Clinical Study Metastatic Behavior in Melanoma: Timing, Pattern, Survival, and Influencing Factors

Metastatic melanoma (MM) is a fatal disease with a rapid systemic dissemination. This study was conducted to investigate the metastatic behavior, timing, patterns, survival, and influencing factors in MM. 214 patients with MM were evaluated retrospectively. Distant metastases (82%) were the most frequent for patients initially metastatic. The median and 1-year survival rates of initially MM patients were 10 months and 41%, respectively. The median time to metastasis for patients with localized disease was 28 months. The timing of appearance of metastases varied minimally; however, times to metastases for distant organs varied greatly. For the first metastatic pathway, more than half of the primary metastases were M1A (57%). These findings were in contrast to the results compared with those with metastatic in diagnosis (P < 0.001). The median and 1-year survival rates of all patients were 12 months and 49%, respectively. Outcome was higher in M1A than visceral metastases (P < 0.001). In conclusion, the fact that over half of all recurrences/metastases occurred within 3 years urges us to concentrate follow-up in the early time periods following diagnosis. Because the clinical behavior of MM is variable, the factors for survival consisting of site and number of metastases should be emphasized

Meta-analysis of trials comparing anastrozole and tamoxifen for adjuvant treatment of postmenopausal women with early breast cancer

<p>Abstract</p> <p>Objective</p> <p>It was aimed to review the literature and make a meta-analysis of the trials on both upfront, switching, and sequencing anastrozole in the adjuvant treatment of early breast cancer.</p> <p>Methods</p> <p>The PubMed, ClinicalTrials.gov and Cochrane databases were systematically reviewed for randomized-controlled trials comparing anastrozole with tamoxifen in the adjuvant treatment of early breast cancer.</p> <p>Results</p> <p>The combined hazard rate of 4 trials for event-free survival (EFS) was 0.77 (95%CI: 0.70–0.85) (<it>P </it>< 0.0001) for patients treated with anastrozole compared with tamoxifen. In the second analysis in which only ITA, ABCSG 8, and ARNO 95 trials were included and ATAC (upfront trial) was excluded, combined hazard rate for EFS was 0.64 (95%CI: 0.52–0.79) (<it>P </it>< 0.0001). In the third analysis including hazard rate for recurrence-free survival (excluding non-disease related deaths) of estrogen receptor-positive patients for ATAC trial and hazard rate for EFS of all patients for the rest of the trials, combined hazard rate was 0.73 (95%CI: 0.65–0.81) (<it>P </it>< 0.0001).</p> <p>Conclusion</p> <p>Anastrozole appears to have superior efficacy than tamoxifen in the adjuvant hormonal treatment of early breast cancer. Until further clinical evidence comes up, aromatase inhibitors should be the initial hormonal therapy in postmenopausal early breast cancer patients and switching should only be considered for patients who are currently receiving tamoxifen.</p

Metastatic Behavior in Melanoma: Timing, Pattern, Survival, and Influencing Factors

Metastatic melanoma (MM) is a fatal disease with a rapid systemic dissemination. This study was conducted to investigate the metastatic behavior, timing, patterns, survival, and influencing factors in MM. 214 patients with MM were evaluated retrospectively. Distant metastases (82%) were the most frequent for patients initially metastatic. The median and 1-year survival rates of initially MM patients were 10 months and 41%, respectively. The median time to metastasis for patients with localized disease was 28 months. The timing of appearance of metastases varied minimally; however, times to metastases for distant organs varied greatly. For the first metastatic pathway, more than half of the primary metastases were M1A (57%). These findings were in contrast to the results compared with those with metastatic in diagnosis (<0.001). The median and 1-year survival rates of all patients were 12 months and 49%, respectively. Outcome was higher in M1A than visceral metastases (<0.001). In conclusion, the fact that over half of all recurrences/metastases occurred within 3 years urges us to concentrate follow-up in the early time periods following diagnosis. Because the clinical behavior of MM is variable, the factors for survival consisting of site and number of metastases should be emphasized

An analysis of the most-cited research papers on oncology: which journals have they been published in?

The most-cited papers (MCPs) are likely those that impressed researchers and had profound influence on clinical practice or future developments in the related scientific field. This study was conducted to explore a bibliometric approach to assess where the oncology-related MCPs have been published in. The source of the data presented in this study was provided by using the InCitesTM, Web of Science, Thomson Reuters Database (2013). It contained any journal indexed by ISI between 1979 and 2013. The term MCPs arbitrarily defined as equal or more than 100 citations. A total of 565 publications were cited equal or more than 100 times. They were published in 79 different journals (64 oncology, 12 medicine, and 3 science), led by the Journal of Clinical Oncology (n = 76; 13.5 %) and Cancer Research (n = 66; 11.7 %) followed by Oncogene (n = 46; 8.1 %), Nature Reviews Cancer (n = 41; 7.3 %), and Cancer (n = 37; 6.5 %). Moreover, the journal categories with the MCPs were the Oncology with 495 articles (87.6 %), followed by the Medicine with 60 (10.6 %) articles. However, the numbers of journals related to Science (n = 10; 1.8 %) were the least. The MCPs were cited a total of 118,531 times. The citations ranged from 100 to 1,790, and the median number was 149. The total numbers of MCPs were the most prominent for the journals, the New England Journal of Medicine (median 398), Lancet (median 213), and Nature Reviews Cancer (median 210). In other side, the counts of MCPs were the highest for the Science and Medicine-categorized journals (median 212.5 and 192.5 citations, respectively). The MCPs categorized as Oncology were the least cited (median 145). The median number of MCPs per year was 18.7 with range 4.1-858.5. The annual most valuable MCPs were also published in the journal Nature Reviews Cancer (median 42) and the New England Journal of Medicine (median 38.7). Likewise, the numbers of MCPs were the highest for the Science-categorized journals (median 37), whereas the citations per year were significantly lower in Medicine and Oncology-categorized journals (25.8 and 17.8, respectively). In conclusion, most of the MCPs were published in Oncology specialized journals

Factors Influencing the Hormone Receptor and HER2 Levels in Breast Cancer: A Population-Based Analysis

Background: Breast cancer (BC) is regarded as a heterogeneous disease that is classified into various molecular subtypes using gene expression analysis. The aim of this study was to perform a population-based analysis of the prevalence of molecular BC subtypes in Turkish women, and to determine their association with known prognostic and clinicopathological factors. Patients and Methods: A total of 1,025 cases with operable BC, who presented within a 2-year period (2006-2007), were evaluated. Estrogen receptor (ER), Progesterone receptor (PR), and HER2 expression were determined immunohistochemically. Results: 68.3% of patients were ER-positive, and 71.5% were PR-positive. Among the 28.3% of HER2-positive tumors, the majority (19.2%) stained +++. Almost 50% of the tumors were ER+ PR+ HER2-, which makes this the predominant tumor type. For both triple-negative and -positive status, a ratio of approximately 10% was determined. For ER+ PR+ HER2-, tumor histology, tumor stage, and histological grade were found to be correlated. Menopausal status, obesity, tumor histology, histological grade, in-situ component, and lymphovascular invasion were associated with triple-positive tumors. A significant relationship was found between the variables - including histological grade, in-situ component, and involvement of axillary lymph nodes - and triple-negative status. Conclusion: A more thorough understanding of the biological background and underlying mechanisms of BC may allow the development of rational targeted approaches and therapies