This is the first study that seeks to establish the prognostic value of circulating tumor cell (CTC) (determined by CellSearch system) in patients with stage III CRC.
Our results suggest that given ...the low number of CTC in patients with localized CRC and the particular pattern of metastatic dissemination in patients with CRC, it is likely that CTC does not have a prognostic role in this setting.
The prognostic role of circulating tumor cells (CTC) in early colorectal cancer (CRC) has not been determined yet. We evaluated the potential prognostic value of CTC in stage III CRC patients.
Prospective multicenter study of 519 patients with stage III CRC recruited between January 2009 and June 2010. CTC were enumerated with the CellSearch System after primary tumor resection and before the start of adjuvant therapy. A total of 472 patients were included in the analysis.
CTC ≥1, ≥2, ≥3 and ≥5 were detected in 166 (35%), 93 (20%), 57 (12%) and 34 (7%) patients, respectively. Median follow-up was 40 months. In the overall population, CTC ≥1 (disease-free survival (DFS): HR 0.97,P = 0.85; overall survival (OS): HR 1.03,P = 0.89), ≥2 (DFS: HR 1.07,P = 0.76; OS: HR 1.02,P = 0.95), ≥3 (DFS: HR 0.96,P = 0.87; OS: HR 0.74,P = 0.41) and ≥5 (DFS: HR 0.72,P = 0.39; OS: HR 0.48,P = 0.21) were not associated with worse DFS and OS. No clinicopathological characteristics were significantly associated with the presence of CTC. In patients with disease relapse, the proportion with CTC ≥1 was not significantly different between those with single versus multiple metastatic locations (37.9% versus 31.4%,P = 0.761). In the multivariate analysis, CTC ≥1 was not an independent prognostic factor for DFS (HR 0.97,P = 0.87) and OS (HR 0.96,P = 0.89).
CTC detection was not associated with worse DFS and OS in patients with stage III CRC. Given the scarcity of CTC in these patients, it is likely that CTC determined by CellSearch system does not have a prognostic role in this setting. However, a longer follow-up is needed.
Periodic limb movements (PLMs) can be found isolated or related to other sleep disorders, as Obstructive Sleep Apnea (OSA). Nevertheless, this association was described before the proposal for ...modification of the World Association of Sleep Medicine (WASM), which incorporated major changes modifying the definition of respiratory-related leg movements (RRLM) so that the relationship between OSA and PLM could be affected.
A total of 131 PSG were studied (children with ages from 5 to 12 years old), all referred because of a suspicion of sleep-disordered breathing (65 children were diagnosed of OSA, and 66 presented snoring but no sleep apnea). Leg movements were manually scored according to both 2006 and 2016 WASM/IRLSSG criteria.
According to 2006 WASM rules, statistical differences were found, not only for PLM index (p 0.002), but all indexes. Nevertheless, according to new 2016 WASM rules, no statistical differences were found for PLM index (p 0.677), non-REM PLM index (p 0.299), REM PLM index (P 0.511) or PLM with arousal index (p 0.180), between OSA and non-OSA group. Positive correlation between PLM and RRLM have been found with both set of rules. The percentage of children with PLM>5/h is higher when using the prior PLM scoring criteria developed in 2006 (38.93%) versus the updated PLM scoring criteria (19.08%).
The lack of association when using the new WASM/IRLSSG scoring rules together with the absence of a previous clear etiopathology explanation may suggest that the association between OSA and PLM might be indeed overestimated and that, perhaps, it really did not exist.
•The association between periodic limb movements (PLM) and obstructive sleep apnea (OSA) has been made according to the AAMS.•When considering the new 2016 WASM/IRLSSG criteria the association seems to disappear found between OSA and non-OSA patients.•It might be possible that PLM data in OSA had been consistently overestimated.•A global review of the scoring criteria for RRLM is needed to address the current confusion.
•Drying of foods shaped as whole or sections of cylinders is investigated.•A simple method is developed to estimate anisotropic diffusion coefficients.•Diffusivities along axial, radial and angular ...directions can be estimated.•Proposed methodology was tested with two sets of convective drying data of carrot.•Anisotropic behavior of carrot was confirmed.
In this study, a method to estimate water diffusivity in axial, radial and angular directions during drying of anisotropic cylindrical solids is proposed. The method is based on the analytical solution for non-steady state mass transfer equation in products shaped as longitudinal sections of finite anisotropic cylinders. A sequential approach is applied where radial and axial diffusion coefficients are first estimated from drying curves of whole cylinders with increasing height, while angular diffusivity is obtained thereafter from drying experiments carried out with longitudinal sections of fixed-height cylinders varying cut angle. Developed theory was applied to the analysis of two sets of convective drying data of carrot obtained at 80°C with an air velocity of 2m/s. The first experiment set was conducted with carrot cylinders of 2.2cm diameter and heights of 1, 2,…,10cm, while cylinders in the second set were longitudinally cut as halves, quarters, sixths and eighths with a constant height of 10cm. Under such experimental conditions, identified water diffusivities were in the range of 0.53–2.93×10−9m2/s. Differences in water diffusivity for studied mass transfer directions were significant (p<0.05), with SEM images revealing structural differences between longitudinal and transversal product cuts, thus further supporting numerical results. Present findings suggest that, depending on product, anisotropic diffusion should be included in drying modeling in order to obtain an accurate process description.
Background
Addition of carboplatin (C) to trastuzumab (T) and paclitaxel (P) improves the efficacy in HER2+ metastatic breast cancer (MBC). The aim of this phase-II study was to evaluate the efficacy ...and safety of this combination given weekly (3×) followed by a week off. The primary endpoint was: objective response rate (ORR), and secondary endpoints were: time to progression (TTP), overall survival (OS), and toxicity profile.
Methods
HER2+ MBC patients were included in the study. Treatment was as follows: T (loading dose:4 mg/kg per week and 2 mg/kg per day thereafter), P (80 mg/m
2
) and C (AUC 2) given weekly 3×, followed by 1 week off until disease progression or unacceptable toxicity.
Results
Forty-one patients (pts) were enrolled—median age: 54.5 years (range 29–75); 87.8% PS 0 or 1; 39 (97.5%) had received prior adjuvant or neoadjuvant treatment; 11 (27%) had received one prior CT line for metastatic disease; disease sites: liver (40%), bone (32.5%), lymph nodes (32.5%) and lung (20%); 19 (47.5%) had ≥2 lesions and 97.5% had measurable disease. A total of 37 pts were evaluated for response: 11(26.8%) CR; 12 (29.3%) PR; 9 (22%) SD; 5 (12.2%) PD and 4 NE, resulting in an ORR of 56.1% (95% CI 39.7–71.5%) and tumor growth control rate (RR + SD) of 78% (95% CI 62.4–89.4%). With a median follow up of 39.4 months, 26 (70.3%) patients have progressed. The median time to progression was 12.3 months (95% CI 8.2–15.5). At the time of this report, ten patients have died. Forty patients received 202 cycles (median five cycles). Grades 3–4 toxicities/pts: 3 (7.5%) anemia, 2 (5%) leucopenia, 10 (25%) neutropenia, 1 (2.5%) febrile neutropenia,1 (2.5%) thrombopenia, 2 (5%) asthenia, 2 (5%) diarrhea, 3 (7.5%) nausea, 2 (5%) vomiting, and 3 (7.5%) mucositis.
Conclusions
The schedule showed an interesting activity, taking into account that 27% of patients had received previous treatment for MBC. One week of rest may benefit not only the patient but may also improve tolerability and efficacy of the combination.
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