Could salvage surgery after chemotherapy have clinical impact on cancer survival of patients with metastatic urothelial carcinoma?

The clinical impact of salvage surgery after chemotherapy on cancer survival of patients with metastatic urothelial carcinoma is controversial. We aimed to verify the clinical role of salvage surgery by analyzing the long-term outcome in patients with urothelial carcinoma treated by chemotherapy. Between 2003 and 2010 at a single institution, 31 of 47 patients (66%) with metastatic urothelial carcinoma showed objective responses (CR in 4, PR in 27) after multiple courses of cisplatin/gemcitabine/paclitaxel-based chemotherapy, and a cohort of patients with partial response (PR) were retrospectively enrolled. Twelve (10 male and 2 female, median age 64.0 years) of 27 patients with PR underwent salvage surgeries after the chemotherapy: metastatectomy of residual lesions (10 retroperitoneal lymph nodes, 2 lung), and 6 radical surgeries for primary lesions as well. Progression-free survival and overall patient survival rates were analyzed retrospectively and compared with those of patients without salvage surgery. All 12 patients achieved surgical CR. Pathological findings of metastatic lesions showed viable cancer cells in 3 patients. In univariate analysis, sole salvage surgery affected overall survival in 27 patients with PR to the chemotherapy (P = 0.0037). Progression-free survival and overall survival rates in patients with salvage surgery were better than those in 15 PR patients without the surgery (39.8 vs. 0%, and 71.6 vs. 12.1% at 3 years, P = 0.01032 and 0.01048; log-rank test). Salvage surgery for patients with residual tumor who achieve partial response to chemotherapy could have a possible impact on cancer survival

Conceptual similarity effects on working memory in sentence contexts: Testing a theory of anaphora

The degree of semantic similarity between an anaphoric noun phrase (e.g., the bird) and its antecedent (e.g., a robin) is known to affect the anaphor resolution process, but the mechanisms that underlie this effect are not known. One proposal (Almor, 1999) is that semantic similarity triggers interference effects in working memory and makes two crucial assumptions: First, semantic similarity impairs working memory just as phonological similarity does (e.g., Baddeley, 1992), and, second, this impairment interferes with processes of sentence comprehension. We tested these assumptions in two experiments that compared recall accuracy between phonologically similar, semantically similar, and control words in sentence contexts. Our results do not provide support for Almor's claims: Phonological overlap decreased recall accuracy in sentence contexts, but semantic similarity did not. These results shed doubt on the idea that semantic interference in working memory is an underlying mechanism in anaphor resolution. © 2009 The Experimental Psychology Society