British journal of cancer
-
British journal of cancer · Feb 1999
Peritoneal cytology in the surgical evaluation of gastric carcinoma.
Many patients undergoing surgery for gastric carcinoma will develop peritoneal metastases. A method to identify those patients at risk of peritoneal recurrence would help in the selection of patients for adjuvant therapy. Peritoneal cytology has received little attention in the West, but may prove a useful additional means of evaluating patients with gastric cancer. ⋯ Among serosa-positive patients, survival was significantly reduced if cytology was positive, if cases yielded by brushings and imprint cytology were included (log-rank test = 8.44; 1 df, P = 0.004). In conclusion, free peritoneal malignant cells can be identified in patients with gastric cancer who have a poor prognosis; the yield can be increased with brushings and imprint cytology in addition to conventional peritoneal lavage. Evaluation of peritoneal cytology by these methods may have a role in the selection of patients with the poorest prognosis who may benefit most from adjuvant therapy.
-
British journal of cancer · Jan 1999
ReviewEstimating relative survival among people registered with cancer in England and Wales.
Because routinely collected survival data for cancer patients in England and Wales do not typically specify cause of death, conventional estimates of survival in cancer patients based on such data are a measure of their mortality from all causes rather than their mortality due to cancer. As a result, trends in survival over time are difficult to interpret because changes in overall survival may well reflect changes in the risk of death from other causes, rather than from the cancer of interest. One way of overcoming this problem is to use some form of 'relative survival' defined as a measure of survival corrected for the effect of other independent causes of death. ⋯ In addition, a particularly simple, but robust approach, is highlighted based on expected and observed mortality. This method is illustrated using preliminary data from the Office for National Statistics on cancer survival in patients born after 1939 and diagnosed with cancer during 1972-84. The examples presented, although limited to analyses on a small number of selected sites, highlight some encouraging trends in survival in people aged under 35 diagnosed with leukaemia, Hodgkin's disease and testicular cancer during this period.
-
British journal of cancer · Nov 1998
Clinical TrialA phase I clinical and pharmacokinetic study of the new topoisomerase inhibitor GI147211 given as a 72-h continuous infusion.
GI147211 is a novel, totally synthetic camptothecin with promising preclinical and early clinical activity. This study was designed to determine the maximum tolerated dose of Gl147211 as a 72-h infusion and to describe its pharmacokinetics and pharmacodynamics on this schedule. In a single-arm, rising-dose study in patients with advanced cancer, eight cohorts of three or more patients received 72-h infusions of Gl147211 at doses ranging from 0.25 to 2.5 mg m(-2) day(-1). ⋯ The recommended phase II doses for this regimen are 1.75 mg m(-2) day(-1) and 1.2 mg m(-2) day(-1) for minimally pretreated and heavily pretreated patients respectively. At these doses, steady-state Gl147211 concentrations within the range of those effective in vitro were achieved. Extensive phase II evaluation of this compound and further phase I trials evaluating more prolonged infusions are ongoing.
-
British journal of cancer · Sep 1998
Aromatase inhibitors and their future role in post-menopausal women with early breast cancer.
Anastrozole is the first aromatase inhibitor to show a significant survival advantage over megestrol acetate in post-menopausal women with advanced breast cancer. The rationale for extending the use of aromatase inhibitors to the treatment of early breast cancer is based on the efficacy observed in the advanced setting, combined with good tolerability and a convenient dosing regimen. Furthermore, oestrogen deprivation by ovarian ablation (similar to oestrogen antagonism with tamoxifen) is already established as an effective adjuvant treatment in premenopausal women with modality breast cancer. ⋯ The lack of oestrogen agonist activity, however, may possibly have detrimental effects on bone mineral density and blood lipid profile. Current clinical trials are investigating the efficacy and safety of anastrozole in the early breast cancer setting. The results of these trials will help to determine whether anastrozole has any benefits over tamoxifen, the current treatment of choice in post-menopausal women with early breast cancer.
-
British journal of cancer · Jun 1998
Synthesis and breakdown of fibrillar collagens: concomitant phenomena in ovarian cancer.
The synthesis and degradation of type I and type III interstitial collagens releases several antigenic metabolites, whose measurement allows the metabolism of connective tissue to be evaluated under a variety of different conditions. In this study we investigated the influence of benign and malignant ovarian neoplasms on the metabolism of these collagens. The study population comprised patients with benign (n = 53), borderline (n = 6) or malignant (n = 36) ovarian neoplasms. ⋯ The different distributions of PIIINP, PINP and ICTP suggests dominance of synthetic processes or retarded elimination of PIIINP and PINP in ovarian cancer. In advanced malignancies, the accumulation of PINP and PIIINP in abdominal space, possibly due to increased synthesis and/or failed resorption, may promote ascites formation. This study shows that both accelerated synthesis and breakdown of fibrillar collagens are characteristic of ovarian malignancy, and suggests that measurements of cyst fluid or ascitic fluid concentrations of collagen metabolites or CSF-1 could be used in the differential diagnosis of benign and malignant ovarian neoplasms.