Abstract. 1A randomised, prospective, multicenter phase III trial of adjuvant chemotherapy with gemcitabine vs. PC)J. Langrehr, H. Oettle, S. Post, K. Gellert, K. Ridwelski, H. Schramm, C. Zülke, G. Fahlke, L. Roll, P. Tabtight professional, free when you need it, VPN service. 1. A randomised, prospective, multicenter phase III trial of adjuvant chemotherapy with gemcitabine vs. observation in patients with resected pancreatic cancer (PC). Statistical Techniques | Statistical Mechanics. Neuhaus, H. Riess Charitè – Universitätsmedizin Berlin - Campus Virchow Klinikum; Ruprecht- Karls- Universitüt, Mannheim; Oskar- Ziethen- Krankenhaus, Berlin; Otto- von- Guericke- Universität, Magdeburg; Wald- Klinikum, Gera; Universität Regensburg, Regensburg; for the German pancreatic cancer study group (supported by AIO; CAO; Deutsche Krebsgesellschaft E. V.)Background. Chemotherapy with Gemcitabine (G) is standard therapy in advanced, inoperable PC. The value of adjuvant therapy has not been clearly defined yet, and no randomised trial with G in the adjuvant setting is available. Methods. This study was designed to evaluate the efficacy and toxicity of adjuvant G in patients (pts) with resectable pancreas cancer. Within 6 weeks after operation, pts were randomised to receive G or observation (O) after stratification for positive or negative resection margins, nodal tumor involvement and tumor stage. G was administered at a dosage of 1 g/m. ![]() Pts in the O arm received no specific postoperative treatment, but were followed similar to the G group. Primary endpoint was disease free survival (DFS), secondary endpoints included overall survival (OS) and side effects in both groups. The study was powered to detect a significant difference with 9. Results. Between 0. Excluding 1. 2 ineligible pts, 1. G and 1. 77 to O. Pts characteristics were well balanced (G/O) with regard to median age (6. T3 + T4 8. 6/8. 6%), nodal status (N neg: 2. N pos: 7. 1/7. 3%), resection margin R0: 8. R1: 1. 9/1. 6%). February 2. DFS. Analysis shows a difference in median DFS [G: 1. O: 7. 5 m, p < 0. Subgroup analysis demonstrated increased DFS in pts with (n = 6. Grade 3/4 toxicities per pt were: leucocytes (G: 8. O: 0%), platelets (G: 2. O: 0%), diarrhea (G: 2. O: 1. 1%), nausea (G: 4. O: 0. 6%). Conclusion. Preliminary results demonstrate an increased DFS in pts with resected PC when treated with G for 6 months after resection. The most recent survival data will be presented at the meeting. Final results will be expected in late 2. The impact of margins on outcome following hepatic resection for colorectal metastasis. Chandrakanth Are, MD, Mithat Gonen, Ph. D, Kathleen Zazzali, DO, Ronald P. Dematteo, MD, William R. Jarnagin, MD, Yuman Fong, MD, Leslie H. Blumgart, MD, Michael D.’ Angelica, MDMemorial Sloan Kettering Cancer Centre, New York, NYIntroduction. The optimal margin width in hepatic resection for colorectal metastasis (CRM) is unclear. The aim of this study was to analyze the impact of margins on survival in a large single institution series and ascertain the optimal margin width. Material and Methods. All patients undergoing hepatic resection for CRM from 1. The effect of tumor related and technical factors on margin width and survival was analyzed. The associations between clinical risk factor and margins were tested using Cochran- Armitage trend test. Survival curves were estimated using Kaplan- Meier methods and compared with log- rank test. Multivariate analysis was done using Cox regression. Results. A total of 1. Analysis of margin width as a continuous variable suggested the following grouping: Group I: involved and < 1 mm (n = 1. Group II- 1–1. 0 mm (n = 5. Group III- > 1. Bilateral resections (p = < 0. There was a statistically significant difference in median survival between the three groups: 3. Groups I, II and III respectively (p < 0. Margin width retained its significance (p < 0. After adjustment, survival in Group III was significantly better than either Group I or II (p < 0. Group I and Group II (p = 0. Conclusion. This study provides evidence that margin width of > 1 cm is optimal and an independent predictor of survival following hepatic resection for CRM. However subcentimeter resections are also associated with acceptable survival and therefore should not preclude patients from undergoing resection. Impact of Margins, Biological and Technical Factors on Survivaln. Median Survival (months)Uni- variate p. Multi variate p. Less than lobectomy vs Lobectomy or more. NSUnilateral resection vs Bilateral resection. Size < 5 cm vs Size > 5 cm. Node negative primary vs Node positive primary. DFI > 1. 2 months vs DFI < 1. NSMetachronous vs Synchronous. NSMargin > 1 cm vs Negative margin 1–1. Positive margin. 34. C- acetate is superior to. F- fluorodeoxyglucose (FDG) positron emission tomography (PET) in evaluating patients with hepatocellular carcinoma: Results of a pilot trial. Sean C. Glasgow, MD, Farrokh Dehdashti, MD, Barry A. Siegel, MD, William C. Chapman, MDWashington University, St. Louis, MOIntroduction. Although FDG- PET is widely accepted for the evaluation for metastatic tumors within the liver, its sensitivity for detecting hepatocellular carcinoma (HCC) is poor. Adequate pretransplantation staging of patients with HCC is crucial to assure optimization of scarce resources, and determination of recurrent disease post- ablation is often difficult using standard tomographic imaging. C- acetate (AC) may be a better PET radiopharmaceutical for the detection of HCC; however, extensive data providing direct comparison between the two tracers are lacking and the potential impact of AC- PET in the management of patients with HCC is unknown. Methods. Adult patients with either a history of biopsy- proven or suspected HCC (AFP > 2. L or arterially- enhancing hepatic mass) were prospectively enrolled in this IRB- approved trial. Subjects underwent synchronous FDG- and AC- PET, and the imaging studies were interpreted independently in a blinded manner by two nuclear radiologists. Further evaluations and therapies were performed at the discretion of the treating surgeon. Participants were then followed to determine whether either functional imaging test influenced treatment decisions. Results. Thirty patients participated, with a total of 4. HCC lesions greater than 1 cm diameter evaluated by both FDG- and AC- PET. AC- PET was positive in 3. FDG- PET was positive in only 1. Only one lesion was undetectable by either PET modality (false- negative rate 3%). The sensitivity of AC- PET in patients with normal serum AFP levels was 7. FDG- PET. In seven patients evaluated following HCC- specific treatment (RF ablation or transplantation), the specificity of AC- PET was 1. Additionally, AC- PET was the sole diagnostic modality to detect HCC in two subjects: HCC recurrence following liver transplantation in one patient allowed timely RF ablation, while HCC metastatic to the adrenal gland was detected in a second patient. Conclusions. This pilot study demonstrated the utility of AC- PET in the management of patients with HCC, while confirming the lack of sensitivity of standard FDG- PET for this malignancy. The superiority of AC- PET was independent of clinical features such as AFP. AC- PET may have a role in screening certain patients prior to liver transplantation, particularly those beyond UNOS stage 2. It may also prove useful in following disease progression after ablative procedures. Effect of exending- 4 tretment in a minimal islet mass transplant model in streptozotocin- induced diabetic mice. Yong Wang, MD, Jose Avilar, MD, Qi Meirigeng, MD, Barbaro Barbara, Ph. D, Joseph Kuechle, MD, Mark Brown, MD, Enciro Benedetti, MD, Jose Oberholzer, MDUniversity of Illinois at Chicago, Chicago, ILBackground. Exendin- 4 (EX- 4), a long acting agonist of GLP- 1 receptor and potent intestinal insulinotropic hormone, augments insulin secretion in rodent models of diabetes and in human subjects. EX- 4 and GLP- 1 have been demonstrated to promote replication and differentiation of beta- cells in vivo and in vitro. In this study, we examined the effect of EX- 4 on minimal mass islet transplants and the native pancreas of streptozotocin- induced diabetic mice. Methods. Two hundred isogeneic C5. BL6 islets were transplanted under the kidney capsule of streptozotocin- induced diabetic C5. BL6 mice. For the control group, islets were transplanted without EX- 4 treatment. In the treatment group, mice were treated with daily intraperitoneally injection of EX- 4 at 0. Islet function was monitored by daily glycemia and intraperitoneal glucose tolerance test (IPGTT, 2 gram/kg glucose) at week 2 and 4. Google Reader – Google. What will happen to my Google Reader data? All Google Reader subscription data (eg.
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November 2017
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