Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Curated”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMed1996

Adjuvant chemo-immunotherapy after curative resection of Stage II and IIIA primary lung cancer.

Out of 642 primary lung cancer patients who underwent surgery between 1986 and 1992, 82 cases who underwent curative resection were enrolled for a randomized prospective controlled study of postsurgical adjuvant immunotherapy using Interleukin 2 (IL-2) and lymphokine activated killer (LAK) cells. From 1986 to 1989 (the initial period), Stage IIIA patients were divided into three groups: group A (chemo-immunotherapy) received IL-2, LAK cell adoptive immunotherapy after two courses of anticancer (CDDP, VDS, MMC) chemotherapy, group B (control) received no adjuvant therapy, and group C (chemotherapy) received the same anticancer chemotherapy as group A. In the latter (1990-1992) period, group C was discontinued because of poor results and Stage II and IIIA cases were randomly assigned to group A or B. The 5- and 7-year survival rates of group A (33 cases) and B (36 cases) were 58.2% and 31.5%, respectively in Stage II and IIIA cases. The prognosis of group A was significantly better than that of group B (P = 0.0038 by the Cox-Mantel (C-M) test and 0.0033 by the generalized Wilcoxon (G-W) test). The 5- and 8-year survival rates of each group for Stage IIIA cases were 53.4% (group A, 25 cases), 33.4% (group B, 26 cases), and 30.8%, 15.3% (group C, 13 cases). The prognosis of group A was significantly better than that of group B (P = 0.045 by the C-M and 0.036 by the G-W test). The difference between group A and B was also significant in N0, N1 (P < 0.01), in T1, T2 (P < 0.01), and T3 (P < 0.05) cases. These results indicate that adjuvant immunotherapy using IL-2 and LAK cells in combination with chemotherapy is significantly effective in improving the postsurgical prognosis of lung cancer patients.

Adenocarcinoma↗
PubMed1983

Effect of dietary administration of the rubber curative trithiocyanuric acid to the rat.

Trithiocyanuric acid (TCY) is a rubber curative of low oral and dermal toxicity and with a low potential for eye and skin irritation. This study determined the effects of TCY on Sprague-Dawley rats at levels of 0.0, 625, 2500 and 5000 ppm in the diet for 2-30 days. While there were some effects on body-weight gain and survival at the higher levels of intake, the main effects concerned unusual lesions of the pinna and the distal portions of the tail. Purplish discolorations of the ear margin and tip of the tail were noted in some animals on the 2500- and 5000-ppm diets. The tail lesion was evident microscopically at day 16 only in the 5000-ppm group and consisted of congestion of the vasculature in the subepidermal connective tissue with focal necrosis of the distal tail segment. By day 16 the ear lesion was also microscopically identifiable only in the group on the 5000-ppm diet. It was found in 33% of these animals at day 8 and in 67% at day 16 and consisted of a localized cellulitis characterized by moderate infiltrates of polymorphonuclear leucocytes in the epidermal and subepidermal tissues. The lesions caused by high levels of TCY were apparently site-specific, since histopathological examination of selected internal organs did not detect any lesions. The no-effect levels determined were 2500 ppm for microscopic lesions during an 8-16-day treatment period and 625 ppm for gross pathological lesions in a 30-day feeding study.

Animals↗
PubMed1984

Analysis of failure following curative irradiation of gallbladder and extrahepatic bile duct carcinoma.

Twenty patients with carcinoma of the gallbladder (GB-4 patients) or extrahepatic bile ducts (EHBD-16 patients) received radiation therapy with curative intent between January, 1980 and December, 1982. All 20 received 4500-5000 rad in 180-200 rad fractions to the tumor and regional lymph nodes. A 1000 to 1500 rad external beam boost was delivered in 180-200 rad fractions in 10 patients who received external beam alone or concomitant 5-Fluorouracil (5-FU). Three of the four GB and 5 of the 16 EHBD patients received a transcatheter boost with 192-Iridium (192Ir) to a dose of 2000-2500 rad calculated at a 0.5-0.1 cm radius. An additional 2 patients with EHBD lesions received an intraoperative electron (IORT) boost of 1500-2000 rad in one fraction calculated to the 90% isodose. Survival and patterns of failure were analyzed by site and treatment method. All four patients with GB carcinoma are dead of disease at 5 1/2, 6, 9 and 10 months from the date of diagnosis respectively. Three of the four developed diffuse peritoneal carcinomatosis. Five of the 16 patients with EHBD carcinoma are alive with a median follow-up of 18 months (range 6-23 months). Four of the 5 patients received a transcatheter 192Ir or IORT boost and all are without evidence of disease. Four of 9 patients who had a subtotal resection with transection of tumor, dilatation of the bile ducts with probes or curettement of the bile ducts developed either diffuse peritoneal carcinomatosis (3 patients) or a recurrence in the surgical scar (2 patients). Local failure was documented in 3 of the nine patients treated with external beam alone +/- 5-FU, and has been documented in one of the seven patients who received an IORT or transcatheter 192Ir boost. Further experience is necessary to determine whether this aggressive treatment will result in long-term disease-free survival in these patients.

Adult↗
PubMed1984

Local failure following curative resection of colonic adenocarcinoma.

A retrospective review of the medical records of 533 patients undergoing resection with curative intent of large bowel above the peritoneal reflection was undertaken to identify subsets of patients at high risk for local failure. The overall local failure rate was 102/533 (19%) with 32/102 patients having local failure only and 70/102 patients having concurrent local failure and distant metastases. Pathological confirmation of local failure was obtained in 79% of the cases and by surgical exploration in 75%. Overall local failure rates increased with advancing stage of disease. Tumors staged B3, C2 and C3 all had local failure rates in excess of 30%, whereas for Stage A, B1, B2 and C1 lesions, the incidence of local failure was less than 4%. Stage B2 tumors arising in high and low sigmoid and splenic and hepatic flexure had a moderate incidence of local failure (21%) compared to low incidence (5%) at all other sites. The majority of local and regional failures 84/102 (82%) occurred in tumor bed and adjacent soft tissues whereas only 18/102 (18%) local failures occurred in regional nodal groups. The overall local failure rate increased from 27% with one lymph node involved to 50% with greater than 5 lymph nodes involved. Patients with Stage B3, C2 and C3 colon tumors at all sites and selected B2 tumors have a high rate of local failure after surgical resection. The value of postoperative radiotherapy should be formally studied in these patients.

Adenocarcinoma↗
PubMed1984

The metastasis-free interval following curative treatment for breast cancer.

Although much research has been done to isolate factors that have good prognostic value for cure in breast cancer, comparatively little attention has been paid to the large variation in the metastasis-free interval (MFI) in those who are not cured. In this paper we studied 247 patients who were given curative treatment for breast cancer, all of whom developed metastatic disease. The MFI varied from 2 months to 22 years and was found to depend on nodal status, initial T-stage, and possibly, location of the tumor within the breast; it did not depend on age of the patient or histologic appearance of the tumor. In addition, the time from first relapse to death did not correlate with the MFI. With one exception (brain) the initial site of distant metastasis was the same in late relapsers as in early relapsers.

Adult↗
PubMed1985

Prognostic factors in patients undergoing curative irradiation for breast cancer.

We have evaluated 147 patients who received primary curative irradiation for breast cancer to determine if there were any common factors that predisposed to failure. There were 10 local recurrences, for an overall local control rate of 93.2%, with a 2 to 16 year follow-up. Disease-free survivals were 85% in Stage I, 69% in Stage II, and 50% in Stage III. Age seemed to be a determinant, with a 31.6% local recurrence rate in women under 50 vs. a 3.1% rate of local recurrence in women age 50 or older when treated. We have also noted a correlation between the radiation dose and local recurrence, with a recurrence rate of 9.1% following a dose of 6000 rad or less, vs. a rate of 4.7% with a dose of 6400 rad or more. The size of the primary carcinoma and the status of the axillary lymph nodes, each considered individually, were not significant prognostic factors. There was no relationship between recurrence and the performance of an axillary dissection. There was evidence suggesting that the recurrence rate was lower when a wide local excision was performed, compared to a lesser procedure. Multiple foci of carcinoma and a high nuclear grade appear to have a poor prognosis. Five of the recurrences occurred early (under 2 years) and three of these were accompanied by fatal distant metastases. None of the five patients with late recurrences (37 to 116 months) developed metastatic disease, suggesting that late recurrences may have a better prognosis.

Adult↗
PubMed1988

Nasopharyngeal carcinoma in Saudi Arabia: a retrospective study of 166 cases treated with curative intent.

A retrospective review was performed of the medical records of 166 adult patients with biopsy-proven carcinomas of the nasopharynx treated with curative intent at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. All patients were treated between June 1975 and December 1985 using megavoltage therapy equipment. Most patients presented with advanced nodal disease: 23 patients (13.9%) were N0, 16 patients (9.6%) were N1, 29 patients (17.5%) were N2, and 98 patients (59%) were N3. The overwhelming majority of patients had nonkeratinizing lesions (158/166). At the time of analysis, mean follow-up time was 24.2 months (range 2-108). Actuarial curves are presented for local/regional control as a function of T-stage and N-stage and for survival and time to development of distant metastases as a function of N-stage. At 4 years local/regional control was 70% for T1 lesions, 59% for T2 lesions, 30% for T3 lesions, and 35% for T4 lesions. There was little correlation between local/regional control and N-stage being about 50% at 4 years for all nodal subgroups. Only six patients exhibited an isolated first failure in the regional nodes alone, whereas 60 patients failed initially at the primary site (either alone or in conjunction with a simultaneous nodal failure). The development of distant metastases correlated to some extent with nodal disease ranging from 20% at 4 years for T1/T2 N0 patients to 70% for patients who initially presented with N3 disease. Survival data was more difficult to obtain due to cultural biases in a medically unsophisticated patient population. True survival curves are bounded by calculating actuarial curves in two ways: death as the failure endpoint and death plus lost-with-active-disease as failure endpoints. In terms of the latter curves, at 4 years "survival" ranged from 39% for patients with T1/T2 N0 lesions to 23% for patients with N3 lesions.

Adult↗
PubMed1990

Causes of failure of curative radiation therapy in 205 early glottic cancers.

A retrospective analysis of the results obtained with curative radiation therapy in a series of 205 patients affected by early glottic cancer treated from 1970 to 1985 at the Florence University and Hospital Departments of Radiotherapy is presented. All patients were staged according to TNM System (UICC 1978) as T1-T2 NO. The overall 5-year local control rates were 88% for T1a, 75% for T1b, and 64 for T2. The main cause of failure was progression or recurrence in T (41/48); five failures were observed in T and N at the same time and two in N. Of these 48 patients, 21 (44%) were salvaged with surgery. After surgical salvage of radiation failures, the 5-year survival rates were 95%, 91%, and 73%, respectively, for T1a, T1b, and T2. The extent of T and the number of subsites involved significantly affected local control. Vocal cord mobility was less important. The incidence of failures and damages was analyzed according to the radiation beam, the size of the irradiated volume, fractionation, and total tumor dose.

Adult↗
PubMed1990

Curative radiotherapy for laparotomy-staged IA, IIA, IIIA Hodgkin's disease: an evaluation of the gains achieved with radical radiotherapy.

Between 1970 and 1983, 179 patients with pathologically staged IA, IIA, and IIIA Hodgkin's disease were treated with curative radiotherapy. From 1970 to 1974, patients were treated with standard extended or total nodal field irradiation (Treatment Group 1). Since 1975, because of the high prevalence of recurrences in patients with large mediastinal mass and/or hilar disease and/or splenic involvement (LMM &/or H+ &/or S+), treatment was modified to include low-dose lung irradiation within the mantle field for those patients with LMM &/or H+ and low-dose liver irradiation within the infradiaphragmatic field for patients with S+ (radical XRT). Patients who did not have those characteristics were treated with standard radiotherapy (standard XRT). A total of 122 patients were treated from 1975 to 1983 (Treatment Group 2), of whom 61 received radical XRT and 61 received standard XRT. An analysis was done to evaluate whether the progressive-improvement in outcome since 1970 at the University of Minnesota Hospital resulted from the contribution of modified treatment or from progressive improvement in treatment overall. There was a statistical improvement in recurrence-free survival (RFS) in Treatment Group 2 (Tr Gr 2) compared to Treatment Group 1 (Tr Gr 1), with 10-year RFS of 80% versus 57% (p less than 0.001 for time to event). The improvement in RFS was attributed to treatment modification consisting of radical XRT for those patients with LMM &/or S+. There was no change in RFS for those patients without LMM &/or H+ &/or S+ who were treated in Tr Gr 1 and Tr Gr 2, with 10-year RFS of 78% versus 86% (p = 0.29), respectively. However, treatment results for patients with LMM &/or H+ &/or S+ improved considerably in the radical XRT group. Comparing standard versus radical XRT, 10-year RFS was 36% versus 78% (p = 0.001), and 10-year OS was 72% versus 92% (p = 0.034). Patterns of relapse also changed for patients with LMM &/or H+ &/or S+ who were treated with radical XRT. Rather than showing a high frequency of intrathoracic recurrence as was seen in those patients with LMM &/or H+ &/or S+ after standard XRT, the relapse pattern was similar to patients without LMM &/or H+ &/or S+. Salvage treatment was well tolerated for patients who failed after radical XRT. Delayed, life-threatening effects, such as pulmonary and cardiovascular complications and SMN, were equivalent for patients in Tr Gr 1 versus 2, and for those who received standard and radical XRT.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1991

Curative radiotherapy following chemotherapy for invasive bladder carcinoma (a preliminary report).

Twenty-five patients with invasive transitional cell carcinoma of the bladder (Stage T2, T3, T4) received combined modality therapy using four cycles of methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) chemotherapy followed by surgery or radiation therapy (RT). Sixteen patients had complete (N = 8) or partial (N = 8) response to MVAC. Curative RT was delivered to 11 responders with T2 or T3 disease and to 2 patients with T4 disease. All 11 with T2 and T3 disease are currently alive, 7 with normal bladder function. The two with T4 disease are dead of disease. Three patients required salvage cystectomy for local recurrence and one patient had cystectomy for bladder stones. Follow-up ranged from 11 to 50 months with a median of 31 months. No late chemo-radiotherapy treatment-related complications to the intestines or in bladder function (other than one bladder stone formation) occurred. These preliminary results are encouraging and warrant further evaluation of this innovative approach in treating invasive carcinoma of the bladder. T2 and T3 patients with a complete or partial response to MVAC may be excellent candidates for a bladder-sparing treatment.

Adult↗
PubMed1994

Curative radiotherapy for technically operable stage I nonsmall cell lung cancer.

PURPOSE: Retrospective study of patients with Stage I nonsmall cell lung cancer (NSCLC) unable to undergo surgery or refusing surgery. METHODS AND MATERIALS: Between 1984 and 1990, 47 patients with technically operable Stage I NSCLC received hypofractionated radiotherapy. The total dose varied from 32 Gy in six fractions (two fractions/week) or 40 Gy split course in ten fractions (low-dose schedules) to 48 Gy in 12 fractions or 56 Gy in 20 fractions (high-dose schedules). The mean age of the patients was 75 years. Three patients refused surgery and 44 patients were inoperable due to their medical condition. Severe associated disease was present in 34 patients (72.3%). RESULTS: The intrathoracic recurrence rate was 25.5%. In a multivariate analysis, tumor size was identified as the only significant factor predictive for intrathoracic failure (p < 0.001). Disease-specific survival was 90, 53, and 32% at 1, 3, and 5 years, respectively. In Cox's proportional hazards analysis, only tumor size was predictive for disease-specific survival. Overall survival (all causes) was 70, 33, and 15% at 1, 3, and 5 years, respectively. In Cox's proportional hazards analysis, only the presence of severe associated disease was predictive for overall survival (p < 0.01), while tumor size did not attain statistical significance (p = 0.08). There were no severe acute or late side-effects. CONCLUSION: Radiotherapy can effectively control small nonsmall cell tumors. The reported results are comparable to those achieved with more fractionated radiation schedules. In patients of age or in poor medical condition, hypofractionated radiotherapy can be given with curative intent, with minimal burden to the patient.

Carcinoma, Non-Small-Cell Lung↗
PubMed1992

Curative non-surgical combined treatment of squamous cell carcinoma of the oesophagus.

Between April 1982 and June 1989, 65 patients (15 T1, 13 T2, 32 T3, 5 T4) with squamous cell carcinoma of the oesophagus were treated with a curative intent with multimodality combined treatment. A first course of 5-fluorouracil and cisplatin was given during work up, especially if NdYAG laser therapy was used. Irradiation was started 3-4 weeks after induction and two courses of concomitant chemotherapy were given during the radio therapy (aiming at 64 Gy over 7 weeks). Actuarial survival was 79.6% at 1, 36.7% at 3 and 26.7% at 5 years. 5 year survival rates were 56.3% for T1, 29.8% for T2 and 12.9% for T3. All T4 cases died within 16 months. Complete initial disease response was achieved in 76%. Tolerance was good. Thus patients with squamous cell carcinoma of the oesophagus can have long survival and may be cured with combined modality therapy. This treatment may be an alternative to radical surgery when there is a high risk of operative mortality.

Adult↗
PubMed1995

Combined intraperitoneal plus intravenous chemotherapy after curative resection for colonic adenocarcinoma.

Patients who underwent potential curative surgery for colonic adenocarcinoma were enrolled in a prospectively randomised, controlled clinical trial of combined intraperitoneal (i.p.) plus systemic intravenous (i.v.) chemotherapy with 5-fluorouracil (5-FU) and leucovorin (LV). We investigated whether this adjuvant treatment approach, specifically addressing the risk of peritoneal and hepatic recurrence, could improve disease-free and overall survival. Between May 1988 and December 1990, 121 patients with resected stage III or high-risk stage II (T4N0M0) colon cancer were randomly assigned for observation (which was considered standard care until the NIH consensus conference) or adjuvant chemotherapy with LV (200 mg/m2) plus 5-FU (350 mg/m2), both given i.v. (days 1-4) and i.p. (days 1 and 3) every 4 weeks for a total of six courses. After a median follow-up time of 4.6 years, a comparative analysis between the two groups of patients suggested both an improvement in disease-free survival (75% versus 58%; P = 0.06) and a survival advantage (78% versus 63%; P = 0.05) in favour of adjuvant chemotherapy. The sites of recurrence were also different, i.e. local regional and intrahepatic tumour recurrences were observed in only 6/58 (10%) and 5/58 (9%) adjuvant treated patients as compared to 11/60 (18%) and 10/60 (17%) observed patients. The overall benefit of adjuvant therapy appeared to be greatest in patients with stage III colon cancer. Treatment-associated toxicity was infrequent and generally mild with only 5% experiencing severe (WHO grade 3) adverse reactions. Interim results of this adjuvant trial suggest that combined i.p. plus systemic i.v. chemotherapy with 5-FU and LV represents a potentially effective adjuvant regimen in stage II/III colon cancer.

Adenocarcinoma↗
PubMed1992

Risk factors which predict pattern of recurrence after curative surgery for patients with advanced gastric cancer.

The objective of the study was to define risk factors for peritoneal dissemination and haematogenous metastasis after curative resection of patients with an advanced gastric cancer. In retrospective analyses of 405 patients, 168 died of a tumour recurrence. Patients who died of gastric cancer were more likely to have large, invasive tumours which had spread throughout the stomach, metastasized to lymph nodes, and vessel invasion by gastric cancerous cells (P < 0.01 or P < 0.05). Of the 168 deaths, 60 (35.7%) were secondary to haematogenous recurrence, 53 (31.5%) were related to peritoneal dissemination, and 19 (11.3%) were related to a local recurrence. To determine the independent risk factors related to peritoneal dissemination and haematogenous metastasis, multivariate analyses using a stepwise logistic model suggested that serosal invasion (P < 0.01, relative risk = 2.57) and Borrmann type 4 (P < 0.01, relative risk = 1.95) were the greatest risk factors for peritoneal dissemination. The presence of lymph node metastasis (P < 0.01, relative risk = 2.62) and presence of vessel invasion by cancerous cells (P < 0.05, relative risk = 1.59) were the greatest risk factors for a haematogenous metastasis.

Cause of Death↗
PubMed1992

Histopathological prediction of liver metastasis after curative resection of colorectal cancer.

To estimate the risk of liver metastasis after curative resection of colorectal cancer, resected specimens from 290 patients (45 with metachronous liver metastasis) were examined and the relationships between 10 histopathological variables and liver metastasis were analysed using our application of the Akaike information criterion (AIC). Of the 10 variables examined, the depth of venous invasion (Vd) had the greatest prognostic value for metastasis, followed by the number of venous invasions, the number of lymphovascular invasions, lymph node metastasis and type of infiltration. The prediction of liver metastasis was further improved by combining Vd with lymphocyte infiltration, mucinous production, interstitial fibrosis or depth of penetration, although these four variables per se were minimally informative for metastasis. We conclude that the prediction of liver metastasis is best achieved by combining Vd with other variables. Our risk group classification, and the estimated probability of liver metastasis for each group, are shown.

Adenocarcinoma↗
PubMed1989

Curative surgical treatment of atrioventricular junctional re-entrant tachycardia by perinodal dissection.

The medical treatment of an atrioventricular junctional (AV-nodal) re-entrant tachycardia (AVJRT) is often ineffective due to failure of response or significant side effects. Recently, reports of curative surgical procedures using either dissection or cryocoagulation in the AV node area with preservation of normal AV conduction, have been published with excellent short term results in small series. The present paper describes our experience of surgical treatment using the dissection method in five patients. In all patients, AVJRT with short retrograde conduction intervals was diagnosed during the pre- and intraoperative electrophysiological studies. The earliest site of atrial activation during tachycardia was seen close to the triangle of Koch, antero-medially to the AV node. Elective open heart surgery was performed and after cold cardioplegic arrest, the right atrial endocardium was incised and the perinodal atrium carefully disconnected from the AV node. After surgery, a tachycardia could not be induced in any of the patients. In a follow-up period of 14-29 months, all patients have been free of symptoms without antiarrhythmic drugs. Early electrophysiological evaluation of patients with supraventricular tachycardia is advocated and in patients with medically refractory AVJRT, surgery is recommended.

Adolescent↗
PubMed2004

Pulmonary resection after curative intent radiotherapy (>59 Gy) and concurrent chemotherapy in non-small-cell lung cancer.

BACKGROUND: Pulmonary resection after chemotherapy and concurrent full-dose radiotherapy (>59 Gy) has previously been associated with unacceptably high morbidity and mortality. Subsequently neoadjuvant therapy protocols have used reduced and potentially suboptimal radiotherapy doses of 45 Gy. We report a series of 40 patients with locally advanced non-small-cell lung cancer who successfully underwent pulmonary resection after receiving greater than 59 Gy radiation and concurrent chemotherapy. Operative results and midterm survival follow-up are presented. METHODS: Data were reviewed from 40 consecutive patients who underwent lung resection after receiving high-dose radiotherapy and concurrent platinum-based chemotherapy between January 1994 and May 2000. The follow-up closing interval for this study was until August 2003 or time of death. RESULTS: Preoperative stage was IIb (7 patients), IIIA (21 patients), IIIB (10 patients), and IV (2 patients with isolated brain metastasis). Thirteen patients exhibited Pancoast tumors. Median time from completion of induction therapy to surgery was 53 days. Twenty-nine lobectomies and 11 pneumonectomies (7 right, 4 left) were performed. There were no postoperative deaths. Intercostal muscle flaps were used prophylactically in all but one pneumonectomy patient. Seven patients required perioperative transfusions. Median intensive care unit (ICU) time averaged 2 days and the total length of stay was 6 days. One patient exhibited postpneumonectomy pulmonary edema and a bronchopleural fistula developed in another patient (not receiving an intercostal muscle flap). Thirty-four of 40 patients (85%; 95% CI: 70%-94%) were downstaged pathologically, 33 out of 40 patients (82.5%, 95% confidence interval [CI]: 67%-93%) indicated no residual lymphadenopathy, and 18 out of 40 patients (45%, 95% CI: 29%-61%) exhibited a complete pathologic response. Median follow-up was 2.8 years. The 1-, 2-, and 5-year overall survival rates were 92.4%, 66.7%, and 46.2%, respectively. Disease-free 1-, 2-, and 5-year survival rates were 73.0%, 67.2%, and 56.4%, respectively. Median disease-free survival has not been reached. CONCLUSIONS: Pulmonary resection may be performed safely after curative intent concurrent chemotherapy and radiotherapy to greater than 59 Gy. High pathologic complete response rates and sterilization of mediastinal lymph nodes were observed accompanied by highly favorable survival rates. This experience, though promising, will require confirmation in a prospective multiinstitutional clinical trial.

Adult↗
PubMed2005

Can aberrant promoter hypermethylation of CpG islands predict the clinical outcome of non-small cell lung cancer after curative resection?

BACKGROUND: Aberrant methylation of CpG islands acquired in tumor cells in promoter regions is one cause for the loss of gene function. We examined whether aberrant DNA hypermethylation could be used to predict the clinical outcomes of patients with primary nonsmall cell lung cancer (NSCLC) after curative resection. METHODS: We tested 61 patients with NSCLC using methylation-specific polymerase chain reaction (MSP) and searched for promoter hypermethylation of the genes p16INK4a, retinoic acid receptor beta-promoter (RARbetaP2), death-associated protein kinase (DAPK), and O6-methylguanine-DNA-methyltransferase (MGMT). The clinical data, the presence of DNA hypermethylation, and clinical outcomes were analyzed. RESULTS: Hypermethylation in the tumor samples was detected in 67% (41 of 61) for p16(INK4a), 49% (30 of 61) for RARbetaP2, 30% (18 of 61) for DAPK, and 62% (38 of 61) for MGMT. Thirty patients (49%) developed recurrence within 33 months; 16 in the remaining lung, 10 in other organs, and 4 in both. We found no correlation between the specific DNA hypermethylation and any of the clinicopathological characteristics of the patients. DNA hypermethylation was not associated with a different survival or recurrence rate. However, the aberrant hypermethylation of RARbetaP2 seemed to be related to the location of cancer recurrence. Although advanced T stage and preoperative chemotherapy were statistically significant in univariate analysis, unmethylation of DAPK (p = 0.030) and hypermethylation of RARbetaP2 (p = 0.014), as well as advanced T stage (p = 0.075) and preoperative chemotherapy (p = 0.025), were significant risk factors in multivariate analysis for early recurrence in the remaining lung. CONCLUSIONS: The P2 hypermethylation of the RARbeta gene and unmethylation of DAPK seem to be important factors in predicting early cancer recurrence in the remaining lung and could be used as a prognostic marker in NSCLC. However, the clinical implications of this finding need further investigation.

Adult↗