Combining 18F-DOPA PET and MRI with perfusion-weighted imaging improves delineation of high-grade subregions in enhancing and non-enhancing gliomas prior treatment: a biopsy-controlled study

Abstract Background Patients with long-standing ulcerative colitis (UC) are at an increased risk of colorectal cancer. Risk stratification is important to identify patients who require more frequent endoscopic surveillance. Serrated epithelial change (SEC) found in patients with long-standing colitis may be associated with neoplasia and serve as a marker to stratify patients at higher risk of colorectal cancer (CRC). Methods A case-control study was performed to compare the rates of neoplasia between UC patients with SEC and UC patients without SEC who were matched for age, disease duration, and disease extent. Paired tests, conditional logistic regression, and Kaplan-Meier analyses were used to compare groups. A systematic review with meta-analysis was performed, combining our local data with previously published data. Results This study included 196 UC patients without prior neoplasia, 98 with SEC and 98 without SEC. Ulcerative colitis patients with SEC had a significantly higher rate of synchronous or metachronous neoplasia than UC patients without SEC (26.5% vs 3.1%; P < 0.001). Synchronous or metachronous high-grade dysplasia and CRC were found more frequently in UC patients with SEC than UC patients without SEC (11.2% vs 2.0%; P = 0.02). A meta-analysis was consistent with these findings, showing a higher rate of neoplasia in patients with SEC compared with those without SEC (16.4% vs 3.9%; P < 0.001). Conclusion Serrated epithelial change is associated with a significantly increased risk of synchronous and metachronous neoplasia including high-grade dysplasia and CRC in patients with UC. Histopathological findings of SEC should warrant closer endoscopic surveillance for CRC.

Download Full-text

Su1195 ENDOSCOPIC ULTRASOUND-GUIDED BILIARY DRAINAGE VS. ERCP IN INOPERABLE MALIGNANT HIGH-GRADE DISTAL BILE DUCT OBSTRUCTION: PROSPECTIVE RANDOMIZED CONTROLLED STUDY: A PRELIMINARY ANALYSIS

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.1216 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB309-AB310

Author(s):

Thanapon Yaowmaneerat ◽

Nisa Netinatsunton ◽

Tanawat Pattarapuntakul ◽

Bancha Ovartlarnporn

Keyword(s):

Bile Duct ◽

Endoscopic Ultrasound ◽

Biliary Drainage ◽

Preliminary Analysis ◽

Controlled Study ◽

High Grade ◽

Distal Bile Duct ◽

Ultrasound Guided ◽

Duct Obstruction ◽

Randomized Controlled

Download Full-text

A phase III randomized, double-blind placebo controlled study of armodafinil (Nuvigil) to reduce cancer-related fatigue in patients with high-grade glioma (Alliance A221101).

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.12007 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 12007-12007

Author(s):

Alyx B. Porter ◽

Heshan Liu ◽

Sadhna Kohli ◽

Jane H. Cerhan ◽

Jeff A. Sloan ◽

...

Keyword(s):

High Grade Glioma ◽

Phase Iii ◽

Controlled Study ◽

High Grade ◽

Double Blind ◽

Meaningful Improvement ◽

Fatigue Score ◽

Severe Fatigue ◽

Significant Difference ◽

Endpoint Data

12007 Background: Up to 96% of patients with high grade glioma (HGG) report moderate to severe fatigue. Armodafinil, the R-enantiomer of modafinil, is a psychostimulant with low potential for abuse that has shown potential for improving severe fatigue in HGG patients. Methods: In this phase III double blinded placebo-controlled study, adults with HGG and moderate to severe fatigue, > 4 weeks after completing radiotherapy, were randomized to receive armodafinil daily (150 mg or 250 mg) or placebo for a total of 8 weeks. The primary outcome was efficacy in treating severe fatigue. Secondary outcomes included evaluation of tolerability, neurocognitive function, and quality of life. Patients were evaluated at baseline, 4 and 8 weeks. Results: A total of 328 patients were enrolled between 6/3/13-3/1/19. There were 103 (150 mg arm), 97 (250 mg arm) and 97 (placebo arm) evaluable patients with primary endpoint data available. The median age was 60 years (20-85) with a median Brief Fatigue Inventory (BFI) worst fatigue score of 8 (6-10). 60.3% were male, 80.5% received concomitant chemotherapy, and 39.7% were on corticosteroids. The global fatigue score at end of weeks 4 and 8 were lower than at baseline (p<0.0001) and in the 250 mg arm than placebo (p=0.0356) and was higher for corticosteroid users than non-users (p=0.0002). There was no statistically significant difference for clinically meaningful improvement in BFI usual fatigue score from baseline to end of week 8 between the three arms (p=0.9601). Patients reported an improvement in concentration at week 4 from baseline on the 150 mg arm(P=0.0311). There was no statistically significant difference on neurocognitive tests from baseline to end of week 4 (p>0.05) or week 8 (p>0.05) between arms. More patients reported insomnia on the 250 mg arm (p=0.0083). Conclusions: There is no meaningful benefit of the use of armodafinil to reduce moderate to severe fatigue in patients with HGG. In certain cases there may be benefit of armodafinil 150 mg to aid concentration without the risk of insomnia.Support: UG1CA189823;U10CA180868 (NRG). Clinical trial information: NCT01781468 .

Download Full-text