PubMed | Virginia Piper Cancer Institute, New York University, Stanford University, University of Modena and Reggio Emilia and 19 more.
Type: | Journal: Cancer | Year: 2016
Long-term survival in patients with aggressive peripheral T-cell lymphoma (PTCL) is generally poor, and there currently is no clear consensus regarding the initial therapy used for these diseases. Herein, the authors analyzed treatment patterns and outcomes in a prospectively collected cohort of patients with a new diagnosis of nodal PTCL in the United States.Comprehensive Oncology Measures for Peripheral T-cell Lymphoma Treatment (COMPLETE) is a prospective multicenter cohort study designed to identify the most common prevailing treatment patterns used for patients newly diagnosed with PTCL in the United States. Patients with nodal PTCL and completed records regarding baseline characteristics and initial therapy were included in this analysis. All statistical tests were 2-sided.Of a total of 499 patients enrolled, 256 (51.3%) had nodal PTCL and completed treatment records. As initial therapy, patients received doxorubicin-containing regimens (41.8%), regimens containing doxorubicin plus etoposide (20.9%), other etoposide regimens (15.8%), other single-agent or combination regimens (19.2%), and gemcitabine-containing regimens (2.1%). Survival was found to be statistically significantly longer for patients who received doxorubicin (log-rank P=.03). After controlling for disease histology and International Prognostic Index, results demonstrated a trend toward significance in mortality reduction in patients who received doxorubicin compared with those who did not (hazard ratio, 0.71; 95% confidence interval, 0.48-1.05 [P=.09]).To the authors knowledge, there is no clear standard of care in the treatment of patients with PTCL in the United States. Although efforts to improve frontline treatments are necessary, anthracyclines remain an important component of initial therapy for curative intent. Cancer 2016. 2016 American Cancer Society.
News Article | November 30, 2016
MINNEAPOLIS - (Nov.30, 2016) - Women who had acupuncture treatments after breast cancer surgery at Abbott Northwestern Hospital had a greater reduction in pain, nausea, and anxiety and were better able to cope on the first post-operative day compared with patients who had traditional care, according to a study published in the Oncology Nursing Forum in November. "We are always looking for non-pharmacologic pain management options. This study showed that acupuncture in the hospital after mastectomy is not only feasible, it also appears to decrease patients' symptoms of pain, nausea, and anxiety," said Sue Sendelbach, RN, PhD, director of Nursing Research at Abbott Northwestern. Researchers chose the study variables -- pain, nausea, anxiety and ability to cope - based on an Oncology Nursing Society survey in which members were asked to report the symptoms that are the most distressing and difficult to manage. Abbott Northwestern study patients entered their levels -- on a zero to ten scale -- of pain, nausea, anxiety, and ability to cope into a tablet computer immediately before and after receiving acupuncture. Acupuncture was delivered as many as two times after surgery at least 12 hours apart. Patients in the usual care group were seen two times after surgery at least 12 hours apart to collect the same variables. "The results of this study demonstrate that acupuncture reduced patients' perception of pain, anxiety and nausea by about 1.5 units, which is both clinically and statistically significant. For comparison, it is known that opioid medications reduce patients' perception of pain by 1.9 units, which is comparable to the decrease for acupuncture in this study," said Jeffery A. Dusek, PhD, director of Research for the Penny George™ Institute for Health and Healing. The study was funded by the Abbott Northwestern Foundation, and study participants were sought from among patients at the Piper Breast Center® at Abbott Northwestern. When patients are hospitalized at the Virginia Piper Cancer Institute® at Abbott Northwestern, they are eligible to receive integrative medicine services from Penny George™ practitioners. Abbott Northwestern, Virginia Piper Cancer Institute® and Penny George™ Institute for Health and Healing are part of Allina Health. Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 13 hospitals, 14 retail pharmacies, specialty care centers and specialty medical services, home care, senior transitions, hospice care, home oxygen and medical equipment and emergency medical transportation services. For more information, visit us at allinahealth.org, Facebook, Twitter, YouTube or Healthy Set Go.
Biel M.A.,Virginia Piper Cancer Institute |
Biel M.A.,University of Minnesota
Methods in Molecular Biology | Year: 2010
Over 1,500 patients have been treated with PDT using Photofrin, HPD, ALA, or Foscan for head and neck cancers. These patients include a mixture of presentations including primary, recurrent, and metastatic lesions. The predominant histology is squamous cell carcinoma, but other histologies treated include mucosal melanoma, Kaposi's sarcoma, adenocarcinoma, metastatic breast carcinoma, and adenoid cystic carcinoma. Several multi-institutional phase II clinical trials evaluating PDT treatment of head and neck cancers have demonstrated the efficacy of this minimally invasive therapy in the treatment of early oropharyngeal primary and recurrent cancers as well as the palliative treatment of refractory head and neck cancers. Patients with early stage cancers or early recurrences in the oral cavity and larynx (Cis, T1, T2) tend to have an excellent response to PDT. Of 518 patients treated with Cis, T1, or T2 cancers of the oral cavity, larynx, pharynx, and nasopharynx, 462 (89.1%) obtained a complete clinical response after one PDT treatment. Laryngeal cancers, comprising 171 patients in this group, obtained a durable complete response rate of 89% with up to a 16-year follow-up. Photodynamic therapy is as effective as conventional therapies for the treatment of early (Cis, T1, T2) squamous cell cancers of the head and neck. It is also a promising therapy to be used in association with surgery to increase tumor-free margins and therefore increase cure rates. © 2010 Springer Science+Business Media, LLC.
Lipham J.C.,University of Southern California |
DeMeester T.R.,University of Southern California |
Ganz R.A.,Minnesota Gastroenterology |
Ganz R.A.,Abbott Laboratories |
And 6 more authors.
Surgical Endoscopy and Other Interventional Techniques | Year: 2012
Background: Sphincter augmentation with the LINX® Reflux Management System is a surgical option for patients with chronic gastroesophageal disease (GERD) and an inadequate response to proton pump inhibitors (PPIs). Clinical experience with sphincter augmentation is now available out to 4 years. Methods: In a multicenter, prospective, single-arm study, 44 patients underwent a laparoscopic surgical procedure for placement of the LINX System around the gastroesophageal junction (GEJ). Each patient's baseline GERD status served as the control for evaluations post implant. Long-term efficacy measures included esophageal acid exposure, GERD quality-of-life measures, and use of PPIs. Adverse events and long-term complications were closely monitored. Results: For esophageal acid exposure, the mean total % time pH<4 was reduced from 11.9 % at baseline to 3.8 % at 3 years (p<0.001), with 80 % (18/20) of patients achieving pH normalization (B5.3 %). At C4 years, 100 % (23/23) of the patients had improved quality-of-life measures for GERD, and 80 % (20/25) had complete cessation of the use of PPIs. There have been no reports of death or long-term device-related complications such as migration or erosion. Conclusions: Sphincter augmentation with the LINX Reflux Management System provided long-term clinical benefits with no safety issues, as demonstrated by reduced esophageal acid exposure, improved GERD-related quality of life, and cessation of dependence on PPIs, with minimal side effects and no safety issues. Patients with inadequate symptom control with acid suppression therapy may benefit from treatment with sphincter augmentation. © Springer Science+Business Media, LLC 2012.
Biel M.A.,Virginia Piper Cancer Institute |
Biel M.A.,University of Minnesota
Methods in Molecular Biology | Year: 2010
Biofilms have been found to be involved in a wide variety of microbial infections in the body, by one estimate 80% of all infections. Infectious processes in which biofilms have been implicated include common problems such as urinary tract infections, catheter infections, middle-ear infections, sinusitis, formation of dental plaque, gingivitis, coating contact lenses, endocarditis, infections in cystic fibrosis, and infections of permanent indwelling devices such as joint prostheses and heart valves. Bacteria living in a biofilm usually have significantly different properties from free-floating bacteria of the same species, as the dense and protected environment of the film allows them to cooperate and interact in various ways. One benefit of this environment is increased resistance to detergents and antibiotics, as the dense extracellular matrix and the outer layer of cells protect the interior of the community. In some cases antibiotic resistance can be increased 1000-fold. Also, the biofilm bacteria excrete toxins that reversibly block important processes such as translation and protecting the cell from bactericidal antibiotics that are ineffective against inactive targets. In the head and neck area, biofilms are a major etiologic factor in periodontitis, wound infections, oral candidiasis, and sinus and ear infections. For the past several decades, photodynamic treatment has been reported in the literature to be effective in eradicating various microorganisms using different photosensitizers, different wavelengths of light, and different light sources. PDT has been further studied to demonstrate its effectiveness for the eradication of both Gram-negative and Gram-positive antibiotic-resistant bacteria. This chapter will focus on the use of PDT in the treatment of antibiotic-resistant biofilms, antibiotic-resistant wound infections, and azole-resistant oral candidiasis using methylene blue-based photodynamic therapy. © 2010 Springer Science+Business Media, LLC.
Chun Y.S.,Virginia Piper Cancer Institute |
Huang M.,Fox Chase Cancer Center |
Rink L.,Chase Medical |
Von Mehren M.,Chase Medical
World Journal of Surgical Oncology | Year: 2014
Background: The insulin-like growth factor (IGF) pathway is implicated in the pathogenesis of hepatocellular carcinoma (HCC) and may be important in nonalcoholic fatty liver disease (NAFLD). The aim of this study is to determine expression levels of IGFs and receptors in NAFLD-associated HCC.Methods: Tissue microarrays were constructed from patients who underwent hepatectomy for HCC. Immunohistochemistry was performed using antibodies for IGF ligands and receptors. Immunostain results were scored by a pathologist blinded to clinical data.Results: Among 27 patients with HCC, the most common underlying liver diseases included NAFLD, hepatitis C, and alcoholic hepatitis. Expression levels of IGFs and receptors were not associated with patients' underlying liver disease. In all patients, IGF-2 expression was upregulated in tumor and adjacent non-neoplastic liver. Expression of IGF-1 was low in adjacent liver in 6 of 10 patients with cirrhosis, compared with 2 of 17 patients without cirrhosis (P = 0.025). Higher IGF-1 expression in liver adjacent to tumor was associated with poorer median survival of 22 months, compared with 72 months with equal or lower IGF-1 expression in adjacent liver relative to tumor (P = 0.006).Conclusions: Our preliminary results demonstrate significant associations between IGF-1 expression and liver cirrhosis and survival after resection in patients with HCC, independent of their underlying liver disease. © 2014 Chun et al.; licensee BioMed Central Ltd.
Misdraji J.,Harvard University |
Lauwers G.Y.,Harvard University |
Irving J.A.,University of British Columbia |
Batts K.P.,Virginia Piper Cancer Institute |
Young R.H.,Harvard University
American Journal of Surgical Pathology | Year: 2014
Appendiceal or cecal endometriosis uncommonly presents diagnostic challenges, but rare cases with intestinal metaplasia can mimic mucinous tumors of the appendix. We describe 6 cases of appendiceal or cecal endometriosis with intestinal metaplasia that grossly and microscopically mimicked appendiceal mucinous tumors. The cases were characterized by marked mural hypertrophy and elastosis, with distortion of the appendix, and virtual obliteration of the lumen of the appendix. All cases had conventional endometriosis, together with varying amounts of endometriosis with intestinal-type epithelium. In 2 cases, scant or virtually no stroma around some mucin-filled glands made their recognition as endometriosis more difficult. None of the cases had dysplasia of the mucinous epithelium. All patients had benign follow-up (mean 3.6 y). Endometriosis with intestinal metaplasia is a rare phenomenon that, when it occurs in the appendix or cecum, may lead to misdiagnosis as a low-grade appendiceal mucinous neoplasm or mucinous carcinoma. © 2014 by Lippincott Williams and Wilkins.
PubMed | Suburban Radiologic Consultants Ltd., Hospital Pathology Associates HPA, Piper Breast Center, Virginia Piper Cancer Institute and United Hospital Piper Breast Center
Type: Journal Article | Journal: Clinical breast cancer | Year: 2016
Management recommendations for lobular neoplasia (LN) including lobular carcinoma-in-situ (LCIS) and atypical lobular hyperplasia (ALH) diagnosed in core biopsies (CB) are controversial. Our aim was to prospectively identify a subset of patients who do not require subsequent surgical excision (SE).All patients diagnosed with LN on CB were enrolled and referred for SE. Cases with coexistent ductal carcinoma-in-situ or invasive carcinoma were excluded. Cases with coexistent ductal atypia (LN-DA) and LCIS variants (LN-V) were separated from pure classic LN (LN-C). Dedicated breast pathologists and radiologists reviewed cases with careful imaging/pathology correlation.Of 13,772 total percutaneous breast CB procedures, 302 of 370 patients diagnosed with LN underwent SE. Upgrade to carcinoma was present in 3.5% (8/228) LN-C, 26.7% LN-V (4/15), and 28.3% LN-DA (15/53). Calcifications were the imaging target for 180 (79%) of 228 LN-C cases; 7 were associated with upgrade (3.9%). Upgrades were rare for mass lesions (1/32) and magnetic resonance imaging-targeted lesions (0/14). Upgrades were similar for ALH and LCIS (3.4% vs. 4.5%). During postsurgical follow-up (mean, 34.5 months), 6.5% LN-C patients developed carcinoma in either breast.Although LN with nonclassic morphology or with associated ductal atypia requires SE, this can be avoided in LN-C diagnosed on CB targeting calcifications when careful imaging/pathology correlation is applied. Until larger numbers are studied, excising LN-C diagnosed as masses or magnetic resonance imaging-detected lesions may be prudent. Regardless of their selection for surgical management, LN patients need close surveillance in view of their long-term risk of breast cancer.
Siddiqui U.D.,Yale University |
Rossi F.,Virginia Piper Cancer Institute |
Padda M.S.,Yale University |
Rosenthal L.S.,Yale University |
Aslanian H.R.,Yale University
Pancreas | Year: 2011
Background: Endoscopic ultrasound with fine needle aspiration (EUS-FNA) is used for the diagnosis of pancreatic malignancy. However, there are limited data as to patient preferences regarding the delivery of cancer diagnoses. Objectives: This study aimed to assess if patients had met the endosonographer before their EUS, their suspicion of having cancer, and whether they would like the cytology results given to them by their referring physician (with whom they had a previous relationship) or the endosonographer. This question was also asked with respect to the timing of receiving cytology results. Methods: A total of 131 patients with a suspected solid pancreatic mass undergoing EUS-FNA at 2 tertiary referral centers were prospectively enrolled and completed a preprocedure questionnaire. Results: One hundred twenty patients (92%) had not met the endosonographer before their EUS-FNA, and only 37 patients (28%) thought they had a pancreatic malignancy. Of the 131 patients, 89 (68%) stated that they wanted to hear results from the endosonographer (P = 0.0001) and 100 patients (76%) chose to hear results as soon as possible from the endosonographer (P = 0.001). Conclusions: Our data highlight the importance of the endosonographer's role in the delivery of cancer diagnoses and that patients value expediency of reporting results over long-term physician relationships. Copyright © 2011 by Lippincott Williams & Wilkins.
Hutchison N.A.,Virginia Piper Cancer Institute
Minnesota medicine | Year: 2010
Cancer rehabilitation is a relatively new subspecialty. Its goal is to help patients who have been diagnosed with cancer minimize the physical effects of treatment and disease and regain control over many aspects of their life. This article introduces the concept of cancer rehabilitation and offers examples from a Minnesota clinic of how it can benefit patients at different stages of treatment.