuvant chemotherapy over postoperative adjuvant chemotherapy, the role of neoadjuvant chemotherapy in treatment of breast cancer remains unclear. But for the effect of down-staging the primary tumor is confirmed, 60-80% of patients with resectable breast cancer can be treated by a breast conservation procedure after neoadjuvant chemotherapy. Large randomized clinical trials are needed to evaluate the survival benefit for neoadjuvant chemotherapy. The detection of clinical and new biological markers will be studied to select the nonresponders of neoadjuvant chemotherapy for alternative treatment approaches.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Antibodies to heat shock protein 65 kD in type 1 diabetes mellitus.

To determine whether antibodies to mycobacterial heat shock protein of 65 kD molecular weight (hsp 65) could be important in the pathogenesis of Type 1 diabetes we tested patients before and at diagnosis of diabetes, as well as patients with rheumatoid arthritis. Using ELISA, increased hsp 65 antibodies were detected in 2 of 8 pre-diabetic twins, 1 of 13 newly diagnosed untreated diabetic patients and 3 of 10 rheumatoid arthritis patients. Levels of hsp 65 antibodies in pre-diabetic twins, median (range), 0.25 (0.104-1.904) and newly diagnosed diabetic patients (mean +/- SD) (0.299 +/- 0.220), did not differ significantly either from each other or from their control subjects (0.134 +/- 0.123). In contrast, levels of hsp 65 antibodies in rheumatoid patients (0.59 +/- 0.42) were significantly higher than in their control subjects (0.21 +/- 0.18; p = 0.02). Of twins studied prospectively before diagnosis, at diagnosis but before insulin treatment, and soon after diagnosis, three of four had hsp 65 antibodies at some stage. We conclude that serological immunity to mycobacterial hsp 65 can occur in Type 1 diabetes, but it is neither a characteristic nor a specific feature of the disease.

Adult↗
PubMedDate not supplied

A phase II study of carboplatin in nasopharyngeal carcinoma.

This is a phase II study to evaluate the efficacy and toxicity of short-course carboplatin in advanced-stage nasopharyngeal carcinoma (NPC). Thirty-three previously untreated stage III-IV NPC patients were studied. Carboplatin was given as a rapid intravenous injection every 3 weeks. The dose of carboplatin was calculated according to the individual patient's creatinine clearance and desired platelet nadir of 75,000/microliter according to the Egorin formula. Response and toxicity were evaluated. Thirty-two patients were evaluated for response. The median age was 54 years, range 30-70 years. Twenty-four patients had local regional disease and 8 patients had metastatic disease. The median dose of carboplatin given was 415 mg/m2 (range 91-791 mg/m2). Fourteen (44%) patients had a partial response with a 95% confidence interval of 26-62%. Fifteen (47%) patients had stable disease and 3 (9%) progressive disease. The overall median survival rate was not reached at 43 months. Overall toxicity was tolerable. Grade III-IV myelosuppression occurred in 4 (12%) patients. There were no other major toxicity- or treatment-related deaths. We conclude that carboplatin has a significant anticancer effect in advanced NPC. Thus carboplatin combination chemotherapy for the treatment of NPC is worthy of future clinical investigations.

Adult↗
PubMedDate not supplied

Poorer prognosis in young patients with gastric cancer?

BACKGROUND/AIMS: Although the relationship between prognosis and age of patients with gastric cancer is controversial, a poorer prognosis in young patients has been suggested by most investigators. To further examine the hypothesis, a retrospective study was undertaken to analyze a large series of patients with gastric cancer in Taiwan. METHODOLOGY: A total of 1,642 consecutive patients diagnosed with gastric cancer and receiving further management at one medical center from 1988 to 1993 were reviewed. The gender, TNM tumor stage, rate of curative resection and survival of the patients were compared in the young age group (< or = 39 years) and the old age group (> 39 years). Survival was estimated with the product-limit method and difference in survival was tested by the log-rank test. Multivariate analysis was done by the Cox proportional hazard model. RESULTS: Among the 1,642 patients, 61 patients were in the young age group and 1,581 patients were in the old age group. There was no significant difference for the 2 groups of patients in the distribution of TNM stage (stage I: 20%; II: 8%; III: 13%; IV: 59% vs. 19%, 11%, 25% and 45% respectively, in the old age group, p = 0.098) and rate of curative resection (38% vs 51% in the old age group, p = 0.059). The overall 5-year survival showed no significant difference between the 2 groups (25% vs. 29% in the old). Subgroup analyses showed that survival after curative resection and survival without curative treatment (including palliative resection and no resection) also had no difference in the 2 groups. Multivariate analysis also showed that age was not an independent factor. CONCLUSIONS: Although most reports suggested a dismal prognosis in young patients with gastric cancer, based on our findings, young patients (< or = 39 years) do not have a worse prognosis than older patients.

Adult↗
PubMedDate not supplied

Serum matrix metalloproteinase-9 level associated with stromal reaction in patients with gastric cancer.

BACKGROUND: Matrix metalloproteinase 9 (MMP-9) plays an important role in cancer invasion and metastasis. The relationship between serum MMP-9 levels and clinicopathological factors in gastric cancer patients is not clear. MATERIALS AND METHODS: Preoperative serum was obtained from 170 patients who had undergone gastrectomy for gastric cancer at the Veterans General Hospital-Taipei. The serum MMP-9 level was measured using a sandwich enzyme-linked immunoassay by monoclonal antibodies. RESULTS: The median serum MMP-9 level was 368.6 ng/mL (range: 43.9-1871.3 ng/mL). Univariate analysis showed that stromal reaction and Lauren's histological classification were two factors related to serum MMP-9 levels (p = 0.014 and p = 0.030 respectively). Multivariate analysis revealed that stromal reaction was the only factor independently (odds ratio: 1.695) associated with MMP-9 levels. Patients with a serum MMP-9 level < 368.5 ng/mL had a tendency towards better survival rate (5-year survival rate: 64.4%) than those with > 368.5 ng/mL (58.5%), but this tendency did not reach statistical significance (p = 0.512). CONCLUSION: These data suggests that serum MMP-9 levels are associated with stromal reaction in gastric cancer.

Aged↗
PubMedDate not supplied

Comparison of the UICC/AJCC 1992 and 1997 pN categories for gastric cancer patients after surgery.

BACKGROUND/AIMS: UICC/AJCC 1997 classification changes pN category. We evaluated its prognostic impact. METHODOLOGY: A total of 710 patients who underwent a > or = D2 gastrectomy were recruited. Among them, the data of 319 patients who had involved regional lymph nodes and no evidence of distant metastases were used for comparing the 1992 and 1997 pN categories. RESULTS: For 1997 category, 201 patients (64%) were pN1, 75 (23.5%) pN2, and 43 (13.5%) pN3. For 1992 category, 143 patients (44.8%) were pN1, and 147(46.1%) pN2. 29 patients (9.1%) with lymph node metastasis to the hepatoduodenal ligament were distant metastasis. The 1997 pN category was a more powerful prognostic discriminant (relative risk: 2.086) than the 1992 category. Compared to the 1992 stage classification, the 1997 one had a skewed distribution of patients with marked shift of patients of stage IIIA (105-126 patients), IIIB (116-58 patients), and IV (100-122 patients). The survival difference between stage IIIA and IIIB for the 1997 stage classification is narrower than for 1992. CONCLUSIONS: The 1997 pN category allows for estimation of prognosis superior to the 1992 category.

Adenocarcinoma↗
PubMedDate not supplied

Tie-1 tyrosine kinase is an independent prognostic indicator for invasive breast cancer.

Receptor tyrosine kinases are known to be involved in the growth, progression and metastasis of solid tumors. We investigated the relationship between tie-1 expression and progression of invasive ductal breast carcinoma with immunohistochemical analysis. Tie-1 protein was detected in the microvessel endothelial cells and cytoplasm of tumor cells. The tumor size and stage were significantly associated with the expression of tie-1, which portends a worse 5-year disease-free status (39.3% v 59.2%, p = 0.07) and overall survival rate (67.3% v 93%, p = 0.02) than those without tie-1 expression. Multivariate analysis demonstrated that larger tumor size, presence of lymph node metastasis and tie-1 expression were independent prognostic parameters, both in 5-year disease-free survival and overall survival. Patients with lymph node metastases and tie-1 expression had the worst 5-year disease-free survival (0%) and overall survival (42.4%) compared to those without tie-1 expression (50.2%, 85%). In lymph node negative patients, those without tie-1 expression had better 5-year disease-free survival and overall survival (72.9%, 100%) compared to those with tie-1 expression (65.5%, 87.7%). We conclude that tie-1 expression is an independent prognostic factor for invasive ductal breast carcinoma, adversely affecting survival of breast cancer patients with positive nodes to a significant extent.

Biomarkers, Tumor↗
PubMedDate not supplied

Is gastric remnant cancer clinically different from primary gastric cancer?

BACKGROUND/AIMS: Poorer survival, uncertain etiology and a possible surgically induced carcinoma prompted the question of whether the gastric remnant cancer is a special form of gastric carcinoma. A retrospective study was done to see if gastric remnant cancer is clinically different from primary gastric cancer without consideration of its etiology. MATERIALS AND METHODS: There are 77 patient with gastric remnant cancer diagnosed in our hospital in past 15 years. Thirty-two out of 77 patients underwent gastrectomy. Another 536 patients with primary gastric cancer and 73 patients with proximal third gastric cancer were used as the controls. The clinicopathological characteristics including gender, age, TNM tumor stage, Lauren's classification, degree of tumor cell differentiation, rate of curative resection and 5-year survival rate were analyzed to see if there is significant difference among the three groups. RESULTS: Almost 90% of patients with gastric remnant cancer had a partial gastrectomy with Billroth II operation before and the median incubation interval was 24.5 years. Male predominance in gastric remnant cancer was shown in our series. However, the age distribution, TNM tumor stage, Lauren's classification, degree of tumor cell differentiation, rate of curative resection and 5-year survival after curative resection were no different among the three groups. CONCLUSIONS: There was no difference in clinical behavior of resected gastric remnant cancer from other gastric carcinoma. Since most of the tumors were detected too late to be resected, early detection is the only way to increase the resection rate and improve the survival. Annual endoscopic surveillance after gastrectomy was recommended for early detection.

Aged↗