Keeping you up to date on recent headlines in oncology

Long-term survival improved for patients with gastric cancer with D2 lymphadenectomy ... Many studies favor an extended lymphadenectomy at the time of a potentially curative gastrectomy for node-positive gastric cancer, and the risk of long-term death tends to decrease when the number of resected lymph nodes increases to about 25. However, few studies have assessed the relative contribution of the total number of resected lymph nodes to the outcome of patients with node-negative gastric cancer. An article published in the World Journal of Gastroenterology addresses this question. This study was performed by a team led by Professor Chang-Ming Huang from Department of Oncology, Affiliated Union Hospital of Fujian Medical University (Fujian, China). Two hundred and eleven patients with node-negative gastric cancer who underwent D2 curative resection were analyzed retrospectively. The effects of the number of lymph nodes resected in a large population of patients with node-negative gastric cancer were investigated. The number of dissected LNs emerges as one of the most important prognostic indicators. Patients with comparable depth of invasion had a better survival as the number of resected LNs increased. Based on their results, the authors suggest that a large number of dissected lymph nodes in the procedure of D2 dissection is recommended in order to improve the long-term survival and reduce the recurrence rate of patients with node-negative gastric cancer.

Precision radiation treatment fights cancer ... Kansas City Cancer Center (KCCC; Kansas) has treated its first patient with the new TomoTherapy radiation therapy – made by TomoTherapy (Madison, Wisconsin) technology at its new KCCC-Shawnee Mission office. KCCC is the only healthcare provider in the greater Kansas City metropolitan area with a TomoTherapy treatment machine, one which combines CT imaging with conformal radiation therapy. Used to treat a wide variety of cancers, KCCC's use of the TomoTherapy Hi Art treatment system is delivering radiation with pinpoint accuracy. Radiation Oncologist James Coster, MD, said that this form of external beam radiation will protect patients from the harm that results from killing more than just the cancer. "It's so precise that radiation can be localized to the cancer itself while nearly eliminating the dose to the surrounding healthy tissues," Coster said. "It completely changes the way we fight cancers of the head, neck, breast and prostate, and the impact we can make on overall patient health."

Family, friends may impact breast cancer surgery decision ... About three-quarters of women newly diagnosed with breast cancer have a friend or family member with them at their first visit with a surgeon. And that person plays a significant role in the patient's decision of what type of surgery to have, according to a new study from the University of Michigan Comprehensive Cancer Center (Ann Arbor). The study looked at factors affecting a woman's choice between a mastectomy to remove the entire breast or breast-conserving surgery, which involves removing only the tumor and is followed by radiation treatments. It found that when the patient, rather than the doctor, drives the surgery decision, the patient is more likely to choose a mastectomy. This proved to be the case among all racial and ethnic groups. The paper appears in the Journal of the National Cancer Institute. The study also found that women who had a friend or family member accompany them to the surgical consultation were more likely to receive a mastectomy, compared to women who attended the appointment alone. Latinas who speak little English were most influenced by family in their decision-making: 75%, compared to 34% of white women. Researchers also found that factors such as concern about cancer recurrence, body image and the effects of radiation impacted a woman's surgery decision. Women who said that concerns about recurrence or radiation were very important in their surgical treatment decision-making were more likely to choose mastectomy, while women very concerned about body image were more likely to have breast conserving surgery.

Racial disparity gap for prostate cancer narrows ... The racial disparity in prostate cancer stage at diagnosis has decreased statistically significantly over time, according to an article in the Journal of the National Cancer Institute. By analyzing data from the Surveillance, Epidemiology, and End Results (SEER) program, Grace Lu-Yao, PhD, of The Cancer Institute of New Jersey and the University of Medicine and Dentistry of New Jersey (New Brunswick), and colleagues also found that more men were diagnosed with prostate cancer at a younger age and earlier stage in 2004-2005 than in earlier years. The researchers used SEER data to generate a contemporary profile of prostate cancer patients. They found that the incidence of stage T3 or T4 cancer at diagnosis has decreased in both blacks and whites, and the racial disparity in cancer state at diagnosis has decreased over time. Compared with patients in the trial, patients in the SEER population had a lower prostate-specific antigen level and earlier stage cancer at diagnosis. "It will be important to examine whether more patients being diagnosed at earlier stages ultimately results in a decreased mortality from this highly prevalent malignancy and whether the narrowing of the racial disparity in the presentation of advanced prostate cancer is ultimately accompanied by similar trend in mortality," the authors wrote.

Gene assay to help to predict lung cancer treatment resistance ... The genes that may contribute to drug resistance in non-small cell lung cancer (NSCLC) can be predicted. Researchers writing in BMC Cancer found good correlation between genes believed to be involved in drug sensitivity and resistance and actual in vitro chemosensitivity. Ian Cree, from Queen Alexandra Hospital (Portsmouth, UK), led a team of researchers who assessed the chemosensitivity of a series of 49 NSCLC tumors and compared this with quantitative expression of putative resistance genes measured by RT-PCR. He said, "There was considerable heterogeneity between tumors, and while this showed no direct correlation with individual gene expression, there was strong correlation of multi-gene signatures for many of the single chemotherapy agents and combinations tested. This may allow the definition of predictive signatures to guide individualized chemotherapy in lung cancer." The researchers tested docetaxel, cisplatin, gemcitabine and combinations of the agents on tumor cells taken from 49 fresh NSCLC samples. There were considerable differences between tumors in their sensitivity to individual agents and combinations, though the combination of cisplatin + gemcitabine was usually the most active. When these results were compared to the gene expression in the tumors, Cree and his colleagues were able to identify a number of patterns, especially in chemosensitivity to combinations of treatments.

IT specialists win bioinformatics award ... A team of researchers and information technology specialists at the University of Alabama at Birmingham (UAB) Comprehensive Cancer Center has won the caBIG 2009 Deployment Award from the National Cancer Institute (NCI). The award honors the university's progress toward adopting the cancer Biomedical Informatics Grid, or caBIG. The project is a NCI-led, secure online resource of shared data and software used to improve and boost cancer-research collaboration. Today, more than 1,500 individuals from more than 450 research centers and organizations worldwide use caBIG and contribute to its projects. "This team from the UAB undertook a major initiative to adapt its existing data-entry system to work with caBIG tools and within the caBIG infrastructure," according to the NCI. "The pioneering efforts of the team have resulted in a tremendous amount of institutional knowledge about the adaptation process. Moreover, the UAB team has embraced the caBIG vision and continues to share what they have learned with other disciplines."

— Compiled by Lynn Yoffee, MDD; lynn.yoffee@ahcmedia.com