We evaluated in 74 patients with resectable primary gastric carcinoma, the prognostic value of the preoperative circulating serum levels of CEA and TAG-72. Serum levels of CEA were above the cutoff level of 6 ng/ml in 18.9% of patients; TAG-72 levels were higher than 6 U/ml in 31% of patients. Pretreatment mean CEA levels were significantly lower (p < 0.01) in patients with stage I tumors (2.9 +/- 0.3 ng/ml) than in those with more advanced tumors (stage II: 14.5 +/- 6.8 ng/ml; stage III-IV: 6.8 +/- 1.5 ng/ml). Similarly, significant differences in mean TAG-72 serum levels were found between stage I (3.5 +/- 1.8 U/ml) and stage II and stage III-IV (30.4 +/- 20.7 U/ml and 26.1 +/- 9.7 U/ml, respectively) (p < 0.05). In addition, TAG-72 levels were also higher in poorly differentiated and moderately differentiated tumors (38.5 +/- 20.1 U/ml and 23.1 +/- 9.4 U/ml, respectively) than in well differentiated tumors (4.4 +/- 0.9 U/ml) (p < 0.05). The results further indicated that high preoperative serum levels of CEA predicted shorter relapse-free survival duration (p < 0.01), and that high TAG-72 levels were associated with shorter relapse-free and overall survival (p < 0.0001 and p < 0.0005, respectively). In addition, separate Cox multivariate analysis showed that preoperative TAG-72 was, after stage, the strongest factor to predict both relapse-free and overall survival (p < 0.0001 and p < 0.005, respectively) in patients with gastric cancer.
This Galician consensus statement is a joint oncologists/cardiologists initiative indented to establish basic recommendations on how to prevent and to manage the cardiotoxicity in breast cancer with the aim of ensuring an optimal cardiovascular care of these patients. A clinical screening of the patients before treatment is recommended to stratify them into a determined risk group based on their intrinsic cardiovascular risk factors and those extrinsic arose from breast cancer therapy, thereby providing individualized preventive and monitoring measures. Suitable initial and ongoing assessments for patients with low and moderate/high risk and planned treatment with anthracyclines and trastuzumab are given; also, measures aimed at preventing and correcting any modifiable risk factor are pointed out .
A dose-dense schedule of docetaxel followed by AC as neoadjuvant treatment is an effective and safe treatment for locally advanced breast cancer. Primary prophylaxis with G-CSF, and possibly the change in the sequence of drug administration, appears to play a major role in avoiding the excessive toxicity of dose-dense schedules.
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