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  • 1
    Keywords: CANCER ; CANCER CELLS ; CELLS ; EXPRESSION ; radiotherapy ; SURVIVAL ; tumor ; TUMOR-CELLS ; AGENTS ; BLOOD ; CELL ; Germany ; THERAPY ; SAMPLE ; SAMPLES ; transcription ; PATIENT ; treatment ; bone marrow ; BONE-MARROW ; STAGE ; resistance ; colorectal cancer ; COLORECTAL-CANCER ; EFFICACY ; RATES ; chemotherapy ; CANCER-CELLS ; CANCER-PATIENTS ; CARCINOMAS ; CYTOKERATIN-20 ; POLYMERASE-CHAIN-REACTION ; adenocarcinoma ; BINARY ; ELIMINATION ; neoadjuvant treatment
    Abstract: Objective: To compare the detection rates for rectal cancer cells in blood and bone marrow in patients with or without preoperative chemoradiation.Summary Background Data: Previous reports have postulated a resistance of disseminated tumor cells to antiproliferative agents because of tumor cell dormancy.Methods: Blood samples from 142 patients (pre, intra-, and postoperative samples) and bone marrow samples from 127 patients undergoing resection of rectal adenocarcinoma were analyzed for tumor cells using a cytokeratin (CK) 20-reverse transcription polymerase chain reaction. The results were stratified according to preoperative therapy.Results: In patients without preoperative chemoradiation, tumor cell detection in blood and bone marrow correlated to tumor stage (Cochran Armitage trend test, P 〈 0.05). Tumor cells were detected in 34 of 103 (33%) bone marrow and 65 of 117 (55.6%) blood samples of patients without neoadjuvant treatment versus in 4 of 24 (16.7%) bone marrow and in 10 of 25 (40%) blood samples of patients with neoadjuvant treatment. The tumor cell detection rate was significantly lower in the group having undergone chemoradiation (binary logistic regression analysis, P 〈 0.05). The overall and disease-free survival were significantly worse in patients with tumor cell detection in the bone marrow after neoadjuvant therapy.Conclusions: Preoperative chemoradiation is associated with a decreased detection rate of rectal cancer cells in blood and bone marrow. These findings may explain the observed clinical benefit of patients with rectal cancer receiving chemoradiation. This is the first study suggesting that detection of disseminated rectal cancer cells may be useful for assessing the efficacy of neoadjuvant therapy
    Type of Publication: Journal article published
    PubMed ID: 14501498
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  • 2
    Keywords: radiotherapy ; SURVIVAL ; tumor ; Germany ; MODEL ; DIAGNOSIS ; FOLLOW-UP ; IMAGES ; imaging ; TOOL ; TISSUE ; TUMORS ; PATIENT ; ASSOCIATION ; BREAST-CANCER ; chemotherapy ; positron emission tomography ; POSITRON-EMISSION-TOMOGRAPHY ; tomography ; HEAD ; PROGNOSTIC-SIGNIFICANCE ; COMPUTED-TOMOGRAPHY ; PET ; NECK-CANCER ; MULTIVARIATE-ANALYSIS ; ADULT ; overall survival ; ADULT PATIENTS ; CELL-CARCINOMA ; F-18 ; FDG-PET ; standardized uptake value ; STANDARDIZED UPTAKE VALUES ; SUV
    Abstract: Objective: The objective of this study was to evaluate the prognostic significance of preoperative positron emission tomography (PET) using 2-fluoro-2-deoxy-D-glucose (FDG) by calculating the mean standardized uptake values (SUV) in patients with resectable soft tissue sarcomas (STS). Summary and Background Data: FDG-PET might be used as an adjunctive tool (in addition to biopsy and radiologic tomography) in the preoperative prognostic assessment of resectable STS. Methods: A total of 74 adult patients with STS underwent preoperative FDG-PET imaging with calculation of the SUV. Clinicopathologic data and the SUV were analyzed for an association with the clinical outcome. The first and the third quartiles of the SUV distribution function were used as cutoff values (1.59 and 3.6). Survival was estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed using log-rank test and the Cox proportional hazards regression model. Results: In 55 cases, STS were completely resected (follow up 40 months): 5-year recurrence-free survival rates in patients with SUV 〈 1.59, 1.59 to 〈3.6, and greater than or equal to3.6 were 66%, 24%, and 11%, respectively (P = 0.0034). SUV was a predictor for overall survival (5-year rates: 84% [SUV 〈1.59], 45% [SUV 1.59 to 〈3.6], and 38% [SUV greater than or equal to 3.6]; P = 0.057) and local tumor control (5-year rates: 93% [SUV 〈1.59], 43% [SUV 1.59 to 〈3.61, and 15% [SUV greater than or equal to 3.6]; P = 0.00 17). By multivariate analysis, SUV was found to be predictive for recurrence-free survival. The prognostic differences with respect to the SUV were associated with tumor grade (P = 0.002). Conclusion: The semiquantitative FDG uptake, as measured by the mean SUV on preoperative PET images in patients with resectable STS, is a useful prognostic parameter. SUV with cutoff values at the first and the third quartiles of the SUV distribution predicted overall survival, recurrence-free survival, and local tumor control. Therefore, FDG-PET can be used to improve the preoperative prognostic assessment in patients with resectable STS
    Type of Publication: Journal article published
    PubMed ID: 15650639
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