Other highlights in the February 2 JNCI

Despite some improvement since 1988, the majority of patients with colorectal cancer in 2001 received inadequate lymph node evaluation to see if their cancer had spread, according to a new study.

Lymph node status is the strongest predictor of outcome for colorectal cancer patients. Only 40% of patients with lymph node metastases will survive for 5 years after diagnosis compared with 68% of patients with no metastases. Detection of lymph node metastases, therefore, is important for predicting patient outcomes and ensuring that patients receive necessary treatment. Current guidelines recommend that a minimum of 12 lymph nodes be examined to ensure adequate sampling.

To determine if colorectal cancer patients receive adequate lymph node evaluation, Nancy N. Baxter, M.D., Ph.D., of the University of Minnesota in Minneapolis, and colleagues examined data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. They looked at lymph node evaluations from nearly 117,000 adults who had been diagnosed with colorectal cancer between 1988 and 2001. Only 37% of patients had received adequate lymph node evaluation--i.e., 12 or more lymph nodes examined. However, the proportion of patients who received adequate lymph node evaluation increased over time, from 32% in 1988 to 44% in 2001.

"Further research should evaluate factors associated with increased lymph node retrieval and should assess intervention strategies to ensure proper surgical care and pathologic assessment," the authors write.

Contact: Mary Lawson, University of Minnesota Cancer Center, 612-624-6165, mlawson@umn.edu

Rises in Obesity and Malignant Lymphomas Not Related, Study Concludes

Obesity is not associated with an increased risk of malignant lymphomas, according to a new study.

The recent worldwide increases in both obesity and non-Hodgkin lymphoma have led some researchers to suggest that the former might explain the latter. However, studies seeking evidence that obesity might increase the risk of non-Hodgkin lymphoma have had mixed results.

Ellen T. Chang, Sc.D., of the Karolinska Institute in Stockholm, Sweden, and colleagues conducted a population-based case–control study of 3,055 non-Hodgkin lymphoma patients, 618 Hodgkin lymphoma patients, and 3,187 control subjects. They found no association between body mass index and overall risk of either non-Hodgkin or Hodgkin lymphomas.

The authors conclude that the growing incidence in obesity is unlikely to explain the increasing incidence worldwide of non-Hodgkin lymphoma.

Contact: Ellen Chang, Karolinska Institute, 781-643-6765, ellen.chang.meb.ki.se

Study Examines Reason Behind High Cure Rate of Down Syndrome Children With Type of Leukemia

After treatment with chemotherapy regimens that include the drug cytosine arabinoside, children with Down syndrome who have acute myeloid leukemia (AML) have much higher survival rates and lower rates of relapse than non-Down syndrome AML patients. A new study has found that a gene mutation commonly found in Down syndrome children with a type of AML called acute megakaryocytic leukemia (AMkL), the predominant subtype of AML in these children, may be responsible for the survival difference.

Jeffrey W. Taub, M.D., of Children's Hospital of Michigan and the Barbara Ann Karmanos Cancer Institute, both in Detroit, and colleagues found that a protein encoded by the GATA1 gene transcriptionally upregulates cytidine deaminase, an enzyme that transforms cytosine arabinoside into an inactive metabolite. GATA1 is nearly always mutated in Down syndrome children with AMkL but not in non-Down syndrome AML patients. The authors conclude that this difference might explain why Down syndrome AMkL patients are more sensitive to the drug and respond better than non-Down syndrome AML patients.

Contact: Kelly C. Scheer, Public Relations, Barbara Ann Karmanos Cancer Institute, 313-966-0872, scheerk@karmanos.org

Use of Imaging in Assessing Angiogenesis Drugs Reviewed

Designing clinical trials of angiogenesis drugs--drugs intended to cut off the growth of tumors' blood vessels--is difficult because it can take a long time for a drug's effect to be observed. Because antiangiogenic and antineovascular therapies are designed to affect the abnormal blood vessels found in tumors, changes in factors, such as blood volume and blood flow, may be promising biomarkers that herald a positive clinical response to therapy.

In a review article, Janet C. Miller, D.Phil., of Massachusetts General Hospital in Boston, and colleagues examine the validity and reproducibility of different imaging methods, including magnetic resonance imaging, optical imaging, positron emission tomography, ultrasound, and x-ray computed tomography, that have been used for imaging angiogenic vasculature.

Contact: Susan R. McGreevey, Public Affairs Office, Massachusetts General Hospital, 617-724-2764, smcgreevey@partners.org

Also in the February 2 JNCI: