#701 Background: Controversy surrounds the prognosis of breast cancer patients with T1a,bN0M0 tumors following locoregional therapy and the need for adjuvant systemic therapy, especially for HER2+ disease. The purposes of the study were to determine the recurrence-free survival (RFS), and distant recurrence-free survival (DRFS) in small HER2+ tumors compared with hormone receptor ( HR)+ and triple receptor- (TN) tumors.
 Methods: Stage T1a,bN0M0 breast cancers diagnosed between 1973-2003 were reviewed by dedicated breast pathologists. HER2+ tumors were defined as 3+ by IHC or gene amplification. Patients were categorized into 3 groups:TN (ER-, PR-and HER2-), HER2+ (regardless of HR status) and HR+ (HER2-). RFS and DRFS were estimated by the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards models were fit to determine the association of each group with the risk of recurrence after adjustment for other characteristics.
 Results: Of the 1796 patients, 427 were excluded from the analysis due to being male (2), lack of receptor information (249), and adjuvant chemotherapy (176) leaving 1369 pts for analysis. Median age was 57 years,(range, 26-88). There were 381(28%) T1a and 988(72%) T1b tumors; HR+ 68%, TN 23%, HER2+ 9%. Patients who had HER2+ breast cancer tended to be younger,(p=0.001); have more T1a tumors, (p=0.001); and have higher nuclear grade,(p<0.001). At a median follow-up of 74 months(range 1-350), there were 160 recurrences and 77 distant metastases. Five and 10-year RFS and DRFS are summarized in the table. After adjustment for other characteristics, patients with HER2+ breast cancer had a significantly worse RFS (HR: 5.19, 95% CI: 3.21-8.39, p<0.0001) and DRFS (HR: 4.66, 95% CI: 2.47-8.80, p<0.0001) compared to patients with HR-positive breast cancer.
 Conclusions: Breast cancer patients with HER2+ T1a,bN0M0 tumors have a significant risk of relapse and should be considered candidates for adjuvant systemic therapy including anti-HER2 agents.
 
 Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 701.
Objectives: The number of citations an article receives is an important indication of its impact. The main objectives of this investigation provide readers with a practical guide in evaluating head and neck oncology literature and determine the characteristics of trends in ORL. Methods: This was a retrospective bibliometric analysis that did not involve human participant. The Thomson Reuters Web of Science was searched to determine the citations of all published HNO articles. Most cited 300 article analyzed and a total of 100 articles were included in our investigation under the topic search “Head AND NECK AND (cancer OR carcinoma OR oncology).” Articles include malignancies other than head and neck are excluded. The top 100 cited articles were selected and analyzed by 2 independent investigators. Country, Institution, First Author, Journal name, study design, cites per year information gathered and analyzed. Results: The journal with the highest number of top 100 cited articles was New England Journal Of Medicine with 19 paper, followed by The Journal of Clinical Oncology(17) and Cancer Research (12). The top article on the list (Radiotherapy plus cetuximab for squamous cell carcinoma of the head and neck-NEJM) has 2243 citations. A statistically significant association was found between the journal impact factor and the number of top 100 cited articles ( P < .05). The United States had the highest number of articles (63). John Hopkins is differed from other institutions with 15 contributing articles. Conclusion: Our analysis provides an insight into the citation frequency of top cited articles published in HNO to help recognize the quality of the works, discoveries and the trends steering the study of HNO. This is also a modern reading list for young HNO scientist.
Objectives. PAX8/PPARG chromosomal rearrangement is frequently seen in thyroid cancer, and PPARG overexpression has been shown in the follicular variant of papillary thyroid carcinoma, but not in papillary thyroid carcinoma other than the follicular variant. The main aim of this study was to investigate the frequency of PPARG overexpression among papillary thyroid carcinoma and if there were any variants of papillary thyroid carcinoma with PPARG overexpression other than the follicular variant. Methods. Immunohistochemical analysis of PPARG overexpression was performed using a PPARG monoclonal antibody in a series of 111 paraffin-embedded blocks of thyroid tumours. Of the patients in our study, 100 were diagnosed with papillary thyroid carcinoma, 9 with follicular adenoma and 2 with follicular carcinoma. Results. PPARG staining was detected in 19 of the 111 cases. Sixteen patients with PPARG overexpression had papillary thyroid carcinoma and 3 had follicular adenoma. Conclusion. PPARG overexpression was detected mainly in follicular-variant papillary thyroid carcinoma. Vascular invasion, lymphatic invasion, thyroid capsule invasion and lymph node positivity were lower in patients with PPARG overexpression. KEY WORDS: papillary thyroid carcinoma, PPARG overexpression, prognostic parameters, PAX8/PPARG fusion protein (PPFP), pioglitazone RIASSUNTO Obiettivi. Il riarrangiamento cromosomico PAX8/PPARG è frequentemente osservato nel cancro della tiroide, la sovraespressione della proteina PPARG è stata già dimostrata nella variante follicolare del carcinoma papillare della tiroide, ma non nelle varianti del carcinoma papillare della tiroide, diverse da quella follicolare. L'obiettivo principale di questo studio è stato quello di indagare la sovraespressione di PPARG nel carcinoma papillare della tiroide e se ci sia qualche variante del carcinoma papillare della tiroide, diversa da quella follicolare, con sovraespressione di PPARG. Metodi. È stata eseguita una analisi immunoistochimica della sovraespressione di PPARG, utilizzando un anticorpo monoclonale PPARG in una serie di 111 campioni di tumori tiroidei inclusi in paraffina. In 100 casi, è stato diagnosticato un carcinoma papillare della tiroide, in 9, adenoma follicolare e 2, carcinoma follicolare. Risultati. La proteina PPARG è stata rilevata in 19 dei 111 casi. Sedici di quei pazienti con sovraespressione di PPARG avevano carcinoma papillare della tiroide e 3 pazienti avevano adenoma follicolare. Conclusione. La sovraespressione di PPARG è stata rilevata principalmente nella variante follicolare del carcinoma papillare della tiroide. L'invasione vascolare, l'invasione linfatica, l'invasione della capsula tiroidea e la positività dei linfonodi sono risultate inferiori nei pazienti con sovraespressione di PPARG.
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