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Ceyhan M, Somasundar P. A Comprehensive Oncology Program for Elders (COPE): Lessons Learned from Longitudinal Data - Community Hospital Perspective. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00414-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Saur N, Montroni I, Ugolini G, Spinelli A, Rostoft S, Somasundar P, Van Leuween B, De Liguori Carino N, Ferrari G, Ghignone F, Costanzi A, Sermonesi G, Di Candido F, Foca F, Zingaretti C, Vertogen B, Audisio R. OUTCOMES THAT MATTER TO PATIENTS? THE GERIATRIC ONCOLOGY SURGICAL ASSESSMENT AND FUNCTIONAL RECOVERY AFTER SURGERY (GOSAFE) STUDY: SUBGROUP ANALYSIS OF 440 PATIENTS UNDERGOING COLORECTAL CANCER SURGERY. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31137-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Montroni I, Ugolini G, Spinelli A, Jacklitsh M, Rostoft S, Van Leuween B, Ercolani G, Somasundar P, De Liguori Carino N, Saur N, Ferrari G, Ghignone F, Sermonesi G, Di Candido F, Zingaretii C, Foca F, Vertogen B, Audisio R. PATIENT-REPORTED OUTCOMES MEASURES (PROMS) IN GERIATRIC PATIENTS UNDERGOING MAJOR SURGERY FOR SOLID CANCER: 90-DAY PRELIMINARY REPORT ON 643 PATIENTS FROM THE GERIATRIC ONCOLOGY SURGICAL ASSESSMENT AND FUNCTIONAL RECOVERY AFTER SURGERY (GOSAFE) STUDY. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31132-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cholankeril G, Hu M, Tanner E, Cholankeril R, Reha J, Somasundar P. Skilled nursing facility placement in hospitalized elderly patients with colon cancer. Eur J Surg Oncol 2016; 42:1660-1666. [PMID: 27387271 DOI: 10.1016/j.ejso.2016.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/10/2016] [Accepted: 06/10/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND The current study sought to determine predictive risk factors and inpatient resource utilization associated with discharge to skilled nursing facility (SNF) in hospitalized elderly patients with colon cancer. MATERIALS AND METHODS Inpatient data from U.S. community hospital discharges from 2003 to 2011 was analyzed in a retrospective cohort study using the Healthcare Cost and Utilization Project, National Inpatient Sample (HCUP-NIS). Subjects included hospitalized postoperative colon cancer patients over age of 65 (N = 98,797). RESULTS The proportion of elderly colon cancer patients discharged to a SNF increased by 16.67% from 2003 to 2011 (18-21%). Elderly patients discharged to a SNF had increased hospitalization costs (+$10,293.70, p < 0.01) compared to elderly colon cancer patients discharged home. Hospitalization predictive risk factors associated with SNF placement include age above 75 (OR, 4.07; 95% CI, 3.90, 4.25; p < 0.01), paralysis (OR, 3.60; 95% CI, 3.06-4.23; p < 0.01), length of stay (LOS) 10 days or more (OR, 3.00; 95% CI, 2.88-3.13; p < 0.01), psychoses (OR, 2.91; 95% CI, 2.56-3.32; p < 0.01), and neurological disorders (OR, 2.34; 95% CI, 2.17-2.52; p < 0.01). CONCLUSIONS Despite increased costs and worse clinical outcomes associated with SNF placement, over 40% increase of hospital discharge to SNF should be anticipated from this population over the next 20 years. Neurologic and psychiatric comorbidities have significantly negative clinical impacts and increase the likelihood of colon cancer patients' discharge to a SNF.
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Affiliation(s)
- G Cholankeril
- Department of Internal Medicine, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States; Department of Medicine, 72 East Concord Street, Boston University School of Medicine, Boston, MA, 02118, United States.
| | - M Hu
- Department of Biostatistics, 121 South Main Street, Brown University School of Public Health, Providence, RI, 02903, United States
| | - E Tanner
- Department of Internal Medicine, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States; Department of Medicine, 72 East Concord Street, Boston University School of Medicine, Boston, MA, 02118, United States
| | - R Cholankeril
- Department of Internal Medicine, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States
| | - J Reha
- Department of Surgical Oncology, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States
| | - P Somasundar
- Department of Surgical Oncology, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States
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Ahmad A, Khan H, Cholankeril G, Katz SC, Somasundar P. The impact of age on nodal metastases and survival in gastric cancer. J Surg Res 2016; 202:428-35. [PMID: 27229119 DOI: 10.1016/j.jss.2016.02.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 02/03/2016] [Accepted: 02/26/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND In gastric adenocarcinoma, the disparity in lymph node involvement between different age groups has not been thoroughly investigated. The objective of our study was to compare age-associated differences in adequate lymph node harvest and nodal involvement in gastric adenocarcinoma patients. METHODS We analyzed data extracted from the Surveillance, Epidemiology and End Results database on 13,165 patients diagnosed with stage I-III gastric adenocarcinoma between 2004 and 2011. All patients underwent surgical resection. Statistical comparisons between various age groups were done using the chi-square test and Cox regression. RESULTS Among 13,165 gastrectomy patients, proportion of patients that had >15 lymph nodes examined decreases significantly with increasing age (P < 0.0001). When adequately staged, older patients had a significantly lower proportion of node-positive tumors (P < 0.0001). Adequate nodal staging was also associated with improved 5-y disease-specific survival across all age groups. CONCLUSIONS In gastric adenocarcinoma, older patients are less likely to be adequately staged. However, when adequately staged, they are less likely to have node-positive tumors. Adherence to national guidelines, regardless of age, is associated with improved survival outcomes and may alter multimodality management of gastric cancer in the elderly.
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Affiliation(s)
- A Ahmad
- Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island; Boston University School of Medicine, Boston, Massachusetts
| | - H Khan
- Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island; Boston University School of Medicine, Boston, Massachusetts
| | - G Cholankeril
- Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island; Boston University School of Medicine, Boston, Massachusetts
| | - S C Katz
- Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island; Boston University School of Medicine, Boston, Massachusetts
| | - P Somasundar
- Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island; Boston University School of Medicine, Boston, Massachusetts.
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Ghignone F, van Leeuwen B, Montroni I, Huisman M, Somasundar P, Cheung K, Audisio R, Ugolini G. The assessment and management of older cancer patients: A SIOG surgical task force survey on surgeons' attitudes. Eur J Surg Oncol 2016; 42:297-302. [DOI: 10.1016/j.ejso.2015.12.004] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 11/21/2015] [Accepted: 12/01/2015] [Indexed: 11/25/2022] Open
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Ghignone F, Ugolini G, Montroni I, Zattoni D, Somasundar P, Audisio R, Huisman M, Veronose G. State of the art in the assessment and management of oncogeriatric surgical patients. Results from the SIOG surgical task force survey among ESSO and SSO members. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bhagat V, Isaiah B, Soriano-Pisaturo M, Somasundar P. Understanding the importance of caregivers in improving the care of geriatric oncology patients. J Geriatr Oncol 2014. [DOI: 10.1016/j.jgo.2014.09.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Somasundar P. Bring your challenging cases: Surgical oncology. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Somasundar P. Colorectal cancer - pre-habilitation before colorectal surgery. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nadelson J, Pang M, Toubia N, Somasundar P. Predicting malignancy of intraductal papillary mucinous neoplasms of the pancreas in elderly. J Geriatr Oncol 2013. [DOI: 10.1016/j.jgo.2013.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Boutros C, Gary M, Baldwin K, Somasundar P. Gallbladder cancer: past, present and an uncertain future. Surg Oncol 2012; 21:e183-91. [PMID: 23025910 DOI: 10.1016/j.suronc.2012.08.002] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 08/27/2012] [Accepted: 08/28/2012] [Indexed: 02/06/2023]
Abstract
Although gallbladder cancer (GBC) is the most common malignancy of the biliary tract, its relatively low incidence and confounding symptomatology result in advanced disease at the time presentation, contributing to the poor prognosis and decreased survival associated with this disease. It is therefore increasingly important to understand its pathogenesis and risk factors to allow for the earliest possible diagnosis. To date, gallbladder cancer is poorly understood compared to other malignancies, and is still most commonly discovered incidentally after cholecystectomy. Moreover, while much is known about biliary neoplasms as a whole, understanding the clinical and molecular nuances of GBC as a separate disease process will prove a cornerstone in the development of early intervention, potential screening and overall more effective treatment strategies. The present work reviews the most current understanding of the pathogenesis, diagnosis, staging and natural history of GBC, with additional focus on surgical treatment. Further, review of current adjuvant therapies for unresectable and advanced disease as well as prognostic factors provide fertile ground for the development of future studies which will hopefully improve treatment outcomes and affect overall survival for this highly morbid, poorly understood malignancy.
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Affiliation(s)
- C Boutros
- University of Maryland School of Medicine, Division of Surgical Oncology, Baltimore, MD, USA
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Munireddy S, Katz S, Somasundar P, Espat NJ. Thermal tumor ablation therapy for colorectal cancer hepatic metastasis. J Gastrointest Oncol 2012; 3:69-77. [PMID: 22811871 DOI: 10.3978/j.issn.2078-6891.2012.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 01/13/2012] [Indexed: 12/22/2022] Open
Abstract
Surgical resection for colorectal hepatic metastases (CRHM) is the preferred treatment for suitable candidates, and the only potentially curative modality. However, due to various limitations, the majority of patients with CRHM are not candidates for liver resection. In recent years, there has been an increasing interest in the role of thermal tumor ablation (TTA) as a component of combined resection-ablation strategies, staged hepatic resections, or as standalone adjunct treatment for patients with CRHM. Thus, ablative approaches have expanded the group of patients with CRHM that may benefit from liver-directed treatment strategies.
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Affiliation(s)
- Sanjay Munireddy
- Surgical Oncology, Roger Williams Medical Center, Boston University School of Medicine, Providence, Rhode Island, USA
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Boutros C, Somasundar P, Espat NJ. Low common bile duct bifurcation incidentally discovered during pancreaticoduodenectomy. J Gastrointest Surg 2009; 13:2092-3. [PMID: 19184611 DOI: 10.1007/s11605-009-0811-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2008] [Accepted: 01/12/2009] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Bile duct injury due to failure to recognize anatomical variations can have considerable consequences. DISCUSSION We report an incidental discovery of a low common bile duct bifurcation below the level of the cystic duct, incidentally discovered during pancreaticoduodenectomy.
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Affiliation(s)
- C Boutros
- Division Surgical Oncology, Roger Williams Medical Center, 825 Chalkstone Ave., Providence, RI 02908, USA
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Boutros C, Somasundar P, Garrean S, Saied A, Espat NJ. Microwave coagulation therapy for hepatic tumors: review of the literature and critical analysis. Surg Oncol 2009; 19:e22-32. [PMID: 19268571 DOI: 10.1016/j.suronc.2009.02.001] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 01/12/2009] [Accepted: 02/04/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Surgical resection of malignant hepatic tumors has been demonstrated to increase overall survival; however, the majority of patients are not candidates for resection. For patients with unresectable tumors, various chemical and thermal ablation modalities have been developed. microwave coagulation therapy (MCT) is one such thermal ablation modality and the purpose of this review is to evaluate the presently available data for MCT and assess the level of evidence to support its clinical use. METHODS This review is limited to published studies in the English literature including at least 30 patients per study with MCT for hepatocellular cancer (HCC) or colorectal hepatic metastasis (CRHM). Patterns of local recurrence, complications and survival outcome of MCT ablation are presented and discussed including assessment of Asian experience using the 2.4GHZ device and American experience using the 914MHZ device. CONCLUSIONS Although randomized controlled trials comparing RFA and MCT for hepatic ablation are lacking, our review (based on level 2 data) supports that MCT may be optimal when larger necrosis zones and/or ablation of multiple lesions are the objectives. The data support that the potential procedural advantage(s) noted for ablation of CRHM and HCC >3cm, is not supported for HCC <3cm; moreover MCT shares with all other ablation modalities a high rate of locoregional recurrence in HCC; likely due to the multicentricity of this disease process.
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Affiliation(s)
- C Boutros
- Hepatobiliary and Surgical Oncology, Roger Williams Medical Center, 825 Chalkstone Ave., Providence, RI 02908, USA
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Taneja C, Somasundar P, Stager S, Carroll E, Wanebo HJ, Radie-Keane K, Nadeem O. Although substantial (qol) quality of life problems may occur due to acute and delayed complications of therapy for advanced head & neck squamous cancer, overall long term qol is good/acceptable. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.15510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15510 Background: Patients with locally advanced head and neck squamous cell cancer (HNSCCA) have traditionally been treated with aggressive regimens of concurrent chemo-radiation, or more recently, induction chemotherapy followed by concurrent chemo-radiation, to achieve high rates of tumor control at our institution. Objectives: We initiated a QOL study in patients who were free of tumor and available for long term follow up with a focus on acute & delayed complications and long term QOL observation. Methods: The study included 75 patients with stage III-IV HNSCCA treated with either concurrent chemo-radiation or induction chemotherapy followed by concurrent chemo-radiation at our institution. All patients had completed therapy and were considered free of disease at the time of survey. We were unable to complete the survey in 43 pts largely due to patient access problems or unavailability at time of survey. In the remaining 32 patients, the University of Washington QOL survey could be completed over the telephone. Two pts were excluded due to recent demonstration of recurrence. Additional information regarding acute toxicity during treatment was also recorded. Results: There were 11 women and 19 men with a median duration of follow up of 36 months (range 3–120 months) after completion of treatment. Early complications were associated with gastrostomy tube placement (5 leaks & 6 infections,12/31 patients, 38.7%) and portacath placements (2 deep vein thrombosis requiring port removal and anticoagulation, 6.45%). No patients in this group were still dependent on their gastrostomy tube for nutrition at the time of follow up. Of note, 9% of patients were still smoking and drinking on a regular basis. The composite scores for 9 QOL domains ranged from 370–875, with a median score of 615/900. Major problem issues regarding QOL were associated saliva 11/31 (35.5%), swallowing 10/31 (32.2%), followed by mood 6/31 (19.3%), pain 5/31 (16.12%), chewing 4/31 (12.9%), local pain 5/31 (16.12%) and shoulder problems 5/31 (16.12%). Conclusion: Initial QOL problems in advanced HNSCCA appear related to surgical/chemo therapy related problems, whereas late QOL issues appear primarily related to radiation. Most patients however had a good or acceptable quality of life after treatment for advanced HNSCCA. No significant financial relationships to disclose.
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Affiliation(s)
- C. Taneja
- Roger Williams Medical Center, Providence, RI; NorthMain Radiation Oncology, Providence, RI; Landmark Medical Center, Woonsocket, RI
| | - P. Somasundar
- Roger Williams Medical Center, Providence, RI; NorthMain Radiation Oncology, Providence, RI; Landmark Medical Center, Woonsocket, RI
| | - S. Stager
- Roger Williams Medical Center, Providence, RI; NorthMain Radiation Oncology, Providence, RI; Landmark Medical Center, Woonsocket, RI
| | - E. Carroll
- Roger Williams Medical Center, Providence, RI; NorthMain Radiation Oncology, Providence, RI; Landmark Medical Center, Woonsocket, RI
| | - H. J. Wanebo
- Roger Williams Medical Center, Providence, RI; NorthMain Radiation Oncology, Providence, RI; Landmark Medical Center, Woonsocket, RI
| | - K. Radie-Keane
- Roger Williams Medical Center, Providence, RI; NorthMain Radiation Oncology, Providence, RI; Landmark Medical Center, Woonsocket, RI
| | - O. Nadeem
- Roger Williams Medical Center, Providence, RI; NorthMain Radiation Oncology, Providence, RI; Landmark Medical Center, Woonsocket, RI
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Somasundar P, Riggs D, Jackson B, Cunningham C, McFadden D. Inositol hexaphosphate (IP6): A novel treatment for pancreatic cancer. J Surg Res 2004. [DOI: 10.1016/j.jss.2004.07.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Frankenberry K, Somasundar P, McFadden DW, Vona-Davis L. Leptin receptor expression and SOCS-3 signaling in breast cancer: A critical link. Ann Surg Oncol 2004. [DOI: 10.1007/bf02524105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Vona-Davis L, Skinner H, Jackson B, Riggs D, Somasundar P, McFadden D. Leptin activates MAPK signaling in human breast and prostate cancer. J Surg Res 2003. [DOI: 10.1016/j.jss.2003.08.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yu A, Somasundar P, Balsubramaniam A, Rose AT, Vona-Davis L, McFadden DW. Vitamin E and the Y4 agonist BA-129 decrease prostate cancer growth and production of vascular endothelial growth factor. J Surg Res 2002; 105:65-8. [PMID: 12069504 DOI: 10.1006/jsre.2002.6454] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND A biologically active form of vitamin E, alpha-tocopherol succinate (ATS), has been shown to induce apoptosis of hormone-refractory prostate cancer in vitro and inhibit cell growth in vivo. The gastrointestinal hormone peptide YY (PYY) has growth inhibitory activity against multiple cancer cell lines and is synergistic with ATS against breast and pancreatic cancer growth. BA-129, a specific Y4 receptor agonist, has growth inhibitory effects on pancreatic cancer in vitro. We investigated the effects of BA-129 and ATS on prostate cancer growth and evaluated their effects on vascular endothelial growth factor (VEGF) production. METHODS A hormone-refractory human prostate cancer cell line, PC-3, was treated with ATS alone at 10 pg/ml, PYY or BA-129 alone at doses of 75 and 500 pmol/ml, or a combination of the two agents. Cell growth was measured by MTT assay and hemocytometry using trypan blue. Quantitative measurement of VEGF was performed by ELISA. Statistical analysis was achieved by ANOVA. RESULTS ATS exhibited significant (P < 0.05) growth inhibitory effects in prostate cancer cells. PYY also inhibited growth (P < 0.05). ATS treatment reduced VEGF production (P < 0.05). PYY treatment increased VEGF. When ATS was given in combination with BA-129, VEGF production was further reduced (P < 0.05). CONCLUSIONS Both PYY and ATS inhibit growth in hormone-refractory prostate cancer, with augmentation when used in combination. VEGF production is inhibited by vitamin E, but increased by PYY. ATS abolishes the augmented VEGF response to PYY. Our data suggest that PYY is involved in the regulation of VEGF production and prostate cancer growth.
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Affiliation(s)
- A Yu
- Department of Surgery, Robert C. Byrd Health Sciences Center, Morgantown, West Virginia 26506-9238, USA
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Yu A, Vona-Davis Z, Zhu X, Somasundar P, McFadden D. Persantine improves acute pancreatitis in vitro. W V Med J 2001; 97:292-4. [PMID: 11828675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Persantine combined with TNF-a enhances antiproliferative activity in human tumor cells. We hypothesized that the vasodilator persantine would ameliorate acute pancreatitis (AP) in vitro. Rat pancreatic ductal cells were cultured using standard techniques. Acute pancreatitis was induced by adding cerulein (10(-9) M) or TNF-a (200 ng/ml). AP was verified by increased amylase production. Persantine was added at concentrations from 0.1 uM to 100 uM post cerulein or TNF-a treatment. Statistical analysis was achieved by ANOVA. Amylase production was significantly increased (p < 0.05) compared with control upon stimulation with either cerulein or TNF-a. When persantine was added in graded concentrations from 0.1 uM to 100 uM to cerulein treated cells, it decreased amylase production significantly (p < 0.05) at 100 uM. However, when persantine was added to TNF-a treated cells, it decreased amylase production (p < 0.05) at the lower concentrations of 0.1 uM and 1 uM. We have shown for the first time that AP, resulting from either mild (cerulein) or severe (TNF-a) stimulation, is significantly improved by treatment with persantine.
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Affiliation(s)
- A Yu
- Department of Surgery, West Virginia University School of Medicine, Morgantown, USA
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Abstract
BACKGROUND AND OBJECTIVES This study is a review of 14 patients with paragangliomas between 1986 and 1996. The purpose was to determine the sites of origin, clinical manifestations and analyze the benefits of different treatment modalities. METHODS There were 20 tumors in 14 patients. Three (21.0%) of the patients had familial history. There were 7 (50%) females and 7 (50%) males. Anatomically 14 (70%) tumors were in head and neck, 5 (25%) were in the retroperitoneum, one (5%) was in the heart. Of the head and neck tumors 9 (64.25%) were in the carotid body, 3 (21.42%) were found in the vagus, and 2(14.33%) were found in the middle ear. The tumor found in the heart was in the atrial septum. The clinical behavior of paragangliomas is determined by cellular characteristics, secreting capabilities and tumor location. The symptoms and signs depend on the site of origin and the stage at which it presents. The clinically functioning tumors were 3 (17%) in our experience and they typically present with uncontrolled hypertension. The carotid body and mediastinal tumors usually manifested as asymptomatic masses. The intravagal tumors presented with paresis of the nerve. Malignancy rarely occurs and is defined by the existence of metastasis rather than by histology. In our series 2 (10%) of the patients presented with metastasis to lymph nodes, and the vertebrae. The diagnoses in our patients were established by CT and MRI scanning. Angiography was performed in 5 patients with carotid body tumor, two of whom underwent therapeutic embolization to reduce the tumor size. The mainstay of treatment was surgical removal, though radiation has been advocated for patients who cannot undergo surgery. RESULTS All patients underwent successful surgical resection of the tumor after appropriate preoperative preparation. Late mortality occurred in two (12.5%) patients at 3 and 5 years from unrelated etiology. Four (25%) patients were lost to follow-up. Three (18.7%) patients developed new primaries, two of them at two years and one after 8 years. One (6%) patient developed recurrent paraganglioma after remaining disease free for 20 years. CONCLUSION In conclusion, paragangliomas are rare with multicentricity being more common in patients with familial history. The malignant potential of the tumor is determined by metastasis as there are no characteristic cellular change. Aggressive surgery is mandatory to obtain disease free survival with low morbidity and mortality. Recurrences can also be successfully operated with low morbidity.
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Affiliation(s)
- P Somasundar
- Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
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