R. Jeffrey Lee
LDS Hospital
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Featured researches published by R. Jeffrey Lee.
International Journal of Radiation Oncology Biology Physics | 2003
David K. Gaffney; Derek Haslam; Alex Tsodikov; Elizabeth H. Hammond; James Seaman; Joseph A. Holden; R. Jeffrey Lee; Karen Zempolich; Mark K. Dodson
PURPOSE The purpose of this study was to examine a variety of biomarkers in carcinoma of the cervix to better characterize (1). the natural history of the disease, (2). response to radiotherapy (RT), and (3). potential for new therapeutic strategies. MATERIALS AND METHODS Fifty-five patients with Stage IB-IVA carcinoma of the cervix, treated with definitive intent RT, and on whom tumor tissue blocks were available were included in this study. Charts were reviewed for clinical parameters and disease status. Immunohistochemistry was performed for epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), CD34, topoisomerase II alpha (topo-II), and cyclooxygenase-2 (COX-2). Univariate and multivariate Cox proportional hazards modeling was performed with disease-free survival (DFS) and overall survival (OS) as the end points. Biomarkers were evaluated for correlation between various prognostic factors. RESULTS In this series of 55 patients with carcinoma of the cervix treated with definitive RT, only stage was significant on univariate analysis for DFS (p < 0.0001). On univariate analysis, increasing FIGO stage (p < 0.0001) and membranous staining of EGFR (p < 0.037) indicated diminished OS. On multivariate analysis for DFS, COX-2, VEGF, and stage were significant (p = 0.012, p = 0.014, and p = 0.03, respectively), with increased expression indicating a worse prognosis. For OS, multivariate analysis revealed that VEGF, EGFR, and FIGO stage were significant (p = 0.005, p = 0.011, and p < 0.0001, respectively). Significant direct correlations were identified between VEGF and CD34 (p = 0.04), COX-2 and topo-II (p = 0.04), COX-2 and grade (p = 0.04), and tumor size and clinical stage (p = 0.04). CONCLUSION Multivariate analysis revealed that increased staining for VEGF and COX-2 indicated diminished DFS, and VEGF and EGFR identified patients at increased risk of death. A significant direct correlation between VEGF and CD34 implicates the process of angiogenesis. Topo-II is a proliferative marker and it correlated directly with COX-2, indicating that expression of COX-2 may be greater in more proliferative tumors. Increased expression of EGFR, VEGF, and COX-2 has identified patients with a worse prognosis in cancer of the cervix. These data support the investigation of therapeutics that target these proteins in carcinoma of the cervix.
Urology | 1994
R. Jeffrey Lee; William T. Sause
OBJECTIVE To assess the long-term outcome of patients with lymphadenectomy-staged prostate cancer treated with external beam radiotherapy. METHODS A retrospective analysis was performed on all patients with prostate cancer who underwent staging pelvic lymphadenectomy before treatment with definitive radiotherapy from 1970 to February 1978. This included 71 patients who were evaluated for a minimum of fifteen years. No patients were lost to follow-up. Thirty-five patients were node negative and 36 were node positive. RESULTS Fifteen-year actuarial overall survival, cause-specific survival, and local control for the 20 patients with clinically organ-confined disease (T1b-T2 N0M0) was 40 percent, 75 percent, and 92 percent, respectively. The results for the 15 T3 N0M0 patients were 15 percent, 22 percent, and 60 percent. Patients with positive nodes did much worse, with rates of 5 percent, 6 percent, and 45 percent. Thirty-four patients received hormonal therapy at the time of first failure. No patient who was clinically free of disease at fifteen years had an elevated level of prostate-specific antigen (PSA). CONCLUSIONS Our data suggest excellent results in a cohort of patients (T1b-T2 N0M0) treated with primary radiotherapy who would be considered candidates for radical prostatectomy. Outcome is significantly worse in patients with T3 lesions and node-positive disease.
Gynecologic Oncology | 2005
Christopher M. Lee; Dennis C. Shrieve; Karen Zempolich; R. Jeffrey Lee; Elizabeth H. Hammond; Diana L. Handrahan; David K. Gaffney
International Journal of Radiation Oncology Biology Physics | 2007
Jergin Chen; R. Jeffrey Lee; Diana Handrahan; William T. Sause
Gynecologic Oncology | 2004
Christopher M. Lee; R. Jeffrey Lee; Elizabeth H. Hammond; Alex Tsodikov; Mark K. Dodson; Karen Zempolich; David K. Gaffney
International Journal of Radiation Oncology Biology Physics | 2004
John K O'Connor; James M. Avent; R. Jeffrey Lee; Jennifer Fischbach; David K. Gaffney
Urology | 2007
Javier F. Torres-Roca; Michelle DeSilvio; Linda B. Mora; Li Yan Khor; Elizabeth H. Hammond; Nazeel Ahmad; Richard Jove; Jeffrey D. Forman; R. Jeffrey Lee; Howard M. Sandler; Alan Pollack
International Journal of Radiation Oncology Biology Physics | 2004
Jergin Chen; R. Jeffrey Lee; Alex Tsodikov; Lynn M. Smith; David K. Gaffney
International Journal of Radiation Oncology Biology Physics | 2006
John K. O’Connor; Lisa J. Hazard; James M. Avent; R. Jeffrey Lee; Jennifer Fischbach; David K. Gaffney
Urology | 2007
O. Kenneth Macdonald; R. Jeffrey Lee; Greg Snow; Christopher M. Lee; Anthony W. Middleton; George W. Middleton; William T. Sause