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Kloft M, Nankivell M, Cunningham D, Allum W, Langley R, Magee D, Grabsch H. SO-10 The prognostic role of microarchitecture in tumour-positive lymph nodes in oesophageal cancer patients: Results from the UK MRC OE02 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.409] [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: 11/25/2022] Open
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2
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Kloft M, Samarska I, Nankivell M, Cunningham D, Allum W, Langley R, Magee D, Grabsch H. SO-6 Microarchitectural changes in regional lymph nodes after chemotherapy in oesophageal cancer: Results from the UK MRC OE02 trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.030] [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] Open
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3
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Alkhaffaf B, Metryka A, Blazeby JM, Glenny AM, Adeyeye A, Costa PM, Diez del Val I, Gisbertz SS, Guner A, Law S, Lee HJ, Li Z, Nakada K, Reim D, Vorwald P, Baiocchi GL, Allum W, Chaudry MA, Griffiths EA, Williamson PR, Bruce IA. Core outcome set for surgical trials in gastric cancer (GASTROS study): international patient and healthcare professional consensus. Br J Surg 2021; 108:znab192. [PMID: 34165555 PMCID: PMC10364901 DOI: 10.1093/bjs/znab192] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Surgery is the primary treatment that can offer potential cure for gastric cancer, but is associated with significant risks. Identifying optimal surgical approaches should be based on comparing outcomes from well designed trials. Currently, trials report different outcomes, making synthesis of evidence difficult. To address this, the aim of this study was to develop a core outcome set (COS)-a standardized group of outcomes important to key international stakeholders-that should be reported by future trials in this field. METHODS Stage 1 of the study involved identifying potentially important outcomes from previous trials and a series of patient interviews. Stage 2 involved patients and healthcare professionals prioritizing outcomes using a multilanguage international Delphi survey that informed an international consensus meeting at which the COS was finalized. RESULTS Some 498 outcomes were identified from previously reported trials and patient interviews, and rationalized into 56 items presented in the Delphi survey. A total of 952 patients, surgeons, and nurses enrolled in round 1 of the survey, and 662 (70 per cent) completed round 2. Following the consensus meeting, eight outcomes were included in the COS: disease-free survival, disease-specific survival, surgery-related death, recurrence, completeness of tumour removal, overall quality of life, nutritional effects, and 'serious' adverse events. CONCLUSION A COS for surgical trials in gastric cancer has been developed with international patients and healthcare professionals. This is a minimum set of outcomes that is recommended to be used in all future trials in this field to improve trial design and synthesis of evidence.
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Affiliation(s)
- B Alkhaffaf
- Department of Oesophago-Gastric Surgery, Salford Royal Hospital, Salford Royal NHS Foundation Trust, Salford, UK
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - A Metryka
- Paediatric Ear, Nose and Throat Department, Royal Manchester Children’s Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - J M Blazeby
- Centre for Surgical Research and Bristol and Weston National Institute for Health Research Biomedical Research Centre, University of Bristol, Bristol, UK
| | - A -M Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - A Adeyeye
- University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - P M Costa
- Cirurgia Geral, Hospital Garcia de Orta, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | | | - S S Gisbertz
- Department of Surgery, Cancer Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - A Guner
- Department of General Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - S Law
- Department of Surgery, University of Hong Kong, Hong Kong, China
| | - H -J Lee
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, South Korea
| | - Z Li
- Peking University Cancer Hospital and Institute, Beijing, China
| | - K Nakada
- Department of Laboratory Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - D Reim
- Department of Surgery, TUM School of Medicine, Munich, Germany
| | - P Vorwald
- Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - G L Baiocchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - W Allum
- Department of Academic Surgery, Royal Marsden NHS Foundation Trust, London, UK
| | - M A Chaudry
- Department of Academic Surgery, Royal Marsden NHS Foundation Trust, London, UK
| | - E A Griffiths
- Department of Upper Gastrointestinal Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - P R Williamson
- Medical Research Council North West Hub for Trials Methodology Research, University of Liverpool, Liverpool, UK
| | - I A Bruce
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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4
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Markar SR, Sounderajah V, Johar A, Zaninotto G, Castoro C, Lagergren P, Elliott JA, Gisbertz SS, Mariette C, Alfieri R, Huddy J, Pinto E, Scarpa M, Klevebro F, Sunde B, Murphy CF, Greene C, Ravi N, Piessen G, Brenkman H, Ruurda J, van Hillegersberg R, Lagarde SM, Wijnhoven BP, Pera M, Roigg J, Castro S, Matthijsen R, Findlay J, Antonowicz S, Maynard N, McCormack O, Ariyarathenam A, Sanders G, Cheong E, Jaunoo S, Allum W, van Lanschot J, Nilsson M, Reynolds JV, van Berge Henegouwen MI, Hanna GB. Patient-reported outcomes after oesophagectomy in the multicentre LASER study. Br J Surg 2021; 108:1090-1096. [PMID: 33975337 PMCID: PMC10364861 DOI: 10.1093/bjs/znab124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life. METHODS This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016. Patients had to be disease-free for at least 1 year. They were asked to complete a 28-symptom questionnaire at a single time point, at least 1 year after surgery. Principal component analysis was used to assess for clustering and association of symptoms. Risk factors associated with the development of severe symptoms were identified by multivariable logistic regression models. RESULTS Of 1081 invited patients, 876 (81.0 per cent) responded. Symptoms in the preceding 6 months associated with previous surgery were experienced by 586 patients (66.9 per cent). The most common severe symptoms included reduced energy or activity tolerance (30.7 per cent), feeling of early fullness after eating (30.0 per cent), tiredness (28.7 per cent), and heartburn/acid or bile regurgitation (19.6 per cent). Clustering analysis showed that symptoms clustered into six domains: lethargy, musculoskeletal pain, dumping, lower gastrointestinal symptoms, regurgitation/reflux, and swallowing/conduit problems; the latter two were the most closely associated. Surgical approach, neoadjuvant therapy, patient age, and sex were factors associated with severe symptoms. CONCLUSION A long-term symptom burden is common after oesophageal cancer surgery.
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Affiliation(s)
- S R Markar
- Department Surgery and Cancer, Imperial College London, London, UK.,Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - V Sounderajah
- Department Surgery and Cancer, Imperial College London, London, UK
| | - A Johar
- Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - G Zaninotto
- Department Surgery and Cancer, Imperial College London, London, UK
| | - C Castoro
- Unit of Surgical Oncology of the Oesophagus and Digestive Tract, Veneto Institute of Oncology, Padua, Italy
| | - P Lagergren
- Department Surgery and Cancer, Imperial College London, London, UK.,Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - J A Elliott
- Department of Surgery, Trinity Centre for Health Sciences, St James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - S S Gisbertz
- Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - C Mariette
- Department of Digestive and Oncological Surgery, University of Lille, Claude Huriez University Hospital, F-59000 Lille, France
| | - R Alfieri
- Unit of Surgical Oncology of the Oesophagus and Digestive Tract, Veneto Institute of Oncology, Padua, Italy
| | - J Huddy
- Department Surgery and Cancer, Imperial College London, London, UK
| | - E Pinto
- Unit of Surgical Oncology of the Oesophagus and Digestive Tract, Veneto Institute of Oncology, Padua, Italy
| | - M Scarpa
- Unit of Surgical Oncology of the Oesophagus and Digestive Tract, Veneto Institute of Oncology, Padua, Italy
| | - F Klevebro
- Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - B Sunde
- Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - C F Murphy
- Department of Surgery, Trinity Centre for Health Sciences, St James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - C Greene
- Department of Surgery, Trinity Centre for Health Sciences, St James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - N Ravi
- Department of Surgery, Trinity Centre for Health Sciences, St James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - G Piessen
- Department of Digestive and Oncological Surgery, University of Lille, Claude Huriez University Hospital, F-59000 Lille, France
| | - H Brenkman
- Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - J Ruurda
- Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - R van Hillegersberg
- Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - S M Lagarde
- Department of Surgery, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - B P Wijnhoven
- Department of Surgery, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - M Pera
- Department of Surgery, University Hospital del Mar, Barcelona, Spain
| | - J Roigg
- Department of Surgery, University Hospital del Mar, Barcelona, Spain
| | - S Castro
- Department of Surgery, University Hospital del Mar, Barcelona, Spain
| | - R Matthijsen
- Department of Gastrointestinal Surgery, ETZ Tildburg, Tildburg, the Netherlands
| | - J Findlay
- Oesophago-gastric Centre, Churchill Hospital, University of Oxford, Oxford, UK
| | - S Antonowicz
- Oesophago-gastric Centre, Churchill Hospital, University of Oxford, Oxford, UK
| | - N Maynard
- Oesophago-gastric Centre, Churchill Hospital, University of Oxford, Oxford, UK
| | - O McCormack
- Department of Oesophago-Gastric Surgery, Royal Marsden Hospital, London, UK
| | - A Ariyarathenam
- Department of Oesophago-Gastric Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - G Sanders
- Department of Oesophago-Gastric Surgery, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - E Cheong
- Department of Upper Gastrointestinal Surgery, Norfolk and Norwich Hospitals NHS Trust, Norwich, UK
| | - S Jaunoo
- Department of Upper Gastrointestinal Surgery, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - W Allum
- Department of Oesophago-Gastric Surgery, Royal Marsden Hospital, London, UK
| | - J van Lanschot
- Department of Surgery, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - M Nilsson
- Division of Surgery, Department of Clinical Science Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - J V Reynolds
- Department of Surgery, Trinity Centre for Health Sciences, St James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - M I van Berge Henegouwen
- Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - G B Hanna
- Department Surgery and Cancer, Imperial College London, London, UK
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Evrard S, van de Velde C, Noordhoek I, Caballero C, Ceelen W, Polom K, Kolacinska A, Allum W, D'Ugo D, Malik HZ, Rubio IT, Wyld L, Leidenius M, Rivoire M, Zoras O, Polkowski W, Poston GJ, Audisio RA, Kovacs T, González-Moreno S. European Society of Surgical Oncology's strategy for clinical research: Paving the way for a culture of research in cancer surgery. Eur J Surg Oncol 2019; 45:1515-1519. [PMID: 31085024 DOI: 10.1016/j.ejso.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/30/2018] [Revised: 03/26/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022] Open
Abstract
As part of its mission to promote the best surgical care for cancer patients, the European Society of Surgical Oncology (ESSO) has been developing multiple programmes for clinical research along with its educational portfolio. This position paper describes the different research activities of the Society over the past decade and an action plan for the upcoming five years to lead innovative and high quality surgical oncology research. ESSO proposes to consider pragmatic research methodologies as a complement to randomised clinical trials (RCT), advocates for increased funding and operational support in conducting research and aims to enable young surgeons to be active in research and establish partnerships for translational research activities.
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Affiliation(s)
- S Evrard
- Institut Bergonié and Université de Bordeaux, Bordeaux, France.
| | - C van de Velde
- Leiden University Medical Center, Leiden, the Netherlands
| | - I Noordhoek
- Leiden University Medical Center, Leiden, the Netherlands
| | - C Caballero
- European Society of Surgical Oncology Clinical Research Committee, Brussels, Belgium
| | - W Ceelen
- Ghent University Hospital, Ghent, Belgium
| | - K Polom
- University of Siena, Siena, Italy; Medical University of Gdansk, Gdańsk, Poland
| | - A Kolacinska
- Department of Head and Neck Cancer Surgery, Breast Unit, Medical University of Lodz, Cancer Center, Lodz, Poland
| | - W Allum
- Royal Marsden NHS Foundation Trust, London, UK
| | - D D'Ugo
- Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - H Z Malik
- Aintree University Hospital, Liverpool, UK
| | - I T Rubio
- Clinica Universidad de Navarra, Madrid, Spain
| | - L Wyld
- Medical School, University of Sheffield, Sheffield and Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - M Leidenius
- Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - M Rivoire
- Centre Léon Bérard and Université de Lyon, Lyon, France
| | - O Zoras
- Medical School, University of Crete, Heraklion, Greece
| | | | | | - R A Audisio
- Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden
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Harries RL, Glasbey J, Gokani VJ, Griffiths G, Allum W. Effect of publishing surgeon-specific outcomes on surgical training. Br J Surg 2019; 106:1019-1025. [DOI: 10.1002/bjs.11150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/16/2018] [Accepted: 02/04/2019] [Indexed: 11/06/2022]
Abstract
Abstract
Background
Over the past 10 years, the National Health Service in England has started to publish surgeon-specific outcomes publicly. The aim of this study was to investigate how this has affected training case exposure for surgeons in training.
Methods
Anonymized data were collected from the Intercollegiate Surgical Curriculum Programme database for operations in each specialty with published surgeon outcomes, involving surgical trainees on an approved training programme between 1 January 2011 and 31 December 2016. Trainee and supervisor involvement in operations before and after the start of publication of surgeon-specific outcomes were compared using mixed-effects models.
Results
A total of 163 076 recorded operative procedures were included. A statistically significant improvement in exposure to training procedures was observed for anterior resection of rectum, carotid endarterectomy, gastrectomy, meningioma excision, prostatectomy and thyroidectomy following the introduction of publication of surgeon outcomes. In coronary artery bypass grafting (CABG) and total hip replacement (THR), however, there was a reduction in involvement in training procedures. This was apparent for both trainee and supervisor involvement in CABG, and for trainee involvement in THR.
Conclusion
Exposure to training procedures has improved rather than declined in the UK in the majority of surgical specialties, since the publication of surgeon-specific outcomes.
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Affiliation(s)
- R L Harries
- Association of Surgeons in Training, 35–43 Lincoln's Inn Fields, London WC2A 3PE, UK
| | - J Glasbey
- Association of Surgeons in Training, 35–43 Lincoln's Inn Fields, London WC2A 3PE, UK
| | - V J Gokani
- Association of Surgeons in Training, 35–43 Lincoln's Inn Fields, London WC2A 3PE, UK
| | - G Griffiths
- Joint Committee on Surgical Training, 35–43 Lincoln's Inn Fields, London WC2A 3PE, UK
| | - W Allum
- Joint Committee on Surgical Training, 35–43 Lincoln's Inn Fields, London WC2A 3PE, UK
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Mariette C, Carneiro F, Grabsch HI, van der Post RS, Allum W, de Manzoni G. Correction to: Consensus on the pathological definition and classification of poorly cohesive gastric carcinoma. Gastric Cancer 2019; 22:421. [PMID: 30631987 DOI: 10.1007/s10120-019-00925-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Indexed: 02/07/2023]
Abstract
The authors would like to correct the error in the publication of the original article. The surname and given names of the authors were swapped in the "Acknowledgements". The corrected detail is given below.
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Affiliation(s)
- C Mariette
- Department of Surgery, Hôpital Claude-Huriez, Lille, France
| | - F Carneiro
- Departments of Pathology, Centro Hospitalar São João, Faculty of Medicine of Porto University and Institute for Research and Innovation in Health (i3S), Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
| | - H I Grabsch
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Pathology and Tumour Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - R S van der Post
- Department of Pathology, Radboud university medical center, Nijmegen, The Netherlands
| | - W Allum
- Department of Upper Gastrointestinal Surgery, Royal Marsden Hospital, London, UK
| | - Giovanni de Manzoni
- General and Upper GI Surgery Division, Department of Surgery, University of Verona, Piazzale Stefani 1, 37126, Verona, Italy.
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Claassen Y, Bastiaannet E, Hartgrink H, Dikken J, De Steur W, Slingerland M, Verhoeven R, Van Eycken E, De Schutter H, Lindblad M, Hedberg J, Johnson E, Hjortland G, Jensen L, Larsson H, Koessler T, Chevallay M, Allum W, Van de Velde C. International comparison of treatment strategy and survival in metastatic gastric cancer: a survey from the EURECCA Upper GI group. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.089] [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: 10/27/2022] Open
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Davidson M, Nankivell M, Cunningham D, Starling N, Koh DM, Brown G, Allum W, Wotherspoon A, Smyth E, Ly L, Kleovoulou N, Langley R, Riddell A. Magnetic resonance imaging in oesophageal (oes) cancer: Results from the STO3 MRI substudy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.021] [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: 11/15/2022] Open
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10
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Hewitt LC, Inam IZ, Saito Y, Yoshikawa T, Quaas A, Hoelscher A, Bollschweiler E, Fazzi GE, Melotte V, Langley RE, Nankivell M, Cunningham D, Allum W, Hutchins GG, Grabsch HI. Epstein-Barr virus and mismatch repair deficiency status differ between oesophageal and gastric cancer: A large multi-centre study. Eur J Cancer 2018; 94:104-114. [PMID: 29550565 PMCID: PMC5914544 DOI: 10.1016/j.ejca.2018.02.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oesophageal (OeC) and gastric (GC) cancer patients are treated with similar multimodal therapy and have poor survival. There remains an urgent clinical need to identify biomarkers to individualise patient management and improve outcomes. Therapy with immune checkpoint inhibitors has shown promising results in other cancers. Proposed biomarkers to predict potential response to immune checkpoint inhibitors include DNA mismatch repair (MMR) and/or Epstein-Barr virus (EBV) status. The aim of this study was to establish and compare EBV status and MMR status in large multi-centre series of OeC and GC. METHODS EBV was assessed by EBV-encoded RNA (EBER) in situ hybridisation and MMR protein expression by immunohistochemistry (IHC) in 988 OeC and 1213 GC from multiple centres. In a subset of OeC, microsatellite instability (MSI) was tested in parallel with MMR IHC. RESULTS Frequency of MMR deficiency (MMRdef) and MSI was low in OeC (0.8% and 0.6%, respectively) compared with GC (10.3%). None of the OeCs were EBER positive in contrast to 4.8% EBER positive GC. EBV positive GC patients were younger (p = 0.01), more often male (p = 0.001) and had a better overall survival (p = 0.012). MMRdef GC patients were older (p = 0.001) and showed more often intestinal-type histology (p = 0.022). CONCLUSIONS This is the largest study to date indicating that EBV and MMRdef do not play a role in OeC carcinogenesis in contrast to GC. The potential clinical usefulness of determining MMRdef/EBV status to screen patients for eligibility for immune-targeting therapy differs between OeC and GC patients.
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Affiliation(s)
- L C Hewitt
- Department of Pathology and GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Pathology and Tumour Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - I Z Inam
- Pathology and Tumour Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Y Saito
- Department of Pathology and GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - T Yoshikawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - A Quaas
- Institute for Pathology, University Hospital Cologne, Cologne, Germany
| | - A Hoelscher
- German Center for Esophageal and Gastric Surgery, Agaplesion Markus Hospital, Frankfurt, Germany
| | - E Bollschweiler
- Department of Visceral Surgery, University Hospital Cologne, Cologne, Germany
| | - G E Fazzi
- Department of Pathology and GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - V Melotte
- Department of Pathology and GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Clinical Genetics, University of Rotterdam, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - R E Langley
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - M Nankivell
- Medical Research Council Clinical Trials Unit at University College London, London, UK
| | - D Cunningham
- The Royal Marsden Hospital NHS Foundation Trust, London and Surrey, UK
| | - W Allum
- Department of Surgery, Royal Marsden National Health Services Foundation Trust, London, UK
| | - G G Hutchins
- Pathology and Tumour Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - H I Grabsch
- Department of Pathology and GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; Pathology and Tumour Biology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK.
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Smyth E, Fassan M, Kouvelakis K, Nankivell M, Peckitt C, Wotherspoon A, Valeri N, Rugge M, Allum W, Langley R, Cunningham D. ATM loss, MSI and survival in the MAGIC trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.031] [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: 11/15/2022] Open
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12
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Lee MJ, Bhangu A, Blencowe NS, Nepogodiev D, Gokani VJ, Harries RL, Akinfala M, Ali O, Allum W, Bosanquet D, Boyce K, Bradburn M, Chapman S, Christopher E, Coulter I, Dean B, Dickfos M, El Boghdady M, Elmasry M, Fleming S, Glasbey J, Healy C, Kasivisvanathan V, Khan K, Kolias A, Lee S, Morton D, O'Beirne J, Sinclair P, Sutton P. Academic requirements for Certificate of Completion of Training in surgical training: Consensus recommendations from the Association of Surgeons in Training/National Research Collaborative Consensus Group. Int J Surg 2016; 36 Suppl 1:S24-S30. [DOI: 10.1016/j.ijsu.2016.08.236] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 08/20/2016] [Indexed: 10/21/2022]
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Smyth E, Rowley S, Allum W, Stenning S, Wotherspoon A, Robb C, Grabsch H, Alderson D, Crosby T, Mason R, Griffin M, Mansoor W, Darby S, Seymour M, Thompson J, Sothi S, Sumpter K, Blazeby J, Langley R, Cunningham D. A randomised phase II study of perioperative epirubicin, cisplatin and capecitabine (ECX) ± lapatinib for operable, HER-2 positive gastric, oesophagogastric junctional (OGJ) or lower oesophageal adenocarcinoma: Results from the UK MRC ST03 lapatinib feasibility study (ISRCTN 46020948). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw435.17] [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: 11/13/2022] Open
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14
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Smyth EC, Verheij M, Allum W, Cunningham D, Cervantes A, Arnold D. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016; 27:v38-v49. [PMID: 27664260 DOI: 10.1093/annonc/mdw350] [Citation(s) in RCA: 1033] [Impact Index Per Article: 129.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- E C Smyth
- Department of Gastrointestinal Oncology, Royal Marsden Hospital, London and Surrey, UK
| | - M Verheij
- Department of Radiation Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - W Allum
- Department of Surgery, Royal Marsden Hospital, London and Surrey
| | - D Cunningham
- Department of Medicine, Royal Marsden Hospital, London and Surrey, UK
| | - A Cervantes
- Medical Oncology Department, INCLIVA University of Valencia, Valencia, Spain
| | - D Arnold
- Instituto CUF de Oncologia (I.C.O.), Lisbon, Portugal
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15
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Fontana E, Smyth E, Cunningham D, Allum W, Thompson J, Waddell T, Peckitt C, Rao S, Starling N, Chau I, Watkins D. 195P Carboplatin for operable oesophageal and gastric adenocarcinoma (OGA): Royal Marsden (RMH) experience 2001-2010. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.56] [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: 11/14/2022] Open
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16
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Coupland VH, Konfortion J, Jack RH, Allum W, Kocher HM, Riaz SP, Lüchtenborg M, Møller H. Resection rate, hospital procedure volume and survival in pancreatic cancer patients in England: Population-based study, 2005-2009. Eur J Surg Oncol 2015; 42:190-6. [PMID: 26705143 DOI: 10.1016/j.ejso.2015.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 07/09/2015] [Revised: 10/14/2015] [Accepted: 11/08/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE We assessed the association between population resection rates, hospital procedure volume and death rates in pancreatic cancer patients in England. DESIGN Patients diagnosed with pancreatic cancer were identified from a linked cancer registration and Hospital Episode Statistics dataset. Cox regression analyses were used to assess all-cause mortality according to resection quintile and hospital volume, adjusting for sex, age, deprivation and comorbidity. RESULTS There were 31,973 pancreatic cancer patients studied, 2580 had surgery. Increasing resection rates were associated with lower mortality among all patients (χ(2)(1df) = 176.18, ptrend < 0.001), with an unadjusted hazard ratio (HR) of 0.78 95%CI [0.75 to 0.81] in the highest versus the lowest resection quintile. Adjustment changed the estimate slightly (HR 0.82, 95%CI [0.79 to 0.85], (χ(2)(1df) = 99.44, ptrend < 0.001)). Among patients that underwent surgery, higher procedure volume was associated with lower mortality (HR = 0.88 95%CI [0.75-1.03] in hospitals carrying out 30+ versus <15 operations a year, shared frailty model, χ(2)(1df) = 1.82, ptrend = 0.177). CONCLUSION Higher population resection rates were associated with lower mortality. The association with hospital procedure volume was less clear possibly due to small number of patients who underwent surgery. Nevertheless these results suggest survival is higher in hospitals that carry out a greater number of operations a year, particularly those doing 30+ operations, supporting the benefit of centralising perioperative expertise in specialist centres. Ensuring people are increasingly diagnosed when they are suitable candidates for surgery, and have access to these specialist centres may lead to an increase in the proportion of patients that undergo surgical resection which could plausibly increase survival of pancreatic cancer patients.
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Affiliation(s)
- V H Coupland
- Public Health England, National Cancer Intelligence Network, London, UK.
| | - J Konfortion
- Public Health England, National Cancer Intelligence Network, London, UK
| | - R H Jack
- Public Health England, National Cancer Intelligence Network, London, UK
| | - W Allum
- The Royal Marsden NHS Foundation Trust, Department of Surgery, London, UK
| | - H M Kocher
- Centre for Tumour Biology, Barts Cancer Institute - a Cancer Research UK Centre of Excellence, Queen Mary University of London, London EC1M 6BQ, UK
| | - S P Riaz
- Public Health England, National Cancer Intelligence Network, London, UK
| | - M Lüchtenborg
- Public Health England, National Cancer Intelligence Network, London, UK; King's College London, Division of Cancer Studies, London, UK
| | - H Møller
- King's College London, Division of Cancer Studies, London, UK
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17
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Fontana E, Smyth E, Cunningham D, Morano F, Rao S, Watkins D, Allum W, Thompson J, Waddell T, Moorcraft S, Peckitt C, Starling N, Chau I. P-079 Impact of disease biology and stage on outcomes for oesophageal and gastric adenocarcinoma (OGA) treated with neoadjuvant chemotherapy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.79] [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: 11/12/2022] Open
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18
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Waddell T, Verheij M, Allum W, Cunningham D, Cervantes A, Arnold D. Gastric cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014; 24 Suppl 6:vi57-63. [PMID: 24078663 DOI: 10.1093/annonc/mdt344] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- T Waddell
- GI Clinical Trials Unit, Royal Marsden Hospital, Sutton, UK
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19
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Abstract
Application for a Certificate of Completion of Training (CCT) in general surgery includes assessment of a validated logbook. The content of a satisfactory logbook has long been an area of contention. The logbook allows trainees to record their operative experience and to show the level of supervision. It is tempting to set a specific number of procedures to be completed by the end of training. However, such a number must be evidence based rather than chosen subjectively.
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Affiliation(s)
- W Allum
- Past Chairman, General Surgery Specialist Advisory Committee
| | - S Hornby
- President, Association of Surgeons in Training
| | - G Khera
- Past President, Association of Surgeons in Training
| | - E Fitzgerald
- Past President, Association of Surgeons in Training
| | - G Griffiths
- Past Chairman, Association of Surgeons in Training
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20
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Rusby JE, Agabiti E, Waheed S, Barry P, Roche N, Allum W, Gui G, MacNeill F, Christaki G, Osin P, Nerurkar A. Abstract P1-01-11: Is OSNA mRNA copy number in sentinel lymph node biopsy predictive of further disease in the axilla? Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p1-01-11] [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: 11/16/2022]
Abstract
Abstract
Introduction: Intra-operative assessment of sentinel nodes (SLNs) allows immediate completion axillary dissection (cALND) in breast cancer patients. Molecular assessment such as one-step nucleic acid amplication (OSNA) promises greater sensitivity and provides a more accurate quantitative assessment than traditional methods.
Our unit policy is to proceed to cALND in patients with macrometastases but not for micrometastases. However, evidence of upstaging has led us to seek to raise the threshold for proceeding to cALND. The CK19 mRNA copy number is an expression of the metastatic burden in the SLN and may be related to the presence of additional disease in the cALND. Since the original copy number threshold between micro (250–5000 copies/microliter) and macrometastasis (>5000 copies/microliter) was based on few patients and serial pathological sections, we investigated the mRNA copy number in patients with and without additional disease in the cALND.
Methods: All patients in our unit undergo pre-operative axillary ultrasound with fine needle aspiration cytology of any suspicious nodes. Those with malignant cytology proceed directly to ALND. Radiologically and cytologically node negative patients undergo sentinel lymph node biopsy (SLNB) and OSNA. Electronic records of consecutive patients with invasive breast cancer undergoing SLNB with OSNA from August 2011 to March 2012 were retrospectively reviewed. Two parameters of mRNA copy number were examined: Copy number of the highest copy number SLN and the summed copy numbers of all positive SLNs. Their relationship to the presence of further disease in the axilla was examined using Student's t test.
Results: Of 201 SLNBs, 45 (22%) had macrometastasis-positive OSNA and therefore underwent cALND (1 patient declined). Twenty patients (45%) had no further positive nodes (a negative cALND) with a total axillary metastatic burden of 1–2 in 11–27 nodes. Twenty four (55%) showed further disease (a positive cALND) with a burden of 2–20 in 9–30 nodes, including the SLNs.
There was no significant difference in tumour size or grade between patients with additional positive nodes in the cALND compared with those with no further disease.
There was no significant difference in the copy number of the highest copy number positive SLN (p = 0.44) or in the summed copy number of all positive SLNs (p = 0.36) between the cALND positive and negative groups.
Conclusion: OSNA CK19 mRNA copy number does not correlate with the cALND metastatic burden. Therefore, raising the copy number threshold may be too simplistic as a method to better select patients with high probability of a positive cALND. A predictive model will be derived based on multivariate analysis of the larger patient population (>400 patients) that will have undergone SLNB with OSNA by the time of SABCS.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-01-11.
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Affiliation(s)
- JE Rusby
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - E Agabiti
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - S Waheed
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - P Barry
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - N Roche
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - W Allum
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - G Gui
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - F MacNeill
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - G Christaki
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - P Osin
- Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - A Nerurkar
- Royal Marsden NHS Foundation Trust, London, United Kingdom
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21
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Coupland VH, Lagergren J, Konfortion J, Allum W, Mendall MA, Hardwick RH, Linklater KM, Møller H, Jack RH. Ethnicity in relation to incidence of oesophageal and gastric cancer in England. Br J Cancer 2012; 107:1908-14. [PMID: 23059745 PMCID: PMC3504951 DOI: 10.1038/bjc.2012.465] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/04/2012] [Accepted: 09/18/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study investigated the variation in incidence of all, and six subgroups of, oesophageal and gastric cancer between ethnic groups. METHODS Data on all oesophageal and gastric cancer patients diagnosed between 2001 and 2007 in England were analysed. Self-assigned ethnicity from the Hospital Episode Statistics dataset was used. Male and female age-standardised incidence rate ratios (IRRs) were calculated for each ethnic group, using White groups as the references. RESULTS Ethnicity information was available for 83% of patients (76 130/92 205). White men had a higher incidence of oesophageal cancer, with IRR for the other ethnic groups ranging from 0.17 95% confidence interval (CI) (0.15-0.20) (Pakistani men) to 0.58 95% CI (0.50-0.67) (Black Caribbean men). Compared with White women, Bangladeshi women (IRR 2.02 (1.24-3.29)) had a higher incidence of oesophageal cancer. For gastric cancer, Black Caribbean men (1.39 (1.22-1.60)) and women (1.57 (1.28-1.92)) had a higher incidence compared with their White counterparts. In the subgroup analysis, White men had a higher incidence of lower oesophageal and gastric cardia cancer compared with the other ethnic groups studied. Bangladeshi women (3.10 (1.60-6.00)) had a higher incidence of upper and middle oesophageal cancer compared with White women. CONCLUSION Substantial ethnic differences in the incidence of oesophageal and gastric cancer were found. Further research into differences in exposures to risk factors between ethnic groups could elucidate why the observed variation in incidence exists.
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Affiliation(s)
- V H Coupland
- King's College London, Thames Cancer Registry, 1st Floor Capital House, 42, Weston Street, London SE1 3QD, UK.
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22
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Abstract
1 The interaction between phenylephrine and debrisoquine was studied using normal and hypertensive human volunteers, measuring blood pressure, pulse rate and pupil diameter. Single doses of phenylephrine were given before, during and after a short course of debrisoquine treatment. 2 The circulatory effects of phenylephrine are potentiated by debrisoquine; in a few subjects this potentiation was marked and a potential hazard. 3 Limited deductions could be made about the effects of debrisoquine on baroceptor responses and adrenergic mechanisms.
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Affiliation(s)
- W Allum
- Department of Pharmacology and Therapeutics, London Hospital Medical College, Turner Street, London
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23
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Okines AFC, Langley RE, Thompson LC, Stenning SP, Stevenson L, Falk S, Seymour MT, Coxon FY, Middleton GW, Smith D, Evans L, Slater S, Waters JS, Ford D, Hall M, Iveson T, Petty RD, Plummer C, Allum W, Cunningham D. Safety results from a randomized trial of perioperative epirubicin, cisplatin plus capecitabine (ECX) with or without bevacizumab (B) in patients (pts) with gastric or type II/III oesophagogastric junction (OGJ) adenocarcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Yeow WC, Thomee E, MacNeill F, Gui G, Roche N, Allum W, Rusby J. Is completion axillary lymph node dissection necessary for micrometastases? Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.03.011] [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] Open
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25
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Okines A, Verheij M, Allum W, Cunningham D, Cervantes A. Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2010; 21 Suppl 5:v50-4. [PMID: 20555102 DOI: 10.1093/annonc/mdq164] [Citation(s) in RCA: 247] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- A Okines
- Royal Marsden Hospital, Sutton, UK
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26
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Pitsinis V, Khan A, Cranshaw I, Allum W. 158 POSTER Single center experience of the management of gastrointestinal stromal tumours. Eur J Surg Oncol 2006. [DOI: 10.1016/s0748-7983(06)70593-5] [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: 11/25/2022] Open
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27
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Archer CD, Parton M, Smith IE, Ellis PA, Salter J, Ashley S, Gui G, Sacks N, Ebbs SR, Allum W, Nasiri N, Dowsett M. Early changes in apoptosis and proliferation following primary chemotherapy for breast cancer. Br J Cancer 2003; 89:1035-41. [PMID: 12966422 PMCID: PMC2376965 DOI: 10.1038/sj.bjc.6601173] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Patients undergoing primary chemotherapy for invasive breast cancer consented to a core biopsy of the invasive breast primary pre- and 24 h postchemotherapy. The resulting tissue was analysed for apoptosis, Ki67, ER and HER-2 using immunohistochemical techniques. These data were then used to evaluate the relationship between these biological markers and response to chemotherapy and overall survival. Response rate to chemotherapy in this group was 86%, 16 patients (25%) achieved a clinical complete response and 41 (63%) a partial response. Prechemotherapy there was a significant correlation between Ki67 and apoptotic index (AI), r=0.6, (P<0.001). A significant rise in AI (P<0.001), and fall in Ki67 (P=0.002) was seen 24 h following chemotherapy. No relationship was seen between pretreatment AI and clinical response, but higher Ki67 and growth index (Ki67/AI ratio, GI) did correlate with clinical response (both r=0.31, P<0.025). No correlation was seen between the change in AI or Ki67 at 24 h and clinical response or survival. Significant changes in apoptosis and proliferation can be demonstrated 24 h following chemotherapy, but these changes do not relate to clinical response or outcome in this study. Pretreatment proliferation and GI are however predictive of response to chemotherapy in breast cancer.
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MESH Headings
- Adult
- Antineoplastic Agents/therapeutic use
- Apoptosis/drug effects
- Breast Neoplasms/drug therapy
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/metabolism
- Carcinoma, Lobular/pathology
- Cell Division/drug effects
- Female
- Humans
- Immunoenzyme Techniques
- Ki-67 Antigen/metabolism
- Middle Aged
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Survival Rate
- Treatment Outcome
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Affiliation(s)
- C D Archer
- Breast Unit, Royal Marsden NHS Trust, Fulham Road, London SW3 6JJ, UK.
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28
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Cunningham D, Allum W, Weeden S. 45 Perioperative chemotherapy in operable gastric and lower oesophageal cancer: a randomised, controlled trial of the UK NCRI upper GI clinical studies group (the MAGIC trial, ISRCTN 93793971). EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90079-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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29
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Bancewicz J, Girling D, Allum W, Cunningham D, Stenning S. Pre- and postoperative chemotherapy for resectable gastric adenocarcinoma. Ann R Coll Surg Engl 1998; 80:73. [PMID: 9579137 PMCID: PMC2502750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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30
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Mack P, Allum W, Pristman T, Fielding J. Single radiotherapy treatments in the palliation of painful pelvic adenocarcinoma. Clin Radiol 1987. [DOI: 10.1016/s0009-9260(87)80312-4] [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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31
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Allum W, Aminu J, Bloomfield TH, Davies C, Scales AH, Vere DW. Interaction between debrisoquine and phenylephrine in man. Br J Pharmacol 1973; 47:675P-676P. [PMID: 4730881 PMCID: PMC1776350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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