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Biomedical subjects

N H Gordon

Publications and source records attributed to N H Gordon.

7 recordsLinked to original sources
PubMed1992

Socioeconomic factors and race in breast cancer recurrence and survival.

The relation of breast cancer recurrence and overall survival to age, level of estrogen receptors, number of positive lymph nodes, obesity, race, socioeconomic status, and tumor size at the time of diagnosis was considered for 1,392 breast cancer patients (253 black, 1,132 white, and 7 of other races) entered into two multi-institutional prospective clinical trials. Baseline for the first trial was 1974-1979, and that for the second was 1980-1985; follow-up for this report ended in August 1990. Univariately, all factors except age and obesity were significantly related to disease-free survival, and all except age were significantly related to overall survival. A multivariate analysis using Cox's proportional hazards model indicated that a greater number of positive lymph nodes, a larger tumor diameter, lower socioeconomic status, and negative estrogen receptors were significantly related to shorter disease-free survival. After adjustment for socioeconomic status, race ceased to be a significant indicator of either disease-free survival or overall survival. Patients of either race who are of a lower socioeconomic status are more likely to have a recurrence and to die of breast cancer.

Black or African American↗
PubMed1992

Primary tumor size. Relevance to breast cancer survival.

In view of current emphasis on identifying prognostic factors for patients with early breast cancer, we studied the importance of tumor size to survival among 1392 patients with primary operable breast cancer who were followed up prospectively. All patients had modified radical mastectomies. Nine hundred seventeen patients had negative nodes and did not receive postoperative adjuvant therapy. Four hundred seventy-five patients had node involvement and received combination chemoendocrine therapy. In a Cox's proportional hazards model, tumor size was a significant predictor of disease-free and overall survival when the number of positive nodes, estrogen receptor status, menopausal status, and race were considered. Among the node-negative group, tumor size explained considerable variation in disease-free and overall survival, varying from a 10-year disease-free and overall survival of 80% and 99% for patients with estrogen receptor-positive tumors measuring 1 cm or less to a 10-year disease-free and overall survival of 51% and 59% for patients with tumors larger than 5 cm.

Aged↗
PubMed1992

Using toxicity grades in the design and analysis of cancer phase I clinical trials.

Ethical considerations in a cancer phase I trial require a design allowing determination of the maximum tolerated dose with a minimum number of patients treated at low ineffectual or high overly toxic doses. It would also be advantageous to complete the phase I trial in as short a period of time and with as few patients as possible to allow further resources for later studies in which patients are treated at the optimal dose. Several dose escalation schemes are compared. These are the Fibonacci, two two-stage schemes, and a proposed scheme which uses knowledge of all toxicity grades. Estimates of the maximum tolerated dose are obtained and compared using the dose escalation schemes alone, a logit model, and a proposed mean response model. Confidence intervals using the delta method are obtained from the logit and mean response models. The proposed scheme and the two-stage schemes have the advantage of requiring fewer patients, particularly at low doses. Confidence intervals obtained from the mean response model have better coverage than those from the logit model. Data from a cancer phase I trial of dipyridamole and acivicin is presented to illustrate the methods.

Antineoplastic Agents↗
PubMed1991

Estrogen receptor determination and long term survival of patients with carcinoma of the breast.

To investigate whether or not hormone receptor determination gives independent prognostic information for long term survival of patients with carcinoma of the breast, we studied 1,392 patients with early carcinoma of the breast. Patients were part of two prospective, multi-institutional trials, the first begun in 1974 and the second in 1980. Estrogen receptor assays were performed on all primary specimens taken of the carcinoma of the breast. Initial treatment for all patients was a modified radical mastectomy. Nine hundred and seventeen patients had negative axillary nodes and were observed without additional therapy. Four hundred and seventy-five had positive nodes and were randomized to receive combination chemoendocrine adjuvant therapy. One thousand and sixty-three (76.4 per cent) of the patients were found to have estrogen receptor positive (ER+) tumors (greater than or equal to 3 femtomoles per milligram cytosol of protein). The ten year over-all survival rate of 65.9 per cent was significantly better than that of 329 (23.6 per cent) patients with estrogen receptor negative (ER-) tumors (less than 3 femtomoles per milligram cytosol protein), who had a ten year over-all survival rate of 56.0 per cent (p = 0.0001). Higher estrogen receptor values were associated with Caucasian (p = 0.0001) and postmenopausal patients (p = 0.0001). In a proportional hazards regression model, patients with ER+ tumors had a significantly longer over-all survival period (p = 0.0001), but only a marginally improved disease-free survival time (p = 0.07) when compared with patients who had ER- tumors. These results indicate that ER determination does have prognostic value for long term over-all survival of patients with carcinoma of the breast. The greater importance of ER analysis to over-all compared with disease-free survival may be related to more easily managed recurrent disease among the ER+ group.

Aged↗
PubMed1978

Comparative assessment of fenoprofen and paracetamol given in combination for pain after surgery.

In a double-blind study of patients suffering from pain after surgery, fenoprofen 200 mg and paracetamol 500 mg was compared with each drug given separately and with a placebo. There was a significant difference between the combination and the placebo, whereas, separately, the drugs were only marginally better than the placebo in relieving pain. There was a significant linear trend indicating a better clinical result as the number of active components in the regimen was increased.

Acetaminophen↗
PubMed1977

Forced expiratory flow-volume relationships. Changes after upper abdominal surgery.

Forced expiratory flow-volume relationships have been used to investigate changes in lung mechanics caused by upper abdominal operations. The slope of the 'effort independent' portion of the flow-volume curve increases after operation, suggesting that restriction of respiratory movement is associated with an increase in lung recoil.

Abdomen↗