Bernard S. Aron

PURPOSE: To compare sequential methotrexate (M) and fluorouracil (F) (M-->F) with surgery (National Surgical Adjuvant Breast and Bowel Project [NSABP] B-13) and cyclophosphamide (C), M, and F with M-->F (NSABP B-19), in patients with estrogen receptor (ER)-negative tumors and negative axillary nodes. PATIENTS AND METHODS: A total of 760 patients were randomized to B-13; 1,095 patients with the same eligibility requirements were randomized to B-19. Disease-free survival (DFS), distant disease-free survival (DDFS), and survival were determined using life-table estimates. RESULTS: A significant benefit in overall DFS (74% v 59%; P < .001) was demonstrated at 8 years in all B-13 patients who received M-->F (69% v 56% [P = .006] in those <or= 49 years of age, and 81% v 63% [P = .002] in those >or= 50 years). A survival advantage was evident in older patients (89% v 80%; P = .03). In B-19, through 5 years, an overall DFS advantage (82% v 73%; P < .001) and a borderline survival advantage (88% v 85%; P = .06) were evident with CMF. The DFS (84% v 72%; P < .001) and survival (89% v 84%; P = .04) benefits from CMF were greater in women aged <or= 49 years. M-->F or CMF after lumpectomy and breast irradiation resulted in a low probability of ipsilateral breast tumor recurrence (IBTR). In B-13, the frequency of IBTR was 2.6% following M-->F versus 13.4% in women treated by lumpectomy; it was 0.6% following CMF in B-19. Toxicity >or= grade 3 was more frequent among CMF patients in B-19. The age-related difference in CMF benefit was not related to amount of drug received. CONCLUSION: M-->F and CMF are effective for node-negative patients with ER-negative tumors. The incidence of local-regional or distant metastases and IBTR decreased after either therapy. The benefit from either therapy was evident in all patients, but the CMF advantage was greater in those <or= 49 years. Because it is less toxic, M-->F may be used in patients with medical problems that would preclude CMF administration.

BACKGROUND: The incidence of cancers after renal transplantation is significantly higher than in populations that have not undergone transplantation. The authors report a group of renal transplant patients from the University of Cincinnati who had cancer develop; the focus is on the patients' clinical course. METHODS: Since 1968, 876 renal transplantations have been performed for a variety of causes of end stage renal disease. Charts of transplant patients who had neoplasms were reviewed. RESULTS: Forty-four patients had epithelial skin cancers, and 36 had nonskin cancers or melanoma. No correlations could be established between disease course and type of immunosuppressive agent, type of disease for which transplantation was required, or type of renal allograft donor. The skin cancers demonstrated a propensity for multifocality: 22 of the 44 patients had multiple separate lesions develop. Of the patients with cancer not of the skin, six were treated surgically for carcinoma in situ, and none have experienced disease recurrence. Of 11 patients treated for early invasive disease, 6 are disease-free, 3 died of intercurrent disease, and 2 died of progressive disease 11 and 13 months, respectively, after disease diagnosis. Nineteen patients had advanced disease, and only 1 is alive and disease-free. Sixteen died of progressive disease at a median of 1 month from the time of diagnosis, and 2 died of intercurrent disease within 1 week of diagnosis. CONCLUSIONS: The natural history of cancers developing in renal transplant patients often is more aggressive than would be expected in patients who have not undergone transplants. The immunosuppression induced to allow viability of the renal allograft may allow tumor cells to thrive.

Four cases of radiation-associated gliomas are described. All patients were white men, irradiated in childhood for craniopharyngioma, anaplastic ependymoma, retinoblastoma of the orbit, and Burkitt's lymphoma, respectively. The dose ranged from 1800 to 5900 rads, and the latency period was 5 to 25 years. All primary and secondary tumors were verified histologically, and no evidence of persistence of the primary tumors was found. All secondary tumors arose in the fields of irradiation. Ninety-six cases of radiation-induced tumors of the central nervous system have been reported in the literature to date. Twenty-four were gliomas and occurred mainly in young men.

No AccessJournal of UrologyPediatric Urology1 Apr 1974Renal Adenocarcinoma in Children: Incidence, Therapy and Prognosis Ronald D. Castellanos, Bernard S. Aron, and Arthur T. Evans Ronald D. CastellanosRonald D. Castellanos , Bernard S. AronBernard S. Aron , and Arthur T. EvansArthur T. Evans View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)60009-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1974 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byASANUMA H, NAKAI H, TAKEDA M, SHISHIDO S, TAJIMA E, KAWAMURA T, HARA H, MORIKAWA Y and KAWAMURA T (2018) RENAL CELL CARCINOMA IN CHILDREN: EXPERIENCE AT A SINGLE INSTITUTION IN JAPANJournal of Urology, VOL. 162, NO. 4, (1402-1405), Online publication date: 1-Oct-1999.Freedman A, Vates T, Stewart T, Padiyar N, Perlmutter A and Smith C (2018) Renal Cell Carcinoma in Children: The Detroit ExperienceJournal of Urology, VOL. 155, NO. 5, (1708-1710), Online publication date: 1-May-1996.Goto S, Ikeda K, Nakagawara A, Daimaru Y, Tsuneyoshi M and Enjoji M (2018) Renal Cell Carcinoma in Japanese ChildrenJournal of Urology, VOL. 136, NO. 6, (1261-1263), Online publication date: 1-Dec-1986.Lack E, Cassady J and Sallan S (2018) Renal Cell Carcinoma in Childhood and Adolescence: A Clinical and Pathological Study of 17 CasesJournal of Urology, VOL. 133, NO. 5, (822-828), Online publication date: 1-May-1985.Weiss J, Rosenberg H, Borden S, Meadows A, Chatten J, Duckett J and Snyderv H (2018) Rapidly Expanding Right Renal Mass in a 12-Year-Old BoyJournal of Urology, VOL. 133, NO. 2, (254-257), Online publication date: 1-Feb-1985.Skinner D (2018) Editorial CommentJournal of Urology, VOL. 125, NO. 2, (168-168), Online publication date: 1-Feb-1981.Lieber M, Tomera F, Taylor W and Farrow G (2018) Renal Adenocarcinoma in Young Adults: Survival and Variables Affecting PrognosisJournal of Urology, VOL. 125, NO. 2, (164-168), Online publication date: 1-Feb-1981.J.W.D. (2018) Editorial CommentJournal of Urology, VOL. 121, NO. 3, (366-366), Online publication date: 1-Mar-1979.Shah K, Wasan S and Lott S (2018) Wilms Tumor in AdolescenceJournal of Urology, VOL. 121, NO. 3, (365-366), Online publication date: 1-Mar-1979.Cummings K (2018) Editorial CommentJournal of Urology, VOL. 121, NO. 1, (94-94), Online publication date: 1-Jan-1979.Abrams H, Buchbinder M and Sutton A (2018) Renal Carcinoma in AdolescentsJournal of Urology, VOL. 121, NO. 1, (92-94), Online publication date: 1-Jan-1979.Patel N and Lavengood R (2018) Renal Cell Carcinoma: Natural History and Results of TreatmentJournal of Urology, VOL. 119, NO. 6, (722-726), Online publication date: 1-Jun-1978.Amarjit S, Singh A, Sehgal R and Kaur B (2018) Bilateral Hypernephroma in a ChildJournal of Urology, VOL. 118, NO. 2, (323-324), Online publication date: 1-Aug-1977.Fisher R, Granmayeh M, Wallace S and Johnson D (2018) Renal Adenocarcinoma in Adolescence and Childhood: Emphasis on Angiographic FindingsJournal of Urology, VOL. 118, NO. 1 Part 1, (83-86), Online publication date: 1-Jul-1977.Wyatt R, William McRoberts J and Holland N (2018) Hematuria in Childhood: Significance and ManagementJournal of Urology, VOL. 117, NO. 3, (366-368), Online publication date: 1-Mar-1977. Volume 111Issue 4April 1974Page: 534-537 Advertisement Copyright & Permissions© 1974 by The American Urological Association Education and Research, Inc.Metrics Author Information Ronald D. Castellanos American Cancer Society Clinical Fellow. More articles by this author Bernard S. Aron More articles by this author Arthur T. Evans More articles by this author Expand All Advertisement PDF downloadLoading ...