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Sample records for radioassisted oncological surgery

  1. An improved hand-held four-detector gamma-probe for radioassisted oncological surgery

    CERN Document Server

    Dusi, W; Bollini, D; Moroni, C; Ricard, M

    2000-01-01

    The performance of an improved intraoperative gamma-probe for radioassisted oncological surgery is presented and discussed. The probe is based on a square array of four 5x5 mm sup 2 coplanar CdTe room temperature semiconductor detectors and each detector has an independent read out electronic chain, allowing an original handling of the signal. Therefore, the search for gamma-emission hot points may be carried out in two different, independent ways: (1) Finding out the position of the probe corresponding to the maximum value of the total counting rate, on the basis of a trial and error procedure (typical for the conventional probe; (2) Finding out the position of the probe where both the differences between the counting rate performed by orthogonal, adjacent halves of the array vanish (differential method). This makes the new probe sensitive to the bidimensional gradient of the gamma-ray flux, measured on the scanned plane. Furthermore, the algebraic sign of the difference indicates in which direction the prob...

  2. Robot-assisted surgery in gynecological oncology

    DEFF Research Database (Denmark)

    Kristensen, Steffen E; Mosgaard, Berit J; Rosendahl, Mikkel

    2017-01-01

    INTRODUCTION: Robot-assisted surgery has become more widespread in gynecological oncology. The purpose of this systematic review is to present current knowledge on robot-assisted surgery, and to clarify and discuss controversies that have arisen alongside the development and deployment. MATERIAL...... was performed by screening of titles and abstracts, and by full text scrutiny. From 2001 to 2016, a total of 76 references were included. RESULTS: Robot-assisted surgery in gynecological oncology has increased, and current knowledge supports that the oncological safety is similar, compared with previous...

  3. Approaching airways in oncology surgery of the head and neck

    International Nuclear Information System (INIS)

    Lopez Rabassa, Sahily Irene; Diaz Mediondo, Miosotis; Diez Sanchez, Yanelys

    2013-01-01

    A descriptive prospective study was conducted in 'Maria Curie' Oncology Teaching Provincial Hospital during the period from January 2010 to December 2010. The sample included 210 patients studied with the purpose of identifying morbimortality of the difficult airway in Oncology Surgery of the head and neck in our institution

  4. Oncology

    International Nuclear Information System (INIS)

    1998-01-01

    This paper collects some scientific research works on nuclear medicine developed in Ecuador. The main topics are: Brain metastases, computed tomography assessment; Therapeutic challenge in brain metastases, chemotherapy, surgery or radiotherapy; Neurocysticercosis and oncogenesis; Neurologic complications of radiation and chemotherapy; Cerebral perfusion gammagraphy in neurology and neurosurgery; Neuro- oncologic surgical patient anesthesic management; Pain management in neuro- oncology; Treatment of metastatic lesions of the spine, surgically decompression vs radiation therapy alone; Neuroimagining in spinal metastases

  5. Metabolic and oncological consequences of laparoscopic surgery

    NARCIS (Netherlands)

    N.D. Kannekens-Bouvy (Nicole)

    1997-01-01

    textabstractIn 1986, Philip Mouret and his colleagues performed the first laparoscopic cholecystectomy. They initiated the most revolutionary change in traditional surgery, since the introduction of anaesthesia, asepsis, antibiotics and blood-transfusion. At the same time, industry propelled this

  6. Soft Tissue Coverage of the Lower Limb following Oncological Surgery.

    Science.gov (United States)

    Radtke, Christine; Panzica, Martin; Dastagir, Khaled; Krettek, Christian; Vogt, Peter M

    2015-01-01

    The treatment of lower limb tumors has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For the development of a comprehensive surgical plan, the identity of the tumor should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumor board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncological surgery will be described along with the five clinical cases.

  7. Soft tissue coverage of the lower limb following oncological surgery

    Directory of Open Access Journals (Sweden)

    Christine eRadtke

    2016-01-01

    Full Text Available The treatment of lower limb tumours has been shifted by advancements in adjuvant treatment protocols and microsurgical reconstruction from limb amputation to limb salvage. Standard approaches include oncological surgery by a multidisciplinary team in terms of limb sparing followed by soft tissue reconstruction and adjuvant therapy when indicated. For development of a comprehensive surgical plan, the identity of the tumour should first be determined by histology after biopsy. Then the surgical goal and comprehensive treatment concept should be developed by a multidisciplinary tumour board and combined with soft tissue reconstruction. In this article, plastic surgical reconstruction options for soft coverage of the lower extremity following oncologic surgery will be described along with five clinical cases.

  8. New applications of radio guided surgery in oncology

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    Bitencourt, Almir Galvao Vieira; Pinto, Paula Nicole Vieira; Martins, Eduardo Bruno Lobato; Chojniak, Rubens [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Image], e-mail: almirgvb@yahoo.com.br; Lima, Eduardo Nobrega Pereira [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Nuclear Medicine

    2009-07-01

    Objective: To report oncological cases (excluding those related to breast cancer) for which radioguided surgery has been used in combination with the Radioguided Occult Lesion Localization technique. Introduction: Radioguided surgery enables a surgeon to identify lesions or tissues that have been preoperatively marked with radioactive substances. The Radioguided Occult Lesion Localization technique has been widely used to identify the sentinel lymph node and occult lesions in patients with breast cancer. However, few studies have reported the use of this technique for non-breast cancer pathologies. Methodology: In all cases, injection of Technetium-99m sulfur colloid was performed, directly inside or near by the suspicious lesion, guided by ultrasound or computed tomography, up to 36 hours prior to the surgical procedure. Intraoperative lesion detection was carried out using a gamma-probe. Results: We report five oncology cases in which preoperative markings of the lesions were carried out using the Radioguided Occult Lesion Localization technique. The patients presented with the following: recurrence of renal cell carcinoma, cervical recurrence of papillary carcinoma of the thyroid, recurrence of retroperitoneal sarcoma, lesions of the popliteal fossa, and recurrence of rhabdomyosarcoma of a thigh. In each case, the lesions that were marked preoperatively were ultimately successfully excised. Conclusions: Radioguided surgery has proven to be a safe and effective alternative for the management of oncology patients. The Radioguided Occult Lesion Localization technique can be useful in selected cases where suspect lesions may be difficult to identify intraoperatively, due to their dimensions or anatomical location. The procedure allows for more conservative excisions and reduces the surgery-related morbidity. (author)

  9. [Economic aspects of oncological esophageal surgery : Centralization is essential].

    Science.gov (United States)

    von Dercks, N; Gockel, I; Mehdorn, M; Lorenz, D

    2017-01-01

    The incidence of esophageal carcinoma has increased in recent years in Germany. The aim of this article is a discussion of the economic aspects of oncological esophageal surgery within the German diagnosis-related groups (DRG) system focusing on the association between minimum caseload requirements and outcome quality as well as costs. The margins for the DRG classification G03A are low and quickly exhausted if complications determine the postoperative course. A current study using nationwide German hospital discharge data proved a significant difference in hospital mortality between clinics with and without achieving the minimum caseload requirements for esophagectomy. Data from the USA clearly showed that besides patient-relevant parameters, the caseload of a surgeon is relevant for the cost of treatment. Such cost-related analyses do not exist in Germany at present. Scientific validation of reliable minimum caseload numbers for oncological esophagectomy is desirable in the future.

  10. Transoral laser surgery for laryngeal carcinoma: has Steiner achieved a genuine paradigm shift in oncological surgery?

    Science.gov (United States)

    Harris, A T; Tanyi, A; Hart, R D; Trites, J; Rigby, M H; Lancaster, J; Nicolaides, A; Taylor, S M

    2018-01-01

    Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO 2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predominantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase 'paradigm shift' in his groundbreaking book The Structure of Scientific Revolutions. He argued that the arrival of the new and often incompatible idea forms the core of a new paradigm, the birth of an entirely new way of thinking. This article discusses whether Steiner and colleagues truly brought about a paradigm shift in oncological surgery. By rejecting the principle of en block resection and by replacing it with the belief that not only is it oncologically safe to cut through the substance of the tumour but in doing so one can actually achieve better results, Steiner was able to truly revolutionise the management of laryngeal cancer. Even though within this article the repercussions of his insight are limited to the upper aerodigestive tract oncological surgery, his willingness to question other peoples' dogma makes his contribution truly a genuine paradigm shift.

  11. Real-time Fluorescence Image-Guided Oncologic Surgery

    Science.gov (United States)

    Mondal, Suman B.; Gao, Shengkui; Zhu, Nan; Liang, Rongguang; Gruev, Viktor; Achilefu, Samuel

    2014-01-01

    Medical imaging plays a critical role in cancer diagnosis and planning. Many of these patients rely on surgical intervention for curative outcomes. This requires a careful identification of the primary and microscopic tumors, and the complete removal of cancer. Although there have been efforts to adapt traditional imaging modalities for intraoperative image guidance, they suffer from several constraints such as large hardware footprint, high operation cost, and disruption of the surgical workflow. Because of the ease of image acquisition, relatively low cost devices and intuitive operation, optical imaging methods have received tremendous interests for use in real-time image-guided surgery. To improve imaging depth under low interference by tissue autofluorescence, many of these applications utilize light in the near-infra red (NIR) wavelengths, which is invisible to human eyes. With the availability of a wide selection of tumor-avid contrast agents, advancements in imaging sensors, electronic and optical designs, surgeons are able to combine different attributes of NIR optical imaging techniques to improve treatment outcomes. The emergence of diverse commercial and experimental image guidance systems, which are in various stages of clinical translation, attests to the potential high impact of intraoperative optical imaging methods to improve speed of oncologic surgery with high accuracy and minimal margin positivity. PMID:25287689

  12. Aspirin for Prophylaxis Against Venous Thromboembolism After Orthopaedic Oncologic Surgery.

    Science.gov (United States)

    Mendez, Gregory M; Patel, Yash M; Ricketti, Daniel A; Gaughan, John P; Lackman, Richard D; Kim, Tae Won B

    2017-12-06

    Patients who undergo orthopaedic oncologic surgical procedures are at increased risk of developing a venous thromboembolism (VTE). Guidelines from surgical societies are shifting to include aspirin as a postoperative VTE prophylactic agent. The purpose of this study was to review our experience using aspirin as postoperative VTE prophylaxis for orthopaedic oncologic surgical procedures. This study was a retrospective review of patients diagnosed with a primary malignant soft-tissue or bone tumor or metastatic carcinoma. Demographic information, histopathologic diagnosis, VTE history, surgical procedure, and VTE prophylaxis were analyzed. VTE rates in the overall and prophylactic-specific cohorts were recorded and compared. A total of 142 distinct surgical procedures in 130 patients were included. VTE prophylaxis with aspirin was used after 103 procedures, and non-aspirin prophylaxis was used after 39. In 33 cases, imaging was used to investigate for VTE because of clinical signs and symptoms. VTE developed after 7 (4.9%) of the 142 procedures. There were 6 deep venous thromboses (DVTs) and 1 pulmonary embolism, and 2 of the VTEs presented in patients with a VTE history. VTE developed in 2.9% (3) of the 103 aspirin cases and 10.3% (4) of the 39 non-aspirin cases. No patient in the aspirin group who had been diagnosed with metastatic carcinoma, malignant soft-tissue sarcoma, lymphoma, or multiple myeloma developed a VTE. Risk factors for VTE development included diabetes mellitus (odds ratio [OR] = 10.40, 95% confidence interval [CI] = 1.61 to 67.30), a history of VTE (OR = 7.26, 95% CI = 1.19 to 44.25), postoperative transfusion (OR = 34.50, 95% CI = 3.94 to 302.01), and estimated blood losses of 250 mL (OR = 1.50, 95% CI = 1.11 to 2.03), 500 mL (OR = 2.26, 95% CI = 1.23 to 4.13), and 1,000 mL (OR = 5.10, 95% CI = 1.52 to 17.04). Aspirin may be a suitable and effective option for VTE chemoprophylaxis in patients treated with orthopaedic oncologic surgery, especially

  13. Computer-assisted surgery in orthopedic oncology : Technique, indications, and a descriptive study of 130 cases

    NARCIS (Netherlands)

    Gerbers, Jasper G.; Stevens, Martin; Ploegmakers, Joris J. W.; Bulstra, Sjoerd K.; Jutte, Paul C.

    2014-01-01

    Background and purpose - In orthopedic oncology, computerassisted surgery (CAS) can be considered an alternative to fluoroscopy and direct measurement for orientation, planning, and margin control. However, only small case series reporting specific applications have been published. We therefore

  14. Does robotics improve minimally invasive rectal surgery? Functional and oncological implications.

    Science.gov (United States)

    Guerra, Francesco; Pesi, Benedetta; Amore Bonapasta, Stefano; Perna, Federico; Di Marino, Michele; Annecchiarico, Mario; Coratti, Andrea

    2016-02-01

    Robot-assisted surgery has been reported to be a safe and effective alternative to conventional laparoscopy for the treatment of rectal cancer in a minimally invasive manner. Nevertheless, substantial data concerning functional outcomes and long-term oncological adequacy is still lacking. We aimed to assess the current role of robotics in rectal surgery focusing on patients' functional and oncological outcomes. A comprehensive review was conducted to search articles published in English up to 11 September 2015 concerning functional and/or oncological outcomes of patients who received robot-assisted rectal surgery. All relevant papers were evaluated on functional implications such as postoperative sexual and urinary dysfunction and oncological outcomes. Robotics showed a general trend towards lower rates of sexual and urinary postoperative dysfunction and earlier recovery compared with laparoscopy. The rates of 3-year local recurrence, disease-free survival and overall survival of robotic-assisted rectal surgery compared favourably with those of laparoscopy. This study fails to provide solid evidence to draw definitive conclusions on whether robotic systems could be useful in ameliorating the outcomes of minimally invasive surgery for rectal cancer. However, the available data suggest potential advantages over conventional laparoscopy with reference to functional outcomes. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  15. Current concepts in oncologic surgery in small animals.

    Science.gov (United States)

    Matz, Brad M

    2015-05-01

    Surgical oncology is experiencing rapid transition in veterinary medicine. Mast cell tumors and soft tissue sarcomas are two of the most common neoplasms in small animal patients. Clinicians should be familiar with the need for staging and the procedures involved in treating patients with these tumors. Clinicians should be comfortable with available adjuvant therapies and when to use them in certain patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. The need for more workshops in laparoscopic surgery and surgical anatomy for European gynaecological oncology trainees

    DEFF Research Database (Denmark)

    Manchanda, Ranjit; Halaska, Michael J; Piek, Jurgen M

    2013-01-01

    OBJECTIVE: The objective of this study was to highlight the relative preference of European gynecologic oncology trainees for workshops that could support and supplement their training needs. METHODS: A Web-based survey was sent to 900 trainees on the European Network of Young Gynaecological...... to the survey, giving a 21% response rate. The 3 most important topics reported were laparoscopic surgery; surgical anatomy, and imaging techniques in gynecologic oncology. The Dendron plot indicated 4 different clusters of workshops (research related skills, supportive ancillary skills, related nonsurgical...... questionnaire was 0.78, which suggests good internal consistency/reliability. CONCLUSIONS: This report for the first time highlights the relative importance and significance European trainees attach to some of their training needs in gynecologic oncology. Laparoscopic surgery, surgical anatomy, and imaging...

  17. REPORT ON FIRST INTERNATIONAL WORKSHOP ON ROBOTIC SURGERY IN THORACIC ONCOLOGY

    Directory of Open Access Journals (Sweden)

    Giulia Veronesi

    2016-10-01

    Full Text Available A workshop of experts from France, Germany, Italy and the United States took place at Humanitas Research Hospital Milan, Italy, on 10-11 February 2016, to examine techniques for and applications of robotic surgery to thoracic oncology. The main topics of presentation and discussion were: robotic surgery for lung resection; robot-assisted thymectomy; minimally invasive surgery for esophageal cancer; new developments in computer-assisted surgery and medical applications of robots; the challenge of costs; and future clinical research in robotic thoracic surgery. The following article summarizes the main contributions to the workshop. The Workshop consensus was that, since video-assisted thoracoscopic surgery (VATS is becoming the mainstream approach to resectable lung cancer in North America and Europe, robotic surgery for thoracic oncology is likely to be embraced by an increasing numbers of thoracic surgeons, since it has technical advantages over VATS, including intuitive movements, tremor filtration, more degrees of manipulative freedom, motion scaling, and high definition stereoscopic vision. These advantages may make robotic surgery more accessible than VATS to trainees and experienced surgeons, and also lead to expanded indications. However the high costs of robotic surgery and absence of tactile feedback remain obstacles to widespread dissemination. A prospective multicentric randomized trial (NCT02804893 to compare robotic and VATS approaches to stage I and II lung cancer will start shortly.

  18. Report on First International Workshop on Robotic Surgery in Thoracic Oncology.

    Science.gov (United States)

    Veronesi, Giulia; Cerfolio, Robert; Cingolani, Roberto; Rueckert, Jens C; Soler, Luc; Toker, Alper; Cariboni, Umberto; Bottoni, Edoardo; Fumagalli, Uberto; Melfi, Franca; Milli, Carlo; Novellis, Pierluigi; Voulaz, Emanuele; Alloisio, Marco

    2016-01-01

    A workshop of experts from France, Germany, Italy, and the United States took place at Humanitas Research Hospital Milan, Italy, on February 10 and 11, 2016, to examine techniques for and applications of robotic surgery to thoracic oncology. The main topics of presentation and discussion were robotic surgery for lung resection; robot-assisted thymectomy; minimally invasive surgery for esophageal cancer; new developments in computer-assisted surgery and medical applications of robots; the challenge of costs; and future clinical research in robotic thoracic surgery. The following article summarizes the main contributions to the workshop. The Workshop consensus was that since video-assisted thoracoscopic surgery (VATS) is becoming the mainstream approach to resectable lung cancer in North America and Europe, robotic surgery for thoracic oncology is likely to be embraced by an increasing numbers of thoracic surgeons, since it has technical advantages over VATS, including intuitive movements, tremor filtration, more degrees of manipulative freedom, motion scaling, and high-definition stereoscopic vision. These advantages may make robotic surgery more accessible than VATS to trainees and experienced surgeons and also lead to expanded indications. However, the high costs of robotic surgery and absence of tactile feedback remain obstacles to widespread dissemination. A prospective multicentric randomized trial (NCT02804893) to compare robotic and VATS approaches to stages I and II lung cancer will start shortly.

  19. Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes.

    Science.gov (United States)

    Araujo, Sergio Eduardo Alonso; Seid, Victor Edmond; Klajner, Sidney

    2014-10-21

    Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and stable view, articulated instruments, and reduction of physiologic tremors leading to superior dexterity and ergonomics. Therefore, robotic platforms could potentially address limitations of laparoscopic rectal surgery. It was aimed at reviewing current literature on short-term clinical and oncological (pathological) outcomes after robotic rectal cancer surgery in comparison with laparoscopic surgery. A systematic review was performed for the period 2002 to 2014. A total of 1776 patients with rectal cancer underwent minimally invasive robotic treatment in 32 studies. After robotic and laparoscopic approach to oncologic rectal surgery, respectively, mean operating time varied from 192-385 min, and from 158-297 min; mean estimated blood loss was between 33 and 283 mL, and between 127 and 300 mL; mean length of stay varied from 4-10 d; and from 6-15 d. Conversion after robotic rectal surgery varied from 0% to 9.4%, and from 0 to 22% after laparoscopy. There was no difference between robotic (0%-41.3%) and laparoscopic (5.5%-29.3%) surgery regarding morbidity and anastomotic complications (respectively, 0%-13.5%, and 0%-11.1%). Regarding immediate oncologic outcomes, respectively among robotic and laparoscopic cases, positive circumferential margins varied from 0% to 7.5%, and from 0% to 8.8%; the mean number of retrieved lymph nodes was between 10 and 20, and between 11 and 21; and the mean distal resection margin was from 0.8 to 4.7 cm, and from 1.9 to 4.5 cm. Robotic rectal cancer surgery is being undertaken by experienced surgeons. However, the quality of the assembled evidence does not support definite conclusions about most studies variables. Robotic rectal cancer surgery is associated to increased costs and operating time. It also seems to be

  20. Fasting abbreviation among patients submitted to oncologic surgery: systematic review

    OpenAIRE

    PINTO, Andressa dos Santos; GRIGOLETTI, Shana Souza; MARCADENTI, Aline

    2015-01-01

    INTRODUCTION: The abbreviation of perioperative fasting among candidates to elective surgery have been associated with shorter hospital stay and decreased postoperative complications. OBJECTIVE: To conduct a systematic review from randomized controlled trials to detect whether the abbreviation of fasting is beneficial to patients undergoing cancer surgery compared to traditional fasting protocols. METHOD: A literature search was performed in electronic databases: MEDLINE (PubMed), SciELO...

  1. Enhanced Recovery Pathways for Improving Outcomes After Minimally Invasive Gynecologic Oncology Surgery.

    Science.gov (United States)

    Chapman, Jocelyn S; Roddy, Erika; Ueda, Stefanie; Brooks, Rebecca; Chen, Lee-Lynn; Chen, Lee-May

    2016-07-01

    To estimate whether an enhanced recovery after surgery pathway facilitates early recovery and discharge in gynecologic oncology patients undergoing minimally invasive surgery. This was a retrospective case-control study. Consecutive gynecologic oncology patients undergoing laparoscopic or robotic surgery between July 1 and November 5, 2014, were treated on an enhanced recovery pathway. Enhanced recovery pathway components included patient education, multimodal analgesia, opioid minimization, nausea prophylaxis as well as early catheter removal, ambulation, and feeding. Cases were matched in a one-to-two ratio with historical control patients on the basis of surgery type and age. Primary endpoints were length of hospital stay, rates of discharge by noon, 30-day hospital readmission rates, and hospital costs. There were 165 patients included in the final cohort, 55 of whom were enhanced recovery pathway patients. Enhanced recovery patients were more likely to be discharged on postoperative day 1 compared with patients in the control group (91% compared with 60%, Pcontrol patients (P=.03). Postoperative pain scores decreased (2.6 compared with 3.12, P=.03) despite a 30% reduction in opioid use. Average total hospital costs were decreased by 12% in the enhanced recovery group ($13,771 compared with $15,649, P=.01). Readmission rates, mortality, and reoperation rates did not differ between the two groups. An enhanced recovery pathway in patients undergoing gynecologic oncology minimally invasive surgery is associated with significant improvements in recovery time, decreased pain despite reduced opioid use, and overall lower hospital costs.

  2. Successful Translation of Fluorescence Navigation During Oncologic Surgery: A Consensus Report.

    Science.gov (United States)

    Rosenthal, Eben L; Warram, Jason M; de Boer, Esther; Basilion, James P; Biel, Merrill A; Bogyo, Matthew; Bouvet, Michael; Brigman, Brian E; Colson, Yolonda L; DeMeester, Steven R; Gurtner, Geoffrey C; Ishizawa, Takeaki; Jacobs, Paula M; Keereweer, Stijn; Liao, Joseph C; Nguyen, Quyen T; Olson, James M; Paulsen, Keith D; Rieves, Dwaine; Sumer, Baran D; Tweedle, Michael F; Vahrmeijer, Alexander L; Weichert, Jamey P; Wilson, Brian C; Zenn, Michael R; Zinn, Kurt R; van Dam, Gooitzen M

    2016-01-01

    Navigation with fluorescence guidance has emerged in the last decade as a promising strategy to improve the efficacy of oncologic surgery. To achieve routine clinical use, the onus is on the surgical community to objectively assess the value of this technique. This assessment may facilitate both Food and Drug Administration approval of new optical imaging agents and reimbursement for the imaging procedures. It is critical to characterize fluorescence-guided procedural benefits over existing practices and to elucidate both the costs and the safety risks. This report is the result of a meeting of the International Society of Image Guided Surgery (www.isigs.org) on February 6, 2015, in Miami, Florida, and reflects a consensus of the participants' opinions. Our objective was to critically evaluate the imaging platform technology and optical imaging agents and to make recommendations for successful clinical trial development of this highly promising approach in oncologic surgery. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  3. Navigation in head and neck oncological surgery: an emerging concept.

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    Gangloff, P; Mastronicola, R; Cortese, S; Phulpin, B; Sergeant, C; Guillemin, F; Eluecque, H; Perrot, C; Dolivet, G

    2011-01-01

    Navigation surgery, initially applied in rhinology, neurosurgery and orthopaedic cases, has been developed over the last twenty years. Surgery based on computed tomography data has become increasingly important in the head and neck region. The technique for hardware fusion between RMI and computed tomography is also becoming more useful. We use such device since 2006 in head and neck carcinologic situation. Navigation allows control of the resection in order to avoid and protect the precise anatomical structures (vessels and nerves). It also guides biopsy and radiofrequency. Therefore, quality of life is much more increased and morbidity is decreased for these patients who undergo major and mutilating head and neck surgery. Here we report the results of 33 navigation procedures performed for 31 patients in our institution.

  4. Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery.

    Science.gov (United States)

    Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke

    2015-12-01

    Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

  5. Burnout syndrome in surgical oncology and general surgery nurses: a cross-sectional study.

    Science.gov (United States)

    Książek, Ilona; Stefaniak, Tomasz J; Stadnyk, Magdalena; Książek, Janina

    2011-09-01

    The occurrence of burnout syndrome is strongly associated with and modulated by multiple personality and environmental factors. In Poland, nurses experience a discrepancy between the demands, expectations and social status of the position of their profession and low salaries. Such a situation provokes frustration and depression, and further leads to problems of adaptation including burnout syndrome. The aim of this study was to evaluate the occurrence of burnout syndrome among nurses working in general surgery and surgical oncology specialties. The study was designed as a cross-sectional questionnaire survey. It was undertaken in the largest Hospital in the Pomeranian region of Poland. The participants included 60 nurses working in two departments: General Surgery and Surgical Oncology. The study was based upon an anonymous self-test composed of a questionnaire and three psychological measures: Maslach Burnout Inventory (MBI), Psychological Burden Scale and a self-constructed questionnaire on job satisfaction. Intensity of burnout syndrome was significantly higher among oncology nurses than among surgical ones. There was also a strong but not significant trend towards higher Psychological Burden Scale in the group of oncology nurses. The study revealed a high degree of emotional burden and burnout in nurses working in the study hospital suggesting that nurses are at great occupational risk. The findings of the study provide evidence of the potential need to restructure the system and suggest that nurses need more control of their work including a higher degree of involvement in clinical decision-making. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Four Cases of Chylous Ascites following Robotic Gynecologic Oncological Surgery

    Directory of Open Access Journals (Sweden)

    Ahmet Göçmen

    2014-01-01

    Full Text Available Chylous ascites is an uncommon form of ascites characterized by milky-appearing fluid caused by blocked or disrupted lymph flow through chyle-transporting vessels. The most common causes of chylous ascites are therapeutic interventions and trauma. In this report, we present four cases of chylous ascites following robot-assisted surgery for endometrial staging and the treatment strategies that we used. After retroperitoneal lymph node dissection, leaving a drain is very useful in diagnosing chylous ascites and observing its resolution; furthermore, the use of octreotide in conjunction with TPN appears to be an efficient treatment modality for chylous ascites and should be considered before any invasive intervention.

  7. Towards the centralization of digestive oncologic surgery: changes in activity, techniques and outcome

    Directory of Open Access Journals (Sweden)

    Cristian Tebé

    Full Text Available Aim: The objective of the present study was to examine changes in the activity, surgical techniques and results from the process of centralization of complex digestive oncologic surgery in 2005-2012 as compared to 1996-2000. Material and methods: A retrospective cohort study employing the minimum basic data set of hospital discharge (MBDSHD 1996-2012 from public centers in Catalonia (Spain was performed. The population consisted of individuals aged > 18 who underwent digestive oncologic surgery (esophagus, pancreas, liver, stomach or rectum. Medical centers were divided into low, medium, and high-volume centers (≤ 5, 6-10, and > 10 interventions/year, respectively. The tendency Chi-squared test was used to assess the centralization of patients in high-volume centers and hospital mortality evolution during the study period. Logistic regression was performed to assess the relationship between volume and outcome. Results: A centralization of complex oncologic digestive surgery between 10% (liver and 46% (esophagus was obtained by means of a reduction in the number of hospitals that perform these interventions and a significant rise in the number of patients operated in high-volume centers (all types p ≤ 0.0001, except for esophagus. A significant decrease in mortality was observed, especially in esophagus (from 15% in 1996/2000 to 7% in 2009/12, p = 0.003 and pancreas (from 12% in 1996/2000 to 6% in 2009/12, p trend < 0.0001. Conclusions: A centralization of oncologic digestive surgery in high-volume centers and a reduction of hospital mortality in Catalonia were reported among esophageal and pancreatic cancers. However, no significant changes were found for others cancer types.

  8. Comparing oncologic outcomes after minimally invasive and open surgery for pediatric neuroblastoma and Wilms tumor.

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    Ezekian, Brian; Englum, Brian R; Gulack, Brian C; Rialon, Kristy L; Kim, Jina; Talbot, Lindsay J; Adibe, Obinna O; Routh, Jonathan C; Tracy, Elisabeth T; Rice, Henry E

    2018-01-01

    Minimally invasive surgery (MIS) has been widely adopted for common operations in pediatric surgery; however, its role in childhood tumors is limited by concerns about oncologic outcomes. We compared open and MIS approaches for pediatric neuroblastoma and Wilms tumor (WT) using a national database. The National Cancer Data Base from 2010 to 2012 was queried for cases of neuroblastoma and WT in children ≤21 years old. Children were classified as receiving open or MIS surgery for definitive resection, with clinical outcomes compared using a propensity matching methodology (two open:one MIS). For children with neuroblastoma, 17% (98 of 579) underwent MIS, while only 5% of children with WT (35 of 695) had an MIS approach for tumor resection. After propensity matching, there was no difference between open and MIS surgery for either tumor for 30-day mortality, readmissions, surgical margin status, and 1- and 3-year survival. However, in both tumors, open surgery more often evaluated lymph nodes and had larger lymph node harvest. Our retrospective review suggests that the use of MIS appears to be a safe method of oncologic resection for select children with neuroblastoma and WT. Further research should clarify which children are the optimal candidates for this approach. © 2017 Wiley Periodicals, Inc.

  9. Microsurgery for groin lymphocele and lymphedema after oncologic surgery.

    Science.gov (United States)

    Boccardo, Francesco; Dessalvi, Sara; Campisi, Corrado; Molinari, Lidia; Spinaci, Stefano; Talamo, Giuseppina; Campisi, Corradino

    2014-01-01

    Groin lymphocele (GL) is a frequent complication of inguinal lymph node dissection, and conservative treatment is not always successful. Different surgical methods have been used to treat lymphoceles arising from lymphatics injured during groin surgery. However, they all involve the closure of lymphatics merging at the lymphocele, increasing the risk of postoperative lower limb lymphedema or of worsening lymphedema if already clinically evident. We assessed the efficacy of a diagnostic and therapeutic protocol to manage inguinal lymphoceles using lymphoscintigraphy (LS) and microsurgical procedures. Sixteen GL [seven associated with leg lymphedema (LL)] were studied by LS preoperatively and treated by complete excision of lymphocele and microsurgical lymphatic-venous anastomoses between afferent lymphatics and a collateral branch of great saphenous vein. Lower limb lymphatics were identified intraoperatively using Patent Blue dye injection. Nine patients without lymphedema had complete healing of lymphocele and no appearance of lower limb postoperative lymphedema. The other seven patients with associated secondary lymphedema had complete disappearance of lymphocele and a remarkable reduction of leg volume. Four of them completely recovered without the need of any compression garment, after the first year postoperative. Inguinal lymphocele nonresponsive to conservative treatment can be advantageously studied by LS and successfully treated by microsurgical reconstructive procedures, above all if associated to LL. Copyright © 2013 Wiley Periodicals, Inc.

  10. Oncological and functional outcomes of salvage renal surgery following failed primary intervention for renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Fernando G. Abarzua-Cabezas

    2015-02-01

    Full Text Available Purpose To assess the oncologic and functional outcomes of salvage renal surgery following failed primary intervention for RCC. Materials and Methods We performed a retrospective review of patients who underwent surgery for suspected RCC during 2004-2012. We identified 839 patients, 13 of whom required salvage renal surgery. Demographic data was collected for all patients. Intraoperative and postoperative data included ischemic duration, blood loss and perioperative complications. Preoperative and postoperative assessments included abdominal CT or magnetic resonance imaging, chest CT and routine laboratory work. Estimated glomerular filtration rate (eGFR was calculated according to the Modification of Diet in Renal Disease equation. Results The majority (85% of the patients were male, with an average age of 64 years. Ten patients underwent salvage partial nephrectomy while 3 underwent salvage radical nephrectomy. Cryotherapy was the predominant primary failed treatment modality, with 31% of patients undergoing primary open surgery. Pre-operatively, three patients were projected to require permanent post-operative dialysis. In the remaining 10 patients, mean pre- and postoperative serum creatinine and eGFR levels were 1.35 mg/dL and 53.8 mL/min/1.73 m2 compared to 1.43 mg/dL and 46.6 mL/min/1.73 m2, respectively. Mean warm ischemia time in 10 patients was 17.4 min and for all patients, the mean blood loss was 647 mL. The predominant pathological stage was pT1a (8/13; 62%. Negative surgical margins were achieved in all cases. The mean follow-up was 32.9 months (3.5-88 months. Conclusion While salvage renal surgery can be challenging, it is feasible and has adequate surgical, functional and oncological outcomes.

  11. Perioperative and short-term oncological outcomes of single-port surgery for transverse colon cancer.

    Science.gov (United States)

    Tei, Mitsuyoshi; Suzuki, Yozo; Wakasugi, Masaki; Akamatsu, Hiroki

    2017-06-01

    To compare the perioperative and short-term oncological outcomes of patients who underwent single-port surgery (SPS) with those of patients who underwent multi-port surgery (MPS) for transverse colon cancer. The records of consecutive patients who underwent SPS (n = 75) or MPS (n = 41) for transverse colon cancer in our department between January, 2008 and December, 2015 were analyzed retrospectively. Operative times were significantly shorter in the SPS group than in the MPS group (185 vs. 195 min, respectively; P = 0.043). There were no significant differences in operative procedures, blood loss, or extent of lymph node dissection. The rate of postoperative complications was similar in both groups, but the length of hospital stay was significantly shorter in the single-port group than in the multi-port group (8 vs. 11 days, respectively; P transverse colon cancer.

  12. Less stress, more success? Oncological implications of surgery-induced oxidative stress.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2013-03-01

    Reactive oxygen species (ROS) possess important cell signalling properties. This contradicts traditional thought which associated ROS activity with cell death. Emerging evidence clearly demonstrates that ROS signalling acts as a key regulator in tumour cell survival and in the cellular processes required for tumour cells to successfully metastasise and proliferate. The discovery of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox) family of enzymes in the last decade has unravelled much of the mystery surrounding how ROS are generated. Tumour cells are now known to express Nox enzymes which produce ROS required for cellular signalling. Activation of Nox enzymes occurs via interaction with proinflammatory cytokines and growth factors, all of which are released following surgical trauma. As our understanding of the signalling capabilities of ROS grows, the oncological implications of ROS activity are gradually being revealed. Nox-derived ROS are known to play a central role in each step of the metastatic cascade including invasion, adhesion, angiogenesis and proliferation. This article describes how surgery creates a ROS-rich environment, which facilitates redox signalling, and also examines the role played by Nox enzymes in this process. The authors then explore current knowledge of the oncological implications of surgery-induced redox signalling, and discuss current and future therapeutic strategies targeted at ROS and Nox enzymes in cancer patients.

  13. Evolution in breast cancer suspicion and extent of surgery at a radio-oncology center

    International Nuclear Information System (INIS)

    Lopez L, Veronica; Carvajal C, Claudia; Gallardo M, Manuel; Russo N, Moies

    2014-01-01

    Introduction: Breast cancer diagnosis and treatment ad evolved over the past quarter century. From self-examination to mammography as main suspicion tool and from radical to conservative surgery plus radiotherapy as prefered treatment. The aim of this review was to assess the evolution of presentation and local management of breast cancer at a Chilean radio-oncology center. Materials and Methods: We analyzed 1.204 breast cancer patients who received postoperative irradiation on two four-years periods.The first period included 223 patients and coincides with the introduction of mammography and conservative surgery. The second included 981 patients managed according to current guidelines. The variables analyzed were type of clinical suspicion, time between clinical suspicion and diagnosis confirmation, type of surgery, histology and tumor size. Data were obtained from medical records and analyzed using STATA 2. Results: In the second period mammographic suspicion reached 39.88%. Time between clinical suspicion and histological diagnosis was reduced to 50%, the proportion of tumors larger than 2 cm was reduced from 61 to 45%, the proportion of DCIS was tripled from 6 to 18%, use of conservative surgery as an absolute increase of 28%. All of these differences were statistically significant (p < 0.01). Conclusion: The introduction of mammography and conservative management allowed early diagnosis of breast cancer in the analyzed population

  14. Piezosurgery in head and neck oncological and reconstructive surgery: personal experience on 127 cases

    Science.gov (United States)

    Crosetti, E; Battiston, B; Succo, G

    2009-01-01

    Summary Piezoelectric bone surgery, known simply as piezosurgery, is a new technique of osteotomy and osteoplasty, which requires the use of microvibrations of ultrasonic frequency scalpels. The principle of piezosurgery is ultrasonic transduction, obtained by piezoelectric ceramic contraction and expansion. The vibrations thus obtained are amplified and transferred onto the insert of a drill which, when rapidly applied, with slight pressure, upon the bony tissue, results, in the presence of irrigation with physiological solution, in the cavitation phenomenon, with a mechanical cutting effect, exclusively on mineralized tissues. Personal experience with the use of piezosurgery in head and neck oncological and reconstructive surgery is relatively recent, having been developed in 2002-2006, and, so far, involves 127 cases; preliminary results are interesting and improving in the, hopefully, developmental phases of inserts with specific geometrics on account of the characteristics of the various aspects of surgical ENT operations. Furthermore, with piezoelectric surgery it has been possible to perform precise osteotomy lines, micrometric and curvilinear with absolute confidence, particularly in close proximity to the vessels and nerves and other important facial structures (dura mater). There can be no doubt, since this is a new cutting method, that piezosurgery involves a different learning curve compared to other techniques, requiring obstacles of a psychological nature to be overcome as well as that concerning surgical expertise. Given the numbers of cases treated and the relative power of this instrument, analysis of complications, intra-operative time (which would appear, on average, to be 20% longer) and, therefore, morbility, shows interesting potentiality of the technique. This new ultrasound cutting method will, no doubt, in the future, be increasingly used in ENT surgery, particularly with improvements in power and geometry of the inserts, with possible

  15. Comparison of Oncologic Short Term Results of Laparoscopic Versus Open Surgery of Rectal Cancer

    Directory of Open Access Journals (Sweden)

    Solati

    2015-06-01

    Full Text Available Background Today, with improvements in laparoscopy technique, surgery of rectal cancer is performed by laparoscopy. Objectives This study was performed to evaluate oncologic results of open versus laparoscopic surgery of rectal cancer in terms of resection margins, removal of lymph nodes and recurrence rate. Patients and Methods This descriptive-analytic study was performed on 88 patients with middle and lower rectal cancer in the two equivalent groups of laparoscopic and open surgery in Mashhad Ghaem and Omid hospitals during 2011 - 2013. Information including age, sex, number of removed and involved lymph nodes, proximal, distal, and radial margins, tumor stage and location, recurrence and disease-free survival collected in the questionnaire and analyzed using descriptive statistics and frequency distribution tables and t-test. Results Both groups of open and laparoscopic surgery had similar characteristics of age, sex, recurrence and disease-free survival, tumor margins and one-year mortality. The number of removed and involved lymph nodes was higher in the laparoscopic group (5.16 vs. 3.55, respectively, with P < 0.050, and 1.74 vs. 0.59 with P = 0.023, but the ratio of involved lymph nodes to the total number of removed lymph nodes was not different between the two groups (LNR (P = 0.071. Tumor stage was higher in the laparoscopic group and most were in stages II and III (P < 0.001. Conclusions Laparoscopic surgery is an effective technique for safe margin and removing lymph nodes in rectal cancer.

  16. A call for new standard of care in perioperative gynecologic oncology practice: Impact of enhanced recovery after surgery (ERAS) programs.

    Science.gov (United States)

    Miralpeix, Ester; Nick, Alpa M; Meyer, Larissa A; Cata, Juan; Lasala, Javier; Mena, Gabriel E; Gottumukkala, Vijaya; Iniesta-Donate, Maria; Salvo, Gloria; Ramirez, Pedro T

    2016-05-01

    Enhanced recovery after surgery (ERAS) programs aim to hasten functional recovery and improve postoperative outcomes. However, there is a paucity of data on ERAS programs in gynecologic surgery. We reviewed the published literature on ERAS programs in colorectal surgery, general gynecologic surgery, and gynecologic oncology surgery to evaluate the impact of such programs on outcomes, and to identify key elements in establishing a successful ERAS program. ERAS programs are associated with shorter length of hospital stay, a reduction in overall health care costs, and improvements in patient satisfaction. We suggest an ERAS program for gynecologic oncology practice involving preoperative, intraoperative, and postoperative strategies including; preadmission counseling, avoidance of preoperative bowel preparation, use of opioid-sparing multimodal perioperative analgesia (including loco-regional analgesia), intraoperative goal-directed fluid therapy (GDT), and use of minimally invasive surgical techniques with avoidance of routine use of nasogastric tube, drains and/or catheters. Postoperatively, it is important to encourage early feeding, early mobilization, timely removal of tubes and drains, if present, and function oriented multimodal analgesia regimens. Successful implementation of an ERAS program requires a multidisciplinary team effort and active participation of the patient in their goal-oriented functional recovery program. However, future outcome studies should evaluate the efficacy of an intervention within the pathway, include objective measures of symptom burden and control, study measures of functional recovery, and quantify outcomes of the program in relation to the rates of adherence to the key elements of care in gynecologic oncology such as oncologic outcomes and return to intended oncologic therapy (RIOT). Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Sphincter-sparing surgery after preoperative radiotherapy for low rectal cancers: feasibility, oncological results, and quality of life outcomes

    International Nuclear Information System (INIS)

    Allal, A.S.; Soravia, C.; Gertsch, P.; Bieri, S.; Sprangers, M.A.G.

    1999-01-01

    In cancers of the distal rectum, preoperative radiotherapy is often associated with low anterior resection. This study assesses the choice of surgical procedure, oncological results, and quality of life outcomes in a retrospective cohort of patients with low-lying rectal cancers. The results obtained reinforce the notion of the feasibility, in routine practice, of sphincter-sparing surgery after preoperative radiotherapy in a significant proportion of low rectal cancers. The oncological results seem to be unaffected by the choice of surgical procedure. However, with the possible exception of body image and sexual aspects in males, quality of life parameters were not necessarily better in the restorative surgery group. Prospective studies are mandatory to clarify the putative quality of life advantages of sphincter-conserving procedures in this context. (author)

  18. European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery.

    Science.gov (United States)

    Querleu, Denis; Planchamp, François; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

    2016-09-01

    The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). Quality indicators were based on scientific evidence and/or expert consensus. A 4-step evaluation process included a systematic literature search for the identification of potential QIs and the documentation of scientific evidence, physical meetings of an ad hoc multidisciplinarity International Development Group, an internal validation of the targets and scoring system, and an external review process involving physicians and patients. Ten structural, process, or outcome indicators were selected. Quality indicators 1 to 3 are related to achievement of complete cytoreduction, caseload in the center, training, and experience of the surgeon. Quality indicators 4 to 6 are related to the overall management, including active participation to clinical research, decision-making process within a structured multidisciplinary team, and preoperative workup. Quality indicator 7 addresses the high value of adequate perioperative management. Quality indicators 8 to 10 highlight the need of recording pertinent information relevant to improvement of quality. An ESGO-approved template for the operative report has been designed. Quality indicators were described using a structured format specifying what the indicator is measuring, measurability specifications, and targets. Each QI was associated with a score, and an assessment form was built. The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give

  19. European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery

    NARCIS (Netherlands)

    Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Christiana; van der Zee, Ate; Vergote, Ignace; duBois, Andreas

    Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecological cancers across Europe. Methods The European Society of Gynaecological Oncology

  20. Robotic-Assisted Minimally Invasive Surgery for Gynecologic and Urologic Oncology

    Science.gov (United States)

    2010-01-01

    -term outcomes - Urinary continence - Erectile function Summary of Findings Robotic use for gynecologic oncology compared to: Laparotomy: benefits of robotic surgery in terms of shorter length of hospitalization and less blood loss. These results indicate clinical effectiveness in terms of reduced morbidity and safety, respectively, in the context of study design limitations. The beneficial effect of robotic surgery was shown in pooled analysis for complications, owing to increased sample size. More work is needed to clarify the role of complications in terms of safety, including improved study designs, analysis and measurement. Laparoscopy: benefits of robotic surgery in terms of shorter length of hospitalization, less blood loss and fewer conversions to laparotomy likely owing to the technical difficulty of conventional laparoscopy, in the context of study design limitations. Clinical significance of significant findings for length of hospitalizations and blood loss is low. Fewer conversions to laparotomy indicate clinical effectiveness in terms of reduced morbidity. Robotic use for urologic oncology, specifically prostate cancer, compared to: Retropubic surgery: benefits of robotic surgery in terms of shorter length of hospitalization and less blood loss/fewer individuals requiring transfusions. These results indicate clinical effectiveness in terms of reduced morbidity and safety, respectively, in the context of study design limitations. There was a beneficial effect in terms of decreased positive surgical margins and erectile dysfunction. These results indicate clinical effectiveness in terms of improved cancer control and functional outcomes, respectively, in the context of study design limitations. Surgeon skill had an impact on cancer control and functional outcomes. The results for complications were inconsistent when measured as either total number of complications, pain management or anastomosis. There is some suggestion that robotic surgery is safe with respect to

  1. Single-incision laparoscopic surgery for locally advanced colorectal cancer : feasibility, short-term and oncologic outcomes.

    Science.gov (United States)

    Famiglietti, F; Leonard, D; Bachmann, R; Remue, C; Abbes Orabi, N; van Maanen, A; van den Eynde, M; Kartheuser, A

    2018-01-01

    Data about single-incision laparoscopic surgery (SILS) in locally advanced colorectal cancers are scarce. This study aimed to evaluate perioperative and shortterm oncologic outcomes of SILS in pT3-T4 colorectal cancer. From 2011 to 2015 data from 249 SILS performed in our Colorectal Unit were entered into a prospective database. Data regarding patients with a pT3-T4 colorectal adenocarcinoma were compared to those with pTis-pT2. Factors influencing conversion were assessed by multivariate analysis. There were 100 consecutive patients (T3-T4 = 70, Tis-T2 = 30). Demographics were similar. Tumor size was significantly larger in the T3-T4 group [3.9cm vs 2cm; p2) postoperative complication rate was similar between groups (8.6% vs 10% ; p = 0.999), as well as conversion rate (18.6% vs 6.7% ; p = 0.220). Finally, there were no differences in terms of hospital stay and mortality rate. On multivariate analysis, age (OR = 1.06, 95%CI: 1.012-1.113 ; p = 0.015] and stage IV (OR = 5.372, 95%CI: 1.320-21.862, p = 0.019) were independently associated with conversion. SILS for locally advanced colorectal cancer did not affect the short-term outcomes in this series and oncological clearance remained satisfactory. Age and stage IV disease are independent risk factors for conversion. © Acta Gastro-Enterologica Belgica.

  2. Integration of oncologic margins in three-dimensional virtual planning for head and neck surgery, including a validation of the software pathway

    NARCIS (Netherlands)

    Kraeima, Joep; Schepers, Rutger H.; van Ooijen, Peter M. A.; Steenbakkers, Roel J. H. M.; Roodenburg, Jan L. N.; Witjes, Max J. H.

    2015-01-01

    Purpose: Three-dimensional (3D) virtual planning of reconstructive surgery, after resection, is a frequently used method for improving accuracy and predictability. However, when applied to malignant cases, the planning of the oncologic resection margins is difficult due to visualisation of tumours

  3. The influence of hospital volume on long-term oncological outcome after rectal cancer surgery

    NARCIS (Netherlands)

    Jonker, Frederik H. W.; Hagemans, Jan A. W.; Burger, Jacobus W. A.; Verhoef, Cornelis; Borstlap, Wernard A. A.; Tanis, Pieter J.; Aalbers, A.; Acherman, Y.; Algie, G. D.; Alting von Geusau, B.; Amelung, F.; Aukema, T. S.; Bakker, I. S.; Bartels, S. A.; Basha, S.; Bastiaansen, A. J. N. M.; Belgers, E.; Bemelman, W. A.; Bleeker, W.; Blok, J.; Bosker, R. J. I.; Bosmans, J. W.; Boute, M. C.; Bouvy, N. D.; Bouwman, H.; Brandt-Kerkhof, A.; Brinkman, D. J.; Bruin, S.; Bruns, E. R. J.; Burbach, J. P. M.; Clermonts, S.; Coene, P. P. L. O.; Compaan, C.; Consten, E. C. J.; Darbyshire, T.; de Mik, S. M. L.; de Graaf, E. J. R.; de Groot, I.; de Vos Tot Nederveen Cappel, R. J. L.; de Wilt, J. H. W.; van der Wolde, J.; den Boer, F. C.; Dekker, J. W. T.; Demirkiran, A.; van Duijvendijk, P.; Marres, C. C.; Musters, G. D.; van Rossem, C. C.; Schreuder, A. M.; Swank, H. A.

    2017-01-01

    The association between hospital volume and outcome in rectal cancer surgery is still subject of debate. The purpose of this study was to assess the impact of hospital volume on outcomes of rectal cancer surgery in the Netherlands in 2011. In this collaborative research with a cross-sectional study

  4. European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery

    NARCIS (Netherlands)

    Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

    Objectives The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit

  5. Self-expanding metallic stent as a bridge to surgery in the treatment of left colon cancer obstruction: Cost-benefit analysis and oncologic results.

    Science.gov (United States)

    Flor-Lorente, Blas; Báguena, Gloria; Frasson, Matteo; García-Granero, Alvaro; Cervantes, Andrés; Sanchiz, Vicente; Peña, Andres; Espí, Alejandro; Esclapez, Pedro; García-Granero, Eduardo

    2017-03-01

    The use of a self-expanding metallic stent as a bridge to surgery in acute malignant left colonic obstruction has been suggested as an alternative treatment to emergency surgery. The aim of the present study was to compare the morbi-mortality, cost-benefit and long-term oncological outcomes of both therapeutic options. This is a prospective, comparative, controlled, non-randomized study (2005-2010) performed in a specialized unit. The study included 82 patients with left colon cancer obstruction treated by stent as a bridge to surgery (n=27) or emergency surgery (n=55) operated with local curative intention. The main outcome measures (postoperative morbi-mortaliy, cost-benefit, stoma rate and long-term oncological outcomes) were compared based on an "intention-to-treat" analysis. There were no significant statistical differences between the two groups in terms of preoperative data and tumor characteristics. The technically successful stenting rate was 88.9% (11.1% perforation during stent placement) and clinical success was 81.4%. No difference was observed in postoperative morbi-mortality rates. The primary anastomosis rate was higher in the bridge to surgery group compared to the emergency surgery group (77.8% vs. 56.4%; P=.05). The mean costs in the emergency surgery group resulted to be €1,391.9 more expensive per patient than in the bridge to surgery group. There was no significant statistical difference in oncological long-term outcomes. The use of self-expanding metalllic stents as a bridge to surgery is a safe option in the urgent treatment of obstructive left colon cancer, with similar short and long-term results compared to direct surgery, inferior mean costs and a higher rate of primary anastomosis. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Ergonomic deficits in robotic gynecologic oncology surgery: a need for intervention.

    Science.gov (United States)

    Craven, Renatta; Franasiak, Jason; Mosaly, Prithima; Gehrig, Paola A

    2013-01-01

    To evaluate surgeon strain using validated ergonomic assessment tools. Observational study (Canadian Task Force classification III). Academic medical center. Robotic surgeons performing gynecologic oncology surgical procedures. Videotape footage of surgeons performing robotic gynecologic oncology procedures was obtained. A human factors engineer experienced with health care ergonomics analyzed the video recordings and performed ergonomic evaluations of the surgeons. An initial evaluation was conducted using the Rapid Upper Limb Assessment (RULA) survey, an ergonomic assessment and prioritization method for determining posture, force, and frequency concerns with focus on the upper limbs. A more detailed analysis followed using the Strain Index (SI) method, which uses multiplicative interactions to identify jobs that are potentially hazardous. Seventeen hours of video recordings were analyzed, and descriptive data based on RULA/SI analysis were collected. Ergonomic evaluation of surgeon activity resulted in a mean RULA score of 6.46 (maximum possible RULA score, 7), indicating a need for further investigation. The mean SI grand score was 24.34. SI scores >10 suggest a potential for hazard to the operator. Thus, the current use of the surgical robot is potentially dangerous with regards to ergonomic positioning and should be modified. At a high-volume robotics center, there are ergonomics deficits that are hazardous to gynecologic surgeons and suggest the need for modification and intervention. A training strategy must be developed to address these ergonomic issues and knowledge deficiencies. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  7. Comparative study of oncologic outcomes for laparoscopic vs. open surgery in transverse colon cancer.

    Science.gov (United States)

    Kim, Woo Ram; Baek, Se Jin; Kim, Chang Woo; Jang, Hyun A; Cho, Min Soo; Bae, Sung Uk; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young; Kim, Nam Kyu; Sohn, Seung Kuk

    2014-01-01

    Laparoscopic resection for transverse colon cancer is a technically challenging procedure that has been excluded from various large randomized controlled trials of which the long-term outcomes still need to be verified. The purpose of this study was to evaluate long-term oncologic outcomes for transverse colon cancer patients undergoing laparoscopic colectomy (LAC) or open colectomy (OC). This retrospective review included patients with transverse colon cancer who received a colectomy between January 2006 and December 2010. Short-term and five-year oncologic outcomes were compared between these groups. A total of 131 patients were analyzed in the final study (LAC, 84 patients; OC, 47 patients). There were no significant differences in age, gender, body mass index, tumor location, operative procedure, or blood loss between groups, but the mean operative time in LAC was significantly longer (LAC, 246.8 minutes vs. OC, 213.8 minutes; P = 0.03). Hospital stay was much shorter for LAC than OC (9.1 days vs. 14.5 days, P transverse colon cancer is feasible and safe with comparable short- and long-term outcomes.

  8. Safety and efficacy of prolonged epidural analgesia after oncologic colorectal surgery

    Directory of Open Access Journals (Sweden)

    R. V. Garyaev

    2012-01-01

    Full Text Available This study demonstrates effective thoracic epidural analgesia by ropivacain 0.2 %, phentanyl 2 mkg/ml, adrenaline 2 mkg/ml in single-use infusion pumps in 124 patients, who underwent surgery for colorectal cancer. Safe, effective and controllable analgesia was observed during surgery and postoperative period. Prolonged analgesia facilitates early rehabilitation and improves gastrointestinal peristaltic activity.  Prolonged epidural analgesia is the recommended method of analgesia in this group of patients.

  9. A systematic review of the quality of randomized controlled trials in head and neck oncology surgery.

    Science.gov (United States)

    Carlton, Daniel A; Kocherginsky, Masha; Langerman, Alexander J

    2015-01-01

    To determine the quality of randomized controlled trials (RCTs) in head and neck surgery in which surgery was a primary intervention. Potential articles were identified in PubMed without publication date restrictions. Articles were scored using the CONSORT checklist and the relationship between the checklist score and whether the first and/or last authors were surgeons was investigated. Differences in the checklist score based on how many surgeons were among the first and last authors of the study were analyzed using the Kruskal-Wallis test. Fisher's exact test was used to examine if there was a significant difference of the reporting of individual items from the checklist between surgeons and nonsurgeons. A nonparametric trend test was used to determine whether there was a difference in the reporting of individual items based on whether there were none, one, or two surgeons among first and last authors. A total of 38 publications satisfied the inclusion criteria. There was a trend toward lower quality for studies in which surgeons were either first, last, or both first and last authors compared to studies that were first-authored and last-authored by nonsurgeons (P = 0.068). Nonsurgeons were more likely to report on critical elements regarding hypothesis, sample size determination, randomization, and eligibility of centers (P = 0.023-0.058). The quality of RCTs in head and neck surgery is poor. Improved training in conducting and reporting clinical research is needed in otolaryngology residencies. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  10. [Antibiotic prophylaxis in oncologic pharyngolaryngeal surgery: ceftriaxone versus clindamycin and gentamycin].

    Science.gov (United States)

    Subirana, F X; Lorente, J; Pérez, M; Quesada, J L; Grasa, J; Fortuny, P; Roselló, J; Quesada, P

    2001-03-01

    There are many papers comparing two antibiotic protocols for the profilaxis of head and neck infections after laryngeal surgery. We present one prospective and randomised study in 60 patients comparing the efficacy of two protocols. The comparison was between ceftriaxone versus the association of clindamicyn and gentamicyn. In our database we included the risk factors for infection, the surgical approach, the duration of surgery and the patient characteristics. We observed an incidence of 28% of infection, with a 23.3% in the clindamicyn + gentamicyn group and a 33.3% in the ceftriaxone group. The differences between the two groups were not statistically significant. In this study we observed a small difference between the amount of alcohol comsuption, the effectiveness of the surgical drainage, the surgical approach and the presence of wound infection. The difference was not statistical significant due to the small group of patients. The profilaxis was adequate for the total laryngectomy and cordectomy group, with a higher incidence of wound infection in patients treated with a supraglottic laryngectomy.

  11. COST-EFFECTIVENESS OF PERIOPERATIVE IMMUNONUTRITION IN GASTROINTESTINAL ONCOLOGIC SURGERY: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Reis, Audrey Machado Dos; Kabke, Geórgia Brum; Fruchtenicht, Ana Valéria Gonçalves; Barreiro, Taiane Dias; Moreira, Luis Fernando

    2016-01-01

    Costs, length of hospital staying and morbidity are frequently and significantly increased as a result of infections and other complications following surgical procedure for gastrointestinal tract cancer. Recently, improving host defence mechanisms have become a target of interest. Immunonutrition aims at improving immunity, most likely providing key nutrients to maintain T-lymphocyte and other host defence. To evaluate the immunonutrition in cancer patients who are operated by digestive diseases and assess the cost-effectiveness of this supplementation. This study consisted of a systematic review of the literature based on reference analyses retrieved from current databases such as PubMed, Lilacs and SciELO. The search strategy was defined by terms related to immunonutrition [immunonutrition, arginine, omega-3 and nucleotides] in combination with [costs, cost-effective and cost-effectiveness] as well as [gastrointestinal cancer surgery, oesophageal, gastric or pancreatic surgery] in English, Portuguese or Spanish language. For cost analyses, currencies used in the manuscripts were all converted to American dollars (US$) in order to uniform and facilitate comparison. Six prospective randomized studies were included in this review. The cost-effectiveness was positive in most of studies, demonstrating that this diet can significantly reduce hospital costs in the North hemisphere. However, similar studies needed to be carried to determine such results among us. Custos, tempo de hospitalização e morbidade estão frequentemente aumentados na presença de infecções e outras complicações decorrentes de procedimentos cirúrgicos para o câncer gastrointestinal. Recentemente, a melhora de mecanismos de defesa do hospedeiro tem se tornado um alvo de interesse. Nutrição adequada está fortemente relacionada com competência imune e redução de infeções. Imunonutrição objetiva a melhora da imunidade, principalmente para manutenção de linfócitos-T e outras

  12. Improved oncologic outcome with chemoradiotherapy followed by surgery in unresectable intrahepatic cholangiocarcinoma

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    Cho, Yeona; Kim, Tae Hyung; Seong, Jinsil [Yonsei University College of Medicine, Department of Radiation Oncology, Yonsei Cancer Center, Seoul (Korea, Republic of)

    2017-08-15

    To investigate the ability of chemoradiotherapy (CRT) to down-stage unresectable intrahepatic cholangiocarcinoma (IHCC) to resectable lesions, as well as the factors associated with achieving such down-staging. The study cohort comprised 120 patients diagnosed with stage I-IVA IHCC between 2001 and 2012. Of these patients, 56 underwent surgery and 64 received CRT as their initial treatment. The rate of curative resections for patients who received CRT was assessed, and the locoregional failure-free survival (LRFFS) and overall survival (OS) rates of these patients were compared to those of patients who underwent CRT alone. Median follow-up was 36 months. A partial response after CRT was observed in 25% of patients, whereas a biologic response (a >70% decrease of CA19-9) was observed in 35%. Eight patients (12.5%) received curative resection after CRT and showed significantly improved LRFFS and OS compared to those treated with CRT alone (3-year LRFFS: 50 vs. 15.7%, respectively, p = 0.03; 3-year OS: 50 vs. 11.2%, respectively, p = 0.012); these rates were comparable to those of patients who received initial surgery. Factors associated with curative surgery after CRT were gemcitabine administration, higher radiotherapy dose (biological effective dose ≥55 Gy with α/β = 10), and a >70% reduction of CA19-9. Upfront CRT could produce favorable outcomes by converting unresectable lesions to resectable tumors in selected patients. Higher radiotherapy doses and gemcitabine-based chemotherapy yielded a significant reduction of CA19-9 after CRT; patients with these characteristics had a greater chance of curative resection and improved OS. (orig.) [German] Untersuchung der Faehigkeit der Radiochemotherapie (CRT), unauffaellige intrahepatische Cholangiokarzinome (IHCC) auf resezierbare Laesionen herunterzustufen sowie der Faktoren, die mit dem Erreichen einer solchen Herabstufung verbunden sind. Die Studienkohorte umfasste 120 Patienten mit einem zwischen 2001 und 2012

  13. Sarcopenia and sarcopenic obesity: do they predict inferior oncologic outcomes after gastrointestinal cancer surgery?

    Directory of Open Access Journals (Sweden)

    Kimberly L. Mei

    2016-10-01

    Full Text Available Abstract Sarcopenia, or loss of skeletal muscle mass and quality, has been studied as part of aging and adverse health outcomes in elderly patients but has only recently been evaluated as a separate condition in cancer patients and important indicator of adverse outcomes. Currently, its definition and method of assessment are still being debated. Sarcopenia within an increasingly obese population has led to a subgroup with sarcopenic obesity, at even higher risk of adverse outcomes. Yet, sarcopenia often goes undiagnosed in these patients, hidden beneath higher body mass index. Identifying sarcopenic and sarcopenic obese subpopulations would allow for more effective treatment plans and potential avoidance of suboptimal outcomes, as well as the chance to intervene and combat these modifiable risk factors. This review will examine available literature on the definition and methods of evaluating sarcopenia and sarcopenic obesity, summarize the effectiveness of sarcopenia and sarcopenic obesity as predictors of outcomes after gastrointestinal cancer surgery, including colorectal cancer resection, liver resection, and pancreatic resection, and outline strategies to minimize the impact of sarcopenia. It is clear that untreated sarcopenia and sarcopenic obesity can be associated with suboptimal post-operative outcomes, especially infections and disease-free or overall survival.

  14. Opportunistic bilateral salpingectomy during benign gynecological surgery for ovarian cancer prevention: a survey of Gynecologic Oncology Committee of Japan Society of Obstetrics and Gynecology.

    Science.gov (United States)

    Mikami, Mikio; Nagase, Satoru; Yamagami, Wataru; Ushijma, Kimio; Tashiro, Hironori; Katabuchi, Hidetaka

    2017-07-01

    Recent evidence has supported the concept that epithelial ovarian cancer (EOC) arises from the cells of the fallopian tube or endometrium. This study investigated current practice in Japan with respect to performing opportunistic bilateral salpingectomy (OBS) during gynecological surgery for benign disease for Ovarian Cancer Prevention. We mailed a questionnaire to 767 hospitals and clinics, comprising 628 accredited training institutions of the Japan Society of Obstetrics and Gynecology (JSOG), Japan Society of Gynecologic Oncology (JSGO), or Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (JSGOE) and 139 private institutions with at least one JSGOE-certified licensed gynecologic laparoscopist. Among the 767 institutions, 444 (57.9%) provided responses, including 91 (20.6%) that were both JSGOE and JSGO accredited, 71 (16.0%) that were only JSGO accredited, 88 (19.8%) that were only JSGOE accredited, and 194 (43.7%) that were unaccredited. It was found that awareness and performance of OBS largely depended on the JSGO and/or JSGOE accreditation status. OBS was only performed at 54.0% of responding institutions and just 6.8% of the institutions were willing to participate in randomized controlled trials to validate this method for reducing the incidence of ovarian cancer. The JSOG Gynecologic Tumor Committee will announce its opinion on salpingectomy for ovarian cancer prevention to all JSOG members and will develop a system for monitoring the number of OBS procedures in Japan. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  15. Fertility sparing surgery in young women affected by endometrial stromal sarcoma: an oncologic dilemma or a reliable option? review of literature starting from a peculiar case

    Directory of Open Access Journals (Sweden)

    Noventa M

    2014-12-01

    Full Text Available Marco Noventa, Salvatore Gizzo, Lorena Conte, Angela Dalla Toffola, Pietro Litta, Carlo Saccardi Department of Woman and Child Health, University of Padua, Padua, Italy Background: Endometrial stromal sarcoma (ESS is a term used to define a rare neoplasm that accounts for approximately 0.2%–1% of all uterine malignancies; it is, however, implicated in an estimated 10%–15% of those malignancies with a mesenchymal component. Recent evidence suggests that while the preservation of the ovaries may be considered appropriate in premenopausal women, hysterectomy and bilateral salpingo-oophorectomy remains the recommended treatment in postmenopausal women. Currently, only a few case series reporting the treatment of ESS in young women with a desire to preserve fertility and thus subjected to a fertility-sparing surgery are available in the literature. Case presentation: We report a peculiar case of early stage ESS treated by laparoscopic fertility-sparing surgery and a strict follow-up program (every 3 months of imaging and clinical evaluation. The patient remained disease free 1 year after primary treatment. Three months after completing oncological follow-up, the patient conceived spontaneously and is, to date, pregnant at 11 weeks of gestation without evidence of recurrent disease or obstetric complications. Conclusion: Based on our case report and in accordance with the data available, we suggest that in young patients affected by early stage ESS who wish to preserve reproductive function, fertility-sparing surgery could represent a valid option, though strict oncological follow-up remains mandatory. Keywords: young women, laparoscopic surgery, pregnancy, neoplasia, surgical management, follow up, disease recurrence

  16. Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer—IMIGASTRIC

    Science.gov (United States)

    Desiderio, Jacopo; Jiang, Zhi-Wei; Nguyen, Ninh T; Zhang, Shu; Reim, Daniel; Alimoglu, Orhan; Azagra, Juan-Santiago; Yu, Pei-Wu; Coburn, Natalie G; Qi, Feng; Jackson, Patrick G; Zang, Lu; Brower, Steven T; Kurokawa, Yukinori; Facy, Olivier; Tsujimoto, Hironori; Coratti, Andrea; Annecchiarico, Mario; Bazzocchi, Francesca; Avanzolini, Andrea; Gagniere, Johan; Pezet, Denis; Cianchi, Fabio; Badii, Benedetta; Novotny, Alexander; Eren, Tunc; Leblebici, Metin; Goergen, Martine; Zhang, Ben; Zhao, Yong-Liang; Liu, Tong; Al-Refaie, Waddah; Ma, Junjun; Takiguchi, Shuji; Lequeu, Jean-Baptiste; Trastulli, Stefano; Parisi, Amilcare

    2015-01-01

    Introduction Gastric cancer represents a great challenge for healthcare providers and requires a multidisciplinary treatment approach in which surgery plays a major role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and recently with the spread of robotic surgery, but a number of issues are currently being debated, including the limitations in performing an effective extended lymph node dissection, the real advantages of robotic systems, the role of laparoscopy for Advanced Gastric Cancer, the reproducibility of a total intracorporeal technique and the oncological results achievable during long-term follow-up. Methods and analysis A multi-institutional international database will be established to evaluate the role of robotic, laparoscopic and open approaches in gastric cancer, comprising of information regarding surgical, clinical and oncological features. A chart review will be conducted to enter data of participants with gastric cancer, previously treated at the participating institutions. The database is the first of its kind, through an international electronic submission system and a HIPPA protected real time data repository from high volume gastric cancer centres. Ethics and dissemination This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. A multicentre study with a large number of patients will permit further investigation of the safety and efficacy as well as the long-term outcomes of robotic, laparoscopic and open approaches for the management of gastric cancer. Trial registration number NCT02325453; Pre-results. PMID:26482769

  17. Laparoscopic complete mesocolic excision with central vascular ligation in right colon cancer: Long-term oncologic outcome between mesocolic and non-mesocolic planes of surgery.

    Science.gov (United States)

    Siani, L M; Pulica, C

    2015-12-01

    To analyze our experience in translating the concept of total mesorectal excision to "no-touch" complete removal of an intact mesocolonic envelope (complete mesocolic excision), along with central vascular ligation and apical node dissection, in the surgical treatment of right-sided colonic cancers, comparing "mesocolic" to less radical "non-mesocolic" planes of surgery in respect to quality of the surgical specimen and long-term oncologic outcome. A total of 115 patients with right-sided colonic cancers were retrospectively enrolled from 2008 to 2013 and operated on following the intent of minimally invasive complete mesocolic excision with central vascular ligation. Morbidity and mortality were 22.6% and 1.7%, respectively. Mesocolic, intramesocolic, and muscularis propria planes of resection were achieved in 65.2%, 21.7%, and 13% of cases, respectively, with significant impact for mesenteric plane of surgery on R0 resection rate (97.3%), circumferential resection margin plane of surgery, with R0 resection rate and overall survival falling to 72% and 60%, respectively, and with circumferential resection margin planes of "standard" surgery, significantly impacting loco-regional control and thus overall survival. © The Finnish Surgical Society 2014.

  18. MUST ONCOLOGICAL PRINCIPLES BE IN THE SURGERY OF MENINGIOMAS? EN BLOC REMOVAL OF GIANT RIGHT FRONTAL MENINGIOMA WITH EXTRACRANIAL SPREAD. DESCRIPTION OF A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    V. B. Karakhan

    2014-01-01

    Full Text Available The use of the oncological principle – en bloc ablastic tumor resection – can expect a breakthrough in the treatment of baseline unfavorable patient groups. In the described case of atypical meningioma, its en bloc resection presents significant technical difficulties when accomplishing the task associated with the giant sizes of a tumor as an iceberg growing outside and into the cranial cavity, its rich vascularization from both the internal and external carotid artery system, with the involvement of the superior sagittal sinus, the presence of a dense bone crown that combines the three-component construction of a neoplasm, which made difficult safe mobilization and scanning in the cranial cavity.In such topographic variants, the criteria for the Simpson radical meningioma resection are inapplicable and only en bloc tumor resection may reflect the oncological principles of surgery. The technologies of en bloc resection of intracranial meningiomas should be more frequently used because preoperative neurovisualization and even histological diagnosis does not always allow the grade of meningiomas to be specified.

  19. Objective assessment of quality of life in female patients after esthetic, non-oncologic or oncologic surgery of their mammary glands--reality and perspectives.

    Science.gov (United States)

    Molov, Veselin V; Tepavicharova, Penka P; Deenichin, George P; Mitov, Franz S

    2005-01-01

    The World Health Organisation defines health as a state of complete physical, mental and social well-being, and not merely the absence of a disease or infirmity. The female breast, surgically considered as a "troubled organ", can be affected by disorders of various types. Its normal morphology can be changed by deformities which may have a serious impact on the mental state of female patients. Assessment of these deformities is essential when doctors should define the inclusion and exclusion criteria for each breast operation that has elements of esthetic surgery in it, the breast being indisputably a symbol of female beauty. When we consider the parameters of normal breast morphology, it is only proper to take into account their dependence on race, national culture, folk psychology, etc. For Bulgarian women, P. Tepavicharova has found that the distance from fossa jugularis to the nipple-areolar complex can have the following characteristic proportions: 15.5-17 cm for a woman 155-160 cm in height and with breast circumference of 75-80 cm; 17-18.5 cm for woman 160-165 cm in height and with breast circumference of 89-95 cm; and 18-20 cm for a woman 165-170 cm in height and with breast circumference of 95-100 cm. J. Lalardie points out that breast stability is determined by three principal factors: skin and its elasticity, the condition of the underlying collagenous structure of the breast, and the firm bond between the skin and fibrous elements. RB Brinks defines the four forms of ptosis of the breast: glandular ptosis, true ptosis, parenchymal maldistribution, and pseudoptosis. According to P. Tepavicharova, the violation of breast symmetry is the major factor triggering a sequence of psychosomatic reactions. The basic parameters of female breast morphology are the mammary base, mammary perimeter, the forward projection of the breast, symmetry, breast volume, and the state of the axillary extension. The major deviations from normal breast morphology that can have an

  20. Tumor thrombus of inferior vena cava in patients with renal cell carcinoma – clinical and oncological outcome of 50 patients after surgery

    Directory of Open Access Journals (Sweden)

    Kocot Arkadius

    2012-06-01

    Full Text Available Abstract Background To evaluate oncological and clinical outcome in patients with renal cell carcinoma (RCC and tumor thrombus involving inferior vena cava (IVC treated with nephrectomy and thrombectomy. Methods We identified 50 patients with a median age of 65 years, who underwent radical surgical treatment for RCC and tumor thrombus of the IVC between 1997 and 2010. The charts were reviewed for pathological and surgical parameters, as well as complications and oncological outcome. Results The median follow-up was 26 months. In 21 patients (42% distant metastases were already present at the time of surgery. All patients underwent radical nephrectomy, thrombectomy and lymph node dissection through a flank (15 patients/30%, thoracoabdominal (14 patients/28% or midline abdominal approach (21 patients/42%, depending upon surgeon preference and upon the characteristics of tumor and associated thrombus. Extracorporal circulation with cardiopulmonary bypass (CPB was performed in 10 patients (20% with supradiaphragmal thrombus of IVC. Cancer-specific survival for the whole cohort at 5 years was 33.1%. Survival for the patients without distant metastasis at 5 years was 50.7%, whereas survival rate in the metastatic group at 5 years was 7.4%. Median survival of patients with metastatic disease was 16.4 months. On multivariate analysis lymph node invasion, distant metastasis and grading were independent prognostic factors. There was no statistically significant influence of level of the tumor thrombus on survival rate. Indeed, patients with supradiaphragmal tumor thrombus (n = 10 even had a better outcome (overall survival at 5 years of 58.33% than the entire cohort. Conclusions An aggressive surgical approach is the most effective therapeutic option in patients with RCC and any level of tumor thrombus and offers a reasonable longterm survival. Due to good clinical and oncological outcome we prefer the use of CPB with extracorporal

  1. PET-Probe: Evaluation of Technical Performance and Clinical Utility of a Handheld High-Energy Gamma Probe in Oncologic Surgery.

    Science.gov (United States)

    Gulec, Seza A; Daghighian, Farhad; Essner, Richard

    2016-12-01

    Positron emission tomography (PET) has become an invaluable part of patient evaluation in surgical oncology. PET is less than optimal for detecting lesions PET-positive lesions can be challenging as a result of difficulties in surgical exposure. We undertook this investigation to assess the utility of a handheld high-energy gamma probe (PET-Probe) for intraoperative identification of 18 F-deoxyglucose (FDG)-avid tumors. Forty patients underwent a diagnostic whole-body FDG-PET scan for consideration for surgical exploration and resection. Before surgery, all patients received an intravenous injection of 7 to 10 mCi of FDG. At surgery, the PET-Probe was used to determine absolute counts per second at the known tumor site(s) demonstrated by whole-body PET and at adjacent normal tissue (at least 4 cm away from tumor-bearing sites). Tumor-to-background ratios were calculated. Thirty-two patients (80%) underwent PET-Probe-guided surgery with therapeutic intent in a recurrent or metastatic disease setting. Eight patients underwent surgery for diagnostic exploration. Anatomical locations of the PET-identified lesions were neck and supraclavicular (n = 8), axilla (n = 5), groin and deep iliac (n = 4), trunk and extremity soft tissue (n = 3), abdominal and retroperitoneal (n = 19), and lung (n = 2). PET-Probe detected all PET-positive lesions. The PET-Probe was instrumental in localization of lesions in 15 patients that were not immediately apparent by surgical exploration. The PET-Probe identified all lesions demonstrated by PET scanning and, in selected cases, was useful in localizing FDG-avid disease not seen with conventional PET scanning.

  2. Surgical Management of Metastatic Colorectal Cancer: A Single-Centre Experience on Oncological Outcomes of Pulmonary Resection vs Cytoreductive Surgery and HIPEC.

    Science.gov (United States)

    Wong, Evelyn Yi Ting; Tan, Grace Hwei Ching; Ng, Deanna Wan Jie; Koh, Tina Puay Theng; Kumar, Mrinal; Teo, Melissa Ching Ching

    2017-12-01

    Metastasectomy is accepted as standard of care for selected patients with colorectal pulmonary metastases (CLM); however, the role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal peritoneal metastases (CPM) is not universally accepted. We aim to compare oncological outcomes of patients with CLM and CPM after pulmonary resection and CRS-HIPEC, respectively, by comparing overall survival (OS) and disease-free survival (DFS). A retrospective review of 49 CLM patients who underwent pulmonary resection, and 52 CPM patients who underwent CRS-HIPEC in a single institution from January 2003 to March 2015, was performed. The 5-year OS for CLM patients and CPM patients were 59.6 and 40.5%, respectively (p = 0.100), while the 5-year DFS were 24.0 and 14.2%, respectively (p = 0.173). CPM patients had longer median operative time (8.38 vs. 1.75 h, p CPM patients by multivariate analysis. There were no independent prognostic factors for DFS in CLM patients by multivariate analysis, but peritoneal cancer index score, bladder involvement, and higher nodal stage at presentation of the initial malignancy were independent prognostic factors for DFS in CPM patients. OS and DFS for CPM patients after CRS and HIPEC are comparable to CLM patients after lung resection, although morbidity appears higher. The prognostic factors affecting survival after surgery are different between CPM and CLM patients and must be considered when selecting patients for metastasectomy.

  3. Oncologic imaging

    International Nuclear Information System (INIS)

    Bragg, D.G.; Rubin, P.; Youker, J.E.

    1985-01-01

    This book presents papers on nuclear medicine. Topics considered include the classification of cancers, oncologic diagnosis, brain and spinal cord neoplasms, lymph node metastases, the larynx and hypopharynx, thyroid cancer, breast cancer, esophageal cancer, bladder cancer, tumors of the skeletal system, pediatric oncology, computed tomography and radiation therapy treatment planning, and the impact of future technology on oncologic diagnosis

  4. Evaluation of a specialized oncology nursing supportive care intervention in newly diagnosed breast and colorectal cancer patients following surgery: a cluster randomized trial.

    Science.gov (United States)

    Sussman, Jonathan; Bainbridge, Daryl; Whelan, Timothy J; Brazil, Kevin; Parpia, Sameer; Wiernikowski, Jennifer; Schiff, Susan; Rodin, Gary; Sergeant, Myles; Howell, Doris

    2018-05-01

    Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancer patients. Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services. Newly diagnosed breast and colorectal cancer patients within 7 days of cancer surgery were eligible. The primary outcome was the patient-reported outcome (PRO) of continuity of care (CCCQ) measured at 3 weeks. Secondary outcomes included unmet supportive care needs (SCNS), quality of life (EORTC QLQ-C30), health resource utilization, and level of uncertainty with care trajectory (MUIS) at 3 and/or 8 weeks. A total of 121 breast and 72 colorectal patients were randomized through 28 surgical practices. There was a small improvement in the informational domain of continuity of care (difference 0.29 p = 0.05) and a trend to less emergency room use (15.8 vs 7.1%) (p = 0.07). There were no significant differences between groups on unmet need, quality of life, or uncertainty. We did not find substantial gaps in the PROs measured immediately following surgery for breast and colorectal cancer patients. The results of this study support a more targeted approach based on need and inform future research focused on improving navigation during the initial phases of cancer treatment. ClinicalTrials.gov Identifier: NCT00182234. SONICS-Effectiveness of Specialist Oncology Nursing.

  5. Patient Age and Tumor Subtype Predict the Extent of Axillary Surgery Among Breast Cancer Patients Eligible for the American College of Surgeons Oncology Group Trial Z0011.

    Science.gov (United States)

    Ong, Cecilia T; Thomas, Samantha M; Blitzblau, Rachel C; Fayanju, Oluwadamilola M; Park, Tristen S; Plichta, Jennifer K; Rosenberger, Laura H; Hyslop, Terry; Shelley Hwang, E; Greenup, Rachel A

    2017-11-01

    The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial established the safety of omitting axillary lymph node dissection (ALND) for early-stage breast cancer patients with limited nodal disease undergoing lumpectomy. We examined the extent of axillary surgery among women eligible for Z0011 based on patient age and tumor subtype. Patients with cT1-2, cN0 breast cancers and one or two positive nodes diagnosed from 2009 to 2014 and treated with lumpectomy were identified in the National Cancer Data Base. Sentinel lymph node biopsy (SLNB) was defined as the removal of 1-5 nodes and ALND as the removal of 10 nodes or more. Tumor subtype was categorized as luminal, human epidermal growth factor 2-positive (HER2+), or triple-negative. Logistic regression was used to estimate the odds of receiving SLNB alone versus ALND. The inclusion criteria were met by 28,631 patients (21,029 SLNB-alone and 7602 ALND patients). Patients 70 years of age or older were more likely to undergo SLNB alone than ALND (27.0% vs 20.1%; p alone and 89.7% after ALND. In the multivariate analysis, the uptake of Z0011 recommendations increased over time (2014 vs 2009: odds ratio [OR] 13.02; p alone than older patients (age alone than those with luminal subtypes. Among women potentially eligible for ACOSOG Z0011, the use of SLNB alone increased over time in all groups, but the extent of axillary surgery differed by patient age and tumor subtype.

  6. Cataract Surgery

    Science.gov (United States)

    ... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Are Cataracts? Pediatric Cataracts Cataract Diagnosis and Treatment Cataract Surgery IOL Implants: Lens Replacement After Cataracts ...

  7. Measurement of cardiac index by transpulmonary thermodilution using an implanted central venous access port: a prospective study in patients scheduled for oncologic high-risk surgery.

    Science.gov (United States)

    Suria, Stéphanie; Wyniecki, Anne; Eghiaian, Alexandre; Monnet, Xavier; Weil, Grégoire

    2014-01-01

    Transpulmonary thermodilution allows the measurement of cardiac index for high risk surgical patients. Oncologic patients often have a central venous access (port-a-catheter) for chronic treatment. The validity of the measurement by a port-a-catheter of the absolute cardiac index and the detection of changes in cardiac index induced by fluid challenge are unknown. We conducted a monocentric prospective study. 27 patients were enrolled. 250 ml colloid volume expansions for fluid challenge were performed during ovarian cytoreductive surgery. The volume expansion-induced changes in cardiac index measured by transpulmonary thermodilution by a central venous access (CIcvc) and by a port-a-catheter (CIport) were recorded. 23 patients were analyzed with 123 pairs of measurements. Using a Bland and Altman for repeated measurements, the bias (lower and upper limits of agreement) between CIport and CIcvc was 0.14 (-0.59 to 0.88) L/min/m2. The percentage error was 22%. The concordance between the changes in CIport and CIcvc observed during volume expansion was 92% with an r = 0.7 (with exclusion zone). No complications (included sepsis) were observed during the follow up period. The transpulmonary thermodilution by a port-a-catheter is reliable for absolute values estimation of cardiac index and for measurement of the variation after fluid challenge. clinicaltrials.gov NCT02063009.

  8. Oncological outcome following laparoscopic versus open surgery for cancer in the transverse colon: a nationwide cohort study.

    Science.gov (United States)

    Nordholm-Carstensen, Andreas; Jensen, Kristian Kiim; Krarup, Peter-Martin

    2018-03-30

    The literature on transverse colonic cancer resection is sparse. The optimal surgical approach for this disease is thus unknown. This study aimed to examine laparoscopic versus open surgery for transverse colonic cancer. This study was a nationwide, retrospective cohort study of all patients registered with a transverse colonic cancer in Denmark between 2010 and 2013. Data were obtained from the Danish Colorectal Cancer Group, the Danish Pathology Registry, Danish National Patient Registry, and patients' records. Main outcome measures were surgical resection plane, lymph node yield, and long-term cancer recurrence and survival. In total, 357 patients were included. Non-mesocolic resection was more frequent with laparoscopic compared with open resection (adjusted odds ratio 2.44, 95% CI 1.29-4.60, P = 0.006). Median number of harvested lymph nodes was higher after open compared with laparoscopic resection (22 versus 19, P = 0.03). Non-mesocolic resection (adjusted hazard ratio 2.45, 95% CI 1.25-4.79, P = 0.01) and increasing tumor stage (P transverse colonic cancers led to similar long-term results compared with open resection.

  9. Pediatric oncologic endosurgery.

    Science.gov (United States)

    Boo, Yoon Jung; Goedecke, Jan; Muensterer, Oliver J

    2017-08-01

    Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

  10. Comparison of two threshold detection criteria methodologies for determination of probe positivity for intraoperative in situ identification of presumed abnormal 18F-FDG-avid tissue sites during radioguided oncologic surgery.

    Science.gov (United States)

    Chapman, Gregg J; Povoski, Stephen P; Hall, Nathan C; Murrey, Douglas A; Lee, Robert; Martin, Edward W

    2014-09-13

    Intraoperative in situ identification of (18)F-FDG-avid tissue sites during radioguided oncologic surgery remains a significant challenge for surgeons. The purpose of our study was to evaluate the 1.5-to-1 ratiometric threshold criteria method versus the three-sigma statistical threshold criteria method for determination of gamma detection probe positivity for intraoperative in situ identification of presumed abnormal (18)F-FDG-avid tissue sites in a manner that was independent of the specific type of gamma detection probe used. From among 52 patients undergoing appropriate in situ evaluation of presumed abnormal (18)F-FDG-avid tissue sites during (18)F-FDG-directed surgery using 6 available gamma detection probe systems, a total of 401 intraoperative gamma detection probe measurement sets of in situ counts per second measurements were cumulatively taken. For the 401 intraoperative gamma detection probe measurement sets, probe positivity was successfully met by the 1.5-to-1 ratiometric threshold criteria method in 150/401 instances (37.4%) and by the three-sigma statistical threshold criteria method in 259/401 instances (64.6%) (P < 0.001). Likewise, the three-sigma statistical threshold criteria method detected true positive results at target-to-background ratios much lower than the 1.5-to-1 target-to-background ratio of the 1.5-to-1 ratiometric threshold criteria method. The three-sigma statistical threshold criteria method was significantly better than the 1.5-to-1 ratiometric threshold criteria method for determination of gamma detection probe positivity for intraoperative in situ detection of presumed abnormal (18)F-FDG-avid tissue sites during radioguided oncologic surgery. This finding may be extremely important for reshaping the ongoing and future research and development of gamma detection probe systems that are necessary for optimizing the in situ detection of radioisotopes of higher-energy gamma photon emissions used during radioguided oncologic surgery.

  11. Primary radical ablative surgery and fibula free-flap reconstruction for T4 oral cavity squamous cell carcinoma with mandibular invasion: oncologic and functional results and their predictive factors.

    Science.gov (United States)

    Camuzard, Olivier; Dassonville, Olivier; Ettaiche, Marc; Chamorey, Emmanuel; Poissonnet, Gilles; Berguiga, Riadh; Leysalle, Axel; Benezery, Karen; Peyrade, Frédéric; Saada, Esma; Hechema, Raphael; Sudaka, Anne; Haudebourg, Juliette; Demard, François; Santini, José; Bozec, Alexandre

    2017-01-01

    The aims of this study were to evaluate clinical outcomes and to determine their predictive factors in patients with oral cavity squamous cell carcinoma (OCSCC) invading the mandibular bone (T4) who underwent primary radical surgery and fibula free-flap reconstruction. Between 2001 and 2013, all patients who underwent primary surgery and mandibular fibula free-flap reconstruction for OCSCC were enrolled in this retrospective study. Predictive factors of oncologic and functional outcomes were assessed in univariate and multivariate analysis. 77 patients (55 men and 22 women, mean age 62 ± 10.6 years) were enrolled in this study. Free-flap failure and local and general complication rates were 9, 31, and 22 %, respectively. In multivariate analysis, ASA score (p = 0.002), pathologic N-stage (p = 0.01), and close surgical margins (p = 0.03) were independent predictors of overall survival. Six months after therapy, oral diet, speech intelligibility, and mouth opening functions were normal or slightly impaired in, respectively, 79, 88, and 83 % of patients. 6.5 % of patients remaining dependent on enteral nutrition 6 months after therapy. With acceptable postoperative outcomes and satisfactory oncologic and functional results, segmental mandibulectomy with fibula free-flap reconstruction should be considered the gold standard primary treatment for patients with OCSCC invading mandible bone. Oncologic outcomes are dependent on three main factors: ASA score, pathologic N-stage, and surgical margin status.

  12. Radiation oncology

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    The Radiation Oncology Division has had as its main objectives both to operate an academic training program and to carry out research on radiation therapy of cancer. Since fiscal year 1975, following a directive from ERDA, increased effort has been given to research. The research activities have been complemented by the training program, which has been oriented toward producing radiation oncologists, giving physicians short-term experience in radiation oncology, and teaching medical students about clinical cancer and its radiation therapy. The purpose of the research effort is to improve present modalities of radiation therapy of cancer. As in previous years, the Division has operated as the Radiation Oncology Program of the Department of Radiological Sciences of the University of Puerto Rico School of Medicine. It has provided radiation oncology support to patients at the University Hospital and to academic programs of the University of Puerto Rico Medical Sciences Campus. The patients, in turn, have provided the clinical basis for the educational and research projects of the Division. Funding has been primarily from PRNC (approx. 40%) and from National Cancer Institute grants channeled through the School of Medicine (approx. 60%). Special inter-institutional relationships with the San Juan Veterans Administration Hospital and the Metropolitan Hospital in San Juan have permitted inclusion of patients from these institutions in the Division's research projects. Medical physics and radiotherapy consultations have been provided to the Radiotherapy Department of the VA Hospital

  13. Five year follow-up of a randomized controlled trial on warming and humidification of insufflation gas in laparoscopic colonic surgery--impact on small bowel obstruction and oncologic outcomes.

    Science.gov (United States)

    Sammour, Tarik; Hill, Andrew G

    2015-04-01

    Warming and humidification of insufflation gas has been shown to reduce adhesion formation and tumor implantation in the laboratory setting, but clinical evidence is lacking. We aimed to test the hypothesis that warming and humidification of insufflation CO2 would lead to reduced adhesion formation, and improve oncologic outcomes in laparoscopic colonic surgery. This was a 5-year follow-up of a multicenter, double-blinded, randomized, controlled trial investigating warming and humidification of insufflation gas. The study group received warmed (37°C), humidified (98%) insufflation carbon dioxide, and the control group received standard gas (19°C, 0%). All other aspects of patient care were standardized. Admissions for small bowel obstruction were recorded, as well as whether management was operative or nonoperative. Local and systemic cancer recurrence, 5-year overall survival, and cancer specific survival rates were also recorded. Eighty two patients were randomized, with 41 in each arm. Groups were well matched at baseline. There was no difference between the study and control groups in the rate of clinical small bowel obstruction (5.7% versus 0%, P 0.226); local recurrence (6.5% versus 6.1%, P 1.000); overall survival (85.7% versus 82.1%, P 0.759); or cancer-specific survival (90.3% versus 87.9%, P 1.000). Warming and humidification of insufflation CO2 in laparoscopic colonic surgery does not appear to confer a clinically significant long term benefit in terms of adhesion reduction or oncological outcomes, although a much larger randomized controlled trial (RCT) would be required to confirm this. ClinicalTrials.gov Trial identifier: NCT00642005; US National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894, USA.

  14. Current management of surgical oncologic emergencies.

    Science.gov (United States)

    Bosscher, Marianne R F; van Leeuwen, Barbara L; Hoekstra, Harald J

    2015-01-01

    For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  15. Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2cm or larger: A literature review and analysis of oncological and obstetrical outcomes.

    Science.gov (United States)

    Pareja, Rene; Rendón, Gabriel J; Vasquez, Monica; Echeverri, Lina; Sanz-Lomana, Carlos Millán; Ramirez, Pedro T

    2015-06-01

    Radical trachelectomy is the treatment of choice in women with early-stage cervical cancer wishing to preserve fertility. Radical trachelectomy can be performed with a vaginal, abdominal, or laparoscopic/robotic approach. Vaginal radical trachelectomy (VRT) is generally not offered to patients with tumors 2cm or larger because of a high recurrence rate. There are no conclusive recommendations regarding the safety of abdominal radical trachelectomy (ART) or laparoscopic radical trachelectomy (LRT) in such patients. Several investigators have used neoadjuvant chemotherapy in patients with tumors 2 to 4cm to reduce tumor size so that fertility preservation may be offered. However, to our knowledge, no published study has compared outcomes between patients with cervical tumors 2cm or larger who underwent immediate radical trachelectomy and those who underwent neoadjuvant chemotherapy followed by radical trachelectomy. We conducted a literature review to compare outcomes with these 2 approaches. Our main endpoints for evaluation were oncological and obstetrical outcomes. The fertility preservation rate was 82.7%, 85.1%, 89%; and 91.1% for ART (tumors larger than >2cm), ART (all sizes), NACT followed by surgery and VRT (all sizes); respectively. The global pregnancy rate was 16.2%, 24% and 30.7% for ART, VRT, and NACT followed by surgery; respectively. The recurrence rate was 3.8%, 4.2%, 6%, 7.6% and 17% for ART (all sizes), VRT (all sizes), ART (tumors>2cm), NACT followed by surgery, and VRT (tumors>2cm). These outcomes must be considered when offering a fertility sparing technique to patients with a tumor larger than 2cm. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

    Directory of Open Access Journals (Sweden)

    Christiana Maria Ribeiro Salles Vanni

    2012-01-01

    Full Text Available Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF has been widely used in these specific situations due to its reliability and low rate of failure or complications. Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction. Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria. Results. Reconstruction was successful in 13 cases (76.5%, with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5% and were specifically related to the flap in nine instances (52.9%. An association was identified between the development of major complications and reconstruction of the hypopharynx (=0.013 as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (=0.002. The former condition is also associated with major reconstruction failure (=0.018. An even lower incidence of major complications was noted in patients under the age of 53 (=0.044. Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.

  17. Oncological emergencies for the internist

    Directory of Open Access Journals (Sweden)

    Umesh Das

    2015-01-01

    Full Text Available An oncologic emergency is defined as any acute, potentially life-threatening event, either directly or indirectly related to a patient′s cancer (ca or its treatment. It requires rapid intervention to avoid death or severe permanent damage. Most oncologic emergencies can be classified as metabolic, hematologic, structural, or side effects from chemotherapy agents. Tumor lysis syndrome is a metabolic emergency that presents as severe electrolyte abnormalities. The condition is treated with aggressive hydration, allopurinol or urate oxidase to lower uric acid levels. Hypercalcemia of malignancy is treated with aggressive rehydration, furosemide, and intravenous (IV bisphosphonates. Syndrome of inappropriate antidiuretic hormone should be suspected if a patient with ca presents with normovolemic hyponatremia. This metabolic condition usually is treated with fluid restriction and furosemide. Febrile neutropenia is a hematologic emergency that usually requires inpatient therapy with broad-spectrum antibiotics, although outpatient therapy may be appropriate for low-risk patients. Hyperviscosity syndrome usually is associated with Waldenstrφm′s macroglobulinemia, which is treated with plasmapheresis and chemotherapy. Structural oncologic emergencies are caused by direct compression of surrounding structures or by metastatic disease. Superior vena cava syndrome is the most common structural oncological emergency. Treatment options include chemotherapy, radiation, and IV stenting. Epidural spinal cord compression can be treated with dexamethasone, radiation, or surgery. Malignant pericardial effusion, which often is undiagnosed in ca patients, can be treated with pericardiocentesis or a pericardial window procedure.

  18. Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing.

    Science.gov (United States)

    French, Katy E; Guzman, Alexis B; Rubio, Augustin C; Frenzel, John C; Feeley, Thomas W

    2016-09-01

    With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13% and 28% across the 11 procedures. TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Coping with moral distress in oncology practice: nurse and physician strategies

    OpenAIRE

    Lievrouw, An; Vanheule, Stijn; Deveugele, Myriam; De Vos, Martine; Pattyn, Piet; Van Belle, Simon; Benoit, Dominique

    2016-01-01

    Purpose/Objectives: To explore variations in coping with moral distress among physicians and nurses in a university hospital oncology setting. Research Approach: Qualitative interview study. Setting: Internal medicine (gastroenterology and medical oncology), gastrointestinal surgery, and day clinic chemotherapy at Ghent University Hospital in Belgium. Participants: 17 doctors and 18 nurses with varying experience levels, working in three different oncology hospital settings. M...

  20. [FEMALE SURGEONS SHOULD BE AWARE OF THE IMPORTANCE OF A CLEAR VISION FOR THEIR CAREER AND LIFE PLANS TO ACHIEVE THEIR CAREER DEVELOPMENT.: A SURVEY OF 20 FEMALE SURGEONS AT THE DEPARTMENT OF SURGERY AND ONCOLOGY, KYUSHU UNIVERSITY].

    Science.gov (United States)

    Nagayoshi, Kinuko; Mori, Hitomi; Kameda, Chizu; Nakamura, Katsuya; Ueki, Takashi; Tanaka, Masao

    2015-05-01

    A shortage of surgeons has been a serious problem in recent years. There is an urgent need to utilize female surgeons who tend to resign because of bearing and raising of children. To examine possible measures to deal with the issue, we performed questionnaire survey about work-life balance and career planning on 20 female surgeons in the Department of Surgery and Oncology, Kyushu University. The response rate was 80.0%. In the 16 respondents, seven were unmarried and nine were married. A large fraction of the respondents recognized the importance of work-life-balance. Female surgeons have many difficulties to continue working with good work-life balance; therefore, understanding and cooperation of both their spouses and coworkers is considered to be necessary. Married female surgeons considered that improvement of the working environment and sufficient family support were more important for good work-life balance compared to those who were unmarried. Female surgeons should recognize the importance of improvement of their environment, including the workplace and the family to continue working with good work-life balance in youth and should have the prospects about their career plan of their own.

  1. Neuro-Oncology Branch

    Science.gov (United States)

    ... BTTC are experts in their respective fields. Neuro-Oncology Clinical Fellowship This is a joint program with ... can increase survival rates. Learn more... The Neuro-Oncology Branch welcomes Dr. Mark Gilbert as new Branch ...

  2. A prospective phase II study of adjuvant postoperative radiation therapy following nodal surgery in malignant melanoma-Trans Tasman Radiation Oncology Group (TROG) Study 96.06

    International Nuclear Information System (INIS)

    Burmeister, Bryan H.; Mark Smithers, B.; Burmeister, Elizabeth; Baumann, Kathryn; Davis, Sidney; Krawitz, Hedley; Johnson, Carol; Spry, Nigel

    2006-01-01

    Background: The role of adjuvant postoperative therapy after resection of localised malignant melanoma involving regional lymph nodes remains controversial. There are no randomised trials that confirm that postoperative radiation conveys a benefit in terms of regional control or survival. Methods: Two hundred and thirty-four patients with melanoma involving lymph nodes were registered on a prospective study to evaluate the effect of postoperative radiation therapy. The regimen consisted of 48 Gy in 20 fractions to the nodal basin using recommended treatment guidelines for each of the major node sites. The primary endpoints were regional in-field relapse and late toxicity. Secondary endpoints were adjacent relapse, distant relapse, overall survival, progression-free survival and time to in-field progression. Results: Adjuvant radiation therapy was well tolerated by all of the patients. As the first site of relapse, regional in-field relapses occurred in 16/234 patients (6.8%). The overall survival was 36% at 5 years. The progression-free survival and regional control rates were 27% and 91%, respectively, at 5 years. Patients with more than 2 nodes involved had a significantly worse outcome in terms of distant relapse, overall and progression-free survival. Conclusion: We believe that adjuvant radiation therapy following nodal surgery could offer a possible benefit in terms of regional control. These results require confirmation in a randomised trial

  3. Nanotechnology in Radiation Oncology

    Science.gov (United States)

    Wang, Andrew Z.; Tepper, Joel E.

    2014-01-01

    Nanotechnology, the manipulation of matter on atomic and molecular scales, is a relatively new branch of science. It has already made a significant impact on clinical medicine, especially in oncology. Nanomaterial has several characteristics that are ideal for oncology applications, including preferential accumulation in tumors, low distribution in normal tissues, biodistribution, pharmacokinetics, and clearance, that differ from those of small molecules. Because these properties are also well suited for applications in radiation oncology, nanomaterials have been used in many different areas of radiation oncology for imaging and treatment planning, as well as for radiosensitization to improve the therapeutic ratio. In this article, we review the unique properties of nanomaterials that are favorable for oncology applications and examine the various applications of nanotechnology in radiation oncology. We also discuss the future directions of nanotechnology within the context of radiation oncology. PMID:25113769

  4. Current management of surgical oncologic emergencies.

    Directory of Open Access Journals (Sweden)

    Marianne R F Bosscher

    Full Text Available For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC. In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  5. Guidelines on oncologic imaging

    International Nuclear Information System (INIS)

    1989-01-01

    The present issue of European Journal of Radiology is devoted to guidelines on oncologic imaging. 9 experts on imaging in suspected or evident oncologic disease have compiled a broad survey on strategies as well as techniques on oncologic imaging. The group gives advice for detecting tumours at specific tumour sites and use modern literature to emphasize their recommendations. All recommendations are short, comprehensive and authoritative. (orig./MG)

  6. Career opportunities in oncology.

    Science.gov (United States)

    Farrow, L

    Oncology nursing offers nurses a wide range of opportunities. Nurses need a wide range of skills in order to care for patients who may have acute oncological illnesses or require palliative care. The nature of the nurse/patient relationship can be intense. Nurses generally find this enhances job satisfaction. The pressures exerted on nurses working in oncology can be immense. Oncology nursing is rewarding but very demanding and therefore the nurse has to be resourceful. Early career planning is advisable to take advantage of the opportunities that are currently available.

  7. Acute oncological emergencies.

    LENUS (Irish Health Repository)

    Gabriel, J

    2012-01-01

    The number of people receiving systemic anti-cancer treatment and presenting at emergency departments with treatment-related problems is rising. Nurses will be the first point of contact for most patients and need to be able to recognise oncological emergencies to initiate urgent assessment of patients and referral to the acute oncology team so that the most appropriate care can be delivered promptly. This article discusses the role of acute oncology services, and provides an overview of the most common acute oncological emergencies.

  8. Change in reimbursement and costs in German oncological head and neck surgery over the last decade: ablative tongue cancer surgery and reconstruction with split-thickness skin graft vs. microvascular radial forearm flap.

    Science.gov (United States)

    Hoefert, Sebastian; Lotter, Oliver

    2018-05-01

    Defects after ablative tongue cancer surgery can be reconstructed by split-thickness skin grafts or free microvascular flaps. The different surgical options may influence costs, reimbursement, and therefore possible profits. Our goal was to analyze the development of these parameters for different procedures in head and neck reconstruction in Germany over the last decade. After tumor resection and neck dissection of tongue cancer, three different scenarios were chosen to calculate costs, reimbursement, length of stay (LoS), and profits. Two options considered were reconstruction by split-thickness skin graft with (option Ia) and without (option Ib) tracheotomy. In addition, we analyzed microvascular reconstruction with radial forearm flap (option II). Furthermore, unsatisfactory results after options Ia and Ib may make secondary tongue plastic with split-thickness skin grafting necessary (option I+). The calculations were performed considering the German Diagnosis Related Group (DRG) system and compared to the specific DRG cost data of 250 German reference hospitals. The overall average length of stay (aLoS) declined from 16.7 to 12.8 days with a reduction in every option. Until 2011, all options showed similar accumulated DRG reimbursement. From 2012 onwards, earnings almost doubled for option II due to changes in the DRG allocation. As was expected, the highest costs were observed in option II. Profits (reimbursement minus costs) were also highest for option II (mean 2052 €, maximum 3630 Euros in 2015) followed by options Ia (765 €) and Ib/I+ (681 €). Average profits over time would be 17 to 19% higher if adjusted for inflation. We showed the development of the DRG allocation of two commonly used methods of reconstruction after ablative tongue cancer surgery and the associated LoS, reimbursement, costs, and profits. As expected, the highest values were found for microvascular reconstruction. Microvascular reconstruction may also be the primary choice of

  9. Basic radiation oncology

    International Nuclear Information System (INIS)

    Beyzadeoglu, M. M.; Ebruli, C.

    2008-01-01

    Basic Radiation Oncology is an all-in-one book. It is an up-to-date bedside oriented book integrating the radiation physics, radiobiology and clinical radiation oncology. It includes the essentials of all aspects of radiation oncology with more than 300 practical illustrations, black and white and color figures. The layout and presentation is very practical and enriched with many pearl boxes. Key studies particularly randomized ones are also included at the end of each clinical chapter. Basic knowledge of all high-tech radiation teletherapy units such as tomotherapy, cyberknife, and proton therapy are also given. The first 2 sections review concepts that are crucial in radiation physics and radiobiology. The remaining 11 chapters describe treatment regimens for main cancer sites and tumor types. Basic Radiation Oncology will greatly help meeting the needs for a practical and bedside oriented oncology book for residents, fellows, and clinicians of Radiation, Medical and Surgical Oncology as well as medical students, physicians and medical physicists interested in Clinical Oncology. English Edition of the book Temel Radyasyon Onkolojisi is being published by Springer Heidelberg this year with updated 2009 AJCC Staging as Basic Radiation Oncology

  10. Oncological mamoplasty in the Cancerology National Institute

    International Nuclear Information System (INIS)

    Caicedo, Jose; Nino, Alvaro

    1999-01-01

    The conservative surgery is analyzed in the breast cancer. As premise, it settles down that in the quadrantectomy, the breast should always be left aesthetic. The oncological mamoplasty is then a technique that should be considered and for it should always be left it margin oncology in the borders of the tumors, the surgeon should have experience and it is important to have a good pursuit. The surgery is bilateral and it doesn't leave scars in the superior quadrants. In this revision 53 patients were analyzed, keeping in mind that there are few reports on this technique or to proceed therapeutic in the literature. The procedures were carried out in their majority in patient pre menopauses and they were made inclusive in advanced states. Radiotherapy and chemotherapy were used in the treatment

  11. Cancer Patients and Oncology Nursing: Perspectives of Oncology ...

    African Journals Online (AJOL)

    Background and Aim: Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. Materials and Methods: This survey was conducted with 70 oncology nurses working at ...

  12. Oncology Advanced Practitioners Bring Advanced Community Oncology Care.

    Science.gov (United States)

    Vogel, Wendy H

    2016-01-01

    Oncology care is becoming increasingly complex. The interprofessional team concept of care is necessary to meet projected oncology professional shortages, as well as to provide superior oncology care. The oncology advanced practitioner (AP) is a licensed health care professional who has completed advanced training in nursing or pharmacy or has completed training as a physician assistant. Oncology APs increase practice productivity and efficiency. Proven to be cost effective, APs may perform varied roles in an oncology practice. Integrating an AP into an oncology practice requires forethought given to the type of collaborative model desired, role expectations, scheduling, training, and mentoring.

  13. Psychosocial Issues in Pediatric Oncology

    Science.gov (United States)

    Marcus, Joel

    2012-01-01

    Psychosocial oncology, a relatively new discipline, is a multidisciplinary application of the behavioral and social sciences, and pediatric psychosocial oncology is an emerging subspecialty within the domain of psychosocial oncology. This review presents a brief overview of some of the major clinical issues surrounding pediatric psychosocial oncology. PMID:23049457

  14. Metabolic complications in oncology

    International Nuclear Information System (INIS)

    Sycova-Mila, Z.

    2012-01-01

    Currently, a lot of space and time is devoted to the therapy of oncologic diseases itself. To reach the good therapy results, complex care of the oncologic patient is needed. Management of complications linked with the disease itself and management of complications emerged after administration of chemotherapy, radiotherapy or targeted therapy, plays a significant role. In addition to infectious, hematological, neurological, cardiac or other complications, metabolic complications are relatively extensive and serious. One of the most frequent metabolic complications in oncology is tumor lysis syndrome, hyperuricemia, hypercalcaemia and syndrome of inappropriate secretion of antidiuretic hormone. (author)

  15. 76 FR 61713 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-10-05

    ...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... adult oncology indication, or in late stage development in pediatric patients with cancer. The...

  16. Lymphoscintigraphy in oncology: a rediscovered challenge

    Energy Technology Data Exchange (ETDEWEB)

    Valdes Olmos, R.A.; Hoefnagel, C.A. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Nuclear Medicine; Nieweg, O.E.; Jansen, L.; Rutgers, E.J.T.; Kroon, B.B.R. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Surgery; Borger, J. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Radiotherapy; Horenblas, S. [Netherlands Cancer Inst., Amsterdam (Netherlands). Dept. of Urology

    1999-04-01

    The validation of the sentinel node concept in oncology has led to the rediscovery of lymphoscintigraphy. By combining preoperative lymphatic mapping with intraoperative probe detection this nuclear medicine procedure is being increasingly used to identify and detect the sentinel node in melanoma, breast cancer, and in other malignancies such as penile cancer and vulvar cancer. In the past lymphoscintigraphy has been widely applied for various indications in oncology, and in the case of the internal mammary lymph-node chain its current use in breast cancer remains essential to adjust irradiation treatment to the individual findings of each patient. In another diagnostic area, lymphoscintigraphy is also useful to document altered drainage patterns after surgery and/or radiotherapy; its use in breast cancer patients with upper limb oedema after axillary lymph-node dissection or in melanoma patients with lower-extremity oedema after groin dissection can provide information for physiotherapy or reconstructive surgery. Finally, the renewed interest in lymphoscintigraphy in oncology has led not only to the rediscovery of findings from old literature reports, but also to a discussion about methodological aspects such as tracer characteristics, image acquisition or administration routes, as well as to discussion on the study of migration patterns of radiolabelled colloid particles in the context of cancer dissemination. All this makes the need for standardized guidelines for lymphoscintigraphy mandatory. (orig.) With 10 figs., 1 tab., 56 refs.

  17. [Quality assurance in head and neck medical oncology].

    Science.gov (United States)

    Digue, Laurence; Pedeboscq, Stéphane

    2014-05-01

    In medical oncology, how can we be sure that the right drug is being administered to the right patient at the right time? The implementation of quality assurance criteria is important in medical oncology, in order to ensure that the patient receives the best treatment safely. There is very little literature about quality assurance in medical oncology, as opposed to radiotherapy or cancer surgery. Quality assurance must cover the entire patient care process, from the diagnosis, to the therapeutic decision and drug distribution, including its selection, its preparation and its delivery to the patient (administration and dosage), and finally the potential side effects and their management. The dose-intensity respect is crucial, and its reduction can negatively affect overall survival rates, as shown in breast and testis cancers for example. In head and neck medical oncology, it is essential to respect the few well-standardized recommendations and the dose-intensity, in a population with numerous comorbidities. We will first review quality assurance criteria for the general medical oncology organization and then focus on head and neck medical oncology. We will then describe administration specificities of head and neck treatments (chemoradiation, radiation plus cetuximab, postoperative chemoradiation, induction and palliative chemotherapy) as well as their follow-up. Lastly, we will offer some recommendations to improve quality assurance in head and neck medical oncology.

  18. Innovations in radiation oncology

    International Nuclear Information System (INIS)

    Withers, H.R.

    1988-01-01

    The series 'Medical Radiology - Diagnostic Imaging and Radiation Oncology' is the successor to the well known 'Encyclopedia of Medical Radiology/Handbuch der medizinischen Radiologie'. 'Medical Radiology' brings the state of the art on special topics in a timely fashion. This volume 'Innovation in Radiation Oncology', edited by H.R. Withers and L.J. Peters, presents data on the development of new therapeutic strategies in different oncologic diseases. 57 authors wrote 32 chapters covering a braod range of topics. The contributors have written their chapters with the practicing radiation oncologist in mind. The first chapter sets the stage by reviewing the quality of radiation oncology as it is practiced in the majority of radiation oncology centers in the United States. The second chapter examines how we may better predict the possible causes of failure of conventional radiotherapy in order that the most appropriate of a variety of therapeutic options may eventually be offered to patients on an individual basis. The third chapter discussed how our therapeutic endeavors affect the quality of life, a problem created by our ability to be successful. Following these three introductory chapters there are 29 chapters by highly qualified specialists discussing the newest ideas in subjects of concern to the practicing radiation oncologist. With 111 figs

  19. Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study.

    Science.gov (United States)

    Kim, Jong Wan; Kim, Jeong Yeon; Kang, Byung Mo; Lee, Bong Hwa; Kim, Byung Chun; Park, Jun Ho

    2016-01-01

    The purpose of the present study was to compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery for transverse colon cancer. We conducted a retrospective review of patients who underwent surgery for transverse colon cancer at six Hallym University-affiliated hospitals between January 2005 and June 2015. The perioperative outcomes and oncologic outcomes were compared between laparoscopic and open surgery. Of 226 patients with transverse colon cancer, 103 underwent laparoscopic surgery and 123 underwent open surgery. There were no differences in the patient characteristics between the two groups. Regarding perioperative outcomes, the operation time was significantly longer in the laparoscopic group than in the open group (267.3 vs 172.7 minutes, Pstudy showed that laparoscopic surgery is associated with several perioperative benefits and similar oncologic outcomes to open surgery for the resection of transverse colon cancer. Therefore, laparoscopic surgery offers a safe alternative to open surgery in patients with transverse colon cancer.

  20. Predictors of Lymphedema Following Breast Cancer Surgery

    National Research Council Canada - National Science Library

    Swenson, Karen K

    2006-01-01

    .... Cases will be identified in the physical therapy or cancer centers. Controls will be identified using the oncology registry and include patients with breast cancer surgery who have not developed lymphedema...

  1. Review: Robot assisted laparoscopic surgery in gynaecological ...

    African Journals Online (AJOL)

    Review: Robot assisted laparoscopic surgery in gynaecological oncology. ... robot suggests "to be able to act without human interference and being able to ... or in space), its use as telesurgery is still very limited and practically not feasible.

  2. Pediatric nuclear oncology

    International Nuclear Information System (INIS)

    Howman Giles, R.; Bernard, E.; Uren, R.

    1997-01-01

    Nuclear medicine plays an important and increasing role in the management of childhood malignancy. This is particularly true in the solid tumours of childhood. It is also helpful in the management of the complications of cancer treatment such as the infections which often accompany immune suppression in oncology patients. Scintigraphy is a complementary investigation to other radiological techniques and adds the functional dimension to anatomical investigations such as CT, MRI and ultrasound. In selected malignancies radionuclides are also used in treatment. This review discusses the technical considerations relating to children and the specific techniques relating to pediatric oncology. Specific tumours and the various applications of radionuclides are discussed in particular lymphoma, primary bone tumours, soft tissue sarcomas, neuroblastoma, Wilms' tumour, brain tumours and leukemia. Uncommon tumours are also discussed and how radionuclides are useful in the investigation of various complications which occur in oncology patients

  3. Medicinal herbs and phytochitodeztherapy in oncology.

    Science.gov (United States)

    Treskunov, Karp; Treskunova, Olga; Komarov, Boris; Goroshetchenko, Alex; Glebov, Vlad

    2003-01-01

    Application of clinical phytology in treatment of oncology diseases was limited by intensive development of chemical pharmaceuticals and surgery. The authors had set the task to develop the computer database for phytotherapy application. The database included full information on patient's clinical status (identified diseases, symptoms, syndromes) and applied phytotherapy treatment. Special attention was paid to the application of phyto preparations containing chitosan. The computer database contains information on 2335 patients. It supports reliable data on efficiency of phytotherapy in general and allows to evaluate the efficiency of some particular medicinal herbs and to develop efficient complex phyto preparations for treatment of specific diseases. The application of phytotherapy in treatment of oncology patients confirmed the positive effect on patient's quality of life. In conclusion it should be emphasized that the present situation of practical application of phytotherapy could be considered as unacceptable because of absence of necessary knowledge and practical experience in using phytotherapy in outpatient clinics, hospitals and medicinal centers.

  4. Female Representation in the Academic Oncology Physician Workforce: Radiation Oncology Losing Ground to Hematology Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Awad A. [Sylvester Comprehensive Cancer Center University of Miami Health System, Miami, Florida (United States); Hwang, Wei-Ting [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Chapman, Christina H.; Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Thomas, Charles R. [Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon (United States); Deville, Curtiland, E-mail: cdeville@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland (United States)

    2017-05-01

    Purpose: Our purpose was to assess comparative female representation trends for trainees and full-time faculty in the academic radiation oncology and hematology oncology workforce of the United States over 3 decades. Methods and Materials: Simple linear regression models with year as the independent variable were used to determine changes in female percentage representation per year and associated 95% confidence intervals for trainees and full-time faculty in each specialty. Results: Peak representation was 48.4% (801/1654) in 2013 for hematology oncology trainees, 39.0% (585/1499) in 2014 for hematology oncology full-time faculty, 34.8% (202/581) in 2007 for radiation oncology trainees, and 27.7% (439/1584) in 2015 for radiation oncology full-time faculty. Representation significantly increased for trainees and full-time faculty in both specialties at approximately 1% per year for hematology oncology trainees and full-time faculty and 0.3% per year for radiation oncology trainees and full-time faculty. Compared with radiation oncology, the rates were 3.84 and 2.94 times greater for hematology oncology trainees and full-time faculty, respectively. Conclusion: Despite increased female trainee and full-time faculty representation over time in the academic oncology physician workforce, radiation oncology is lagging behind hematology oncology, with trainees declining in recent years in radiation oncology; this suggests a de facto ceiling in female representation. Whether such issues as delayed or insufficient exposure, inadequate mentorship, or specialty competitiveness disparately affect female representation in radiation oncology compared to hematology oncology are underexplored and require continued investigation to ensure that the future oncologic physician workforce reflects the diversity of the population it serves.

  5. Female Representation in the Academic Oncology Physician Workforce: Radiation Oncology Losing Ground to Hematology Oncology

    International Nuclear Information System (INIS)

    Ahmed, Awad A.; Hwang, Wei-Ting; Holliday, Emma B.; Chapman, Christina H.; Jagsi, Reshma; Thomas, Charles R.; Deville, Curtiland

    2017-01-01

    Purpose: Our purpose was to assess comparative female representation trends for trainees and full-time faculty in the academic radiation oncology and hematology oncology workforce of the United States over 3 decades. Methods and Materials: Simple linear regression models with year as the independent variable were used to determine changes in female percentage representation per year and associated 95% confidence intervals for trainees and full-time faculty in each specialty. Results: Peak representation was 48.4% (801/1654) in 2013 for hematology oncology trainees, 39.0% (585/1499) in 2014 for hematology oncology full-time faculty, 34.8% (202/581) in 2007 for radiation oncology trainees, and 27.7% (439/1584) in 2015 for radiation oncology full-time faculty. Representation significantly increased for trainees and full-time faculty in both specialties at approximately 1% per year for hematology oncology trainees and full-time faculty and 0.3% per year for radiation oncology trainees and full-time faculty. Compared with radiation oncology, the rates were 3.84 and 2.94 times greater for hematology oncology trainees and full-time faculty, respectively. Conclusion: Despite increased female trainee and full-time faculty representation over time in the academic oncology physician workforce, radiation oncology is lagging behind hematology oncology, with trainees declining in recent years in radiation oncology; this suggests a de facto ceiling in female representation. Whether such issues as delayed or insufficient exposure, inadequate mentorship, or specialty competitiveness disparately affect female representation in radiation oncology compared to hematology oncology are underexplored and require continued investigation to ensure that the future oncologic physician workforce reflects the diversity of the population it serves.

  6. Female Representation in the Academic Oncology Physician Workforce: Radiation Oncology Losing Ground to Hematology Oncology.

    Science.gov (United States)

    Ahmed, Awad A; Hwang, Wei-Ting; Holliday, Emma B; Chapman, Christina H; Jagsi, Reshma; Thomas, Charles R; Deville, Curtiland

    2017-05-01

    Our purpose was to assess comparative female representation trends for trainees and full-time faculty in the academic radiation oncology and hematology oncology workforce of the United States over 3 decades. Simple linear regression models with year as the independent variable were used to determine changes in female percentage representation per year and associated 95% confidence intervals for trainees and full-time faculty in each specialty. Peak representation was 48.4% (801/1654) in 2013 for hematology oncology trainees, 39.0% (585/1499) in 2014 for hematology oncology full-time faculty, 34.8% (202/581) in 2007 for radiation oncology trainees, and 27.7% (439/1584) in 2015 for radiation oncology full-time faculty. Representation significantly increased for trainees and full-time faculty in both specialties at approximately 1% per year for hematology oncology trainees and full-time faculty and 0.3% per year for radiation oncology trainees and full-time faculty. Compared with radiation oncology, the rates were 3.84 and 2.94 times greater for hematology oncology trainees and full-time faculty, respectively. Despite increased female trainee and full-time faculty representation over time in the academic oncology physician workforce, radiation oncology is lagging behind hematology oncology, with trainees declining in recent years in radiation oncology; this suggests a de facto ceiling in female representation. Whether such issues as delayed or insufficient exposure, inadequate mentorship, or specialty competitiveness disparately affect female representation in radiation oncology compared to hematology oncology are underexplored and require continued investigation to ensure that the future oncologic physician workforce reflects the diversity of the population it serves. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Navigation in musculoskeletal oncology: An overview

    Directory of Open Access Journals (Sweden)

    Guy Vernon Morris

    2018-01-01

    Full Text Available Navigation in surgery has increasingly become more commonplace. The use of this technological advancement has enabled ever more complex and detailed surgery to be performed to the benefit of surgeons and patients alike. This is particularly so when applying the use of navigation within the field of orthopedic oncology. The developments in computer processing power coupled with the improvements in scanning technologies have permitted the incorporation of navigational procedures into day-to-day practice. A comprehensive search of PubMed using the search terms “navigation”, “orthopaedic” and “oncology” yielded 97 results. After filtering for English language papers, excluding spinal surgery and review articles, this resulted in 38 clinical studies and case reports. These were analyzed in detail by the authors (GM and JS and the most relevant papers reviewed. We have sought to provide an overview of the main types of navigation systems currently available within orthopedic oncology and to assess some of the evidence behind its use.

  8. Quality Assessment in Oncology

    International Nuclear Information System (INIS)

    Albert, Jeffrey M.; Das, Prajnan

    2012-01-01

    The movement to improve healthcare quality has led to a need for carefully designed quality indicators that accurately reflect the quality of care. Many different measures have been proposed and continue to be developed by governmental agencies and accrediting bodies. However, given the inherent differences in the delivery of care among medical specialties, the same indicators will not be valid across all of them. Specifically, oncology is a field in which it can be difficult to develop quality indicators, because the effectiveness of an oncologic intervention is often not immediately apparent, and the multidisciplinary nature of the field necessarily involves many different specialties. Existing and emerging comparative effectiveness data are helping to guide evidence-based practice, and the increasing availability of these data provides the opportunity to identify key structure and process measures that predict for quality outcomes. The increasing emphasis on quality and efficiency will continue to compel the medical profession to identify appropriate quality measures to facilitate quality improvement efforts and to guide accreditation, credentialing, and reimbursement. Given the wide-reaching implications of quality metrics, it is essential that they be developed and implemented with scientific rigor. The aims of the present report were to review the current state of quality assessment in oncology, identify existing indicators with the best evidence to support their implementation, and propose a framework for identifying and refining measures most indicative of true quality in oncologic care.

  9. Quality Assessment in Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Albert, Jeffrey M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Das, Prajnan, E-mail: prajdas@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2012-07-01

    The movement to improve healthcare quality has led to a need for carefully designed quality indicators that accurately reflect the quality of care. Many different measures have been proposed and continue to be developed by governmental agencies and accrediting bodies. However, given the inherent differences in the delivery of care among medical specialties, the same indicators will not be valid across all of them. Specifically, oncology is a field in which it can be difficult to develop quality indicators, because the effectiveness of an oncologic intervention is often not immediately apparent, and the multidisciplinary nature of the field necessarily involves many different specialties. Existing and emerging comparative effectiveness data are helping to guide evidence-based practice, and the increasing availability of these data provides the opportunity to identify key structure and process measures that predict for quality outcomes. The increasing emphasis on quality and efficiency will continue to compel the medical profession to identify appropriate quality measures to facilitate quality improvement efforts and to guide accreditation, credentialing, and reimbursement. Given the wide-reaching implications of quality metrics, it is essential that they be developed and implemented with scientific rigor. The aims of the present report were to review the current state of quality assessment in oncology, identify existing indicators with the best evidence to support their implementation, and propose a framework for identifying and refining measures most indicative of true quality in oncologic care.

  10. Nanomedicine in veterinary oncology.

    Science.gov (United States)

    Lin, Tzu-Yin; Rodriguez, Carlos O; Li, Yuanpei

    2015-08-01

    Nanomedicine is an interdisciplinary field that combines medicine, engineering, chemistry, biology and material sciences to improve disease management and can be especially valuable in oncology. Nanoparticle-based agents that possess functions such as tumor targeting, imaging and therapy are currently under intensive investigation. This review introduces the basic concept of nanomedicine and the classification of nanoparticles. Because of their favorable pharmacokinetics, tumor targeting properties, and resulting superior efficacy and toxicity profiles, nanoparticle-based agents can overcome several limitations associated with conventional diagnostic and therapeutic protocols in veterinary oncology. The two most important tumor targeting mechanisms (passive and active tumor targeting) and their dominating factors (i.e. shape, charge, size and nanoparticle surface display) are discussed. The review summarizes published clinical and preclinical studies that utilize different nanoformulations in veterinary oncology, as well as the application of nanoparticles for cancer diagnosis and imaging. The toxicology of various nanoformulations is also considered. Given the benefits of nanoformulations demonstrated in human medicine, nanoformulated drugs are likely to gain more traction in veterinary oncology. Published by Elsevier Ltd.

  11. Molecular imaging in oncology

    Energy Technology Data Exchange (ETDEWEB)

    Schober, Otmar; Riemann, Burkhard (eds.) [Universitaetsklinikum Muenster (Germany). Klinik fuer Nuklearmedizin

    2013-02-01

    Considers in detail all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. Examines technological issues and probe design. Discusses preclinical studies in detail, with particular attention to multimodality imaging. Presents current clinical use of PET/CT, SPECT/CT, and optical imagingWritten by acknowledged experts. The impact of molecular imaging on diagnostics, therapy, and follow-up in oncology is increasing significantly. The process of molecular imaging includes key biotarget identification, design of specific molecular imaging probes, and their preclinical evaluation, e.g., in vivo using small animal studies. A multitude of such innovative molecular imaging probes have already entered clinical diagnostics in oncology. There is no doubt that in future the emphasis will be on multimodality imaging in which morphological, functional, and molecular imaging techniques are combined in a single clinical investigation that will optimize diagnostic processes. This handbook addresses all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. The first section is devoted to technology and probe design, and examines a variety of PET and SPECT tracers as well as multimodality probes. Preclinical studies are then discussed in detail, with particular attention to multimodality imaging. In the third section, diverse clinical applications are presented, and the book closes by looking at future challenges. This handbook will be of value to all who are interested in the revolution in diagnostic oncology that is being brought about by molecular imaging.

  12. Molecular imaging in oncology

    International Nuclear Information System (INIS)

    Schober, Otmar; Riemann, Burkhard

    2013-01-01

    Considers in detail all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. Examines technological issues and probe design. Discusses preclinical studies in detail, with particular attention to multimodality imaging. Presents current clinical use of PET/CT, SPECT/CT, and optical imagingWritten by acknowledged experts. The impact of molecular imaging on diagnostics, therapy, and follow-up in oncology is increasing significantly. The process of molecular imaging includes key biotarget identification, design of specific molecular imaging probes, and their preclinical evaluation, e.g., in vivo using small animal studies. A multitude of such innovative molecular imaging probes have already entered clinical diagnostics in oncology. There is no doubt that in future the emphasis will be on multimodality imaging in which morphological, functional, and molecular imaging techniques are combined in a single clinical investigation that will optimize diagnostic processes. This handbook addresses all aspects of molecular imaging in oncology, ranging from basic research to clinical applications in the era of evidence-based medicine. The first section is devoted to technology and probe design, and examines a variety of PET and SPECT tracers as well as multimodality probes. Preclinical studies are then discussed in detail, with particular attention to multimodality imaging. In the third section, diverse clinical applications are presented, and the book closes by looking at future challenges. This handbook will be of value to all who are interested in the revolution in diagnostic oncology that is being brought about by molecular imaging.

  13. Economic impact of a head and neck oncologic surgeon: the case mix index.

    Science.gov (United States)

    Jalisi, Scharukh; Sanan, Akshay; Mcdonough, Katie; Hussein, Khalil; Platt, Michael; Truong, Minh Tam; Couch, Marion; Burkey, Brian B

    2014-10-01

    Head and neck oncologic surgery is a time-consuming specialty that requires extensive resources and manpower. Case mix index (CMI) is used in evaluating the complexity and economic impact of surgeons. Head and neck oncologic surgeons generate significant revenue for hospitals, yet compensation is relatively low. Retrospective review of a tertiary hospital's case mix data for 605 otolaryngology admissions from 2009 to 2011 was performed. CMI comparison for head and neck oncologic surgeons versus general otolaryngology was performed. In an otolaryngology department of 9 surgeons; there was a significant difference (p 1) favoring head and neck oncologic surgeons. Head and neck oncologic surgeons increase the CMI for hospitals and ultimately influence the hospital's reimbursement. There is a need for increased collaboration between hospitals and departments in fostering and furthering their head and neck surgical oncology programs by taking CMI into consideration. © 2013 Wiley Periodicals, Inc.

  14. Grade Inflation in Medical Student Radiation Oncology Clerkships: Missed Opportunities for Feedback?

    International Nuclear Information System (INIS)

    Grover, Surbhi; Swisher-McClure, Samuel; Sosnowicz, Stasha; Li, Jiaqi; Mitra, Nandita; Berman, Abigail T.; Baffic, Cordelia; Vapiwala, Neha; Freedman, Gary M.

    2015-01-01

    Purpose: To test the hypothesis that medical student radiation oncology elective rotation grades are inflated and cannot be used to distinguish residency applicants. Methods and Materials: The records of 196 applicants to a single radiation oncology residency program in 2011 and 2012 were retrospectively reviewed. The grades for each rotation in radiation oncology were collected and converted to a standardized 4-point grading scale (honors, high pass, pass, fail). Pass/fail grades were scored as not applicable. The primary study endpoint was to compare the distribution of applicants' grades in radiation oncology with their grades in medicine, surgery, pediatrics, and obstetrics/gynecology core clerkships. Results: The mean United States Medical Licensing Examination Step 1 score of the applicants was 237 (range, 188-269), 43% had additional Masters or PhD degrees, and 74% had at least 1 publication. Twenty-nine applicants were graded for radiation oncology rotations on a pass/fail basis and were excluded from the final analysis. Of the remaining applicants (n=167), 80% received the highest possible grade for their radiation oncology rotations. Grades in radiation oncology were significantly higher than each of the other 4 clerkships studied (P<.001). Of all applicants, 195 of 196 matched into a radiation oncology residency. Higher grades in radiation oncology were associated with significantly higher grades in the pediatrics core clerkship (P=.002). However, other medical school performance metrics were not significantly associated with higher grades in radiation oncology. Conclusions: Although our study group consists of a selected group of radiation oncology applicants, their grades in radiation oncology clerkships were highly skewed toward the highest grades when compared with grades in other core clerkships. Student grading in radiation oncology clerkships should be re-evaluated to incorporate more objective and detailed performance metrics to allow for

  15. Oncology of the ferret (Mustela putorius furo)

    International Nuclear Information System (INIS)

    Bunel Le Coz, Bertrand Jacques Thierry

    2006-01-01

    Ferret oncology is in full evolution. Many types of tumors are mentioned. They affect all the systems of the organism: the endocrine, hemo-lymphatic, integument, digestive, reproductive, musculoskeletal, cardiovascular, nervous, urinary or respiratory systems. Insulinoma, adrenocortical tumors and lymphoma are the three mostly seen tumors. Complementary examination have been developed too. CBC, biochemistry, radiography and ultrasonography can now be completed by cytology, immunohistochemistry, endoscopies, scan, I.R.M. or scintigraphy. Treatments such as surgery, chemotherapy or radiotherapy can be associated. They allow recovery or, if not a palliative solution. (author) [fr

  16. Current situation in gynecological oncology training in Spain: where we are and where we want to go.

    Science.gov (United States)

    Padilla-Iserte, P; Minig, L; Zapardiel, I; Chiva, L; Laky, R; de Santiago, J

    2018-04-01

    It is important to know what a young gynecologic oncologist perceives as a need to achieve a good training in gynecologic oncology. This study aims to evaluate the level of training in gynecologic oncology in Spain. A Web-based anonymous questionnaire was sent via e-mail to Spanish trainees listed in European Network of Young Gynecological Oncology (ENYGO). The survey was developed in four sections: (1) general training in gynecologic oncology, (2) distribution of current clinical activity, (3) surgical training, and (4) perspective future gynecologic oncology. It contained 51 questions, with multiple-choice answers that had to be answered by the ENYGO members. The questionnaire was sent to 64 people listed in the ENYGO database. Of these, 37 members responded (response rate of 58%). Overall, more training in surgery is necessary, to perform radical oncological surgeries. It is claimed a sub-specialty recognition, to ensure an equalitarian and homogeneous training.

  17. DEVELOPMENT OF PLASTIC SURGERY.

    Science.gov (United States)

    Pećanac, Marija Đ

    2015-01-01

    Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  18. Pet in Clinical oncology

    International Nuclear Information System (INIS)

    Hunsche, A.; Grossman, G.; Santana, M.; Santana, C.; Halkar, R.; Garcia, E.

    2003-01-01

    The utility of the PET (positron emission tomography in clinical oncology has been recognized for more than two decades, locating it as a sensible technique for the diagnosis and the prognosis stratification of the oncology patients. The sensitivity and specificity of the PET in comparation to other image studies have demonstrated to be greater. For some years, there was a restriction of PET because of the high cost of the equipment and the cyclotrons. Nevertheless, the relation of cost/benefits is considered as a priority as this technique offers important clinical information. In this article the results observed when using it in diverse types of cancer, as well as the effectiveness shown in the pre-operating evaluation, the evaluation of residual disease, diagnosis of recurrences, pursuit and prognosis stratification of the patients with cancer. (The author)

  19. Quality in radiation oncology

    International Nuclear Information System (INIS)

    Pawlicki, Todd; Mundt, Arno J.

    2007-01-01

    A modern approach to quality was developed in the United States at Bell Telephone Laboratories during the first part of the 20th century. Over the years, those quality techniques have been adopted and extended by almost every industry. Medicine in general and radiation oncology in particular have been slow to adopt modern quality techniques. This work contains a brief description of the history of research on quality that led to the development of organization-wide quality programs such as Six Sigma. The aim is to discuss the current approach to quality in radiation oncology as well as where quality should be in the future. A strategy is suggested with the goal to provide a threshold improvement in quality over the next 10 years

  20. Oncology PET imaging

    International Nuclear Information System (INIS)

    Inubushi, Masayuki

    2014-01-01

    At the beginning of this article, likening medical images to 'Where is Waldo?' I indicate the concept of diagnostic process of PET/CT imaging, so that medical physics specialists could understand the role of each imaging modality and infer our distress for image diagnosis. Then, I state the present situation of PET imaging and the basics (e.g. health insurance coverage, clinical significance, principle, protocol, and pitfall) of oncology FDG-PET imaging which accounts for more than 99% of all clinical PET examinations in Japan. Finally, I would like to give a wishful prospect of oncology PET that will expand to be more cancer-specific in order to assess therapeutic effects of emerging molecular targeted drugs targeting the 'hallmarks of cancer'. (author)

  1. Pediatric oncology in Slovenia.

    Science.gov (United States)

    Jereb, B; Anzic, J

    1996-01-01

    Slovenia, a new country and formerly a part of Yugoslavia, has had its Childrens Hospital in Ljubljana since 1865. This became a part of the University Hospital in 1945, and in the early 1960s the Department of Pediatric Hematology-Oncology was established. The Oncological Institute of Slovenia was established in 1938 and has developed into a modern facility for comprehensive cancer care, research, and teaching. In close cooperation, established in the 1960s, a team from these two institutions takes care of the approximately 60 children per year who develop cancer in Slovenia. Consisting of pediatricians, radiation oncologists, pathologists, cytologists, surgeons, and other ad hoc specialists, the team meets at least twice weekly to plan treatment, follow the patients, discuss the results, and teach. All patients are subject to regular follow-up indefinitely. A separate team has been formed to study the late effects of cancer treatment on survivors, who by now are mostly adults.

  2. Neurologic complications in oncology

    Directory of Open Access Journals (Sweden)

    Andrea Pace

    2010-06-01

    Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

  3. Integrative oncology: an overview.

    Science.gov (United States)

    Deng, Gary; Cassileth, Barrie

    2014-01-01

    Integrative oncology, the diagnosis-specific field of integrative medicine, addresses symptom control with nonpharmacologic therapies. Known commonly as "complementary therapies" these are evidence-based adjuncts to mainstream care that effectively control physical and emotional symptoms, enhance physical and emotional strength, and provide patients with skills enabling them to help themselves throughout and following mainstream cancer treatment. Integrative or complementary therapies are rational and noninvasive. They have been subjected to study to determine their value, to document the problems they ameliorate, and to define the circumstances under which such therapies are beneficial. Conversely, "alternative" therapies typically are promoted literally as such; as actual antitumor treatments. They lack biologic plausibility and scientific evidence of safety and efficacy. Many are outright fraudulent. Conflating these two very different categories by use of the convenient acronym "CAM," for "complementary and alternative therapies," confuses the issue and does a substantial disservice to patients and medical professionals. Complementary and integrative modalities have demonstrated safety value and benefits. If the same were true for "alternatives," they would not be "alternatives." Rather, they would become part of mainstream cancer care. This manuscript explores the medical and sociocultural context of interest in integrative oncology as well as in "alternative" therapies, reviews commonly-asked patient questions, summarizes research results in both categories, and offers recommendations to help guide patients and family members through what is often a difficult maze. Combining complementary therapies with mainstream oncology care to address patients' physical, psychologic and spiritual needs constitutes the practice of integrative oncology. By recommending nonpharmacologic modalities that reduce symptom burden and improve quality of life, physicians also enable

  4. Oncological image analysis.

    Science.gov (United States)

    Brady, Sir Michael; Highnam, Ralph; Irving, Benjamin; Schnabel, Julia A

    2016-10-01

    Cancer is one of the world's major healthcare challenges and, as such, an important application of medical image analysis. After a brief introduction to cancer, we summarise some of the major developments in oncological image analysis over the past 20 years, but concentrating those in the authors' laboratories, and then outline opportunities and challenges for the next decade. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Immunoscintigraphy in gynecological oncology

    International Nuclear Information System (INIS)

    Pateisky, N.

    1987-01-01

    Immunologic and radionuclide methods are used increasingly in diagnostics and therapy. This applies especially to problems of malignant diseases. Tumor localization diagnosis has gained much from immunoscintigraphy, a non-invasive method combining immunologic and nuclear medicine techniques. Activated monoclonal antibodies against tumorous antigens make it possible to show malignant tumors scintigraphically. An introduction is given to the technique as well as first results of applying immunoscintigraphy to gynecological oncology. (author)

  6. Interventional radiology in pediatric oncology

    International Nuclear Information System (INIS)

    Hoffer, Fredric A.

    2005-01-01

    There are many radiological interventions necessary for pediatric oncology patients, some of which may be covered in other articles in this publication. I will discuss a number of interventions including percutaneous biopsy for solid tumor and hematological malignancy diagnosis or recurrence, for the diagnosis of graft versus host disease after stem cell or bone marrow transplantation, and for the diagnosis of complications of immunosuppression such as invasive pulmonary aspergillosis. In the past, tumor localization techniques have been necessary to biopsy or resect small lesions. However improved guidance techniques have allowed for more precise biopsy and the use of thermal ablation instead of excision for local tumor control. A percutaneously placed radio frequency, microwave, laser or cryogen probe can ablate the primary and metastatic tumors of the liver, lung, bone, kidney and other structures in children. This is an alternative treatment for the local control of tumors that may not be amenable to surgery, chemotherapy or radiotherapy. I will also describe how chemoembolization can be used to treat primary or metastatic tumors of the liver that have failed other therapies. This treatment delivers chemotherapy in the hepatic artery infused with emboli to increase the dwell time and concentration of the agents

  7. Encyclopedia of radiation oncology

    Energy Technology Data Exchange (ETDEWEB)

    Brady, Luther W. [Drexel Univ. College of Medicine, Philadelphia, PA (United States); Yaeger, Theodore E. (eds.) [Wake Forest Univ. School of Medicine, Winston-Salem, NC (United States). Dept. of Radiation Oncology

    2013-02-01

    The simple A to Z format provides easy access to relevant information in the field of radiation oncology. Extensive cross references between keywords and related articles enable efficient searches in a user-friendly manner. Fully searchable and hyperlinked electronic online edition. The aim of this comprehensive encyclopedia is to provide detailed information on radiation oncology. The wide range of entries are written by leading experts. They will provide basic and clinical scientists in academia, practice and industry with valuable information about the field of radiation oncology. Those in related fields, students, teachers, and interested laypeople will also benefit from the important and relevant information on the most recent developments. Please note that this publication is available as print only or online only or print + online set. Save 75% of the online list price when purchasing the bundle. For more information on the online version please type the publication title into the search box above, then click on the eReference version in the results list.

  8. Quality Indicators in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Albert, Jeffrey M. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Das, Prajnan, E-mail: prajdas@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-03-15

    Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts to define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts.

  9. Quality Indicators in Radiation Oncology

    International Nuclear Information System (INIS)

    Albert, Jeffrey M.; Das, Prajnan

    2013-01-01

    Oncologic specialty societies and multidisciplinary collaborative groups have dedicated considerable effort to developing evidence-based quality indicators (QIs) to facilitate quality improvement, accreditation, benchmarking, reimbursement, maintenance of certification, and regulatory reporting. In particular, the field of radiation oncology has a long history of organized quality assessment efforts and continues to work toward developing consensus quality standards in the face of continually evolving technologies and standards of care. This report provides a comprehensive review of the current state of quality assessment in radiation oncology. Specifically, this report highlights implications of the healthcare quality movement for radiation oncology and reviews existing efforts to define and measure quality in the field, with focus on dimensions of quality specific to radiation oncology within the “big picture” of oncologic quality assessment efforts

  10. 78 FR 25304 - Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), Including On...

    Science.gov (United States)

    2013-04-30

    ..., USA, Inc., Oncology Care Systems (Radiation Oncology), Including On-Site Leased Workers From Source... Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), including on- site leased... of February 2013, Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology...

  11. Conventional surgery in breast cancer

    International Nuclear Information System (INIS)

    Tapia Herrera, Andres

    2013-01-01

    General aspects of breast cancer were described from the epidemiological point of view, clinical and pathological, as well as its impact at global and national levels. Parenchyma conservative surgery and/or breast skin was analyzed exhaustively as a cancer treatment analyzed exhaustively, to your specifications, requirements, technical aspects, risks, benefits, degree of oncological safety and benefits for patients [es

  12. The Radiation Therapy Oncology in the context of oncological practice

    International Nuclear Information System (INIS)

    Kasdorf, P.

    2010-01-01

    This work is about the radiation therapy oncology in the context of oncological practice. The radiotherapy is a speciality within medicine that involves the generation, application and dissemination of knowledge about the biology, causes, prevention and treatment of the cancer and other pathologies by ionising radiation

  13. Medicinal cannabis in oncology.

    Science.gov (United States)

    Engels, Frederike K; de Jong, Floris A; Mathijssen, Ron H J; Erkens, Joëlle A; Herings, Ron M; Verweij, Jaap

    2007-12-01

    In The Netherlands, since September 2003, a legal medicinal cannabis product, constituting the whole range of cannabinoids, is available for clinical research, drug development strategies, and on prescription for patients. To date, this policy, initiated by the Dutch Government, has not yet led to the desired outcome; the amount of initiated clinical research is less than expected and only a minority of patients resorts to the legal product. This review aims to discuss the background for the introduction of legal medicinal cannabis in The Netherlands, the past years of Dutch clinical experience in oncology practice, possible reasons underlying the current outcome, and future perspectives.

  14. Radiation oncology in Canada.

    Science.gov (United States)

    Giuliani, Meredith; Gospodarowicz, Mary

    2018-01-01

    In this article we provide an overview of the Canadian healthcare system and the cancer care system in Canada as it pertains to the governance, funding and delivery of radiotherapy programmes. We also review the training and practice for radiation oncologists, medical physicists and radiation therapists in Canada. We describe the clinical practice of radiation medicine from patients' referral, assessment, case conferences and the radiotherapy process. Finally, we provide an overview of the practice culture for Radiation Oncology in Canada. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. The IR Evolution in Oncology: Tools, Treatments, and Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Baere, Thierry de, E-mail: thierry.debaere@gustaveroussy.fr [Gustave Roussy Cancer Center, Department of Interventional Radiology (France)

    2017-01-15

    Early focus of interventional oncologists was developing tools and imaging guidance, performing “procedures” acting as a skillful technician without knowledge of clinical patient outcomes, beyond post-treatment image findings. Interventional oncologists must deliver “treatments” and not “procedures”, and focus on clinically relevant outcomes, provide clinical continuity of care, which means stand at multidisciplinary tumor boards, see patients in consultation before treatment and for follow-up. Interventional oncologists have fought for the same “market” with surgery in a head to head, bloody competition called red ocean strategy in marketing terms, resulting in many aborted trials. Wide adoption of interventional oncology is facing the challenge to build evidence with overall survival as endpoint in randomized trials while the benefits of a treatment on overall survival are diluted by the effects of possible/inevitable subsequent therapies. Because interventional oncology is a disruptive force in medicine achieving same results as others (surgery) using different, less invasive approaches, patients where surgery is irrelevant can be target with a blue ocean strategy (to propose treatment where there is no competition). Recently interventional oncology has been included in the ESMO guidelines for colorectal cancer with oligometastatic disease with both surgical resection, and thermal ablation classified in the same category called “local ablative treatments”. Interventional oncologists have to shape the future by publications in oncologic journal, by being active members of oncology scientific societies, and use modern public megaphone (blog, video sharing, …) to disseminate information and let society know that interventional is not a me-too product but a disruptive treatment.

  16. The IR Evolution in Oncology: Tools, Treatments, and Guidelines.

    Science.gov (United States)

    de Baere, Thierry

    2017-01-01

    Early focus of interventional oncologists was developing tools and imaging guidance, performing "procedures" acting as a skillful technician without knowledge of clinical patient outcomes, beyond post-treatment image findings. Interventional oncologists must deliver "treatments" and not "procedures", and focus on clinically relevant outcomes, provide clinical continuity of care, which means stand at multidisciplinary tumor boards, see patients in consultation before treatment and for follow-up. Interventional oncologists have fought for the same "market" with surgery in a head to head, bloody competition called red ocean strategy in marketing terms, resulting in many aborted trials. Wide adoption of interventional oncology is facing the challenge to build evidence with overall survival as endpoint in randomized trials while the benefits of a treatment on overall survival are diluted by the effects of possible/inevitable subsequent therapies. Because interventional oncology is a disruptive force in medicine achieving same results as others (surgery) using different, less invasive approaches, patients where surgery is irrelevant can be target with a blue ocean strategy (to propose treatment where there is no competition). Recently interventional oncology has been included in the ESMO guidelines for colorectal cancer with oligometastatic disease with both surgical resection, and thermal ablation classified in the same category called "local ablative treatments". Interventional oncologists have to shape the future by publications in oncologic journal, by being active members of oncology scientific societies, and use modern public megaphone (blog, video sharing, …) to disseminate information and let society know that interventional is not a me-too product but a disruptive treatment.

  17. The IR Evolution in Oncology: Tools, Treatments, and Guidelines

    International Nuclear Information System (INIS)

    Baere, Thierry de

    2017-01-01

    Early focus of interventional oncologists was developing tools and imaging guidance, performing “procedures” acting as a skillful technician without knowledge of clinical patient outcomes, beyond post-treatment image findings. Interventional oncologists must deliver “treatments” and not “procedures”, and focus on clinically relevant outcomes, provide clinical continuity of care, which means stand at multidisciplinary tumor boards, see patients in consultation before treatment and for follow-up. Interventional oncologists have fought for the same “market” with surgery in a head to head, bloody competition called red ocean strategy in marketing terms, resulting in many aborted trials. Wide adoption of interventional oncology is facing the challenge to build evidence with overall survival as endpoint in randomized trials while the benefits of a treatment on overall survival are diluted by the effects of possible/inevitable subsequent therapies. Because interventional oncology is a disruptive force in medicine achieving same results as others (surgery) using different, less invasive approaches, patients where surgery is irrelevant can be target with a blue ocean strategy (to propose treatment where there is no competition). Recently interventional oncology has been included in the ESMO guidelines for colorectal cancer with oligometastatic disease with both surgical resection, and thermal ablation classified in the same category called “local ablative treatments”. Interventional oncologists have to shape the future by publications in oncologic journal, by being active members of oncology scientific societies, and use modern public megaphone (blog, video sharing, …) to disseminate information and let society know that interventional is not a me-too product but a disruptive treatment.

  18. A Phase 2 Trial of Radiation Therapy With Concurrent Paclitaxel Chemotherapy After Surgery in Patients With High-Risk Endometrial Cancer: A Korean Gynecologic Oncologic Group Study

    International Nuclear Information System (INIS)

    Cho, Hanbyoul; Nam, Byung-Ho; Kim, Seok Mo; Cho, Chi-Heum; Kim, Byoung Gie; Ryu, Hee-Sug; Kang, Soon Beom; Kim, Jae-Hoon

    2014-01-01

    Purpose: A phase 2 study was completed by the Korean Gynecologic Oncologic Group to evaluate the efficacy and toxicity of concurrent chemoradiation with weekly paclitaxel in patients with high-risk endometrial cancer. Methods and Materials: Pathologic requirements included endometrial endometrioid adenocarcinoma stages III and IV. Radiation therapy consisted of a total dose of 4500 to 5040 cGy in 5 fractions per week for 6 weeks. Paclitaxel 60 mg/m 2 was administered once weekly for 5 weeks during radiation therapy. Results: Fifty-seven patients were enrolled between January 2006 and March 2008. The median follow-up time was 60.0 months (95% confidence interval [CI], 51.0-58.2). All grade 3/4 toxicities were hematologic and usually self-limited. There was no life-threatening toxicity. The cumulative incidence of intrapelvic recurrence sites was 1.9% (1/52), and the cumulative incidence of extrapelvic recurrence sites was 34.6% (18/52). The estimated 5-year disease-free and overall survival rates were 63.5% (95% CI, 50.4-76.5) and 82.7% (95% CI, 72.4-92.9), respectively. Conclusions: Concurrent chemoradiation with weekly paclitaxel is well tolerated and seems to be effective for high-risk endometrioid endometrial cancers. This approach appears reasonable to be tested for efficacy in a prospective, randomized controlled study

  19. A Phase 2 Trial of Radiation Therapy With Concurrent Paclitaxel Chemotherapy After Surgery in Patients With High-Risk Endometrial Cancer: A Korean Gynecologic Oncologic Group Study

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hanbyoul [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Women' s Life Medical Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Nam, Byung-Ho [Cancer Biostatistics Branch, Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang (Korea, Republic of); Kim, Seok Mo [Department of Obstetrics and Gynecology, Chonnam National University School of Medicine, Gwangju (Korea, Republic of); Cho, Chi-Heum [Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu (Korea, Republic of); Kim, Byoung Gie [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Ryu, Hee-Sug [Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon (Korea, Republic of); Kang, Soon Beom [Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul (Korea, Republic of); Kim, Jae-Hoon, E-mail: jaehoonkim@yuhs.ac [Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Women' s Life Medical Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-01

    Purpose: A phase 2 study was completed by the Korean Gynecologic Oncologic Group to evaluate the efficacy and toxicity of concurrent chemoradiation with weekly paclitaxel in patients with high-risk endometrial cancer. Methods and Materials: Pathologic requirements included endometrial endometrioid adenocarcinoma stages III and IV. Radiation therapy consisted of a total dose of 4500 to 5040 cGy in 5 fractions per week for 6 weeks. Paclitaxel 60 mg/m{sup 2} was administered once weekly for 5 weeks during radiation therapy. Results: Fifty-seven patients were enrolled between January 2006 and March 2008. The median follow-up time was 60.0 months (95% confidence interval [CI], 51.0-58.2). All grade 3/4 toxicities were hematologic and usually self-limited. There was no life-threatening toxicity. The cumulative incidence of intrapelvic recurrence sites was 1.9% (1/52), and the cumulative incidence of extrapelvic recurrence sites was 34.6% (18/52). The estimated 5-year disease-free and overall survival rates were 63.5% (95% CI, 50.4-76.5) and 82.7% (95% CI, 72.4-92.9), respectively. Conclusions: Concurrent chemoradiation with weekly paclitaxel is well tolerated and seems to be effective for high-risk endometrioid endometrial cancers. This approach appears reasonable to be tested for efficacy in a prospective, randomized controlled study.

  20. Monitoring cancer stem cells: insights into clinical oncology

    Directory of Open Access Journals (Sweden)

    Lin SC

    2016-02-01

    Full Text Available ShuChen Lin,1,* YingChun Xu,2,* ZhiHua Gan,1 Kun Han,1 HaiYan Hu,3 Yang Yao,3 MingZhu Huang,4 DaLiu Min1 1Department of Oncology, Shanghai Sixth People’s Hospital East Campus, Shanghai Jiao Tong University, 2Department of Oncology, Renji Hospital, Shanghai Jiao Tong University, 3Department of Oncology, The Sixth People’s Hospital, Shanghai Jiao Tong University, 4Department of Medical Oncology, Cancer Hospital of Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Cancer stem cells (CSCs are a small, characteristically distinctive subset of tumor cells responsible for tumor initiation and progression. Several treatment modalities, such as surgery, glycolytic inhibition, driving CSC proliferation, immunotherapy, and hypofractionated radiotherapy, may have the potential to eradicate CSCs. We propose that monitoring CSCs is important in clinical oncology as CSC populations may reflect true treatment response and assist with managing treatment strategies, such as defining optimal chemotherapy cycles, permitting pretreatment cancer surveillance, conducting a comprehensive treatment plan, modifying radiation treatment, and deploying rechallenge chemotherapy. Then, we describe methods for monitoring CSCs. Keywords: cancer stem cells, glycolytic inhibition, watchful waiting, rechallenge, immunotherapy

  1. Radiation oncology systems integration

    International Nuclear Information System (INIS)

    Ragan, D.P.

    1991-01-01

    ROLE7 is intended as a complementary addition to the HL7 Standard and not as an alternative standard. Attempt should be made to mould data elements which are specific to radiation therapy with existing HL7 elements. This can be accomplished by introducing additional values to some element's table-of-options. Those elements which might be specific to radiation therapy could from new segments to be added to the Ancillary Data Reporting set. In order to accomplish ROLE7, consensus groups need be formed to identify the various functions related to radiation oncology that might motivate information exchange. For each of these functions, the specific data elements and their format must be identified. HL7 is organized with a number of applications which communicate asynchronously. Implementation of ROLE7 would allow uniform access to information across vendors and functions. It would provide improved flexibility in system selection. It would allow a more flexible and affordable upgrade path as systems in radiation oncology improve. (author). 5 refs

  2. Molecular radio-oncology

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Michael; Krause, Mechthild; Cordes, Nils (eds.) [Technische Univ. Dresden (Germany). Faculty of Medicine and University Hospital

    2016-07-01

    This book concisely reviews our current understanding of hypoxia, molecular targeting, DNA repair, cancer stem cells, and tumor pathophysiology, while also discussing novel strategies for putting these findings into practice in daily clinical routine. Radiotherapy is an important part of modern multimodal cancer treatment, and the past several years have witnessed not only substantial improvements in radiation techniques and the use of new beam qualities, but also major strides in our understanding of molecular tumor biology and tumor radiation response. Against this backdrop, the book highlights recent efforts to identify reasonable and clinically applicable biomarkers using broad-spectrum tissue microarrays and high-throughput systems biology approaches like genomics and epigenomics. In particular, it describes in detail how such molecular information is now being exploited for diagnostic imaging and imaging throughout treatment using the example of positron emission tomography. By discussing all these issues in the context of modern radiation oncology, the book provides a broad, up-to-date overview of the molecular aspects of radiation oncology that will hopefully foster its further optimization.

  3. Oncology in Cambodia.

    Science.gov (United States)

    Eav, S; Schraub, S; Dufour, P; Taisant, D; Ra, C; Bunda, P

    2012-01-01

    Cambodia, a country of 14 million inhabitants, was devastated during the Khmer Rouge period and thereafter. The resources of treatment are rare: only one radiotherapy department, renovated in 2003, with an old cobalt machine; few surgeons trained to operate on cancer patients; no hematology; no facilities to use intensive chemotherapy; no nuclear medicine department and no palliative care unit. Cervical cancer incidence is one of the highest in the world, while in men liver cancer ranks first (20% of all male cancers). Cancers are seen at stage 3 or 4 for 70% of patients. There is no prevention program - only a vaccination program against hepatitis B for newborns - and no screening program for cervical cancer or breast cancer. In 2010, oncology, recognized as a full specialty, was created to train the future oncologists on site at the University of Phnom Penh. A new National Cancer Center will be built in 2013 with modern facilities for radiotherapy, medical oncology, hematology and nuclear medicine. Cooperation with foreign countries, especially France, and international organizations has been established and is ongoing. Progress is occurring slowly due to the shortage of money for Cambodian institutions and the lay public. Copyright © 2012 S. Karger AG, Basel.

  4. Molecular radio-oncology

    International Nuclear Information System (INIS)

    Baumann, Michael; Krause, Mechthild; Cordes, Nils

    2016-01-01

    This book concisely reviews our current understanding of hypoxia, molecular targeting, DNA repair, cancer stem cells, and tumor pathophysiology, while also discussing novel strategies for putting these findings into practice in daily clinical routine. Radiotherapy is an important part of modern multimodal cancer treatment, and the past several years have witnessed not only substantial improvements in radiation techniques and the use of new beam qualities, but also major strides in our understanding of molecular tumor biology and tumor radiation response. Against this backdrop, the book highlights recent efforts to identify reasonable and clinically applicable biomarkers using broad-spectrum tissue microarrays and high-throughput systems biology approaches like genomics and epigenomics. In particular, it describes in detail how such molecular information is now being exploited for diagnostic imaging and imaging throughout treatment using the example of positron emission tomography. By discussing all these issues in the context of modern radiation oncology, the book provides a broad, up-to-date overview of the molecular aspects of radiation oncology that will hopefully foster its further optimization.

  5. Biosimilars: Considerations for Oncology Nurses
.

    Science.gov (United States)

    Vizgirda, Vida; Jacobs, Ira

    2017-04-01

    Biosimilars are developed to be highly similar to and treat the same conditions as licensed biologics. As they are approved and their use becomes more widespread, oncology nurses should be aware of their development and unique considerations. This article reviews properties of biosimilars; their regulation and approval process; the ways in which their quality, safety, and efficacy are evaluated; their postmarketing safety monitoring; and their significance to oncology nurses and oncology nursing.
. A search of PubMed and regulatory agency websites was conducted for references related to the development and use of biosimilars in oncology. 
. Because biologics are large, structurally complex molecules, biosimilars cannot be considered generic equivalents to licensed biologic products. Consequently, regulatory approval for biosimilars is different from approval for small-molecule generics. Oncology nurses are in a unique position to educate themselves, other clinicians, and patients and their families about biosimilars to ensure accurate understanding, as well as optimal and safe use, of biosimilars.

  6. Laparoscopic versus open surgery for rectal cancer (COLOR II)

    DEFF Research Database (Denmark)

    van der Pas, Martijn Hgm; Haglind, Eva; Cuesta, Miguel A

    2013-01-01

    Laparoscopic surgery as an alternative to open surgery in patients with rectal cancer has not yet been shown to be oncologically safe. The aim in the COlorectal cancer Laparoscopic or Open Resection (COLOR II) trial was to compare laparoscopic and open surgery in patients with rectal cancer....

  7. Radiation oncology physics: A handbook for teachers and students

    International Nuclear Information System (INIS)

    Podgorsak, E.B.

    2005-07-01

    Radiotherapy, also referred to as radiation therapy, radiation oncology or therapeutic radiology, is one of the three principal modalities used in the treatment of malignant disease (cancer), the other two being surgery and chemotherapy. In contrast to other medical specialties that rely mainly on the clinical knowledge and experience of medical specialists, radiotherapy, with its use of ionizing radiation in the treatment of cancer, relies heavily on modern technology and the collaborative efforts of several professionals whose coordinated team approach greatly influences the outcome of the treatment. The radiotherapy team consists of radiation oncologists, medical physicists, dosimetrists and radiation therapy technologists: all professionals characterized by widely differing educational backgrounds and one common link - the need to understand the basic elements of radiation physics, and the interaction of ionizing radiation with human tissue in particular. This specialized area of physics is referred to as radiation oncology physics, and proficiency in this branch of physics is an absolute necessity for anyone who aspires to achieve excellence in any of the four professions constituting the radiotherapy team. Current advances in radiation oncology are driven mainly by technological development of equipment for radiotherapy procedures and imaging; however, as in the past, these advances rely heavily on the underlying physics. This book is dedicated to students and teachers involved in programmes that train professionals for work in radiation oncology. It provides a compilation of facts on the physics as applied to radiation oncology and as such will be useful to graduate students and residents in medical physics programmes, to residents in radiation oncology, and to students in dosimetry and radiotherapy technology programmes. The level of understanding of the material covered will, of course, be different for the various student groups; however, the basic

  8. IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

    Science.gov (United States)

    ... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Are Cataracts? Pediatric Cataracts Cataract Diagnosis and Treatment Cataract Surgery IOL Implants: Lens Replacement After Cataracts ...

  9. Cytoreductive surgery for men with metastatic prostate cancer

    Directory of Open Access Journals (Sweden)

    Nikolas Katelaris

    2016-09-01

    Conclusions: This data supports recent findings demonstrating that radical prostatectomy for metastatic prostate cancer is feasible. Further studies are needed to explore the role of cytoreductive surgery with regards to the potential oncological benefit.

  10. Outcomes of cancer surgery after inhalational and intravenous anesthesia

    DEFF Research Database (Denmark)

    Soltanizadeh, Sinor; Degett, Thea H; Gögenur, Ismail

    2017-01-01

    Perioperative factors are probably essential for different oncological outcomes. This systematic review investigates the literature concerning overall mortality and postoperative complications after cancer surgery with inhalational (INHA) and intravenous anesthesia (TIVA). A search was conducted...

  11. Laparoscopic surgery in colorectal cancer

    International Nuclear Information System (INIS)

    Bressler Hernandez, Norlan; Martinez Perez, Elliot; Fernandez Rodriguez, Leopoldo; Torres Core, Ramiro

    2011-01-01

    In the current age of minimally invasive surgery, laparoscopic surgery for colon cancer has been established as oncologically equivalent to conventional open surgery. The advantages of laparoscopic surgery have translated into smaller incisions and shorter recovery. Since the advent of laparoscopy, surgeons have been fueled to develop less invasive operative methods as feasible alternatives to traditional procedures. As techniques evolved and technology advanced, laparoscopy became more widely accepted and is now more commonly used in many institutions. Recently, a trend toward less invasive surgery, driven by patient and surgeon alike, has been a major objective for many institutions because of the ability of laparoscopic surgery to reduce postoperative pain, achieve a quicker recovery time, and improve cosmetic outcomes. Although still evolving, traditional laparoscopy has served as a foundation for even further refinements in the minimally invasive approach and as a result, more advanced equipment and newer techniques have arisen

  12. Mathematical oncology 2013

    CERN Document Server

    Gandolfi, Alberto

    2014-01-01

    With chapters on free boundaries, constitutive equations, stochastic dynamics, nonlinear diffusion–consumption, structured populations, and applications of optimal control theory, this volume presents the most significant recent results in the field of mathematical oncology. It highlights the work of world-class research teams, and explores how different researchers approach the same problem in various ways. Tumors are complex entities that present numerous challenges to the mathematical modeler. First and foremost, they grow. Thus their spatial mean field description involves a free boundary problem. Second, their interiors should be modeled as nontrivial porous media using constitutive equations. Third, at the end of anti-cancer therapy, a small number of malignant cells remain, making the post-treatment dynamics inherently stochastic. Fourth, the growth parameters of macroscopic tumors are non-constant, as are the parameters of anti-tumor therapies. Changes in these parameters may induce phenomena that a...

  13. Pediatric oncologic emergencies

    International Nuclear Information System (INIS)

    Zietz, Hallie A.

    1997-01-01

    Oncologic emergencies arise in three ways: disease or therapy induced cytopenias; a space occupying lesion causing pressure on or obstruction of surrounding tissues; or leukemia or tumors creating life-threatening metabolic or hormonal problems. Knowledge of presenting signs and symptoms of these emergencies are essential in pediatric oncologic nursing. Neutropenia opens the door for all manner of infections, but the most life threatening is septicemia progressing to shock. A variety of organisms can cause septic shock in the neutropenic patient, but episodes are most often due to gram-negative organisms and the endotoxins they release. Shock, while still compensated, may present with a elevated or subnormal temperature, flushed, warm, dry skin, widening pulse pressure, tachycardia, tachypnoea and irritability, but without medical intervention will progress to hypo tension, cool, clammy extremities, decreased urinary out- put, and eventually to bradycardia and cardiogenic shock. Another emergency in the cytopenia category is bleeding as a result of thrombocytopenia. Of greatest concern is intracranial hemorrhage that may occur at platelet counts of less than 5,000/mm3. Space-occupying lesions of the chest may produce superior vena cava syndrome (SVGS), pleural and pericardial effusions, and cardiac tamponade. SVGS is most often caused by non-Hodgkin's lymphoma (NHL) and presents as cough, hoarseness, dyspnea, orthopnea and chest pain. Signs include swelling, plethora, cyanosis, edema of conjunctiva and wheezing. Pleural and pericardial effusions present with respiratory or cardiac distress as does cardiac tamponade. Abdominal emergencies arise because of inflammation, mechanical obstruction, hemorrhage (often from steroid induced ulcers), and perforation. Pain is the most common presenting symptom, although vital sign alterations, fever, blood in vomitus or stool, abdominal distension and cessation of flatus are also important components of the acute abdomen

  14. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  15. Future Research in Psycho-Oncology.

    Science.gov (United States)

    Goerling, Ute; Mehnert, Anja

    2018-01-01

    Since the mid-1970s psycho-oncology and psycho-oncological research have been systematically developed in many industrialized countries and have produced nationally and internationally accepted guidelines. In this article developments and challenges are presented and discussed. From the perspective of various oncological treatment options, different needs for further psycho-oncological research are considered.

  16. [NEURO-ONCOLOGY A NEW FIELD IN DAVIDOFF CANCER CENTER AT RABIN MEDICAL CENTER].

    Science.gov (United States)

    Yust-Katz, Shlomit; Limon, Dror; Abu-Shkara, Ramez; Siegal, Tali

    2017-08-01

    Neuro-oncology is a subspecialty attracting physicians from medical disciplines such as neurology, neurosurgery, pediatrics, oncology, and radiotherapy. It deals with diagnosis and management of primary brain tumors, as well as metastatic and non-metastatic neurological manifestations that frequently affect cancer patients including brain metastases, paraneoplastic syndromes and neurological complications of cancer treatment. A neuro-oncology unit was established in Davidoff Cancer Center at Rabin Medical Center. It provides a multidisciplinary team approach for management of brain tumors and services, such as expert outpatient clinics and inpatient consultations for the departments of oncology, hematology, bone marrow transplantation and other departments in the Rabin Medical Center. In addition, expert consultation is frequently provided to other hospitals that treat cancer patients with neurological manifestations. The medical disciplines that closely collaborate for the daily management of neuro-oncology patients include radiotherapy, hematology, oncology, neuro-surgery, neuro-radiology and neuro-pathology. The neuro-oncology center is also involved in clinical and laboratory research conducted in collaboration with researchers in Israel and abroad. The new service contributes substantially to the improved care of cancer patients and to the advance of research topics in the field of neuro-oncology.

  17. Global Health in Radiation Oncology

    DEFF Research Database (Denmark)

    Rodin, Danielle; Yap, Mei Ling; Grover, Surbhi

    2017-01-01

    programs. However, formalized training and career promotion tracks in global health within radiation oncology have been slow to emerge, thereby limiting the sustained involvement of students and faculty, and restricting opportunities for leadership in this space. We examine here potential structures...... and benefits of formalized global health training in radiation oncology. We explore how defining specific competencies in this area can help trainees and practitioners integrate their activities in global health within their existing roles as clinicians, educators, or scientists. This would also help create...... and funding models might be used to further develop and expand radiation oncology services globally....

  18. 75 FR 66773 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2010-10-29

    ...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... or, are in late stage development for an adult oncology indication. The subcommittee will consider...

  19. 77 FR 57095 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2012-09-17

    ...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... that are in development for an adult oncology indication. The subcommittee will consider and discuss...

  20. 78 FR 63222 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-10-23

    ...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... the public. Name of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory... measures in the pediatric development plans of oncology products. The half-day session will provide an...

  1. 78 FR 63224 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2013-10-23

    ...] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General... oncology indications. The subcommittee will consider and discuss issues relating to the development of each...

  2. Advanced Applications of Robotics in Digestive Surgery

    Science.gov (United States)

    Patriti, Alberto; Addeo, Pietro; Buchs, Nicolas; Casciola, Luciano; Morel, Philippe

    2011-01-01

    Laparoscopy is widely recognized as feasible and safe approach to many oncologic and benign digestive conditions and is associated with an improved early outcome. Robotic surgery promises to overcome intrinsic limitations of laparoscopic surgery by a three-dimensional view and wristed instruments widening indications for a minimally invasive approach. To date, the more interesting applications of robotic surgery are those operations restricted to one abdominal quadrant and requiring a fine dissection and digestive reconstruction. While robot-assisted rectal and gastric surgery are becoming well-accepted options among the surgical community, applications of robotics in hepato-biliary and pancreatic surgery are still debated. PMID:23905029

  3. Whole brain irradiation following surgery or radiosurgery for solitary brain metastases: Mature results of a prematurely closed randomized Trans-Tasman Radiation Oncology Group trial (TROG 98.05)

    International Nuclear Information System (INIS)

    Roos, Daniel E.; Wirth, Andrew; Burmeister, Bryan H.; Spry, Nigel A.; Drummond, Katharine J.; Beresford, Jennifer A.; McClure, Beverley E.

    2006-01-01

    We evaluated the effect of adjuvant whole brain irradiation (WBI) after surgery or radiosurgery for solitary brain metastases in a Phase III multicentre trial with randomization to 30-36 Gy WBI or observation. The study was closed early due to slow accrual after 19 patients (WBI 10, observation 9). There was no difference in CNS failure-free survival or overall survival between the arms. There was a trend to reduced CNS relapse with WBI (30% versus 78%, P = 0.12). Limited analysis of quality of life and neurocognitive function data revealed no evidence of difference between the arms. Our results are not inconsistent with two larger randomized trials and support the use of upfront WBI to decrease brain recurrence in this setting

  4. Exercise Promotion in Geriatric Oncology.

    Science.gov (United States)

    Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M

    2016-09-01

    Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals.

  5. Trends in hospital-physician integration in medical oncology.

    Science.gov (United States)

    Clough, Jeffrey D; Dinan, Michaela A; Schulman, Kevin A

    2017-10-01

    Hospitals have rapidly acquired medical oncology practices in recent years. Experts disagree as to whether these trends are related to oncology-specific market factors or reflect a general trend of hospital-physician integration. The objective of this study was to compare the prevalence, geographic variation, and trends in physicians billing from hospital outpatient departments in medical oncology with other specialties. Retrospective analysis of Medicare claims data for 2012 and 2013. We calculated the proportion of physicians and practitioners in the 15 highest-volume specialties who billed the majority of evaluation and management visits from hospital outpatient departments in each year, nationally and by state. We included 338,998 and 352,321 providers in 2012 and 2013, respectively, of whom 9715 and 9969 were medical oncologists. Among the 15 specialties examined, medical oncology had the highest proportion of hospital outpatient department billing in 2012 and 2013 (35.0% and 38.3%, respectively). Medical oncology also experienced the greatest absolute change (3.3%) between the years, followed by thoracic surgery (2.4%) and cardiology (2.0%). There was marked state-level variation, with the proportion of medical oncologists based in hospital outpatient departments ranging from 0% in Nevada to 100% in Idaho. Hospital-physician integration has been more pronounced in medical oncology than in other high-volume specialties and is increasing at a faster rate. Policy makers should take these findings into consideration, particularly with respect to recent proposals that may continue to fuel these trends.

  6. Topics in clinical oncology. 15

    International Nuclear Information System (INIS)

    Cepcek, P.

    1987-12-01

    The monograph comprising primarily papers on topical subjects of oncology and cancer research, contains also a selection of papers presented at the 2. Congress of the Czechoslovak Society of Nuclear Medicine and Radiation Hygiene. Seven papers were selected on behalf of their subject related to clinical oncology. All of them were iputted in INIS; five of them deal with the scintiscanning of the skeleton of cancer patients, one with radioimmunodetection of tumors, and one with radionuclide lymphography. (A.K.)

  7. Imaging Opportunities in Radiation Oncology

    International Nuclear Information System (INIS)

    Balter, James M.; Haffty, Bruce G.; Dunnick, N. Reed; Siegel, Eliot L.

    2011-01-01

    Interdisciplinary efforts may significantly affect the way that clinical knowledge and scientific research related to imaging impact the field of Radiation Oncology. This report summarizes the findings of an intersociety workshop held in October 2008, with the express purpose of exploring 'Imaging Opportunities in Radiation Oncology.' Participants from the American Society for Radiation Oncology (ASTRO), National Institutes of Health (NIH), Radiological Society of North America (RSNA), American Association of physicists in Medicine (AAPM), American Board of Radiology (ABR), Radiation Therapy Oncology Group (RTOG), European Society for Therapeutic Radiology and Oncology (ESTRO), and Society of Nuclear Medicine (SNM) discussed areas of education, clinical practice, and research that bridge disciplines and potentially would lead to improved clinical practice. Findings from this workshop include recommendations for cross-training opportunities within the allowed structured of Radiology and Radiation Oncology residency programs, expanded representation of ASTRO in imaging related multidisciplinary groups (and reciprocal representation within ASTRO committees), increased attention to imaging validation and credentialing for clinical trials (e.g., through the American College of Radiology Imaging Network (ACRIN)), and building ties through collaborative research as well as smaller joint workshops and symposia.

  8. PRIMARY OPEN-ANGLE GLAUCOMA IN ONCOLOGIC PATIENTS

    Directory of Open Access Journals (Sweden)

    A. A. Ryabtseva

    2015-01-01

    Full Text Available Background: Glaucoma-induced visual impairment negatively influences quality of life of oncologic patients. Yet, tumor in itself and methods of its treatment may promote glaucoma progression. Aim: To study characteristics and course of primary open-angle glaucoma in oncologic patients. Materials and methods: We analyzed case reports of 19 oncologic patients after primary open-angle glaucoma-related sinus trabeculectomy (34 eyes and laser cyclopexy (1 eye. Diagnosed malignancies included colorectal cancer in 5 patients, uterine body and cervical cancer in 4 patients, chronic lymphocytic leukemia in 1 patient, renal cell carcinoma in 1 patient, adrenal cancer in 1 patient, prostatic cancer in 1 patient, breast cancer in 1 patient, vulvar cancer in 1 patient, tongue root cancer in 1 patient. Antiglaucomatous surgery was accomplished during the first 5 years from the diagnosis of tumor in 14 patients. In 9 patients, chemotherapy or hormone therapy was continued by the time of surgery. Follow-up of the patients was undertaken in 4–12 months after the antiglaucomatous operation; it included routine ophthalmological examination and dry eye syndrome functional tests. Results: Duration of postoperative period was 4 months or more. All patients had uveitis postoperatively. During late postoperative period, choroidal detachment was diagnosed in 4 patients. Bleb scarring was found in 2 patients. All patients received hypotensive treatment postoperatively including selective and non-selective beta-adrenergic blockers. Conjunctival and corneal xerosis was observed in all patients. Conclusion: In oncologic patients undergoing antiglaucomatous surgery, long-term (4 months or more postoperative anti-inflammatory therapy is needed along with monthly ophthalmological follow-up during the first year after the operation. In patients with ongoing cytostatic drug treatment, artificial tear should be administrated.

  9. Pre-emptive administration of intravenous acetaminophen with transversus abdominis plane block (tap-blocke in the prevention of fentanil-induced hyperalgesia in pediatric oncological patient undergoing abdominal surgery

    Directory of Open Access Journals (Sweden)

    Dmytro Dmytriiev

    2015-10-01

      Abstract Background: Acetaminophen is a selective COX-2 agonist that has been shown to decrease the intensity of opioid-induced hyperalgesia (OIH in children. We aimed to investigate the effects of preemptive administration of intravenous acitomenofen  in the prevention of high-dose fentanil-induced hyperalgesia in pediatric patients. Methods: 45 patients of  American Society of Anesthesiologists physical status 1-3 undergoing abdominal surgery were randomly assigned to one of the following three groups. each of which received either IV acetaminophen  (an initial dose of 1.5 ml/kg for 40 min before before the induction of anesthesia or placebo saline 40 min before the induction of anesthesia and intraoperative fentanil infusion: group LFH received a placebo and 0.05 μg/kg/min fentanil; group FH received a placebo and 0.3 μg/kg/min fentanil; and group AFH received IV preemptive administration acetaminophen  and TAP-blocke bupivacaine 0,3 mg/kg.             Results: The mechanical hyperalgesia threshold 12 hr after surgery was significantly lower in group FH than in the other two groups. Postoperative pain intensity using visual analog scale (VAS and cumulative volume of a patient controlled analgesia (PCA containing morphine over 12 hr were significantly greater in group FH than in group AFH. The time to the first postoperative analgesic requirement was significantly shorter in group RH than in the other two groups. The sevoflurane requirement was significantly greater in group LFH than in the other groups. The frequency of hypotension and bradycardia was significantly higher, but shivering and postoperative nausea and vomiting were significantly lower in group AFH than in the other two groups. Conclusions: High-doses of fentanil induced hyperalgesia, which presented a decreased mechanical hyperalgesia threshold, enhanced pain intensity, a shorter time to first postoperative analgesic requirement, and greater morphine consumption, but IV

  10. Augmented reality in laparoscopic surgical oncology.

    Science.gov (United States)

    Nicolau, Stéphane; Soler, Luc; Mutter, Didier; Marescaux, Jacques

    2011-09-01

    Minimally invasive surgery represents one of the main evolutions of surgical techniques aimed at providing a greater benefit to the patient. However, minimally invasive surgery increases the operative difficulty since the depth perception is usually dramatically reduced, the field of view is limited and the sense of touch is transmitted by an instrument. However, these drawbacks can currently be reduced by computer technology guiding the surgical gesture. Indeed, from a patient's medical image (US, CT or MRI), Augmented Reality (AR) can increase the surgeon's intra-operative vision by providing a virtual transparency of the patient. AR is based on two main processes: the 3D visualization of the anatomical or pathological structures appearing in the medical image, and the registration of this visualization on the real patient. 3D visualization can be performed directly from the medical image without the need for a pre-processing step thanks to volume rendering. But better results are obtained with surface rendering after organ and pathology delineations and 3D modelling. Registration can be performed interactively or automatically. Several interactive systems have been developed and applied to humans, demonstrating the benefit of AR in surgical oncology. It also shows the current limited interactivity due to soft organ movements and interaction between surgeon instruments and organs. If the current automatic AR systems show the feasibility of such system, it is still relying on specific and expensive equipment which is not available in clinical routine. Moreover, they are not robust enough due to the high complexity of developing a real-time registration taking organ deformation and human movement into account. However, the latest results of automatic AR systems are extremely encouraging and show that it will become a standard requirement for future computer-assisted surgical oncology. In this article, we will explain the concept of AR and its principles. Then, we

  11. Urological oncology. 2. ed.

    International Nuclear Information System (INIS)

    Ammon, J.; Karstens, J.H.; Rathert, P.

    1981-01-01

    The cooperation between urologists and radiologists has brought about new ideas for the therapy of malignant tumours of the urogenital tract. This and the development of new techniques of diagnosis and therapy has brought about a need for revision of present diagnostic and therapeutical conceptions. With the introduction of the TNM classification system for nearly all tumours of the urogenital system, it has become obligatory to have a list of indications for the various techniques to determine the T-, N-, or M-nature of a tumour. Except for tumours of the female genitals, also diagnosis and therapy are based on the new classification system. The use of computerized tomography will have to be re-evaluated. To say the least, it is a decisive aid in physical and technical irradiation planning. The fundamentals of systematic diagnosis and therapy are listed in a table. Cytostatic treatment and combined radio-/chemotherapy must be considered. Side-effects of radiotherapy and their treatment are of practical importance. Post-therapeutical treatment receives special attention. The documented cooperation between radiophysics, radiobiology, radiology, and urology has yielded new knowledge in the sense of a comprehensive conception of urological oncology. (orig./MG) [de

  12. Innovations in robotic surgery.

    Science.gov (United States)

    Gettman, Matthew; Rivera, Marcelino

    2016-05-01

    Developments in robotic surgery have continued to advance care throughout the field of urology. The purpose of this review is to evaluate innovations in robotic surgery over the past 18 months. The release of the da Vinci Xi system heralded an improvement on the Si system with improved docking, the ability to further manipulate robotic arms without clashing, and an autofocus universal endoscope. Robotic simulation continues to evolve with improvements in simulation training design to include augmented reality in robotic surgical education. Robotic-assisted laparoendoscopic single-site surgery continues to evolve with improvements on technique that allow for tackling previously complex pathologic surgical anatomy including urologic oncology and reconstruction. Last, innovations of new surgical platforms with robotic systems to improve surgeon ergonomics and efficiency in ureteral and renal surgery are being applied in the clinical setting. Urologic surgery continues to be at the forefront of the revolution of robotic surgery with advancements in not only existing technology but also creation of entirely novel surgical systems.

  13. Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Moran, Meena S. [Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut (United States); Schnitt, Stuart J. [Department of Pathology, Harvard Medical School, Boston, Massachusetts (United States); Giuliano, Armando E. [Department of Surgery, Cedars Sinai Medical Center, Los Angeles, California (United States); Harris, Jay R. [Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts (United States); Khan, Seema A. [Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois (United States); Horton, Janet [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Klimberg, Suzanne [Department of Surgery, University of Arkansas for Medical Sciences, Fayetteville, Arkansas (United States); Chavez-MacGregor, Mariana [Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Freedman, Gary [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania (United States); Houssami, Nehmat [School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales (Australia); Johnson, Peggy L. [Advocate in Science, Susan G. Komen, Wichita, Kansas (United States); Morrow, Monica, E-mail: morrowm@mskcc.org [Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2014-03-01

    Purpose: To convene a multidisciplinary panel of breast experts to examine the relationship between margin width and ipsilateral breast tumor recurrence (IBTR) and develop a guideline for defining adequate margins in the setting of breast conserving surgery and adjuvant radiation therapy. Methods and Materials: A multidisciplinary consensus panel used a meta-analysis of margin width and IBTR from a systematic review of 33 studies including 28,162 patients as the primary evidence base for consensus. Results: Positive margins (ink on invasive carcinoma or ductal carcinoma in situ) are associated with a 2-fold increase in the risk of IBTR compared with negative margins. This increased risk is not mitigated by favorable biology, endocrine therapy, or a radiation boost. More widely clear margins than no ink on tumor do not significantly decrease the rate of IBTR compared with no ink on tumor. There is no evidence that more widely clear margins reduce IBTR for young patients or for those with unfavorable biology, lobular cancers, or cancers with an extensive intraductal component. Conclusions: The use of no ink on tumor as the standard for an adequate margin in invasive cancer in the era of multidisciplinary therapy is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcomes, and decrease health care costs.

  14. Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer

    International Nuclear Information System (INIS)

    Moran, Meena S.; Schnitt, Stuart J.; Giuliano, Armando E.; Harris, Jay R.; Khan, Seema A.; Horton, Janet; Klimberg, Suzanne; Chavez-MacGregor, Mariana; Freedman, Gary; Houssami, Nehmat; Johnson, Peggy L.; Morrow, Monica

    2014-01-01

    Purpose: To convene a multidisciplinary panel of breast experts to examine the relationship between margin width and ipsilateral breast tumor recurrence (IBTR) and develop a guideline for defining adequate margins in the setting of breast conserving surgery and adjuvant radiation therapy. Methods and Materials: A multidisciplinary consensus panel used a meta-analysis of margin width and IBTR from a systematic review of 33 studies including 28,162 patients as the primary evidence base for consensus. Results: Positive margins (ink on invasive carcinoma or ductal carcinoma in situ) are associated with a 2-fold increase in the risk of IBTR compared with negative margins. This increased risk is not mitigated by favorable biology, endocrine therapy, or a radiation boost. More widely clear margins than no ink on tumor do not significantly decrease the rate of IBTR compared with no ink on tumor. There is no evidence that more widely clear margins reduce IBTR for young patients or for those with unfavorable biology, lobular cancers, or cancers with an extensive intraductal component. Conclusions: The use of no ink on tumor as the standard for an adequate margin in invasive cancer in the era of multidisciplinary therapy is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcomes, and decrease health care costs

  15. Identification of the Key Fields and Their Key Technical Points of Oncology by Patent Analysis.

    Science.gov (United States)

    Zhang, Ting; Chen, Juan; Jia, Xiaofeng

    2015-01-01

    This paper aims to identify the key fields and their key technical points of oncology by patent analysis. Patents of oncology applied from 2006 to 2012 were searched in the Thomson Innovation database. The key fields and their key technical points were determined by analyzing the Derwent Classification (DC) and the International Patent Classification (IPC), respectively. Patent applications in the top ten DC occupied 80% of all the patent applications of oncology, which were the ten fields of oncology to be analyzed. The number of patent applications in these ten fields of oncology was standardized based on patent applications of oncology from 2006 to 2012. For each field, standardization was conducted separately for each of the seven years (2006-2012) and the mean of the seven standardized values was calculated to reflect the relative amount of patent applications in that field; meanwhile, regression analysis using time (year) and the standardized values of patent applications in seven years (2006-2012) was conducted so as to evaluate the trend of patent applications in each field. Two-dimensional quadrant analysis, together with the professional knowledge of oncology, was taken into consideration in determining the key fields of oncology. The fields located in the quadrant with high relative amount or increasing trend of patent applications are identified as key ones. By using the same method, the key technical points in each key field were identified. Altogether 116,820 patents of oncology applied from 2006 to 2012 were retrieved, and four key fields with twenty-nine key technical points were identified, including "natural products and polymers" with nine key technical points, "fermentation industry" with twelve ones, "electrical medical equipment" with four ones, and "diagnosis, surgery" with four ones. The results of this study could provide guidance on the development direction of oncology, and also help researchers broaden innovative ideas and discover new

  16. Resultados de la cirugía pulmonar en el Instituto Nacional de Oncología y Radiobiología de Cuba (2006-2007 Results from pulmonary surgery performed in Cuban National Institute of Oncology and Radiobiology (2006-2007

    Directory of Open Access Journals (Sweden)

    Juan Carlos Collado Otero

    2009-06-01

    aceptables y la satisfacción al egreso y al seguimiento en consulta externa 2 semanas después fue alta. La técnica que permitió alcanzar estos resultados incluyó el uso sistemático del sello de agua, la retirada del catéter peridural el día 2 del posoperatorio y el manejo precoz de los tubos torácicos.INTRODUCTION: To reduce intensive care stay and that of postoperative hospital stay in pulmonary surgery service with a minimal morbidity and mortality becomes in a real research trend for most of thoracic surgery service at world scale. Aim of this paper was to assess results of quality and effectiveness in a thoracic surgery service. METHODS: During a period of 2 years we performed consecutive pulmonary resections by thoracotomy and patients underwent extubation in operating room and referred during the first 24 hours to a progressive care ward. Thoracic tubes were placed with water seal and removed at third postoperative day if there was not an aerial escape and if drain was smaller than 150 mL/day. We used a epidural catheter removed at second postoperative day. Patient was discharged the same day of removed the last tube. RESULTS: At present study were included 156 patients (men with a mean age of 58 years (rank, 21-78 years. In 9 of them a pneumonectomy was performed (6% and lobectomy and bi-lobectomy in 110 patients (71%. Extra-anatomical resections were used for metastasectomies. One hundred ninety nine patients (96% underwent extubation in operating room, and 112 of them (72% were sending during the first hours to a progressive care unit. There were complications in 28 patients (18%, and operative mortality was of 5% (8 patients. Postoperative mean stay was of 4 days (rank, 2-25 days. Ninety nine patients (64% were discharged at forth postoperative day or before. The 97% reported an excellent or good satisfaction degree. CONCLUSIONS: Most of patients could be immediately underwent extubation at operating room, they went directly to ward or needed minimal

  17. Open radical prostatectomy after transurethral resection: perioperative, functional, oncologic outcomes.

    Science.gov (United States)

    Fragkoulis, Charalampos; Pappas, Athanasios; Theocharis, Georgios; Papadopoulos, Georgios; Stathouros, Georgios; Ntoumas, Konstantinos

    2018-04-01

    To demonstrate any differences in the perioperative, functional and oncologic outcomes after radical retropubic prostatectomy (RRP) among those patients having previously performed transurethral resection of prostate (TURP) and those not. A total of 35 patients were diagnosed with prostate cancer (T1a and T1b) after TURP, underwent RRP and completed a 1 year follow up (group A). They were matched with a cohort of another 35 men (group B) in terms of age, body mass index (BMI), prostatic specific antigen (PSA), Gleason score, prostate volume (before surgery), pathological stage and neurovascular bundle-sparing technique. That was a retrospective study completed between September 2011 and March 2014. Not a significant difference was demonstrated among the two groups of patients concerning the functional and oncologic results. On the other hand, previous prostate surgery made the operation procedure more demanding. Besides, operative time and blood loss (though not translated in transfusion rates) were higher among patients in group A. Besides, catheter removal in group A patients was performed later than their counterparts of group B. RRP after TURP is a relatively safe procedure and in the hands of experienced surgeons, a previously performed TURP, does not seem to compromise oncologic outcomes of the operation. Continence is preserved, though erectile function seems to be compromised compared with patients undergoing RRP without prior TURP. Moreover, defining the prostate and bladder neck margins can be challenging and the surgeon has to be aware of the difficulties that might confront.

  18. Molecular imaging in oncology

    International Nuclear Information System (INIS)

    Weber, W.A.

    2007-01-01

    Molecular imaging is generally defined as noninvasive and quantitative imaging of targeted macromolecules and biological processes in living organisms. A characteristic of molecular imaging is the ability to perform repeated studies and assess changes in biological processes over time. Thus molecular imaging lends itself well for monitoring the effectiveness of tumor therapy. In animal models a variety of techniques can be used for molecular imaging. These include optical imaging (bioluminescence and fluorescence imaging), magnetic resonance imaging (MRI) and nuclear medicine techniques. In the clinical setting, however, nuclear medicine techniques predominate, because so far only radioactive tracers provide the necessary sensitivity to study expression and function of macromolecules non-invasively in patients. Nuclear medicine techniques allows to study a variety of biological processes in patients. These include the expression of various receptors (estrogen, androgen, somatostatin receptors and integrins). In addition, tracers are available to study tumor cell proliferation and hypoxia. The by far most commonly used molecular imaging technique in oncology is, however, positron emission tomography (PET) with the glucose analog [ 18 F]fluorodeoxyglucose (FDG-PET). FDG-PET permits non-invasive quantitative assessment of the accelerated exogenous glucose use of malignant tumors. Numerous studies have now shown that reduction of tumor FDG-uptake during therapy allows early prediction of tumor response and patient survival. Clinical studies are currently underway to determine whether FDG-PET can be used to individualize tumor therapy by signaling early in the course of therapy the need for therapeutic adjustments in patients with likely non-responding tumors. (orig.)

  19. FDG PET/CT in oncology: 'raising the bar'

    Energy Technology Data Exchange (ETDEWEB)

    Patel, C.N. [Departments of Radiology and Nuclear Medicine, Churchill Hospital, Oxford Radcliffe NHS Trust, Oxford (United Kingdom); Goldstone, A.R.; Chowdhury, F.U. [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom); Scarsbrook, A.F., E-mail: andrew.scarsbrook@leedsth.nhs.u [Departments of Radiology and Nuclear Medicine, St James' s University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds (United Kingdom)

    2010-07-15

    Integrated positron-emission tomography/computed tomography (PET/CT) with 2-[{sup 18}F]-fluoro-2-deoxy-D-glucose (FDG) has revolutionized oncological imaging in recent years and now has a firmly established role in a variety of tumour types. There have been simultaneous step-wise advances in scanner technology, which are yet to be exploited to their full potential in clinical practice. This article will review these technological developments and explore how refinements in imaging protocols can further improve the accuracy and efficacy of PET/CT in oncology. The promises, and limitations, of emerging oncological applications of FDG PET/CT in radiotherapy planning and therapy response assessment will be explored. Potential future developments, including the use of FDG PET probes in oncological surgery, advanced data analysis techniques, and the prospect of integrated PET/magnetic resonance imaging (PET/MRI) will be highlighted.

  20. Geriatric Oncology Program Development and Gero-Oncology Nursing.

    Science.gov (United States)

    Lynch, Mary Pat; DeDonato, Dana Marcone; Kutney-Lee, Ann

    2016-02-01

    To provide a critical analysis of current approaches to the care of older adults with cancer, outline priority areas for geriatric oncology program development, and recommend strategies for improvement. Published articles and reports between 1999 and 2015. Providing an interdisciplinary model that incorporates a holistic geriatric assessment will ensure the delivery of patient-centered care that is responsive to the comprehensive needs of older patients. Nursing administrators and leaders have both an opportunity and responsibility to shape the future of geriatric oncology. Preparations include workforce development and the creation of programs that are designed to meet the complex needs of this population. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Palliative care and pediatric surgical oncology.

    Science.gov (United States)

    Inserra, Alessandro; Narciso, Alessandra; Paolantonio, Guglielmo; Messina, Raffaella; Crocoli, Alessandro

    2016-10-01

    Survival rate for childhood cancer has increased in recent years, reaching as high as 70% in developed countries compared with 54% for all cancers diagnosed in the 1980s. In the remaining 30%, progression or metastatic disease leads to death and in this framework palliative care has an outstanding role though not well settled in all its facets. In this landscape, surgery has a supportive actor role integrated with other welfare aspects from which are not severable. The definition of surgical palliation has moved from the ancient definition of noncurative surgery to a group of practices performed not to cure but to alleviate an organ dysfunction offering the best quality of life possible in all the aspects of life (pain, dysfunctions, caregivers, psychosocial, etc.). To emphasize this aspect a more modern definition has been introduced: palliative therapy in whose context is comprised not only the care assistance but also the plans of care since the onset of illness, teaching the matter to surgeons in training and share paths. Literature is very poor regarding surgical aspects specifically dedicated and all researches (PubMed, Google Scholar, and Cochrane) with various meshing terms result in a more oncologic and psychosocial effort. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. The Future of Gero-Oncology Nursing.

    Science.gov (United States)

    Kagan, Sarah H

    2016-02-01

    To project the future of gero-oncology nursing as a distinct specialty, framed between analysis of current challenges and explication of prospective solutions. Peer-reviewed literature, policy directives, web-based resources, and author expertise. Oncology nursing faces several challenges in meeting the needs of older people living with cancer. Realigning cancer nursing education, practice, and research to match demographic and epidemiological realities mandates redesign. Viewing geriatric oncology as an optional sub-specialty limits oncology nursing, where older people represent the majority of oncology patients and cancer survivors. The future of gero-oncology nursing lies in transforming oncology nursing itself. Specific goals to achieve transformation of oncology nursing into gero-oncology nursing include assuring integrated foundational aging and cancer content across entry-level nursing curricula; assuring a gero-competent oncology nursing workforce with integrated continuing education; developing gero-oncology nurse specialists in advanced practice roles; and cultivating nurse leadership in geriatric oncology program development and administration along with expanding the scope and sophistication of gero-oncology nursing science. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Information technologies for radiation oncology

    International Nuclear Information System (INIS)

    Chen, George T.Y.

    1996-01-01

    Electronic exchange of information is profoundly altering the ways in which we share clinical information on patients, our research mission, and the ways we teach. The three panelists each describe their experiences in information exchange. Dr. Michael Vannier is Professor of Radiology at the Mallinkrodt Institute of Radiology, and directs the image processing laboratory. He will provide insights into how radiologists have used the Internet in their specialty. Dr. Joel Goldwein, Associate Professor in the Department of Radiation Oncology at the University of Pennsylvania, will describe his experiences in using the World Wide Web in the practice of academic radiation oncology and the award winning Oncolink Web Site. Dr. Timothy Fox Assistant, Professor of Radiation Oncology at Emory University will discuss wide area networking of multi-site departments, to coordinate center wide clinical, research and teaching activities

  4. Responses of advanced directives by Jehovah's Witnesses on a gynecologic oncology service

    Directory of Open Access Journals (Sweden)

    Nagarsheth NP

    2014-12-01

    Full Text Available Nimesh P Nagarsheth,1,2 Nikhil Gupta,3 Arpeta Gupta,4 Erin Moshier,5 Herbert Gretz,1 Aryeh Shander6 1Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA; 2Englewood Hospital and Medical Center, Englewood, NJ, USA; 3Department of Urology, North Shore – Long Island Jewish Health Service, New Hyde Park, NY, USA; 4Department of Endocrinology, Diabetes and Metabolism, St Luke's Hospital of Kansas City, Kansas City, MO, 5Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA; 6Department of Anesthesiology, Englewood Hospital and Medical Center, Englewood, NJ, USA Objectives: To review the responses of advance directives signed by Jehovah's Witness patients prior to undergoing surgery at a gynecologic oncology service. Study design: A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998–2007 was conducted. Demographic, pathologic, and clinical data were recorded. The proportion of patients who accepted and refused various blood-derived products was determined and was compared to previously published results from a similar study of labor and delivery unit patients. Results: No gynecologic oncology patients agreed to accept transfusions of whole blood, red cells, white cells, platelets, or plasma under any circumstance, whereas 9.8% of pregnant patients accepted transfusion (P=0.0385. However, 98% of gynecologic oncology patients agreed to accept some blood products, including fractions such as albumin, immunoglobulins, and clotting factors, while only 39% of pregnant patients agreed (P<0.0001. In addition, all gynecologic oncology patients (100% accepted intraoperative hemodilution, compared to 55% of pregnant patients (P<0.0001. Conclusion: Our results confirm the commonly held belief

  5. Comprehensive Oncologic Emergencies Research Network (CONCERN)

    Science.gov (United States)

    The Comprehensive Oncologic Emergencies Research Network (CONCERN) was established in March 2015 with the goal to accelerate knowledge generation, synthesis and translation of oncologic emergency medicine research through multi-center collaborations.

  6. American Society of Pediatric Hematology/Oncology

    Science.gov (United States)

    ... Learn More Explore career opportunities in pediatric hematology/oncology Visit the ASPHO Career Center. Learn More Join ... Privacy Policy » © The American Society of Pediatric Hematology/Oncology

  7. 76 FR 58520 - Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting

    Science.gov (United States)

    2011-09-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0002] Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee; Notice of Meeting AGENCY: Food... of Committee: Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee. General...

  8. [Vitamins and Minerals in Oncology].

    Science.gov (United States)

    Holch, Julian Walter; Michl, Marlies; Heinemann, Volker; Erickson, Nicole

    2017-06-01

    The use of vitamins and minerals to prevent cancer as well as their supportive use in oncological patients is widespread and often occurs without the knowledge of the treating physician. Beyond general recommendations with regard to a balanced and healthy diet, no evidence exists supporting the use of vitamins and minerals in the prevention of cancer. Furthermore, the diet of oncological patients should contain vitamins and minerals of the same quantity as for healthy individuals. In particular, there is currently no rationale for a high-dosage administration of antioxidants. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Positron emission tomography in oncology

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    This report describes the current and potential uses of positron emission tomography in clinical medicine and research related to oncology. Assessment will be possible of metabolism and physiology of tumors and their effects on adjacent tissues. Specific probes are likely to be developed for target sites on tumors, including monoclonal antibodies and specific growth factors that recognize tumors. To date, most oncological applications of positron emission tomography tracers have been qualitative; in the future, quantitative metabolic measurements should aid in the evaluation of tumor biology and response to treatment

  10. PET/MR in oncology

    DEFF Research Database (Denmark)

    Balyasnikova, Svetlana; Löfgren, Johan; de Nijs, Robin

    2012-01-01

    of the challenges inherent in this new technology, but focus on potential applications for simultaneous PET/MR in the field of oncology. Methods and tracers for use with the PET technology will be familiar to most readers of this journal; thus this paper aims to provide a short and basic introduction to a number...... be applied together with PET increasing the amount of information about the tissues of interest. The potential clinical benefit of applying PET/MR in staging, radiotherapy planning and treatment evaluation in oncology, as well as the research perspectives for the use of PET/MR in the development of new...

  11. Cancer Patients and Oncology Nursing: Perspectives of Oncology ...

    African Journals Online (AJOL)

    2017-10-26

    Oct 26, 2017 ... findings of this study, nurses declared that working with cancer patients increase burnout, they are ..... of working in oncology to entire work life was 75.8% for nurses in the study .... This professional balance is important for ...

  12. Risk adjusted surgical audit in gynaecological oncology: P-POSSUM does not predict outcome.

    Science.gov (United States)

    Das, N; Talaat, A S; Naik, R; Lopes, A D; Godfrey, K A; Hatem, M H; Edmondson, R J

    2006-12-01

    To assess the Physiological and Operative Severity Score for the enumeration of mortality and morbidity (POSSUM) and its validity for use in gynaecological oncology surgery. All patients undergoing gynaecological oncology surgery at the Northern Gynaecological Oncology Centre (NGOC) Gateshead, UK over a period of 12months (2002-2003) were assessed prospectively. Mortality and morbidity predictions using the Portsmouth modification of the POSSUM algorithm (P-POSSUM) were compared to the actual outcomes. Performance of the model was also evaluated using the Hosmer and Lemeshow Chi square statistic (testing the goodness of fit). During this period 468 patients were assessed. The P-POSSUM appeared to over predict mortality rates for our patients. It predicted a 7% mortality rate for our patients compared to an observed rate of 2% (35 predicted deaths in comparison to 10 observed deaths), a difference that was statistically significant (H&L chi(2)=542.9, d.f. 8, prisk of mortality for gynaecological oncology patients undergoing surgery. The P-POSSUM algorithm will require further adjustments prior to adoption for gynaecological cancer surgery as a risk adjusted surgical audit tool.

  13. Primary carcinoma of fallopian tubes in the material of the Institute of Oncology in Gliwice

    Energy Technology Data Exchange (ETDEWEB)

    Franek, K; Zielonka, I; Kwasniewska-Rokicinska, C [Instytut Onkologii, Gliwice (Poland)

    1976-01-01

    The survival of 17 patients treated with postoperative radiotherapy at the Institute of Oncology in Gliwice for primary fallopian tube carcinoma is analysed. The causes of therapeutic failures and short survival (within 2 years) were - too far advanced disease at the time of main treatment which was due to diagnostic difficulties and too late reference of patients for surgery.

  14. Minimally Invasive Surgery in Thymic Malignances

    Directory of Open Access Journals (Sweden)

    Wentao FANG

    2018-04-01

    Full Text Available Surgery is the most important therapy for thymic malignances. The last decade has seen increasing adoption of minimally invasive surgery (MIS for thymectomy. MIS for early stage thymoma patients has been shown to yield similar oncological results while being helpful in minimize surgical trauma, improving postoperative recovery, and reduce incisional pain. Meanwhile, With the advance in surgical techniques, the patients with locally advanced thymic tumors, preoperative induction therapies or recurrent diseases, may also benefit from MIS in selected cases.

  15. Robotic resections in hepatobiliary oncology - initial experience with Xi da Vinci system in India.

    Science.gov (United States)

    Chandarana, M; Patkar, S; Tamhankar, A; Garg, S; Bhandare, M; Goel, M

    2017-01-01

    Minimal invasive surgery has proven its advantages over open surgeries in the perioperative period. Food and Drug Administration approved da Vinci robot in 2000. The latest version, da Vinci Xi system has a mobile tower-based robot with several modifications to improve the functionality, versatility, and operative ease. None of the centers have reported exclusively on hepatobiliary oncology using the da Vinci Xi system. We report our initial experience. To study the feasibility, advantages, and discuss the operative technique of da Vinci Xi system in hepatobiliary oncology. Data were analyzed retrospectively from a prospectively maintained database from June 2015 to October 2016. Twenty-five patients with suspected or proven hepatobiliary malignancies were operated. Total robotic technique using da Vinci Xi system was used. Demographic details and perioperative outcomes were noted. Of the 25 surgeries, 14 patients had a suspected gallbladder malignancy, 11 patients had primary or metastatic liver tumor. Median age was 53 years. The average duration of surgery was 225 min with a median blood loss 150 ml. The median postoperative stay was 4 days. The median nodal yield for radical cholecystectomy was seven. Five patients required conversion. Two of these developed postoperative morbidity. Robotic surgery for hepatobiliary oncology is feasible and can be performed safely in experienced hands. Increasing experience in this field may equal or even prove advantageous over conventional or laparoscopic approach in future. A cautious approach with judicious patient selection is the key to establishing robotic surgery as a standard surgical approach.

  16. Cardiotoxicity of oncological treatment

    International Nuclear Information System (INIS)

    Mlot, B.; Rzepecki, P.

    2010-01-01

    , also increase the risk of cardiotoxicity. These medicaments also cause hypetension, acute coronary syndromes and thromboembolic events. Monoclonal antibodies are also toxic for the heart. Anti-HER2 therapy blocks the receptor which normally protects the heart from impairing factors (such as ischaemia, toxins and adrenergic stimulation). Cardiological disturbances are one of the late complications of radiotherapy of the area of the chest and usually appear after more than 10 years calculating from the end of treatment. It is an essential problem especially in patients with breast cancer or with Hodgkin's lymphoma due to the long-term survivals in these groups. The related abnormalities were located mostly in the pericardium and coronary vessels, but may also involve the myocardium, the conducting system or valves of the heart. In chemotherapy departments, the oncologist has become responsible for the cardiotoxicity risk stratification in patients undergoing/planned for anti-cancer therapy and for the early recognition of cardiac complications. Monitoring of the left ventricular function is now an essential part of oncological procedures using cardiotoxic drugs. ACE inhibitors, ATI receptor blockers, beta-blockers, diuretics and digoxin are drugs of choice in heart failure therapy. The awareness of clinicians regarding the potential adverse effects on cardiac performance by several classes of drugs, particularly in patients with preexisting ventricular dysfunction, may contribute to timely diagnosis and prevention of drug-induced heart failure. (authors)

  17. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  18. Bariatric Surgery

    Science.gov (United States)

    ... often. Each type of surgery has advantages and disadvantages. Bariatric Surgery Benefits Bariatric surgery can improve many ... Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information Diabetes Digestive ...

  19. Lung surgery

    Science.gov (United States)

    ... are thoracotomy and video-assisted thoracoscopic surgery (VATS). Robotic surgery may also be used. Lung surgery using ... Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

  20. Plastic Surgery

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Plastic Surgery KidsHealth / For Teens / Plastic Surgery What's in ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  1. Treatment response in oncology

    International Nuclear Information System (INIS)

    Pandit-Taskar, Neeta; Batraki, Maria; Divgi, Chaitanya

    2004-01-01

    Full text: Currently, the evaluation of response to therapy in Oncology consists of determination of changes in size of lesions measurable by structural imaging, notably computerized tomography. These criteria, formalized using RECIST (Response Evaluation Criteria in Solid Tumors), are the current standard for evaluation (http://www3.cancer. gov/dip/RECIST.htm). An increasing body of evidence suggests that functional changes in tumors precede structural changes, and that methodologies that measure such changes may be able to evaluate the potential of therapy, allowing for better and earlier selection of these potentially cytotoxic therapies. Nuclear Medicine imaging is distinguished by its ability to determine functional characteristics. These include: 1. Receptor status - for example, the presence of sodium iodide symporters detected by radioiodine or pertechnetate imaging, the presence of somatostatin or norepinephrine receptors by pentetreotide or metaiodobenzylguanidine (mIBG) imaging respectively. Such imaging can help guide appropriate therapies with iodine-131, somatostatin analogues (radiolabeled or otherwise) or iodine-131 labeled mIBG. 2. Metabolic status - for example, glycolytic status (with fluorine-18 labeled fluorodeoxyglucose); amino acid metabolism (e.g. using carbon-11 labeled methionine), or tumor proliferation (using radiolabeled thymidine or deoxyuridine). These methods have advantages over structural imaging because in the vast majority of tumors, changes in the functional or molecular status of tumors are seen earlier than are structural changes. 3. Overall cellular status - these imaging agents are still in their early development but hold great promise for the determination of cellular viability. Annexin imaging is the archetype of such imaging modalities that predict the overall fate of the cell, in this instance its entry into the apoptotic pathway. This review will highlight the uses of functional imaging using radiotracers in all three

  2. Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

    Directory of Open Access Journals (Sweden)

    Andre Berger

    2009-01-01

    Full Text Available Introduction. Laparoscopic radical nephroureterectomy (LNU is being increasingly performed at several centers across the world. We review oncologic outcomes after LNU procedure and the techniques for the management of distal ureter. Materials and Methods. A comprehensive review of the literature was performed on the oncological outcomes and management of distal ureter associated with LNU for upper tract transitional cell carcinoma (TCC. Results and Discussion. LNU for upper tract TCC is performed pure laparoscopically (LNU or hand-assisted (HALNU. The management of the distal ureter is still debated. LNU appears to have superior perioperative outcomes when compared to open surgery. Intermediate term oncologic outcomes after LNU are comparable to open nephroureterectomy (ONU. Conclusions. Excision of the distal ureter and bladder cuff during nephroureterectomy remains controversial. Intermediate term oncologic outcomes for LNU compare well with ONU. Initial long-term oncologic outcomes are encouraging. Prospective randomized comparison between LNU and open surgery is needed to define the role of these modalities in the current context.

  3. Laparoscopic surgery for rectal cancer: a single-centre experience of 120 cases.

    LENUS (Irish Health Repository)

    Good, Daniel W

    2011-10-01

    For colorectal surgeons, laparoscopic rectal cancer surgery poses a new challenge. The defence of the questionable oncological safety tempered by the impracticality of the long learning curve is rapidly fading. As a unit specialising in minimally invasive surgery, we have routinely undertaken rectal cancer surgery laparoscopically since 2005.

  4. Robotic surgery in urological oncology: patient care or market share?

    Science.gov (United States)

    Kaye, Deborah R; Mullins, Jeffrey K; Carter, H Ballentine; Bivalacqua, Trinity J

    2015-01-01

    Surgical robotic use has grown exponentially in spite of limited or uncertain benefits and large costs. In certain situations, adoption of robotic technology provides value to patients and society. In other cases, however, the robot provides little or no increase in surgical quality, with increased expense, and, therefore, does not add value to health care. The surgical robot is expensive to purchase, maintain and operate, and can contribute to increased consumerism in relation to surgical procedures, and increased reliance on the technology, thus driving future increases in health-care expenditure. Given the current need for budget constraints, the cost-effectiveness of specific procedures must be evaluated. The surgical robot should be used when cost-effective, but traditional open and laparoscopic techniques also need to be continually fostered.

  5. Robotic Oncological Surgery: Technology That's Here to Stay?

    Directory of Open Access Journals (Sweden)

    HRH Patel

    2009-09-01

    Full Text Available A robot functioning in an environment may exhibit various forms of behavior emerge from the interaction with its environment through sense, control and plan activities. Hence, this paper introduces a behaviour selection based navigation and obstacle avoidance algorithm with effective method for adapting robotic behavior according to the environment conditions and the navigated terrain. The developed algorithm enable the robot to select the suitable behavior in real-time to avoid obstacles based on sensory information through visual and ultrasonic sensors utilizing the robot's ability to step over obstacles, and move between surfaces of different heights. In addition, it allows the robot to react in appropriate manner to the changing conditions either by fine-tuning of behaviors or by selecting different set of behaviors to increase the efficiency of the robot over time. The presented approach has been demonstrated on quadruped robot in several different experimental environments and the paper provides an analysis of its performance.

  6. Not only PET for oncological disorders

    International Nuclear Information System (INIS)

    Soroa, V.E.; victoriasoroa@fibertel. com.ar; Velasques Espeche, M. del H.; Garcia, Luis M.

    2004-01-01

    suppliers. Tc-99m somatostatin receptor imaging being the first radiopharmaceutical labeled in CNEA laboratories came promptly in use, thanks to the availability of the radioisotope label. SPECT imaging is required for both radiopharmaceuticals to identify pathologies such as: thyroid C-cell, gastro-intestinal, paraganglioma, pituitary adenomas, pancreas islet cells, adrenal medulla, pheochromocytoma and lung oat cell cancer. Neurosurgeons at our University Hospital send their patients to obtain an answer if the patient has a tumor growth. Early (10-20 min.) Tc-99m Sestamibi SPECT as compared to 2-hrs. late SPECT imaging is able to give highly accurate answer in 92-95% of the studied cases (20 patients). Internists frequently send oncological patients with fever of unknown origin to detect infection/inflammation conditions or to confirm if it is due to tumor growth or cytostatic treatment. The frequency of the request is higher when the patients have a clinical history of prosthetic materials, multiple cysts, recent surgery or urinary tract infections. Specific infection /inflammation radiopharmaceuticals should be used for scanning early and late 24-hr. images. We have studied a population of 60 patients under these circumstances. In vitro labeled 99mTc homologous leucocytes, 99mTc-antibiotics and 99mTcpolyclonal immunoglobulin were the most frequently used specific markers employed to get an answer in such patients. Nuclear medicine procedures like Tc-99m MUGA also help in monitoring of patients on cardio toxic medication like chemotherapeutic agents. The review of patients imaged for diagnosis, follow-up and prognostication shows that planar and SPECT imaging in oncology is cost-effective and provide significant information for patient management. (author)

  7. Biophysical models in radiation oncology

    International Nuclear Information System (INIS)

    Cohen, L.

    1984-01-01

    The paper examines and describes dose-time relationships in clinical radiation oncology. Realistic models and parameters for specific tissues, organs, and tumor types are discussed in order to solve difficult problems which arise in radiation oncology. The computer programs presented were written to: derive parameters from experimental and clinical data; plot normal- and tumor-cell survival curves; generate iso-effect tables of tumor-curative doses; identify alternative, equally effective procedures for fraction numbers and treatment times; determine whether a proposed course of treatment is safe and adequate, and what adjustments are needed should results suggest that the procedure is unsafe or inadequate; combine the physical isodose distribution with computed cellular surviving fractions for the tumor and all normal tissues traversed by the beam, estimating the risks of recurrence or complications at various points in the irradiated volume, and adjusting the treatment plan and fractionation scheme to minimize these risks

  8. PET/TAC in Oncology

    International Nuclear Information System (INIS)

    Jimenez V, A.M.

    2007-01-01

    From this presentation of PET-TAC in oncology the following advantages on the conventional PET are obtained: 1. More short study and stadium in one session. 2. It adds the information of both techniques. 3. Better localization of leisure: affected organ, stadium change (neck, mediastinum, abdomen). 4. Reduction of false positive (muscle, brown fat, atelectasis, pneumonias, intestine, urinary vials, etc.). 5. Reduction of negative false. 6. Reduction of not conclusive. 7. More understandable for other specialists. 8. Biopsies guide. 9. Planning radiotherapy

  9. Magnetic resonance tomography in oncological diagnostics

    International Nuclear Information System (INIS)

    Lien, Hans Henrik; Taksdal, Ingeborg

    2000-01-01

    MR is well suited for imaging in patients with malignant disease. It is the most sensitive and most specific method in the detection of skeletal metastases. It clearly demonstrates the extent of primary bone tumours and also reveals skip metastases and invasion into neighbouring joints, hence it is an important procedure when surgery of a bone tumour is planned. In case of a soft tissue tumour, MR is the preferable imaging modality because it demonstrates the anatomy and reveals the different tissue constituents. MR is the best method to show tumour manifestations in the central nervous system and it supplements cerebrospinal fluid examination in the detection of meningeal metastasis. MR is the method of choice if there is a cord compression. MR imaging is important in gynaecology and oncology. Cost savings have been reported due to reduced use of other diagnostic tests and expensive surgical procedures. New and faster techniques allow examination of the total body in less than 45 minutes. We expect that MR imaging will be increasingly used in the future in patients with malignant disease

  10. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  11. Patient satisfaction in radiation oncology

    International Nuclear Information System (INIS)

    Zissiadis, Y.; Provis, A.; Dhaliwal, S.S.

    2003-01-01

    In this current economic climate where the costs of providing a good medical service are escalating, patients are demanding a higher level of service from the Radiation Oncology providers. This coupled with the rising level of patients' expectations make it absolutely paramount for Radiation Oncology providers to offer the best possible service to their patients. In order to do this, it is essential to assess the present level of patient satisfaction prior to deciding which aspects of the current service need to be changed. In this pilot study, we assess the level of patient satisfaction with aspects of the radiotherapy service and the level of patient anxiety both prior to and following radiotherapy at the Perth Radiation Oncology Centre. A questionnaire was created using a combination of the Information Satisfaction Questionnaire-1 (ISQ-1), the Very Short Questionnaire 9 (VSQ 9) and the State Trait Anxiety Index (STAI). One hundred new patients were studied, all of whom were to have radiotherapy with curative intent. The results of this study are reviewed in this presentation

  12. PET scanning in plastic and reconstructive surgery.

    Science.gov (United States)

    Liodaki, Eirini; Eirini, Liodaki; Liodakis, Emmanouil; Emmanouil, Liodakis; Papadopoulos, Othonas; Othonas, Papadopoulos; Machens, Hans-Günther; Hans-Günther, Machens; Papadopulos, Nikolaos A; Nikolaos, Papadopulos A

    2012-02-01

    In this report we highlight the use of PET scan in plastic and reconstructive surgery. PET scanning is a very important tool in plastic surgery oncology (melanoma, soft-tissue sarcomas and bone sarcomas, head and neck cancer, peripheral nerve sheath tumors of the extremities and breast cancer after breast esthetic surgery), as diagnosis, staging, treatment planning and follow-up of cancer patients is based on imaging. PET scanning seems also to be useful as a flap monitoring system as well as an infection's imaging tool, for example in the management of diabetic foot ulcer. PET also contributes to the understanding of pathophysiology of keloids which remain a therapeutic challenge.

  13. Clinical and Radiation Oncology. Vol. 1

    International Nuclear Information System (INIS)

    Jurga, L.; Adam, Z.; Autrata, R.

    2010-01-01

    The work is two-volume set and has 1,658 pages. It is divided into 5 sections: I. Principles Clinical and radiation oncology. II. Hematological Malignant tumors. III. Solid tumors. IV. Treatment options metastatic Disease. V. Clinical practice in oncology. First volume contains following sections a chapters: Section I: Principles of clinical and radiation oncology, it contains following chapters: (1) The history of clinical/experimental and radiation oncology in the Czech Republic; (2) The history of clinical/experimental and radiation oncology in the Slovak Republic - development and development of oncology in Slovakia; (3) Clinical and radiation oncology as part of evidence-based medicine; (4) Molecular biology; (5) Tumor Disease; (6) Epidemiology and prevention of malignant tumors; (7) Diagnosis, staging, stratification and monitoring of patients in oncology; (8) Imaging methods in oncology; (9) Principles of surgical treatment of cancer diseases; (10) Symptomatology and signaling of malignant tumors - systemic, paraneoplastic and paraendocrine manifestations of tumor diseases; (11) Principles of radiation oncology; (12 Modeling radiobiological effects of radiotherapy; (13) Principles of anticancer chemotherapy; (14) Hormonal manipulation in the treatment of tumors; (15) Principles of biological and targeted treatment of solid tumors; (16) Method of multimodal therapy of malignant tumors; (17) Evaluation of treatment response, performance evaluation criteria (RECIST); (18) Adverse effects of cancer chemotherapy and the principles of their prevention and treatment; (19) Biological principles of hematopoietic stem cell transplantation; (20) Design, analysis and ethical aspects of clinical studies in oncology; (21) Fundamentals of biostatistics for oncologists; (22) Information infrastructure for clinical and radiological oncology based on evidence; (23) Pharmacoeconomic aspects in oncology; (24) Respecting patient preferences when deciding on the strategy and

  14. Palliative Care: Delivering Comprehensive Oncology Nursing Care.

    Science.gov (United States)

    Dahlin, Constance

    2015-11-01

    To describe palliative care as part of comprehensive oncology nursing care. A review of the palliative care, oncology, and nursing literature over the past 10 years. Palliative care is mandated as part of comprehensive cancer care. A cancer diagnosis often results in distress in the physical, psychosocial, spiritual, and emotional domains of care. Oncology nurses are essential in providing palliative care from diagnosis to death to patients with cancer. They address the myriad aspects of cancer. With palliative care skills and knowledge, oncology nurses can provide quality cancer care. There are many opportunities in which oncology nurses can promote palliative care. Oncology nurses must obtain knowledge and skills in primary palliative care to provide comprehensive cancer care. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. E-learning programs in oncology

    DEFF Research Database (Denmark)

    Degerfält, Jan; Sjöstedt, Staffan; Fransson, Per

    2017-01-01

    BACKGROUND: E-learning is an established concept in oncological education and training. However, there seems to be a scarcity of long-term assessments of E-learning programs in oncology vis-á-vis their structural management and didactic value. This study presents descriptive, nationwide data from...... 2005 to 2014. E-learning oncology programs in chemotherapy, general oncology, pain management, palliative care, psycho-social-oncology, and radiotherapy, were reviewed from our databases. Questionnaires of self-perceived didactic value of the programs were examined 2008-2014. RESULTS: The total number.......6% (MDs: 64.9%; RNs: 66.8%; SHCAs: 77.7%) and as good by 30.6% (MDs: 34.5%; RNs: 32.4%; SHCAs: 21.5%) of the responders. CONCLUSIONS: This descriptive study, performed in a lengthy timeframe, presents high-volume data from multi-professional, oncological E-learning programs. While the E-learning paradigm...

  16. Continuing medical education in radiation oncology

    International Nuclear Information System (INIS)

    Chauvet, B.; Barillot, I.; Denis, F.; Cailleux, P.E.; Ardiet, J.M.; Mornex, F.

    2012-01-01

    In France, continuing medical education (CME) and professional practice evaluation (PPE) became mandatory by law in July 2009 for all health professionals. Recently published decrees led to the creation of national specialty councils to implement this organizational device. For radiation oncology, this council includes the French Society for Radiation Oncology (SFRO), the National Radiation Oncology Syndicate (SNRO) and the Association for Continuing Medical Education in Radiation Oncology (AFCOR). The Radiation Oncology National Council will propose a set of programs including CME and PPE, professional thesaurus, labels for CME actions consistent with national requirements, and will organize expertise for public instances. AFCOR remains the primary for CME, but each practitioner can freely choose an organisation for CME, provided that it is certified by the independent scientific commission. The National Order for physicians is the control authority. Radiation oncology has already a strong tradition of independent CME that will continue through this major reform. (authors)

  17. Effect of Intraperitoneal Bupivacaine on Postoperative Pain in the Gynecologic Oncology Patient.

    Science.gov (United States)

    Rivard, Colleen; Vogel, Rachel Isaksson; Teoh, Deanna

    2015-01-01

    To evaluate if the administration of intraperitoneal bupivacaine decreased postoperative pain in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery. Retrospective cohort study (Canadian Task Force classification II-3). University-based gynecologic oncology practice operating at a tertiary medical center. All patients on the gynecologic oncology service undergoing minimally invasive surgery between September 2011 and June 2013. Starting August 2012, intraperitoneal administration of .25% bupivacaine was added to all minimally invasive surgeries. These patients were compared with historical control subjects who had surgery between September 2011 and July 2012 but did not receive intraperitoneal bupivacaine. One-hundred thirty patients were included in the study. The patients who received intraperitoneal bupivacaine had lower median narcotic use on the day of surgery and the first postoperative day compared with those who did not receive intraperitoneal bupivacaine (day 0: 7.0 mg morphine equivalents vs 11.0 mg, p = .007; day 1: .3 mg vs 1.7 mg, p = .0002). The median patient-reported pain scores were lower on the day of surgery in the intraperitoneal bupivacaine group (2.7 vs 3.2, p = .05) CONCLUSIONS: The administration of intraperitoneal bupivacaine was associated with improved postoperative pain control in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery and should be further evaluated in a prospective study. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  19. Barriers and facilitators experienced in collaborative prospective research in orthopaedic oncology

    DEFF Research Database (Denmark)

    Rendon, J S; Swinton, M; Bernthal, N

    2017-01-01

    by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. METHODS: All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss......: The 13 surgeons who participated in the discussion represented orthopaedic oncology practices from seven countries (Argentina, Brazil, Italy, Spain, Denmark, United States and Canada). Four categories and associated themes emerged from the discussion: the need for collaboration in the field...... of orthopaedic oncology due to the rarity of the tumours and the need for high level evidence to guide treatment; motivational factors for participating in collaborative research including establishing proof of principle, learning opportunity, answering a relevant research question and being part...

  20. Hyperthermia and hyperglycemia in oncology

    International Nuclear Information System (INIS)

    Zhavrid, Eh.A.; Osinskij, S.P.; Fradkin, S.Z.

    1987-01-01

    Consideration is being given to publication data and results of author's investigations into the effect of hyperthermia and hyperglycemia on physico-chemical characteristics and growth of various experimental tumors. Factors, modifying thermosensitivity, mechanisms of hyperthermia effect, various aspects of thermochimio- and thermoradiotherapy have been analyzed. Effect of artificial hyperglycemia on metabolism and kinetics of tumor and some normal cells is considered in detail. Many data, testifying to sufficient growth of efficiency of oncologic patient treatment under conditions of multimodality therapy including hyperthermia and hyperglycemia are presented

  1. Introduction to veterinary clinical oncology

    Energy Technology Data Exchange (ETDEWEB)

    Weller, R.E.

    1991-10-01

    Veterinary clinical oncology involves a multidisciplinary approach to the recognition and management of spontaneously occurring neoplasms of domestic animals. This requires some knowledge of the causes, incidence, and natural course of malignant disease as it occurs in domestic species. The purpose of this course is to acquaint you with the more common neoplastic problems you will encounter in practice, so that you can offer your clients an informed opinion regarding prognosis and possible therapeutic modalities. A major thrust will be directed toward discussing and encouraging treatment/management of malignant disease. Multimodality therapy will be stressed. 10 refs., 3 tabs.

  2. Implementing Genome-Driven Oncology

    Science.gov (United States)

    Hyman, David M.; Taylor, Barry S.; Baselga, José

    2017-01-01

    Early successes in identifying and targeting individual oncogenic drivers, together with the increasing feasibility of sequencing tumor genomes, have brought forth the promise of genome-driven oncology care. As we expand the breadth and depth of genomic analyses, the biological and clinical complexity of its implementation will be unparalleled. Challenges include target credentialing and validation, implementing drug combinations, clinical trial designs, targeting tumor heterogeneity, and deploying technologies beyond DNA sequencing, among others. We review how contemporary approaches are tackling these challenges and will ultimately serve as an engine for biological discovery and increase our insight into cancer and its treatment. PMID:28187282

  3. Robotic surgery

    Science.gov (United States)

    ... with this type of surgery give it some advantages over standard endoscopic techniques. The surgeon can make ... Elsevier Saunders; 2015:chap 87. Muller CL, Fried GM. Emerging technology in surgery: Informatics, electronics, robotics. In: ...

  4. Nose Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  5. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  6. Art Therapy with an Oncology Care Team

    Science.gov (United States)

    Nainis, Nancy A.

    2005-01-01

    Oncology nurses are particularly vulnerable to "burnout" syndrome due to the intensity of their work and the ongoing losses they experience while providing oncology care to their patients. High levels of stress in the workplace left untended lead to high job turnover, poor productivity, and diminished quality of care for patients.…

  7. Nursing 436A: Pediatric Oncology for Nurses.

    Science.gov (United States)

    Jackman, Cynthia L.

    A description is provided of "Pediatric Oncology for Nurses," the first in a series of three courses offered to fourth-year nursing students in pediatric oncology. The first section provides a course overview, discusses time assignments, and describes the target student population. Next, a glossary of terms, and lists of course goals, long-range…

  8. Thyroid Surgery

    Science.gov (United States)

    ... Hypothyroidism in Children and Adolescents Pediatric Differentiated Thyroid Cancer Thyroid Nodules in Children and Adolescents Thyroid Surgery Resources Thyroid Surgery Brochure PDF Thyroid Surgery FAQs PDF En Español Cirugia De La Tiroides El folleto de Cirugia De La Tiroides Search Thyroid ...

  9. Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes

    OpenAIRE

    Simou Maria; Thomakos Nikolaos; Zagouri Flora; Vlysmas Antonios; Akrivos Nikolaos; Zacharakis Dimitrios; Papadimitriou Christos A; Dimopoulos Meletios-Athanassios; Rodolakis Alexandros; Antsaklis Aris

    2011-01-01

    Abstract This review attempts to outline the alternative measures and interventions used in bloodless surgery in the field of gynecologic oncology and demonstrate their effectiveness. Nowadays, as increasingly more patients are expressing their fears concerning the potential risks accompanying allogenic transfusion of blood products, putting the theory of bloodless surgery into practice seems to gaining greater acceptance. An increasing number of institutions appear to be successfully adoptin...

  10. [Therapeutic Aggressiveness and Liquid Oncology].

    Science.gov (United States)

    Barón Duarte, F J; Rodríguez Calvo, M S; Amor Pan, J R

    2017-01-01

    Aggressiveness criteria proposed in the scientific literature a decade ago provide a quality judgment and are a reference in the care of patients with advanced cancer, but their use is not generalized in the evaluation of Oncology Services. In this paper we analyze the therapeutic aggressiveness, according to standard criteria, in 1.001 patients with advanced cancer who died in our Institution between 2010 and 2013. The results seem to show that aggressiveness at the end of life is present more frequently than experts recommend. About 25% of patients fulfill at least one criterion of aggressiveness. This result could be explained by a liquid Oncology which does not prioritize the patient as a moral subject in the clinical appointment. Medical care is oriented to necessities and must be articulated in a model focused on dignity and communication. Its implementation through Advanced Care Planning, consideration of patient's values and preferences, and Limitation of therapeutic effort are ways to reduce aggressiveness and improve clinical practice at the end of life. We need to encourage synergic and proactive attitudes, adding the best of cancer research with the best clinical care for the benefit of human being, moral subject and main goal of Medicine.

  11. Big data in oncologic imaging.

    Science.gov (United States)

    Regge, Daniele; Mazzetti, Simone; Giannini, Valentina; Bracco, Christian; Stasi, Michele

    2017-06-01

    Cancer is a complex disease and unfortunately understanding how the components of the cancer system work does not help understand the behavior of the system as a whole. In the words of the Greek philosopher Aristotle "the whole is greater than the sum of parts." To date, thanks to improved information technology infrastructures, it is possible to store data from each single cancer patient, including clinical data, medical images, laboratory tests, and pathological and genomic information. Indeed, medical archive storage constitutes approximately one-third of total global storage demand and a large part of the data are in the form of medical images. The opportunity is now to draw insight on the whole to the benefit of each individual patient. In the oncologic patient, big data analysis is at the beginning but several useful applications can be envisaged including development of imaging biomarkers to predict disease outcome, assessing the risk of X-ray dose exposure or of renal damage following the administration of contrast agents, and tracking and optimizing patient workflow. The aim of this review is to present current evidence of how big data derived from medical images may impact on the diagnostic pathway of the oncologic patient.

  12. Benchmarking of surgical complications in gynaecological oncology: prospective multicentre study.

    Science.gov (United States)

    Burnell, M; Iyer, R; Gentry-Maharaj, A; Nordin, A; Liston, R; Manchanda, R; Das, N; Gornall, R; Beardmore-Gray, A; Hillaby, K; Leeson, S; Linder, A; Lopes, A; Meechan, D; Mould, T; Nevin, J; Olaitan, A; Rufford, B; Shanbhag, S; Thackeray, A; Wood, N; Reynolds, K; Ryan, A; Menon, U

    2016-12-01

    To explore the impact of risk-adjustment on surgical complication rates (CRs) for benchmarking gynaecological oncology centres. Prospective cohort study. Ten UK accredited gynaecological oncology centres. Women undergoing major surgery on a gynaecological oncology operating list. Patient co-morbidity, surgical procedures and intra-operative (IntraOp) complications were recorded contemporaneously by surgeons for 2948 major surgical procedures. Postoperative (PostOp) complications were collected from hospitals and patients. Risk-prediction models for IntraOp and PostOp complications were created using penalised (lasso) logistic regression using over 30 potential patient/surgical risk factors. Observed and risk-adjusted IntraOp and PostOp CRs for individual hospitals were calculated. Benchmarking using colour-coded funnel plots and observed-to-expected ratios was undertaken. Overall, IntraOp CR was 4.7% (95% CI 4.0-5.6) and PostOp CR was 25.7% (95% CI 23.7-28.2). The observed CRs for all hospitals were under the upper 95% control limit for both IntraOp and PostOp funnel plots. Risk-adjustment and use of observed-to-expected ratio resulted in one hospital moving to the >95-98% CI (red) band for IntraOp CRs. Use of only hospital-reported data for PostOp CRs would have resulted in one hospital being unfairly allocated to the red band. There was little concordance between IntraOp and PostOp CRs. The funnel plots and overall IntraOp (≈5%) and PostOp (≈26%) CRs could be used for benchmarking gynaecological oncology centres. Hospital benchmarking using risk-adjusted CRs allows fairer institutional comparison. IntraOp and PostOp CRs are best assessed separately. As hospital under-reporting is common for postoperative complications, use of patient-reported outcomes is important. Risk-adjusted benchmarking of surgical complications for ten UK gynaecological oncology centres allows fairer comparison. © 2016 Royal College of Obstetricians and Gynaecologists.

  13. ONCOLOGY

    African Journals Online (AJOL)

    cancer is characterized by a later stage of presentation.6 ... may be done as a result of the patient's age or family history on presentation to a ... This may frequently be the first time that the patient has a clinical breast ... and the diagnosis and treatment of their DCIS. ... conservation therapy (either ROLL or WLE), 10 required.

  14. Surgical Oncology Nursing: Looking Back, Looking Forward.

    Science.gov (United States)

    Crane, Patrick C; Selanders, Louise

    2017-02-01

    To provide a historical perspective in the development of oncology nursing and surgical oncology as critical components of today's health care system. Review of the literature and Web sites of key organizations. The evolution of surgical oncology nursing has traversed a historical journey from that of a niche subspecialty of nursing that had very little scientific underpinning, to a highly sophisticated discipline within a very short time. Nursing continues to contribute its expertise to the encyclopedic knowledge base of surgical oncology and cancer care, which have helped improve the lives of countless patients and families who have had to face the difficulties of this diagnosis. An understanding of the historical context for which a nursing specialty such as surgical oncology nursing evolves is critical to gaining an appreciation for the contributions of nursing. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Implementation of nanoparticles in therapeutic radiation oncology

    Science.gov (United States)

    Beeler, Erik; Gabani, Prashant; Singh, Om V.

    2017-05-01

    Development and progress of cancer is a very complex disease process to comprehend because of the multiple changes in cellular physiology, pathology, and pathophysiology resulting from the numerous genetic changes from which cancer originates. As a result, most common treatments are not directed at the molecular level but rather at the tissue level. While personalized care is becoming an increasingly aim, the most common cancer treatments are restricted to chemotherapy, radiation, and surgery, each of which has a high likelihood of resulting in rather severe adverse side effects. For example, currently used radiation therapy does not discriminate between normal and cancerous cells and greatly relies on the external targeting of the radiation beams to specific cells and organs. Because of this, there is an immediate need for the development of new and innovative technologies that help to differentiate tumor cells and micrometastases from normal cells and facilitate the complete destruction of those cells. Recent advancements in nanoscience and nanotechnology have paved a way for the development of nanoparticles (NPs) as multifunctional carriers to deliver therapeutic radioisotopes for tumor targeted radiation therapy, to monitor their delivery, and improve the therapeutic index of radiation and tumor response to the treatment. The application of NPs in radiation therapy has aimed to improve outcomes in radiation therapy by increasing therapeutic effect in tumors and reducing toxicity on normal tissues. Because NPs possess unique properties, such as preferential accumulation in tumors and minimal uptake in normal tissues, it makes them ideal for the delivery of radiotherapy. This review provides an overview of the recent development of NPs for carrying and delivering therapeutic radioisotopes for systemic radiation treatment for a variety of cancers in radiation oncology.

  16. Lessons learned from the science of caring: Extending the reach of psychosocial oncology: The International Psycho-Oncology Society 2016 Sutherland Award Lecture.

    Science.gov (United States)

    Bultz, Barry D

    2017-06-01

    In medicine, referral to a medical oncology specialty is based on recent history, physical examination, pathology, surgery reports, imaging, blood work, and the patient's vital signs. By contrast, referral to a psychosocial specialist has typically been based on the patients expressed request for psychosocial support or the health care team's observation of the patient's limited adjustment or poor coping with the diagnosis, treatment, or end-of-life distress. These observations are usually based on clinical acumen not on metrics. In psychosocial oncology, by committing to the science of caring and relying on the use of standardized tools to screen for distress, the multidisciplinary cancer care team assess, communicate, and intervene on what is measured. That is, health care providers can begin to address the patients' identified concerns. Branding distress as the 6th vital sign and incorporating screening for distress into standard cancer practice can be an effective strategy to challenging the resistance in implementation of psychosocial oncology in cancer care institutions. Accreditation agencies are endorsing the need to assess patient distress and better manage symptoms of distress as part of routine and standardized patient care. While many international organizations and societies support the importance of screening, implementing screening for distress still has a long way to go to be operationalized in many cancer care programs. Screening for distress when implemented does, however, create an opportunity for psychosocial oncology to extend its reach into cancer care programs and institutions. Copyright © 2017 John Wiley & Sons, Ltd.

  17. Virtual Planning and Intraoperative Navigation in Craniomaxillofacial Surgery

    Directory of Open Access Journals (Sweden)

    Jorge Guiñales

    2017-08-01

    Full Text Available Surgery planning assisted by computer represents one important example of the collaboration between surgeons and engineers. Virtual planning allows surgeons to pre-do the surgery by working over a virtual 3D model of the patient obtained through a computer tomography. Through surgical navigation, surgeons are helped while working with deep structures and can check if they are following accurately the surgical plan. These assistive tools are crucial in the field of facial reconstructive surgery. This paper describes two cases, one related to orbital fractures and another one related to oncological patients, showing the advantages that these tools provide, specifically when used for craniomaxillofacial surgery.

  18. Tumor markers in clinical oncology

    International Nuclear Information System (INIS)

    Novakovic, S.

    2004-01-01

    The subtle differences between normal and tumor cells are exploited in the detection and treatment of cancer. These differences are designated as tumor markers and can be either qualitative or quantitative in their nature. That means that both the structures that are produced by tumor cells as well as the structures that are produced in excessive amounts by host tissues under the influence of tumor cells can function as tumor markers. Speaking in general, the tumor markers are the specific molecules appearing in the blood or tissues and the occurrence of which is associated with cancer. According to their application, tumor markers can be roughly divided as markers in clinical oncology and markers in pathology. In this review, only tumor markers in clinical oncology are going to be discussed. Current tumor markers in clinical oncology include (i) oncofetal antigens, (ii) placental proteins, (iii) hormones, (iv) enzymes, (v) tumor-associated antigens, (vi) special serum proteins, (vii) catecholamine metabolites, and (viii) miscellaneous markers. As to the literature, an ideal tumor marker should fulfil certain criteria - when using it as a test for detection of cancer disease: (1) positive results should occur in the early stages of the disease, (2) positive results should occur only in the patients with a specific type of malignancy, (3) positive results should occur in all patients with the same malignancy, (4) the measured values should correlate with the stage of the disease, (5) the measured values should correlate to the response to treatment, (6) the marker should be easy to measure. Most tumor markers available today meet several, but not all criteria. As a consequence of that, some criteria were chosen for the validation and proper selection of the most appropriate marker in a particular malignancy, and these are: (1) markers' sensitivity, (2) specificity, and (3) predictive values. Sensitivity expresses the mean probability of determining an elevated tumor

  19. Supportive care in radiation oncology

    International Nuclear Information System (INIS)

    Rotman, M.; John, M.

    1987-01-01

    The radiation therapist, concerned with the disease process and all the technical intricacies of treatment, has usually not been involved in managing the supportive aspects of caring for the patient. Yet, of the team of medical specialists and allied health personnel required in oncology, the radiation therapist is the one most responsible for overseeing the total care of the cancer patient. At times this might include emotional support, prevention and correction of tissue dysfunction, augmentation of nutrition, metabolic and electrolyte regulation, rehabilitation, and vocational support. This chapter is a brief overview of a considerable volume of literature that has occupied the interest of a rather small group of physicians, nutritionists, and psychologists. The discussion highlights the special management problems of the normal-tissue effects of radiation, the related nutritional aspects of cancer care, and certain emotional and pathologic considerations

  20. Preclinical models in radiation oncology

    Directory of Open Access Journals (Sweden)

    Kahn Jenna

    2012-12-01

    Full Text Available Abstract As the incidence of cancer continues to rise, the use of radiotherapy has emerged as a leading treatment modality. Preclinical models in radiation oncology are essential tools for cancer research and therapeutics. Various model systems have been used to test radiation therapy, including in vitro cell culture assays as well as in vivo ectopic and orthotopic xenograft models. This review aims to describe such models, their advantages and disadvantages, particularly as they have been employed in the discovery of molecular targets for tumor radiosensitization. Ultimately, any model system must be judged by its utility in developing more effective cancer therapies, which is in turn dependent on its ability to simulate the biology of tumors as they exist in situ. Although every model has its limitations, each has played a significant role in preclinical testing. Continued advances in preclinical models will allow for the identification and application of targets for radiation in the clinic.

  1. Communication competencies of oncology nurses in Malaysia.

    Science.gov (United States)

    Maskor, Nor Aida; Krauss, Steven Eric; Muhamad, Mazanah; Nik Mahmood, Nik Hasnaa

    2013-01-01

    This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.

  2. Future of robotic surgery.

    Science.gov (United States)

    Lendvay, Thomas Sean; Hannaford, Blake; Satava, Richard M

    2013-01-01

    In just over a decade, robotic surgery has penetrated almost every surgical subspecialty and has even replaced some of the most commonly performed open oncologic procedures. The initial reports on patient outcomes yielded mixed results, but as more medical centers develop high-volume robotics programs, outcomes appear comparable if not improved for some applications. There are limitations to the current commercially available system, and new robotic platforms, some designed to compete in the current market and some to address niche surgical considerations, are being developed that will change the robotic landscape in the next decade. Adoption of these new systems will be dependent on overcoming barriers to true telesurgery that range from legal to logistical. As additional surgical disciplines embrace robotics and open surgery continues to be replaced by robotic approaches, it will be imperative that adequate education and training keep pace with technology. Methods to enhance surgical performance in robotics through the use of simulation and telementoring promise to accelerate learning curves and perhaps even improve surgical readiness through brief virtual-reality warm-ups and presurgical rehearsal. All these advances will need to be carefully and rigorously validated through not only patient outcomes, but also cost efficiency.

  3. A Comparative Study of Single-Port Laparoscopic Surgery Versus Robotic-Assisted Laparoscopic Surgery for Rectal Cancer

    DEFF Research Database (Denmark)

    Levic, Katarina; Donatsky, Anders Meller; Bulut, Orhan

    2015-01-01

    INTRODUCTION: Conventional laparoscopic surgery is the treatment of choice for many abdominal procedures. To further reduce surgical trauma, new minimal invasive procedures such as single-port laparoscopic surgery (SPLS) and robotic assisted laparoscopic surgery (RALS) have emerged. The aim...... in either of the groups. There was no difference in median follow-up time between groups (P = .58). CONCLUSION: Both SPLS and RALS may have a role in rectal surgery. The short-term oncological outcomes were similar, although RALS harvested more lymph nodes than the SPLS procedure. However, SPLS seems...

  4. Pharmacy Instruction in Medical Oncology: Results of a National Survey.

    Science.gov (United States)

    Cersosimo, Robert J.

    1989-01-01

    A survey concerning oncology instruction in pharmacy schools found it taught primarily as part of a course in medicinal chemistry/pharmacology or therapeutics. Twenty-one schools offer an oncology course, with others planning them. Oncology clerkships are currently available in 42 schools. Increased emphasis on oncology instruction is encouraged.…

  5. PET / MRI vs. PET / CT. Indications Oncology

    International Nuclear Information System (INIS)

    Oliva González, Juan P.

    2016-01-01

    Hybrid techniques in Nuclear Medicine is currently a field in full development for diagnosis and treatment of various medical conditions. With the recent advent of PET / MRI much it speculated about whether or not it is superior to PET / CT especially in oncology. The Conference seeks to clarify this situation by dealing issues such as: State of the art technology PET / MRI; Indications Oncology; Some clinical cases. It concludes by explaining the oncological indications of both the real and current situation of the PET / MRI. (author)

  6. Artificial Intelligence in Medicine and Radiation Oncology.

    Science.gov (United States)

    Weidlich, Vincent; Weidlich, Georg A

    2018-04-13

    Artifical Intelligence (AI) was reviewed with a focus on its potential applicability to radiation oncology. The improvement of process efficiencies and the prevention of errors were found to be the most significant contributions of AI to radiation oncology. It was found that the prevention of errors is most effective when data transfer processes were automated and operational decisions were based on logical or learned evaluations by the system. It was concluded that AI could greatly improve the efficiency and accuracy of radiation oncology operations.

  7. Natural background radiation and oncologic disease incidence

    International Nuclear Information System (INIS)

    Burenin, P.I.

    1982-01-01

    Cause and effect relationships between oncologic disease incidence in human population and environmental factors are examined using investigation materials of Soviet and foreign authors. The data concerning US white population are adduced. The role and contribution of natural background radiation oncologic disease prevalence have been determined with the help of system information analysis. The probable damage of oncologic disease is shown to decrease as the background radiation level diminishes. The linear nature of dose-response relationspip has been established. The necessity to include the life history of the studied population along with environmental factors in epidemiological study under conditions of multiplicity of cancerogenesis causes is emphasized

  8. The Danish Neuro-Oncology Registry

    DEFF Research Database (Denmark)

    Hansen, Steinbjørn

    2016-01-01

    AIM OF DATABASE: The Danish Neuro-Oncology Registry (DNOR) was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. STUDY POPULATION: DNOR has...... advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. CONCLUSION: The establishment of DNOR has optimized the quality...

  9. Clinical and Radiation Oncology. Vol. 2

    International Nuclear Information System (INIS)

    Jurga, L.; Adam, Z.; Autrata, R.

    2010-01-01

    The work is two-volume set and has 1,658 pages. It is divided into 5 sections: I. Principles Clinical and radiation oncology. II. Hematological Malignant tumors. III. Solid tumors. IV. Treatment options metastatic Disease. V. Clinical practice in oncology. Second volume contains following sections a chapters: Section III: Solid nodes, it contains following chapters: (38) Central nervous system tumors; (39) Tumors of the eye, orbits and adnexas; (40) Head and neck carcinomas; (41) Lung carcinomas and pleural mesothelioma; (42) Mediastinal tumors; (43) Tumors of the esophagus; (44) Gastric carcinomas; (45) Carcinoma of the colon, rectum and anus; (46) Small intestinal cancer; (47) Liver and biliary tract carcinomas; (48) Tumors of the pancreas; (49) Tumors of the kidney and upper urinary tract; (50) Bladder tumors of the bladder, urinary tract and penis; (51) Prostate Carcinoma; (52) Testicular tumors; (53) Malignant neoplasm of the cervix, vulva and vagina; (54) Endometrial carcinoma; (55) Malignant ovarian tumors; (56) Gestational trophoblastic disease; (57) Breast carcinoma - based on a evidence-based approach; (58) Thyroid and parathyroid carcinomas; (59) Dental tumors of endocrine glands; (60) Tumors of the locomotory system; (61) Malignant melanoma; (62) Carcinomas of the skin and skin adnexa; (63) Malignant tumors in immunosuppressed patients; (64) Tumors of unknown primary localization; (65) Children's oncology; (66) Geriatric Oncology; (67) Principles of long-term survival of patients with medically and socially significant types of malignant tumors after treatment. Section IV: Options of metastic disease disease, it contains following chapters: (68) Metastases to the central nervous system; (69) Metastases in the lungs; (70) Metastases in the liver; (71) Metastases into the skeleton. Section V: Clinical practice in oncology, it contains following chapters: (72) Acute conditions in oncology; (73) Prevention and management of radiation and chemical toxicity

  10. Future vision for the quality assurance of oncology clinical trials

    Directory of Open Access Journals (Sweden)

    Thomas eFitzGerald, MD

    2013-03-01

    Full Text Available The National Cancer Institute clinical cooperative groups have been instrumental over the past 50 years in developing clinical trials and evidence based process improvements for clinical oncology patient care. The cooperative groups are undergoing a transformation process as we further integrate molecular biology into personalized patient care and move to incorporate international partners in clinical trials. To support this vision, data acquisition and data management informatics tools must become both nimble and robust to support transformational research at an enterprise level. Information, including imaging, pathology, molecular biology, radiation oncology, surgery, systemic therapy and patient outcome data needs to be integrated into the clinical trial charter using adaptive clinical trial mechanisms for design of the trial. This information needs to be made available to investigators using digital processes for real time data analysis. Future clinical trials will need to be designed and completed in a timely manner facilitated by nimble informatics processes for data management. This paper discusses both past experience and future vision for clinical trials as we move to develop data management and quality assurance processes to meet the needs of the modern trial.

  11. Video-assisted thoracoscopic surgery lobectomy via confronting upside-down monitor setting

    OpenAIRE

    Mun, Mingyon; Ichinose, Junji; Matsuura, Yosuke; Nakao, Masayuki; Okumura, Sakae

    2017-01-01

    Video-assisted thoracoscopic surgery (VATS) has been widely accepted as a minimally invasive surgery for treatment of early-stage lung cancer. However, various VATS approaches are available. In patients with lung cancer, VATS should achieve not only minimal invasiveness but also safety and oncological clearance. In this article, we introduce our method of VATS lobectomy.

  12. [Application of three-dimensional computer graphics in oncology].

    Science.gov (United States)

    Joyeux, H; Jaeger, M; Briand, D; Servois, V; Masson, B; Borianne, P; de Reffye, P

    1996-01-01

    Accurate 3D tumoral volume evaluation is now possible through the combined use and progress of computer graphics technics (3D reconstruction and visualization) and medical imagery (helicoidal TDM scanner). Specific organ and pathology oriented softwares can help answer rapidly to problems posed by oncologic praticians. A new decision support for diagnosis, therapy and follow-up is emerging. First results in liver tumors and hepatic regeneration macroscopic biometrics are presented. Tumoral or organ volumic index will be usable in the follow-up. TNM staging, external conformal radiotherapy for prostatic or brain tumors, drugs cytolytic effects evaluation will take great advantage of these technologies. 3D visualization and matching CT and MRI imagery can help computed assisted surgery.

  13. Oncology healthcare professionals' perspectives on the psychosocial support needs of cancer patients during oncology treatment.

    Science.gov (United States)

    Aldaz, Bruno E; Treharne, Gareth J; Knight, Robert G; Conner, Tamlin S; Perez, David

    2017-09-01

    This study explored oncology healthcare professionals' perspectives on the psychosocial support needs of diverse cancer patients during oncology treatment. Six themes were identified using thematic analysis. Healthcare professionals highlighted the importance of their sensitivity, respect and emotional tact during appointments in order to effectively identify and meet the needs of oncology patients. Participants also emphasised the importance of building rapport that recognises patients as people. Patients' acceptance of treatment-related distress and uncertainty was described as required for uptake of available psychosocial supportive services. We offer some practical implications that may help improve cancer patients' experiences during oncology treatment.

  14. Outcome and renal function following salvage surgery for bilateral ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to determine the surgical outcomes and renal function following salvage surgery for bilateral Wilms tumor (BWT). Summary background data The challenge for the surgeon treating BWT lies in striking a fine balance between renal preservation and oncological clearance. Methods: This is ...

  15. Laparoscopic Surgery for Recurrent Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Antonino Spinelli

    2012-01-01

    Full Text Available In spite of the recent improvements in drug therapy, surgery still represents the most frequent treatment for Crohn's disease (CD complications. Laparoscopy has been widely applied over the last twenty years in colorectal surgery and was associated with lower postoperative pain, shorter hospitalization, faster return to daily activities, and better cosmetic results. Laparoscopy experienced a slower diffusion in inflammatory bowel disease surgery than in oncologic colorectal surgery, but proved to be safe and effective, and is currently considered the gold standard for the treatment of primary uncomplicated ileocolic CD. Indications for laparoscopy in CD have recently been widened to embrace more complicated or recurrent CD. This paper reviews the available data on the subset of recurrent CD patients. The reported results indicate that laparoscopy may be safely applied even in selected recurrent CD cases in hands of IBD surgeons with broad laparoscopic experience.

  16. Program for Critical Technologies in Breast Oncology

    National Research Council Canada - National Science Library

    Costa, Jose

    1997-01-01

    In Year 3 of The Program for Critical Technologies in Breast Oncology (PCTBO), we have expanded services that were initiated in July 1994 to establish a core technical and tissue procurement resource that: (1...

  17. The Evolution of Gero-Oncology Nursing.

    Science.gov (United States)

    Bond, Stewart M; Bryant, Ashley Leak; Puts, Martine

    2016-02-01

    This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Peer-reviewed literature, position statements, clinical practice guidelines, Web-based materials, and professional organizations' resources. Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gero-oncology and to develop a body of evidence, nurses and health care systems remain under-prepared to provide high-quality care for older adults with cancer. Nurses must take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Radiation oncology: a primer for medical students.

    Science.gov (United States)

    Berman, Abigail T; Plastaras, John P; Vapiwala, Neha

    2013-09-01

    Radiation oncology requires a complex understanding of cancer biology, radiation physics, and clinical care. This paper equips the medical student to understand the fundamentals of radiation oncology, first with an introduction to cancer treatment and the use of radiation therapy. Considerations during radiation oncology consultations are discussed extensively with an emphasis on how to formulate an assessment and plan including which treatment modality to use. The treatment planning aspects of radiation oncology are then discussed with a brief introduction to how radiation works, followed by a detailed explanation of the nuances of simulation, including different imaging modalities, immobilization, and accounting for motion. The medical student is then instructed on how to participate in contouring, plan generation and evaluation, and the delivery of radiation on the machine. Lastly, potential adverse effects of radiation are discussed with a particular focus on the on-treatment patient.

  19. Collaborative Genomics Study Advances Precision Oncology

    Science.gov (United States)

    A collaborative study conducted by two Office of Cancer Genomics (OCG) initiatives highlights the importance of integrating structural and functional genomics programs to improve cancer therapies, and more specifically, contribute to precision oncology treatments for children.

  20. Towards enhanced PET quantification in clinical oncology

    DEFF Research Database (Denmark)

    Zaidi, Habib; Karakatsanis, Nicolas

    2018-01-01

    is still a matter of debate. Quantitative PET has advanced elegantly during the last two decades and is now reaching the maturity required for clinical exploitation, particularly in oncology where it has the capability to open many avenues for clinical diagnosis, assessment of response to treatment...... and therapy planning. Therefore, the preservation and further enhancement of the quantitative features of PET imaging is crucial to ensure that the full clinical value of PET imaging modality is utilized in clinical oncology. Recent advancements in PET technology and methodology have paved the way for faster...... PET acquisitions of enhanced sensitivity to support the clinical translation of highly quantitative 4D parametric imaging methods in clinical oncology. In this report, we provide an overview of recent advances and future trends in quantitative PET imaging in the context of clinical oncology. The pros...

  1. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ...

  2. Physiologic and psychobehavioral research in oncology.

    Science.gov (United States)

    Redd, W H; Silberfarb, P M; Andersen, B L; Andrykowski, M A; Bovbjerg, D H; Burish, T G; Carpenter, P J; Cleeland, C; Dolgin, M; Levy, S M

    1991-02-01

    A major thrust in research in psychosocial oncology is the study of the interaction of psychologic and physiologic variables. This discussion reviews the current status and future directions of such research. Areas addressed include pain, nausea and vomiting with chemotherapy, sexuality, effects of cancer on psychologic and neuropsychologic function, impact of psychologic factors on cancer and its treatment, and psychoneuroimmunology. In addition, specific recommendations for strategies to facilitate research in these areas of psychosocial oncology are proposed.

  3. A Comprehensive Definition for Integrative Oncology.

    Science.gov (United States)

    Witt, Claudia M; Balneaves, Lynda G; Cardoso, Maria J; Cohen, Lorenzo; Greenlee, Heather; Johnstone, Peter; Kücük, Ömer; Mailman, Josh; Mao, Jun J

    2017-11-01

    Integrative oncology, which is generally understood to refer to the use of a combination of complementary medicine therapies in conjunction with conventional cancer treatments, has been defined in different ways, but there is no widely accepted definition. We sought to develop and establish a consensus for a comprehensive definition of the field of integrative oncology. We used a mixed-methods approach that included a literature analysis and a consensus procedure, including an interdisciplinary expert panel and surveys, to develop a comprehensive and acceptable definition for the term "integrative oncology." The themes identified in the literature and from the expert discussion were condensed into a two-sentence definition. Survey respondents had very positive views on the draft definition, and their comments helped to shape the final version. The final definition for integrative oncology is: "Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products, and/or lifestyle modifications from different traditions alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life, and clinical outcomes across the cancer care continuum and to empower people to prevent cancer and become active participants before,during, and beyond cancer treatment." This short and comprehensive definition for the term integrative oncology will facilitate a better understanding and communication of this emerging field. This definition will also drive focused and cohesive effort to advance the field of integrative oncology. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. 30 Years of Robotic Surgery.

    Science.gov (United States)

    Leal Ghezzi, Tiago; Campos Corleta, Oly

    2016-10-01

    The idea of reproducing himself with the use of a mechanical robot structure has been in man's imagination in the last 3000 years. However, the use of robots in medicine has only 30 years of history. The application of robots in surgery originates from the need of modern man to achieve two goals: the telepresence and the performance of repetitive and accurate tasks. The first "robot surgeon" used on a human patient was the PUMA 200 in 1985. In the 1990s, scientists developed the concept of "master-slave" robot, which consisted of a robot with remote manipulators controlled by a surgeon at a surgical workstation. Despite the lack of force and tactile feedback, technical advantages of robotic surgery, such as 3D vision, stable and magnified image, EndoWrist instruments, physiologic tremor filtering, and motion scaling, have been considered fundamental to overcome many of the limitations of the laparoscopic surgery. Since the approval of the da Vinci(®) robot by international agencies, American, European, and Asian surgeons have proved its factibility and safety for the performance of many different robot-assisted surgeries. Comparative studies of robotic and laparoscopic surgical procedures in general surgery have shown similar results with regard to perioperative, oncological, and functional outcomes. However, higher costs and lack of haptic feedback represent the major limitations of current robotic technology to become the standard technique of minimally invasive surgery worldwide. Therefore, the future of robotic surgery involves cost reduction, development of new platforms and technologies, creation and validation of curriculum and virtual simulators, and conduction of randomized clinical trials to determine the best applications of robotics.

  5. GENERAL SURGERY

    African Journals Online (AJOL)

    in the endoscopy room. GENERAL SURGERY. T du Toit, O C Buchel, S J A Smit. Department of Surgery, University of the Free State, Bloemfontein, ... The lack of video instrumentation in developing countries: Redundant fibre-optic instruments (the old. “eye scope”) are still being used. This instrument brings endoscopists ...

  6. GENERAL SURGERY

    African Journals Online (AJOL)

    mean time to first surgery post burn was 11.5 days with a median volume of 0.73 mls/kg/% ..... Mode. Mean (SD). Upper limit. 95% CI. Lower limit. 95% CI. Mode. Elective surgery .... evaluating single-unit red blood cell transfusions in reducing.

  7. Robotic colorectal surgery: hype or new hope? A systematic review of robotics in colorectal surgery.

    Science.gov (United States)

    Mirnezami, A H; Mirnezami, R; Venkatasubramaniam, A K; Chandrakumaran, K; Cecil, T D; Moran, B J

    2010-11-01

    Robotic colorectal surgery is an emerging field and may offer a solution to some of the difficulties inherent to conventional laparoscopic surgery. The aim of this review is to provide a comprehensive and critical analysis of the available literature on the use of robotic technology in colorectal surgery. Studies reporting outcomes of robotic colorectal surgery were identified by systematic searches of electronic databases. Outcomes examined included operating time, length of stay, blood loss, complications, cost, oncological outcome, and conversion rates. Seventeen Studies (nine case series, seven comparative studies, one randomized controlled trial) describing 288 procedures were identified and reviewed. Study heterogeneity precluded a meta-analysis of the data. Robotic procedures tend to take longer and cost more, but may reduce the length of stay, blood loss, and conversion rates. Complication profiles and short-term oncological outcomes are similar to laparoscopic surgery. Robotic colorectal surgery is a promising field and may provide a powerful additional tool for optimal management of more challenging pathology, including rectal cancer. Further studies are required to better define its role. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

  8. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    -depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed......ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  9. Stress and burnout in oncology.

    Science.gov (United States)

    Kash, K M; Holland, J C; Breitbart, W; Berenson, S; Dougherty, J; Ouellette-Kobasa, S; Lesko, L

    2000-11-01

    This article identifies the professional stressors experienced by nurses, house staff, and medical oncologists and examines the effect of stress and personality attributes on burnout scores. A survey was conducted of 261 house staff, nurses, and medical oncologists in a cancer research hospital, and oncologists in outside clinical practices. It measured burnout, psychological distress, and physical symptoms. Each participant completed a questionnaire that quantified life stressors, personality attributes, burnout, psychological distress, physical symptoms, coping strategies, and social support. The results showed that house staff experienced the greatest burnout. They also reported greater emotional exhaustion, a feeling of emotional distance from patients, and a poorer sense of personal accomplishment. Negative work events contributed significantly to level of burnout; however, having a "hardy" personality helped to alleviate burnout. Nurses reported more physical symptoms than house staff and oncologists. However, they were less emotionally distant from patients. Women reported a lower sense of accomplishment and greater distress. The four most frequent methods of relaxing were talking to friends, using humor, drinking coffee or eating, and watching television. One unexpected finding was that the greater the perception of oneself as religious, the lower the level of burnout. Thus, while the rewards of working in oncology are usually sufficient to keep nurses and doctors in the field, they also experience burnout symptoms that vary by gender and personal attributes. House staff are most stressed and report the greatest and most severe symptoms of stress. Interventions are needed that address the specific problems of each group.

  10. Oncologic imaging: kidney and ureter

    International Nuclear Information System (INIS)

    McClennan, B.L.; Balfe, D.M.

    1983-01-01

    Malignant cancers of the kidney and ureter account for only 2 to 3% of all neoplasms in man. However, early diagnosis and treatment can have a profound effect on patient prognosis and survival. This article seeks to amalgamate a large body of information related to the pathology of primary renal tumors and metastatic disease with current imaging strategies to assist the clinician and enhance his understanding of the wide variety of modern imaging techniques available. Current tumor staging classifications are presented and the various imaging strategies are keyed to detection, definition and treatment options for tumors of the renal parenchyma and ureter. The strengths and limitations of all available imaging modalities are reviewed. An optimal approach to the imaging workup is developed with regard to availability, evolving technology and most importantly, cost efficacy. The controversies and conflicts in imaging and treatment options are explored while constructing a step by step approach that will be both flexible and utilitarian for the clinician faced with daily oncologic management choices

  11. Positron emission tomography in oncology

    International Nuclear Information System (INIS)

    Lecomte, R.; Bentourkia, M.; Benard, F.

    2002-01-01

    Positron Emission Tomography is a sophisticated molecular imaging technique, using a special scanner, that displays the functional status of tissues in the body at the cellular level (their metabolism). It is a diagnostic scan that provides the physician with information not available with traditional anatomic studies such as CT or MRI. PET can detect changes in cell function (disease) long before they are evident as physical (anatomic) changes seen on CT or MRI. In this way PET can add important information about many diseases allowing the physician to make a diagnosis often much earlier than with anatomic imaging techniques such as CT or MRI alone. In addition, in cases where an abnormality is noted on CT or MRI, PET can help differentiate benign changes from changes due to disease. PET scanning also typically images the entire body, unlike CT/MRI which is usually broken up into specific limited body section scans. All cells use glucose as an energy source but cancer cells use much more since they are growing much faster and out of control. This is the basis of imaging with F-18 FDG glucose, the radiotracer agent use in a PET oncology study. The abnormal, accelerated glucose used by cancer cells is detected by the PET scanner that processes the emissions from the F-18 FDG glucose by abnormally high levels of metabolism (tumor)

  12. Oncology information on the Internet.

    Science.gov (United States)

    Goto, Yasushi; Nagase, Takahide

    2012-05-01

    Owing to new developments in Internet technologies, the amount of available oncology information is growing. Both patients and caregivers are increasingly using the Internet to obtain medical information. However, while it is easy to provide information, ensuring its quality is always a concern. Thus, many instruments for evaluating the quality of health information have been created, each with its own advantages and disadvantages. The increasing importance of online search engines such as Google warrants the examination of the correlation between their rankings and medical quality. The Internet also mediates the exchange of information from one individual to another. Mailing lists of advocate groups and social networking sites help spread information to patients and caregivers. While text messages are still the main medium of communication, audio and video messages are also increasing rapidly, accelerating the communication on the Internet. Future health information developments on the Internet include merging patients' personal information on the Internet with their traditional health records and facilitating the interaction among patients, caregivers and health-care providers. Through these developments, the Internet is expected to strengthen the mutually beneficial relationships among all stakeholders in the field of medicine.

  13. Future directions in radiation oncology

    International Nuclear Information System (INIS)

    Peters, L.

    1996-01-01

    Full text: Cancer treatment has evolved progressively over the years as a joint result of improvements in technology and better understanding of the biological responses of neoplastic and normal cells to cytotoxic agents. Although major therapeutic 'breakthroughs' are unlikely absent the discovery of exploitable fundamental differences between cancer cells and their normal homologs, further incremental improvements in cancer treatment results can confidently be expected as we apply existing knowledge better and take advantage of new research insights. Areas in which I can foresee significant improvements (in approximate chronological order) are as follows: better physical radiation dose distributions; more effective radiation and chemoradiation protocols based on radiobiological principles; more rational use of radiation adjuvants based on biologic criteria; use of novel targets and vectors for systemic radionuclide therapy; use of genetic markers of radiosensitivity to determine radiation dose tolerances; and use of radiation as a modulator of therapeutic gene expression. Radiation research has contributed greatly to the efficacy of radiation oncology as it is now practised but has even greater potential for the future

  14. How to perform Mohs micrographic surgery?

    Directory of Open Access Journals (Sweden)

    Gonca Elçin

    2015-12-01

    Full Text Available A considerable number of dermatolologist in Turkey perform standard surgical excision of non-melanoma skin cancer and repair the defects functionally and cosmetically. It is possible to appropriately treat most basal cell carcinomas (BCCs and squamous cell carcinomas (SCCs with standard excision and even with curettage and electrodessication. However, for a group of patients at high risk of recurrence, standard excision cannot provide the desired oncologic cure rates. In order to increase the possibility of oncologic cure, it is recommended that high risk BCCs and SCCs should be excised with larger than 4-6 mm safety margins. On the other hand the most common localization for BCCs and SCCs are the face, and using safety margins larger than 4-6 mm on the face might contradict with the principles of tissue-preserving surgical approach. A more unfavorable situation is that the oncologic cure rates remain below 80% for high-risk BCC and SCC even after standard excisions with safety margins of wider than 4-6 mm. The goal of Mohs micrographic surgery is complete tumor removal with maximum preservation of healthy tissue.. Mohs micrographic surgery is a staged surgery that enables 100% assessment of the entire lateral and deep surgical margins microscopically in minutes after excision with horizontally cut frozen sections for residual cancer. Thus, it increases the oncologic cure rate especially for a certain group of patients with high-risk BCC and SCC. The aim of this paper was to review the Mohs technique, the most thorough method for treating BCC and SCC.

  15. Evolution of thoracic surgery in Canada.

    Science.gov (United States)

    Deslauriers, Jean; Pearson, F Griffith; Nelems, Bill

    2015-01-01

    Canada's contributions toward the 21st century's practice of thoracic surgery have been both unique and multilayered. Scattered throughout are tales of pioneers where none had gone before, where opportunities were greeted by creativity and where iconic figures followed one another. To describe the numerous and important achievements of Canadian thoracic surgeons in the areas of surgery for pulmonary tuberculosis, thoracic oncology, airway surgery and lung transplantation. Information was collected through reading of the numerous publications written by Canadian thoracic surgeons over the past 100 years, interviews with interested people from all thoracic surgery divisions across Canada and review of pertinent material form the archives of several Canadian hospitals and universities. Many of the developments occurred by chance. It was the early and specific focus on thoracic surgery, to the exclusion of cardiac and general surgery, that distinguishes the Canadian experience, a model that is now emerging everywhere. From lung transplantation in chimera twin calves to ex vivo organ preservation, from the removal of airways to tissue regeneration, and from intensive care research to complex science, Canadians have excelled in their commitment to research. Over the years, the influence of Canadian thoracic surgery on international practice has been significant. Canada spearheaded the development of thoracic surgery over the past 100 years to a greater degree than any other country. From research to education, from national infrastructures to the regionalization of local practices, it happened in Canada.

  16. Thoracic epidural analgesia for breast oncological procedures: A better alternative to general anesthesia

    Directory of Open Access Journals (Sweden)

    Parli Raghavan Ravi

    2017-01-01

    Full Text Available Objective: The objective of the study was to compare the outcomes of the incidence of nausea/vomiting and other complications along with the time taken for discharged in patients undergoing Thoracic Epidural Analgesia (TEA and General Anaesthesia (GA for breast oncological surgeries. Background: GA with or without TEA or other postoperative pain-relieving strategies remains the traditional anesthetic technique used for breast oncological procedures. We initiated the use of high segmental TEA for patients undergoing these procedures in our hospital. Methods: Eighty patients undergoing breast oncological procedures performed by one surgical team were randomly allocated into two groups receiving TEA and GA. The Chi-square test and Fisher's exact test were used for categorical parameters, paired t-test and Student's t-test was used for continuous measurements. Results: In comparison with GA, TEA was associated with lesser incidence of complications of nausea/vomiting. In lumpectomy with axillary node dissection, 1 out of 18 patients (5.55% in the TEA group had nausea/vomiting, while 11 out of 19 (57.8% of the GA group had similar symptoms (P < 0.001. The discharge rate for the thoracic epidural group was 12 out of 18 by day 3 (66.6% while all patients in the GA group required more than 3 days of hospitalization (P < 0.001. Conclusion: Thoracic epidural anesthesia is a safe technique and its use in breast oncological procedures could improve patients' recovery and facilitate their early discharge to home.

  17. Coping With Moral Distress in Oncology Practice: Nurse and Physician Strategies.

    Science.gov (United States)

    Lievrouw, An; Vanheule, Stijn; Deveugele, Myriam; Vos, Martine; Pattyn, Piet; Belle, Van; Benoit, Dominique D

    2016-07-01

    To explore variations in coping with moral distress among physicians and nurses in a university hospital oncology setting.
. Qualitative interview study.
. Internal medicine (gastroenterology and medical oncology), gastrointestinal surgery, and day clinic chemotherapy at Ghent University Hospital in Belgium.
. 17 doctors and 18 nurses with varying experience levels, working in three different oncology hospital settings. 
. Patients with cancer were interviewed based on the critical incident technique. Analyses were performed using thematic analysis.
. Moral distress lingered if it was accompanied by emotional distress. Four dominant ways of coping (thoroughness, autonomy, compromise, and intuition) emerged, which could be mapped on two perpendicular continuous axes. Moral distress is a challenging phenomenon in oncology. However, when managed well, it can lead to more introspection and team reflection, resulting in a better interpersonal understanding.
. Team leaders should recognize their own and their team members' preferred method of coping and tailored support should be offered to ease emotional distress.

  18. Cancer patients and oncology nursing: Perspectives of oncology nurses in Turkey.

    Science.gov (United States)

    Kamisli, S; Yuce, D; Karakilic, B; Kilickap, S; Hayran, M

    2017-09-01

    Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. This survey was conducted with 70 oncology nurses working at Hacettepe University Oncology Hospital. Data were collected between January-April 2012. Each participant provided a study form comprising questions about sociodemographic information; about difficulties, positive aspects and required skills for oncology nursing; and questions evaluating level of participation and clinical perception of oncology nursing. Mean age of nurses was 29.9 ± 5.7 years. More than half of the participants were married (51.4%) and 30% had at least one child. Percent of nurses working in oncology for their entire work life was 75.8%. Most frequently expressed difficulties were exhaustion (58.6%), coping with the psychological problems of the patients (25.7%), and frequent deaths (24.3%); positive aspects were satisfaction (37.1%), changing the perceptions about life (30%), and empathy (14.3%); and required skills were patience (60%), empathy (57.1%), and experience (50%). For difficulties of oncology nursing, 28.3% of difficulties could be attributed to job-related factors, 30.3% to patient-related factors, and 77% of difficulties to individual factors. The independent predictors of participation level of the nurses were self-thoughts of skills and positive aspects of oncology nursing. According to the findings of this study, nurses declared that working with cancer patients increase burnout, they are insufficient in managing work stress and giving psychological care to patients, but their job satisfaction, clinical skills and awareness regarding priorities of life has increased.

  19. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  20. Foot Surgery

    Science.gov (United States)

    ... coding trends along with compliance guidelines and practice marketing materials, APMA has you covered whether you are ... crutches after the surgery or in a cast. Fusions: Fusions are usually performed to treat arthritic or ...

  1. Hemorrhoid surgery

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/002939.htm Hemorrhoid surgery To use the sharing features on this page, please enable JavaScript. Hemorrhoids are swollen veins around the anus. They may ...

  2. PLASTIC SURGERY

    African Journals Online (AJOL)

    Department of Plastic and Reconstructive Surgery Sefako Makgatho Health Science University, ... We report on a pilot study on the use of a circumareolar excision and the use of .... and 1 gynecomastia patient) requested reduction in NAC size.

  3. GENERAL SURGERY

    African Journals Online (AJOL)

    influence medical students in pursuing a career in surgery. ... training, females reported significantly higher levels of agreement that surgical training would be better overseas when ..... mentoring surgical research or educational lectures and.

  4. GENERAL SURGERY

    African Journals Online (AJOL)

    1 Department of Surgery, Nelson R Mandela School of Medicine, University of ... in 51 reports. Four reports were illegible; one was conducted by a junior consultant, two by a fourth year trainee specialist ... The study period was 12 months from.

  5. Sinus Surgery

    Science.gov (United States)

    ... sinus computed tomography (CT) scan (without contrast), nasal physiology (rhinomanometry and nasal cytology), smell testing, and selected ... altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult. Image ...

  6. Intensive postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients.

    Science.gov (United States)

    Al-Niaimi, Ahmed N; Ahmed, Mostafa; Burish, Nikki; Chackmakchy, Saygin A; Seo, Songwon; Rose, Stephen; Hartenbach, Ellen; Kushner, David M; Safdar, Nasia; Rice, Laurel; Connor, Joseph

    2015-01-01

    SSI rates after gynecologic oncology surgery vary from 5% to 35%, but are up to 45% in patients with diabetes mellitus (DM). Strict postoperative glucose control by insulin infusion has been shown to lower morbidity, but not specifically SSI rates. Our project studied continuous postoperative insulin infusion for 24h for gynecologic oncology patients with DM and hyperglycemia with a target blood glucose of controlled with intermittent subcutaneous insulin injections. Group 2 was composed of patients with DM and postoperative hyperglycemia whose blood glucose was controlled by insulin infusion. Group 3 was composed of patients with neither DM nor hyperglycemia. We controlled for all relevant factors associated with SSI. We studied a total of 372 patients. Patients in Group 2 had an SSI rate of 26/135 (19%), similar to patients in Group 3 whose rate was 19/89 (21%). Both were significantly lower than the SSI rate (43/148, 29%) of patients in Group 1. This reduction of 35% is significant (p = 0.02). Multivariate analysis showed an odd ratio = 0.5 (0.28-0.91) in reducing SSI rates after instituting this protocol. Initiating intensive glycemic control for 24h after gynecologic oncology surgery in patients with DM and postoperative hyperglycemia lowers the SSI rate by 35% (OR = 0.5) compared to patients receiving intermittent sliding scale insulin and to a rate equivalent to non-diabetics. Copyright © 2014. Published by Elsevier Inc.

  7. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  8. Improving the quality of colon cancer surgery through a surgical education program

    DEFF Research Database (Denmark)

    West, Nicholas P; Sutton, Kate M; Ingeholm, Peter

    2010-01-01

    Recent evidence has demonstrated the importance of dissection in the correct tissue plane for the resection of colon cancer. We have previously shown that meticulous mesocolic plane surgery yields better outcomes and that the addition of central vascular ligation produces an oncologically superio...... specimen compared with standard techniques. We aimed to assess the effect of surgical education on the oncological quality of the resection specimen produced....

  9. Return to intended oncologic treatment (RIOT): a novel metric for evaluating the quality of oncosurgical therapy for malignancy.

    Science.gov (United States)

    Aloia, Thomas A; Zimmitti, Giuseppe; Conrad, Claudius; Gottumukalla, Vijaya; Kopetz, Scott; Vauthey, Jean-Nicolas

    2014-08-01

    After cancer surgery, complications, and disability prevent some patients from receiving subsequent treatments. Given that an inability to complete all intended cancer therapies might negate the oncologic benefits of surgical therapy, strategies to improve return to intended oncologic treatment (RIOT), including minimally invasive surgery (MIS), are being investigated. This project was designed to evaluate liver tumor patients to determine the RIOT rate, risk factors for inability to RIOT, and its impact on survivals. Outcomes for a homogenous cohort of 223 patients who underwent open-approach surgery for metachronous colorectal liver metastases and a group of 27 liver tumor patients treated with MIS hepatectomy were examined. Of the 223 open-approach patients, 167 were offered postoperative therapy, yielding a RIOT rate of 75%. The remaining 56 (25%) patients were unable to receive further treatment due to surgical complications (n = 29 pts) or poor performance status (n = 27 pts). Risk factors associated with inability to RIOT were hypertension (OR 2.2, P = 0.025), multiple preoperative chemotherapy regimens (OR 5.9, P = 0.039), and postoperative complications (OR 2.0, P = 0.039). Inability to RIOT correlated with shorter disease-free and overall survivals (P relationship between RIOT and long-term oncologic outcomes suggests that RIOT rates for both open- and MIS-approach cancer surgery should routinely be reported as a quality indicator. © 2014 Wiley Periodicals, Inc.

  10. Precision oncology: origins, optimism, and potential.

    Science.gov (United States)

    Prasad, Vinay; Fojo, Tito; Brada, Michael

    2016-02-01

    Imatinib, the first and arguably the best targeted therapy, became the springboard for developing drugs aimed at molecular targets deemed crucial to tumours. As this development unfolded, a revolution in the speed and cost of genetic sequencing occurred. The result--an armamentarium of drugs and an array of molecular targets--set the stage for precision oncology, a hypothesis that cancer treatment could be markedly improved if therapies were guided by a tumour's genomic alterations. Drawing lessons from the biological basis of cancer and recent empirical investigations, we take a more measured view of precision oncology's promise. Ultimately, the promise is not our concern, but the threshold at which we declare success. We review reports of precision oncology alongside those of precision diagnostics and novel radiotherapy approaches. Although confirmatory evidence is scarce, these interventions have been widely endorsed. We conclude that the current path will probably not be successful or, at a minimum, will have to undergo substantive adjustments before it can be successful. For the sake of patients with cancer, we hope one form of precision oncology will deliver on its promise. However, until confirmatory studies are completed, precision oncology remains unproven, and as such, a hypothesis in need of rigorous testing. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. 2003 survey of Canadian radiation oncology residents

    International Nuclear Information System (INIS)

    Yee, Don; Fairchild, Alysa; Keyes, Mira; Butler, Jim; Dundas, George

    2005-01-01

    Purpose: Radiation oncology's popularity as a career in Canada has surged in the past 5 years. Consequently, resident numbers in Canadian radiation oncology residencies are at all-time highs. This study aimed to survey Canadian radiation oncology residents about their opinions of their specialty and training experiences. Methods and Materials: Residents of Canadian radiation oncology residencies that enroll trainees through the Canadian Resident Matching Service were identified from a national database. Residents were mailed an anonymous survey. Results: Eight of 101 (7.9%) potential respondents were foreign funded. Fifty-two of 101 (51.5%) residents responded. A strong record of graduating its residents was the most important factor residents considered when choosing programs. Satisfaction with their program was expressed by 92.3% of respondents, and 94.3% expressed satisfaction with their specialty. Respondents planning to practice in Canada totaled 80.8%, and 76.9% plan to have academic careers. Respondents identified job availability and receiving adequate teaching from preceptors during residency as their most important concerns. Conclusions: Though most respondents are satisfied with their programs and specialty, job availability and adequate teaching are concerns. In the future, limited time and resources and the continued popularity of radiation oncology as a career will magnify the challenge of training competent radiation oncologists in Canada

  12. Excisional surgery for cancer cure: therapy at a cost.

    LENUS (Irish Health Repository)

    Coffey, J C

    2012-02-03

    Excisional surgery is one of the primary treatment modalities for cancer. Minimal residual disease (MRD) is the occult neoplastic disease that remains in situ after curative surgery. There is increasing evidence that tumour removal alters the growth of MRD, leading to perioperative tumour growth. Because neoplasia is a systemic disease, this phenomenon may be relevant to all patients undergoing surgery for cancer. In this review we discuss the published work that addresses the effects of tumour removal on subsequent tumour growth and the mechanisms by which tumour excision may alter residual tumour growth. In addition, we describe therapeutic approaches that may protect patients against any oncologically adverse effects of tumour removal. On the basis of the evidence presented, we propose a novel therapeutic paradigm; that the postoperative period represents a window of opportunity during which the patient may be further protected against the oncological effects of tumour removal.

  13. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology.

    Science.gov (United States)

    Neuss, Michael N; Gilmore, Terry R; Belderson, Kristin M; Billett, Amy L; Conti-Kalchik, Tara; Harvey, Brittany E; Hendricks, Carolyn; LeFebvre, Kristine B; Mangu, Pamela B; McNiff, Kristen; Olsen, MiKaela; Schulmeister, Lisa; Von Gehr, Ann; Polovich, Martha

    2016-12-01

    Purpose To update the ASCO/Oncology Nursing Society (ONS) Chemotherapy Administration Safety Standards and to highlight standards for pediatric oncology. Methods The ASCO/ONS Chemotherapy Administration Safety Standards were first published in 2009 and updated in 2011 to include inpatient settings. A subsequent 2013 revision expanded the standards to include the safe administration and management of oral chemotherapy. A joint ASCO/ONS workshop with stakeholder participation, including that of the Association of Pediatric Hematology Oncology Nurses and American Society of Pediatric Hematology/Oncology, was held on May 12, 2015, to review the 2013 standards. An extensive literature search was subsequently conducted, and public comments on the revised draft standards were solicited. Results The updated 2016 standards presented here include clarification and expansion of existing standards to include pediatric oncology and to introduce new standards: most notably, two-person verification of chemotherapy preparation processes, administration of vinca alkaloids via minibags in facilities in which intrathecal medications are administered, and labeling of medications dispensed from the health care setting to be taken by the patient at home. The standards were reordered and renumbered to align with the sequential processes of chemotherapy prescription, preparation, and administration. Several standards were separated into their respective components for clarity and to facilitate measurement of adherence to a standard. Conclusion As oncology practice has changed, so have chemotherapy administration safety standards. Advances in technology, cancer treatment, and education and training have prompted the need for periodic review and revision of the standards. Additional information is available at http://www.asco.org/chemo-standards .

  14. Laparoscopic surgery in colorectal cancer; Cirugia laparoscopica en cancer colorrectal

    Energy Technology Data Exchange (ETDEWEB)

    Bressler Hernandez, Norlan; Martinez Perez, Elliot; Fernandez Rodriguez, Leopoldo; Torres Core, Ramiro, E-mail: bcimeq@infomed.sld.cu [Centro de Investigaciones Medico Quirurgicas, La Habana (Cuba)

    2011-07-01

    In the current age of minimally invasive surgery, laparoscopic surgery for colon cancer has been established as oncologically equivalent to conventional open surgery. The advantages of laparoscopic surgery have translated into smaller incisions and shorter recovery. Since the advent of laparoscopy, surgeons have been fueled to develop less invasive operative methods as feasible alternatives to traditional procedures. As techniques evolved and technology advanced, laparoscopy became more widely accepted and is now more commonly used in many institutions. Recently, a trend toward less invasive surgery, driven by patient and surgeon alike, has been a major objective for many institutions because of the ability of laparoscopic surgery to reduce postoperative pain, achieve a quicker recovery time, and improve cosmetic outcomes. Although still evolving, traditional laparoscopy has served as a foundation for even further refinements in the minimally invasive approach and as a result, more advanced equipment and newer techniques have arisen.

  15. Single site laparoscopic right hemicolectomy: an oncological feasible option

    Directory of Open Access Journals (Sweden)

    Lim Yon Kuei

    2010-09-01

    Full Text Available Abstract Introduction We present the first 7 cases of single site right hemicolectomy in Asia using the new Single Site Laparoscopy (SSL access system from Ethicon Endo-surgery. Methods Right hemicolectomy was performed using the new Single Site Laparoscopy (SSL access system. Patient demographics, operative time, histology and post operative recovery and complications were collected and analysed. Results The median operative time was 90 mins (range 60 - 150 mins and a median wound size of 2.5 cm (range 2 to 4.5 cm. The median number of lymph nodes harvested was 24 (range 20 to 34 lymph nodes. The median length of proximal margin was 70 mm (range 30 to 145 mm and that of distal margin was 50 mm (35 to 120 mm. All patients had a median hospital stay of 7 days (range 5 to 11 and there were no significant perioperative complications except for 1 patient who had a minor myocardial event. Conclusion Right hemicolectomy using SSL access system is feasible and safe for oncologic surgery.

  16. Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study

    Directory of Open Access Journals (Sweden)

    Kim JW

    2016-04-01

    Full Text Available Jong Wan Kim,1 Jeong Yeon Kim,1 Byung Mo Kang,2 Bong Hwa Lee,3 Byung Chun Kim,4 Jun Ho Park5 1Department of Surgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong Si, 2Department of Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon Si, 3Department of Surgery, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Anyang Si, 4Department of Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, 5Department of Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea Purpose: The purpose of the present study was to compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery for transverse colon cancer.Patients and methods: We conducted a retrospective review of patients who underwent surgery for transverse colon cancer at six Hallym University-affiliated hospitals between January 2005 and June 2015. The perioperative outcomes and oncologic outcomes were compared between laparoscopic and open surgery.Results: Of 226 patients with transverse colon cancer, 103 underwent laparoscopic surgery and 123 underwent open surgery. There were no differences in the patient characteristics between the two groups. Regarding perioperative outcomes, the operation time was significantly longer in the laparoscopic group than in the open group (267.3 vs 172.7 minutes, P<0.001, but the time to soft food intake (6.0 vs 6.6 days, P=0.036 and the postoperative hospital stay (13.7 vs 15.7 days, P=0.018 were shorter in the laparoscopic group. The number of harvested lymph nodes was lower in the laparoscopic group than in the open group (20.3 vs 24.3, P<0.001. The 5-year overall survival (90.8% vs 88.6%, P=0.540 and disease-free survival (86.1% vs 78.9%, P=0.201 rates were similar in both groups.Conclusion: The present study showed that laparoscopic surgery is associated

  17. Role of surgery in multimodal cancer therapy for small animals.

    Science.gov (United States)

    Boston, Sarah; Henderson, Ralph A

    2014-09-01

    Surgery is a critical component in the treatment of most solid tumors in small animals. Surgery is increasingly combined with adjuvant therapies such as chemotherapy and radiation so surgeons who are treating cancer must have a good understanding of surgical oncology principles, cancer biology, and the roles and potential interactions of surgery, radiation, and chemotherapy. The sequencing plan for these modalities should be determined before treatment is initiated. The surgical oncologist must have a working knowledge of chemotherapy agents and radiation and the effect of these treatments on the ability of tissues to heal and the outcome for the patient. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is often an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  20. Mohs micrographic surgery

    Science.gov (United States)

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

  1. [Psycho-oncology : the psyche and cancer].

    Science.gov (United States)

    Heussner, P; Hiddemann, W

    2012-11-01

    The relationships between the psyche and cancer are manifold. Psycho-oncology focuses on the psychological adjustment to life-threatening illnesses. Crises are not unusual in health care, but the perception of cancer is totally different because the diagnosis of cancer often results in an irrational shock reaction in all parties involved. A diagnosis of cancer is much more negatively perceived than any other incurable disease, such as cardiopathy or neuropathy with a comparable or worse prognosis. During the shock of having received a diagnosis of cancer, there is no awareness that cancer can be cured. Improvement of quality of life, identification of psychological distress and prevention of mental disorders are the main tasks of psycho-oncology. Psycho-oncological services are not longer regarded a luxury, but are recognized by health care politicians as being important. However, the financing of services remains unclear.

  2. The Evolution of Gero-Oncology Nursing

    Science.gov (United States)

    Bond, Stewart M.; Bryant, Ashley Leak; Puts, Martine

    2016-01-01

    Objectives This article summarizes the evolution of gero-oncology nursing and highlights key educational initiatives, clinical practice issues, and research areas to enhance care of older adults with cancer. Data Sources Peer-reviewed literature, position statements, clinical practice guidelines, web-based materials, and professional organizations’ resources. Conclusion Globally, the older adult cancer population is rapidly growing. The care of older adults with cancer requires an understanding of their diverse needs and the intersection of cancer and aging. Despite efforts to enhance competence in gerooncology and to develop a body of evidence, nurses and healthcare systems remain under-prepared to provide high quality care for older adults with cancer. Implications for Nursing Practice Nurses need to take a leadership role in integrating gerontological principles into oncology settings. Working closely with interdisciplinary team members, nurses should utilize available resources and continue to build evidence through gero-oncology nursing research. PMID:26830263

  3. Review of optical coherence tomography in oncology

    Science.gov (United States)

    Wang, Jianfeng; Xu, Yang; Boppart, Stephen A.

    2017-12-01

    The application of optical coherence tomography (OCT) in the field of oncology has been prospering over the past decade. OCT imaging has been used to image a broad spectrum of malignancies, including those arising in the breast, brain, bladder, the gastrointestinal, respiratory, and reproductive tracts, the skin, and oral cavity, among others. OCT imaging has initially been applied for guiding biopsies, for intraoperatively evaluating tumor margins and lymph nodes, and for the early detection of small lesions that would often not be visible on gross examination, tasks that align well with the clinical emphasis on early detection and intervention. Recently, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This paper reviews the evolution of OCT technologies for the clinical application of OCT in surgical and noninvasive interventional oncology procedures and concludes with a discussion of the future directions for OCT technologies, with particular emphasis on their applications in oncology.

  4. Imaging and Modeling Laboratory in Neurobiology and Oncology - IMNC. Activity report 2008-2012

    International Nuclear Information System (INIS)

    Charon, Yves; Arlaud, Nathalie; Mastrippolito, Roland

    2014-09-01

    The Imaging and Modeling Laboratory in Neurobiology and Oncology (IMNC) is an interdisciplinary unit shared between the Paris-Sud and Paris-Diderot universities and the National Institute of Nuclear and particle physics (IN2P3). Created in January 2006, the laboratory activities are structured around three main topics: the clinical and pre-clinical multi-modal imaging (optical and isotopic), the modeling of tumoral processes, and radiotherapy. This report presents the activities of the laboratory during the years 2008-2012: 1 - Forewords; 2 - Highlights; 3 - Research teams: Small animal imaging; Metabolism, imaging and olfaction; Surgery imaging in oncology; Quantification in molecular imaging; Modeling of biological systems; 4 - Technical innovations: Instrumentation, Scientific calculation, Biology department, valorisation and open-source softwares; 5 - Publications; 6 - Scientific life, communication and teaching activities; 7 - Laboratory operation; 8 - Perspectives

  5. Treatment of Malignant Pleural Mesothelioma: American Society of Clinical Oncology Clinical Practice Guideline.

    Science.gov (United States)

    Kindler, Hedy L; Ismaila, Nofisat; Armato, Samuel G; Bueno, Raphael; Hesdorffer, Mary; Jahan, Thierry; Jones, Clyde Michael; Miettinen, Markku; Pass, Harvey; Rimner, Andreas; Rusch, Valerie; Sterman, Daniel; Thomas, Anish; Hassan, Raffit

    2018-05-01

    Purpose To provide evidence-based recommendations to practicing physicians and others on the management of malignant pleural mesothelioma. Methods ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, pathology, imaging, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2017. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. Results The literature search identified 222 relevant studies to inform the evidence base for this guideline. Recommendations Evidence-based recommendations were developed for diagnosis, staging, chemotherapy, surgical cytoreduction, radiation therapy, and multimodality therapy in patients with malignant pleural mesothelioma. Additional information is available at www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki .

  6. Gender Opportunities in Psychosocial Oncology.

    Science.gov (United States)

    Loscalzo, Matthew; Clark, Karen

    2018-01-01

    So much has happened since the original publication of this chapter. In some ways, the progress made in appreciating the full spectrum of sexual and gender expression has been uneven and in some nations, there has been serious regression and resulting repression. But overall, especially in the industrialized countries, there is much greater awareness of sex and gender and its importance in health and well being. In this updated chapter, we put sex and gender into a historical context that is relevant to psycho-oncology and that openly accepts that society overall, is highly conflicted when it comes to how women and men get the best out of each other, never mind how to best integrate lesbian, gay, bisexual, and transgender (LGBT) communities. With the advent of more tailored treatments and strategic medicine, sex becomes much more important as a variable and this has led to greater scientific requirements to create protocols that integrate sex into all aspects of health from prevention, diagnosis, treatment, survivorship, and death. But we still have a very far way to go. There is a serious dearth of data on sex and gender in science overall and in cancer medicine specifically. Avoidance of discussions of sex and gender in medicine reflects the larger lingering societal discomfort with any discussion that links potential sex and gender differences with superiority. The data shows that there is more intrasexual than intersexual variation in men and women. When speaking about sex and gender the literature reflects that, on average, there are many differences, and although they are small, that when taken together, the impact may be quite robust. Sex and gender differences are relevant to how individuals, couples, and families experience and cope with serious illness; however these important and obvious variables are seldom taken into account when counseling seriously ill patients and their families. Cancer is a complex disease that brings into sharp relief the

  7. Integrated biophotonics in endoscopic oncology

    Science.gov (United States)

    Muguruma, Naoki; DaCosta, Ralph S.; Wilson, Brian C.; Marcon, Norman E.

    2009-02-01

    endoscopic diagnosis is likely to be impacted by a combination of biomarkers and technology, and 'endoscopic molecular imaging' should be defined as "visualization of molecular characteristics with endoscopy". These innovations will allow us not only to locate a tumor or dysplastic lesion but also to visualize its molecular characteristics (e.g., DNA mutations and polymorphisms, gene and/or protein expression), and the activity of specific molecules and biological processes that affect tumor behavior and/or its response to therapy. In the near future, these methods should be promising technologies that will play a central role in gastrointestinal oncology.

  8. Clinical use of organic near-infrared fluorescent contrast agents in image-guided oncologic procedures and its potential in veterinary oncology.

    Science.gov (United States)

    Favril, Sophie; Abma, Eline; Blasi, Francesco; Stock, Emmelie; Devriendt, Nausikaa; Vanderperren, Katrien; de Rooster, Hilde

    2018-04-28

    One of the major challenges in surgical oncology is the intraoperative discrimination of tumoural versus healthy tissue. Until today, surgeons rely on visual inspection and palpation to define the tumoural margins during surgery and, unfortunately, for various cancer types, the local recurrence rate thus remains unacceptably high. Near-infrared (NIR) fluorescence imaging is an optical imaging technique that can provide real-time preoperative and intraoperative information after administration of a fluorescent probe that emits NIR light once exposed to a NIR light source. This technique is safe, cost-effective and technically easy. Several NIR fluorescent probes are currently studied for their ability to highlight neoplastic cells. In addition, NIR fluorescence imaging holds great promise for sentinel lymph node mapping. The aim of this manuscript is to provide a literature review of the current organic NIR fluorescent probes tested in the light of human oncology and to introduce fluorescence imaging as a valuable asset in veterinary oncology. © British Veterinary Association (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits.

    Science.gov (United States)

    Ignoffo, Robert; Knapp, Katherine; Barnett, Mitchell; Barbour, Sally Yowell; D'Amato, Steve; Iacovelli, Lew; Knudsen, Jasen; Koontz, Susannah E; Mancini, Robert; McBride, Ali; McCauley, Dayna; Medina, Patrick; O'Bryant, Cindy L; Scarpace, Sarah; Stricker, Steve; Trovato, James A

    2016-04-01

    With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties-certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits. Copyright © 2016 by American Society of Clinical Oncology.

  10. Contemporary Trends in Radiation Oncology Resident Research

    International Nuclear Information System (INIS)

    Verma, Vivek; Burt, Lindsay; Gimotty, Phyllis A.; Ojerholm, Eric

    2016-01-01

    Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These

  11. Contemporary Trends in Radiation Oncology Resident Research

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek [Department of Radiation Oncology, University of Nebraska, Omaha, Nebraska (United States); Burt, Lindsay [Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States); Gimotty, Phyllis A. [Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Ojerholm, Eric, E-mail: eric.ojerholm@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2016-11-15

    Purpose: To test the hypothesis that recent resident research productivity might be different than a decade ago, and to provide contemporary information about resident scholarly activity. Methods and Materials: We compiled a list of radiation oncology residents from the 2 most recent graduating classes (June 2014 and 2015) using the Association of Residents in Radiation Oncology annual directories. We queried the PubMed database for each resident's first-authored publications from postgraduate years (PGY) 2 through 5, plus a 3-month period after residency completion. We abstracted corresponding historical data for 2002 to 2007 from the benchmark publication by Morgan and colleagues (Int J Radiat Oncol Biol Phys 2009;74:1567-1572). We tested the null hypothesis that these 2 samples had the same distribution for number of publications using the Wilcoxon rank-sum test. We explored the association of demographic factors and publication number using multivariable zero-inflated Poisson regression. Results: There were 334 residents publishing 659 eligible first-author publications during residency (range 0-17; interquartile range 0-3; mean 2.0; median 1). The contemporary and historical distributions were significantly different (P<.001); contemporary publication rates were higher. Publications accrued late in residency (27% in PGY-4, 59% in PGY-5), and most were original research (75%). In the historical cohort, half of all articles were published in 3 journals; in contrast, the top half of contemporary publications were spread over 10 journals—most commonly International Journal of Radiation Oncology • Biology • Physics (17%), Practical Radiation Oncology (7%), and Radiation Oncology (4%). Male gender, non-PhD status, and larger residency size were associated with higher number of publications in the multivariable analysis. Conclusion: We observed an increase in first-author publications during training compared with historical data from the mid-2000s. These

  12. PET scanning in plastic and reconstructive surgery

    International Nuclear Information System (INIS)

    Eirini, L.; Emmanouil, L.; Othonas, P.; Hans-Guenther, M.; Nikolaos, P.A.

    2012-01-01

    In this report we highlight the use of position emission tomography (PET) scan in plastic and reconstructive surgery. PET scanning is a very important tool in plastic surgery oncology (melanoma, soft-tissue sarcomas and bone sarcomas, head and neck cancer, peripheral nerve sheath tumors of the extremities and breast cancer after breast esthetic surgery), as diagnosis, staging, treatment planning and follow-up of cancer patients is based on imaging. PET scanning seems also to be useful as a flap monitoring system as well as an infection's imaging tool, for example in the management of diabetic foot ulcer. PET also contributes to the understanding of pathophysiology of keloids which remain a therapeutic challenge. (author)

  13. Oncoplastia surgery breast conservation. First results

    International Nuclear Information System (INIS)

    Morales Tirado, Roxana; Breff Frometa, Alain; Alfonso Coto, Juan Carlos; Galvez Chavez, Julio Cesar

    2009-01-01

    Oncoplastic surgery is an important tool in the treatment patients with breast cancer stages I and II. A prospective study descriptive period between October 2005 and October 2006, which included 10 patients younger than 60 years in stages I and II, selected from the universe that came to the National Cancer Institute and Havana Radiobiology (INOR), following the inclusion criteria and exclusion. Were assessed before and after surgery from surveys that collected data questioning the patients and data clinical examination performed by the plastic surgeon. The predominant lesion was invasive ductal cancer and most patients were in stage I. There were no loco-regional recurrence in 2 year period. The most common complication was dehiscence surgical wound. Good aesthetic results were obtained in sixty percent of cases. It is confirmed that the surgery is Breast Oncoplastic very effective for the oncological safety and promising in terms of aesthetic results. (Author)

  14. Neuro-oncology of CNS tumors

    International Nuclear Information System (INIS)

    Tonn, J.C.

    2006-01-01

    Diagnosis and treatment modalities for neuro-oncologic diseases have made considerable advances in recent years. There is hardly a segment of the field of solid tumours that is experiencing such dynamic development with regard to basic scientific findings and clinical results. In the present book the world's leading experts have compiled the current practice-relevant knowledge of neuro-oncologic diseases. The book's clear structure and the uniform presentation of all chapters make this volume a valuable reference, especially for practice-oriented activities, allowing swift access to information about current treatment standards. Hence it will be of great value to both clinicians and researchers. (orig.)

  15. Oncology of Reptiles: Diseases, Diagnosis, and Treatment.

    Science.gov (United States)

    Christman, Jane; Devau, Michael; Wilson-Robles, Heather; Hoppes, Sharman; Rech, Raquel; Russell, Karen E; Heatley, J Jill

    2017-01-01

    Based on necropsy review, neoplasia in reptiles has a comparable frequency to that of mammals and birds. Reptile neoplasia is now more frequently diagnosed in clinical practice based on increased use of advanced diagnostic techniques and improvements in reptilian husbandry allowing greater longevity of these species. This article reviews the current literature on neoplasia in reptiles, and focuses on advanced diagnostics and therapeutic options for reptilian patientssuffering neoplastic disease. Although most applied clinical reptile oncology is translated from dog and cat oncology, considerations specific to reptilian patients commonly encountered in clinical practice (turtles, tortoises, snakes, and lizards) are presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Integrative oncology in Indian subcontinent: an overview.

    Science.gov (United States)

    Ramamoorthy, Ananthalakshmi; Janardhanan, Sunitha; Jeevakarunyam, Sathiyajeeva; Jeddy, Nadheem; Eagappan, Senthil

    2015-03-01

    Integrative oncology is a combination of one where complementary and alternative medicine (CAM) with conventional cancer treatment modalities is used to manage symptoms, control side-effects and improve the state of mental wellbeing. The ancient Indian medicinal approach in cancer treatment and management has a wide array of herbs and practices. There is an increasing demand for traditional and natural medicine by the cancer patients. The conventional oncologic surgeons and physicians should be aware of the role of cCAM that are available in Indian subcontinent and provide a treatment that focuses on the physical and mental state of wellness in combating cancer.

  17. Pharmacogenetics in the oncological clinical practice

    International Nuclear Information System (INIS)

    Gruber, S.

    2004-01-01

    The genetic control of drug metabolism allows new insights into the bioavailability, toxicity, and efficacy of chemotherapy. In addition, molecular expression profiles of tumors offers the potential for targeted therapy to be directed more specifically to the biologic behavior of the cancer. Together these strategies are likely to change the practice of clinical oncology. However, appropriate clinical trials will be required to demonstrate the utility of these approaches before they are broadly implemented the biologic behavior of the cancer. Together these strategies are likely to change the practice of clinical oncology. However, appropriate clinical trials will be required to demonstrate the utility of these approaches before they are broadly implemented

  18. Fish Oncology: Diseases, Diagnostics, and Therapeutics.

    Science.gov (United States)

    Vergneau-Grosset, Claire; Nadeau, Marie-Eve; Groff, Joseph M

    2017-01-01

    The scientific literature contains a wealth of information concerning spontaneous fish neoplasms, although ornamental fish oncology is still in its infancy. The occurrence of fish neoplasms has often been associated with oncogenic viruses and environmental insults, making them useful markers for environmental contaminants. The use of fish, including zebrafish, as models of human carcinogenesis has been developed and knowledge gained from these models may also be applied to ornamental fish, although more studies are required. This review summarizes information available about fish oncology pertaining to veterinary clinicians. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. The Danish Neuro-Oncology Registry

    DEFF Research Database (Denmark)

    Hansen, Steinbjørn; Nielsen, Jan; Laursen, René J

    2016-01-01

    BACKGROUND: The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe the establishment of the DNOR and further to evaluate the database completen......BACKGROUND: The Danish Neuro-Oncology Registry (DNOR) is a nationwide clinical cancer database that has prospectively registered data on patients with gliomas since January 2009. The purpose of this study was to describe the establishment of the DNOR and further to evaluate the database...

  20. Citation classics in neuro-oncology: assessment of historical trends and scientific progress.

    Science.gov (United States)

    Hachem, Laureen D; Mansouri, Alireza; Juraschka, Kyle; Taslimi, Shervin; Pirouzmand, Farhad; Zadeh, Gelareh

    2017-09-01

    Citation classics represent the highest cited works in a field and are often regarded as the most influential literature. Analyzing thematic trends in citation classics across eras enables recognition of important historical advances within a field. We present the first analysis of the citation classics in neuro-oncology. The Web of Science database was searched using terms relevant to "neuro-oncology." Articles with >400 citations were identified and the top 100 cited articles were evaluated. The top 100 neuro-oncology citation classics consisted of 43 clinical studies (17 retrospective, 10 prospective, 16 randomized trials), 43 laboratory investigations, 8 reviews/meta-analyses, and 6 guidelines/consensus statements. Articles were classified into 4 themes: 13 pertained to tumor classification, 37 to tumor pathogenesis/clinical presentation, 6 to imaging, 44 to therapy (15 chemotherapy, 10 radiotherapy, 5 surgery, 14 new agents). Gliomas were the most common tumor type examined, with 70 articles. There was a significant increase in the number of citation classics in the late 1990s, which was paralleled by an increase in studies examining tumor pathogenesis, chemotherapy, and new agents along with laboratory and randomized studies. The majority of citation classics in neuro-oncology are related to gliomas and pertain to tumor pathogenesis and treatment. The rise in citation classics in recent years investigating tumor biology, new treatment agents, and chemotherapeutics may reflect increasing scientific interest in nonsurgical treatments for CNS tumors and the need for fundamental investigations into disease processes. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. Oncology knowledge gap among freshly passed interns in a Government Medical College of Eastern India.

    Science.gov (United States)

    Bandyopadhyay, Anis; Das, Anuradha; Ghosh, Ashok; Giri, Rajsekhar; Biswas, Nilay

    2013-04-01

    A survey was conducted among freshly passed undergraduate doctors of a medical college in Eastern India with the aim to investigate their exposure to oncology patients, their knowledge about various aspects of oncology patient management and their confidence in managing patients with cancer. One hundred and twelve newly passed interns of a Government Medical College in Kolkata were interviewed using semi-structured partly open ended and partly closed end questionnaire. The questionnaire dealt with the qualitative and quantitative aspects of knowledge and perception of the interns about the problem of cancer and its management. A total of 82 interns responded to the questionnaire, with a response rate of 73.2%. About 53% of the respondents have seen less than five patients during their undergraduate ward/clinical postings. Among the respondents, 71% felt they were confident in diagnosing cancer, and about 56% were confident in counseling of patient and their relatives about cancer. About 63% were aware about the role of surgery; however, only 32% and 37.5% were aware about the role of radiotherapy and chemotherapy, respectively. A dismal 12.5% were confident of care of terminal and late stage patients. Preparedness was correlated with exposure to patients with cancer (P = 0.03). Majority (87%) felt the need for incorporating oncology training at the undergraduate level and the most frequent method (67%) suggested for doing so was having separate posting in radiotherapy department/oncology wards. There is glaring knowledge gap among newly passed doctors and integrated oncology postings during undergraduate training and during internship may help seal this gap.

  2. Oncology nursing in Cuba: report of the delegation.

    Science.gov (United States)

    Sheldon, Lisa Kennedy; Leonard, Kathleen; Gross, Anne; Hartnett, Erin; Poage, Ellen; Squires, Jennifer; Ullemeyer, Vicki; Schueller, Mary; Stary, Susan; Miller, Mary Alice

    2012-08-01

    In December 2011, the first delegation of oncology nurses from the United States visited Havana, Cuba. The delegation included oncology nurses, educators, and leaders from across America and provided opportunities to learn about the healthcare system, cancer, and oncology nursing in Cuba. Delegation members attended lectures, toured facilities, and enjoyed Cuban culture. This exchange highlighted the similarities in cancer care and oncology nursing between countries and opened doors for future collaborations.

  3. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik

    2016-01-01

    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...... in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard...

  4. The experiential world of the Oncology nurse

    Directory of Open Access Journals (Sweden)

    Dalena van Rooyen

    2008-11-01

    Full Text Available In her experiential world, the oncology nurse experiences unique, challenging and rewarding relationships in a multidimensional, dynamic way. The aim of this study was to describe, from her viewpoint and perspective, how she experiences and reacts to this world. Through this study the researcher wants the oncology nurse’s voice to be heard, the richness of her story acknowledged and the derived data to be applied to the benefit of the field of oncology. In-depth, unstructured phenomenological interviews provided the saturated data from which the uniqueness of the world of the oncology nurse unfolded as the uniqueness of the oncology patients and their world emerged clearly. Findings show that the oncology nurse, attending to the cancer patients and their family, experiences many different relationships. The uniqueness of the oncology nurse-patient relationship is described as unlike any other nurse-patient relationship. The challenging interpersonal relationships with management and other members of the multiprofessional team, as experienced from the perspective of the oncology nurse, are also highlighted. Furthermore, a unifying intrapersonal relationship with the self was identified. This enables the oncology nurse to be both on the giving and receiving end of the intensely emotional environment she works in, explaining, at least partly, the high job satisfaction that permeated the interviews in this study. Recommendations for nursing practice, education and research were formulated. Opsomming In haar leefwêreld ondervind onkologieverpleegkundige unieke, uitdagende en belonende verhoudinge op ‘n multidimensionele en dinamiese wyse. Die doel van hierdie studie was om ‘n beskrywing van die onkologieverpleegkundige se ervarings van en reaksie op haar leefwêreld vanuit haar oogpunt en perspektief. Deur middel van hierdie studie wil die navorser die stem van die onkologieverpleegkundige gehoor laat word, die rykdom van haar verhaal erken en

  5. Audits of oncology units – an effective and pragmatic approach ...

    African Journals Online (AJOL)

    Background. Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. Objective. To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. Methods. Staff in oncology units who ...

  6. Intestinal Surgery.

    Science.gov (United States)

    Desrochers, André; Anderson, David E

    2016-11-01

    A wide variety of disorders affecting the intestinal tract in cattle may require surgery. Among those disorders the more common are: intestinal volvulus, jejunal hemorrhage syndrome and more recently the duodenal sigmoid flexure volvulus. Although general principles of intestinal surgery can be applied, cattle has anatomical and behavior particularities that must be known before invading the abdomen. This article focuses on surgical techniques used to optimize outcomes and discusses specific disorders of small intestine. Diagnoses and surgical techniques presented can be applied in field conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Re-Engineering a Small Oncology Practice for Quality Using the ASCO Quality Oncology Practice Initiative

    OpenAIRE

    Hendricks, Carolyn B.

    2013-01-01

    The field of quality improvement is expanding rapidly, and small oncology practices need to adapt and rise to future challenges. Additional quality measures from ASCO and other organizations will likely focus on palliative care, the Top Five, and electronic measures.

  8. Surgery of malignant pancreatic tumors

    International Nuclear Information System (INIS)

    Loos, M.; Friess, H.; Kleeff, J.

    2009-01-01

    Ductal adenocarcinoma is the most common malignant tumor of the pancreas. Despite great efforts in basic and clinical pancreatic cancer research, the prognosis remains poor with an overall 5-year survival rate of less than 5%. Complete surgical resection represents the only curative treatment option and 5-year survival rates of 20-25% can be achieved following curative resection and adjuvant chemotherapy. Although pancreatic surgery is considered one of the most technically demanding and challenging procedures, there has been constant progress in surgical techniques and advances in perioperative care with a modern interdisciplinary approach including anesthesiology, oncology, radiology and nursing. This has reduced morbidity and especially mortality rates in high-volume centers. Among extended resection procedures multivisceral and venous resections are technically feasible and should be considered if a complete tumor resection can be achieved. Multimodal regimens have shown promising results, however, only adjuvant chemotherapy is supported by solid evidence from randomized controlled trials. (orig.) [de

  9. Robotic Surgery for Lung Cancer

    Science.gov (United States)

    Ambrogi, Marcello C; Fanucchi, Olivia; Melfi, Franco; Mussi, Alfredo

    2014-01-01

    During the last decade the role of minimally invasive surgery has been increased, especially with the introduction of the robotic system in the surgical field. The most important advantages of robotic system are represented by the wristed instrumentation and the depth perception, which can overcome the limitation of traditional thoracoscopy. However, some data still exist in literature with regard to robotic lobectomy. The majority of papers are focused on its safety and feasibility, but further studies with long follow-ups are necessary in order to assess the oncologic outcomes. We reviewed the literature on robotic lobectomy, with the main aim to better define the role of robotic system in the clinical practice. PMID:25207216

  10. Oncologic outcome after local recurrence of chondrosarcoma: Analysis of prognostic factors.

    Science.gov (United States)

    Kim, Han-Soo; Bindiganavile, Srimanth S; Han, Ilkyu

    2015-06-01

    Literature on outcome after local recurrence (LR) in chondrosarcoma is scarce and better appreciation of prognostic factors is needed. (1) To evaluate post-LR oncologic outcomes of disease-specific survival and subsequent LR and (2) to identify prognostic factors for post-LR oncologic outcomes. Review of 28 patients with locally recurrent chondrosarcoma from the original cohort of 150 patients, who were treated surgically with or without adjuvants between 1982 and 2011, was performed. Mean age was 46 years (range, 21-73) which included 20 males and 8 females with mean follow up of 8.4 ± 7.5 years (range, 1.2-31.0). Post-LR survival at 5 years was 58.6 ± 10.3%. Age greater than 50 years (P = 0.011) and LR occurring within 1 year of primary surgery (P = 0.011) independently predicted poor survival. Seven patients suffered subsequent LR, which was significantly affected by surgical margin for LR (P = 0.038). Long-term survival of locally recurrent chondrosarcoma is achievable in a substantial number of patients. Older age at onset of LR and shorter interval from primary surgery to LR identifies high risk patients for poor post-LR survival while, wide surgical margins at LR surgery reduces the risk of subsequent LR. © 2015 Wiley Periodicals, Inc.

  11. CHONDROSARCOMA OF BONE - ONCOLOGIC AND FUNCTIONAL RESULTS

    NARCIS (Netherlands)

    VANLOON, CJM; VETH, RPH; PRUSZCZYNSKI, M; WOBBES, T; LEMMENS, JAM; VANHORN, J

    1994-01-01

    A retrospective review of 27 patients (21 males and 6 females) with chondrosarcoma of bone was performed to evaluate the oncologic and functional results. The average age of the patients was 48 years (range: 17-76). The tumor sites were pelvis in 10 cases, distal femur in 2, proximal tibia in 3, rib

  12. Gamma camera based FDG PET in oncology

    International Nuclear Information System (INIS)

    Park, C. H.

    2002-01-01

    Positron Emission Tomography(PET) was introduced as a research tool in the 1970s and it took about 20 years before PET became an useful clinical imaging modality. In the USA, insurance coverage for PET procedures in the 1990s was the turning point, I believe, for this progress. Initially PET was used in neurology but recently more than 80% of PET procedures are in oncological applications. I firmly believe, in the 21st century, one can not manage cancer patients properly without PET and PET is very important medical imaging modality in basic and clinical sciences. PET is grouped into 2 categories; conventional (c) and gamma camera based ( CB ) PET. CB PET is more readily available utilizing dual-head gamma cameras and commercially available FDG to many medical centers at low cost to patients. In fact there are more CB PET in operation than cPET in the USA. CB PET is inferior to cPET in its performance but clinical studies in oncology is feasible without expensive infrastructures such as staffing, rooms and equipments. At Ajou university Hospital, CBPET was installed in late 1997 for the first time in Korea as well as in Asia and the system has been used successfully and effectively in oncological applications. Our was the fourth PET operation in Korea and I believe this may have been instrumental for other institutions got interested in clinical PET. The following is a brief description of our clinical experience of FDG CBPET in oncology

  13. Neuro-oncology Thallium 201 interest

    International Nuclear Information System (INIS)

    Guyot, M.; Latry, C.; Basse-Cathalinat, B.; Ducassou, D.; Guerin, J.; Maire, J.P.

    1994-01-01

    So and in spite of its histologic specificity absence, Tl 201 has an evident interest in neuro-oncology: for the low grade astrocytoma transformation diagnosis toward one higher grad; for the neoplasm residue and recidive diagnosis; and more generally as forecasted evolution element during the therapy. 2 figs., 4 tabs., 4 graphs

  14. Ethical problems experienced by oncology nurses.

    Science.gov (United States)

    da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins

    2015-01-01

    To know the ethical problems experienced by oncology nurses. Descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. For the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.

  15. Current management of surgical oncologic emergencies

    NARCIS (Netherlands)

    Bosscher, Marianne R. F.; van Leeuwen, Barbara L.; Hoekstra, Harald J.

    2015-01-01

    OBJECTIVES: For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for

  16. Tumor relapse present in oncologic nasal repair

    International Nuclear Information System (INIS)

    Galvez Chavez, Julio Cesar; Sanchez Wals, Lenia; Monzon Fernandez, Abel Nicolas; Morales Tirado, Roxana

    2009-01-01

    Tumor relapse is one of the more fearsome complications of the oncologic course and also to obscure the life prognosis, causing the loss of many reconstructions and of exhausting the repairing surgical possibilities. The aim of this study was to determine the relapse frequency, the repercussion on the repair and the subsequent medical course of patients operated on malign nasal tumors

  17. Use of alternative treatment in pediatric oncology

    NARCIS (Netherlands)

    Grootenhuis, M. A.; Last, B. F.; de Graaf-Nijkerk, J. H.; van der Wel, M.

    1998-01-01

    The use of alternative treatment along with conventional cancer therapy is very popular. However, little is known about the use of alternative treatment in pediatric oncology. A study to determine which medical and demographic characteristics distinguish users from nonusers was conducted in a

  18. Predictors of Patient Satisfaction in Pediatric Oncology.

    Science.gov (United States)

    Davis, Josh; Burrows, James F; Ben Khallouq, Bertha; Rosen, Paul

    To understand key drivers of patient satisfaction in pediatric hematology/oncology. The "top-box" scores of patient satisfaction surveys from 4 pediatric hematology/oncology practices were collected from 2012 to 2014 at an integrated Children's Health Network. One item, "Likelihood of recommending practice," was used as the surrogate for overall patient satisfaction, and all other items were correlated to this item. A total of 1244 satisfaction surveys were included in this analysis. The most important predictors of overall patient satisfaction were cheerfulness of practice ( r = .69), wait time ( r = .60), and staff working together ( r = .60). The lowest scoring items were getting clinic on phone, information about delays, and wait time at clinic. Families bringing their children for outpatient care in a hematology/oncology practice want to experience a cheerful and collaborative medical team. Wait time at clinic may be a key driver in the overall experience for families with children with cancer. Future work should be directed at using this evidence to drive patient experience improvement processes in pediatric hematology/oncology.

  19. Present status and possibilities of radiation oncology

    Energy Technology Data Exchange (ETDEWEB)

    Scherer, E [Essen Univ. (Gesamthochschule) (Germany, F.R.). Strahlenklinik; Essen Univ. (Gesamthochschule) (Germany, F.R.). Poliklinik)

    1979-01-01

    A survey of the current methodical possibilities of radiation therapy within the limits of interdisciplinary oncology is given. Especially new forms of fractionation and current projects to augment the effect of radiation are discussed. The question of fast neutrons, electroaffine substances and local hyperthermia are dealt with.

  20. Clinical PET/MR Imaging in Oncology

    DEFF Research Database (Denmark)

    Kjær, Andreas; Torigian, Drew A.

    2016-01-01

    . The question, therefore, arises regarding what the future clinical applications of PET/MR imaging will be. In this article, the authors discuss ways in which PET/MR imaging may be used in future applications that justify the added cost, predominantly focusing on oncologic applications. The authors suggest...

  1. Comparative oncology: Integrating human and veterinary medicine ...

    African Journals Online (AJOL)

    Cancer constitutes the major health problem both in human and veterinary medicine. Comparative oncology as an integrative approach offers to learn more about naturally occurring cancers across different species. Canine models have many advantages as they experience spontaneous disease, have many genes similar ...

  2. Precision medicine in oncology: New practice models and roles for oncology pharmacists.

    Science.gov (United States)

    Walko, Christine; Kiel, Patrick J; Kolesar, Jill

    2016-12-01

    Three different precision medicine practice models developed by oncology pharmacists are described, including strategies for implementation and recommendations for educating the next generation of oncology pharmacy practitioners. Oncology is unique in that somatic mutations can both drive the development of a tumor and serve as a therapeutic target for treating the cancer. Precision medicine practice models are a forum through which interprofessional teams, including pharmacists, discuss tumor somatic mutations to guide patient-specific treatment. The University of Wisconsin, Indiana University, and Moffit Cancer Center have implemented precision medicine practice models developed and led by oncology pharmacists. Different practice models, including a clinic, a clinical consultation service, and a molecular tumor board (MTB), were adopted to enhance integration into health systems and payment structures. Although the practice models vary, commonalities of three models include leadership by the clinical pharmacist, specific therapeutic recommendations, procurement of medications for off-label use, and a research component. These three practice models function as interprofessional training sites for pharmacy and medical students and residents, providing an important training resource at these institutions. Key implementation strategies include interprofessional involvement, institutional support, integration into clinical workflow, and selection of model by payer mix. MTBs are a pathway for clinical implementation of genomic medicine in oncology and are an emerging practice model for oncology pharmacists. Because pharmacists must be prepared to participate fully in contemporary practice, oncology pharmacy residents must be trained in genomic oncology, schools of pharmacy should expand precision medicine and genomics education, and opportunities for continuing education in precision medicine should be made available to practicing pharmacists. Copyright © 2016 by the

  3. The American Society for Radiation Oncology's 2015 Core Physics Curriculum for Radiation Oncology Residents

    International Nuclear Information System (INIS)

    Burmeister, Jay; Chen, Zhe; Chetty, Indrin J.; Dieterich, Sonja; Doemer, Anthony; Dominello, Michael M.; Howell, Rebecca M.; McDermott, Patrick; Nalichowski, Adrian; Prisciandaro, Joann; Ritter, Tim; Smith, Chadd; Schreiber, Eric; Shafman, Timothy; Sutlief, Steven; Xiao, Ying

    2016-01-01

    Purpose: The American Society for Radiation Oncology (ASTRO) Physics Core Curriculum Subcommittee (PCCSC) has updated the recommended physics curriculum for radiation oncology resident education to improve consistency in teaching, intensity, and subject matter. Methods and Materials: The ASTRO PCCSC is composed of physicists and physicians involved in radiation oncology residency education. The PCCSC updated existing sections within the curriculum, created new sections, and attempted to provide additional clinical context to the curricular material through creation of practical clinical experiences. Finally, we reviewed the American Board of Radiology (ABR) blueprint of examination topics for correlation with this curriculum. Results: The new curriculum represents 56 hours of resident physics didactic education, including a 4-hour initial orientation. The committee recommends completion of this curriculum at least twice to assure both timely presentation of material and re-emphasis after clinical experience. In addition, practical clinical physics and treatment planning modules were created as a supplement to the didactic training. Major changes to the curriculum include addition of Fundamental Physics, Stereotactic Radiosurgery/Stereotactic Body Radiation Therapy, and Safety and Incidents sections, and elimination of the Radiopharmaceutical Physics and Dosimetry and Hyperthermia sections. Simulation and Treatment Verification and optional Research and Development in Radiation Oncology sections were also added. A feedback loop was established with the ABR to help assure that the physics component of the ABR radiation oncology initial certification examination remains consistent with this curriculum. Conclusions: The ASTRO physics core curriculum for radiation oncology residents has been updated in an effort to identify the most important physics topics for preparing residents for careers in radiation oncology, to reflect changes in technology and practice since

  4. GENERAL SURGERY

    African Journals Online (AJOL)

    surgery. Since the first laparoscopic treatment of hydatid disease was described in 1992,14 there has been a steady growth in reports of the laparoscopic treatment of hydatid cysts of liver. Although early reported laparoscopic treatment of liver hydatid disease was confined to simple drainage, more advanced laparoscopic ...

  5. GENERAL SURGERY

    African Journals Online (AJOL)

    Department of Surgery, University of Cape Town Health Sciences Faculty, Groote Schuur Hospital, Observatory, Cape Town,. South Africa ... included all district, regional and tertiary hospitals in the nine provinces. Clinics and so-called ..... large contingency of senior general surgeons from countries such as Cuba, who have ...

  6. TRAUMA SURGERY

    African Journals Online (AJOL)

    meet the criteria for damage control surgery, and ligation of the AVC is a .... There were two vertebral body fractures, one penetrating brain injury from a gunshot wound to the head, one ... two hand fractures, three haemothoraces, one pelvic fracture, .... One patient with an intimal flap injury to his left common iliac artery ...

  7. GENERAL SURGERY

    African Journals Online (AJOL)

    Schwab , using a three-phase approach.5 In 1998, Moore et al. extended the concept and described the five-stage approach.6. The aim of damage control surgery is to prevent severely injured patients from developing the “lethal triad” of hypothermia, coagulopathy and worsening acidosis, as this confers a dismal prognosis ...

  8. Rodding Surgery

    Science.gov (United States)

    ... Physical activity prior to surgery,  Length of the operation; anesthesia issues,  Reason for the choice of rod,  Time in the hospital,  Length of recovery time at home,  Pain management including control of muscle spasms,  The rehabilitation plan. ...

  9. [Feasibility and cosmetic outcome of oncoplastic surgery in breast cancer treatment].

    Science.gov (United States)

    Sherwell-Cabello, Santiago; Maffuz-Aziz, Antonio; Villegas-Carlos, Felipe; Domínguez-Reyes, Carlos; Labastida-Almendaro, Sonia; Rodríguez-Cuevas, Sergio

    2015-01-01

    Breast cancer is the leading oncological cause of death in Mexican women over 25 years old. Given the need to improve postoperative cosmetic results in patients with breast cancer, oncoplastic surgery has been developed, which allows larger tumour resections and minor cosmetic alterations. To determine the oncological feasibility and cosmetic outcome of oncoplastic surgery at the Instituto de Enfermedades de la Mama, FUCAM, AC. A review was conducted from January 2010 to July 2013, which included patients with breast cancer diagnosis treated with conventional breast-conserving surgery or with oncoplastic surgery in the Institute of Diseases of the Breast, FUCAM AC. Clinical and histopathological parameters were compared between the two groups, and a questionnaire of cosmetic satisfaction and quality of life was applied. Of the 171 patients included, 95 of them were treated with conventional breast-conserving surgery and 76 with oncoplastic surgery. Pathological tumour size was significantly larger in patients treated with oncoplastic surgery (p = 0.002). There were no differences found between the groups as regards the number of patients with positive surgical margin, the rate of complications, and cosmetic satisfaction. This study demonstrates the oncological feasibility and high cosmetic satisfaction of oncoplastic surgery with minimal psycho-social impact on patients. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  10. Back to the Future for Clinical Oncology.

    Science.gov (United States)

    Chabner

    1996-01-01

    practice manual, or even the gatekeeper, who watches his or her capitated bottom line with great nervousness. It should be the physician(s) best able to evaluate the alternatives and communicate these choices to the patient and family. Often it is not possible for a solo physician to make these choices in isolation, particularly when the decisions involve multiple specialties and multimodality therapies. At presentation, many primary cancers now require an integration of the opinion of more than one specialist, and increasingly this integration occurs before surgery. Breast, lung, and prostate cancer, three of our most common diseases, illustrate this point with growing clarity. While less convenient for the doctor, and perhaps less efficient than the "old style" of practice, multimodatity disease center clinics offer significant advantages both to the patient and to the research effort, and are here to stay. Certainly for the payer it is faster and cheaper to have one doctor do it all, but I doubt that the results will be as good. Obviously not all patients need this cooperative approach. It would waste good physicians' time to require that all patients be seen by a radiotherapist, surgeon, and medical oncologist or pediatric oncologist. The specific circumstances may clearly dictate a simple approach and an uncomplicated decision, particularly in dealing with metastatic solid tumors, or at the other extreme, in managing easily resectable, low-risk tumors. However, even here, optimal management of local disease or of potentially resectable metastases may require consideration of an expanded series of options. Thus, all cancer specialists need to be aware of the potential of their colleagues to contribute to disease management. ellipsisWhich brings us to the reason for this journal. The editorial board members of The Oncologist hold the belief that the various subspecialists in oncology should share the same information base and read from the same journal. We believe that

  11. Application of ambulatory surgery in breast cancer. Hospital 'V. I Lenin' 1996 - 2006

    International Nuclear Information System (INIS)

    Fernandez Sarabia, Pedro Antonio; Sanz Pupo, Nitza Julia

    2009-01-01

    Breast cancer ranks among the top in incidence and mortality from oncological diseases worldwide. In our country and our province behaves similarly, represents a major health problem. To compare the results of traditional outpatient surgery in patients diagnosed with breast cancer. Was performed a case-series study of patients operated for malignancy in breast oncology service at the 'Hospital Universitario V. I. Lenin'. It involved 1140 cases, including 260 by the traditional method and 880 (77.19%) for the outpatient method. Modified radical mastectomy was performed to 1010 patients and conservative surgery, 30 of them. The rate of complications present in the operated cases was not significant. (Author)

  12. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  13. Technology for Innovation in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Chetty, Indrin J. [Department of Radiation Oncology, Henry Ford Hospital, Detroit, Michigan (United States); Martel, Mary K., E-mail: mmartel@mdanderson.org [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Jaffray, David A. [Departments of Radiation Oncology and Medical Biophysics, Princess Margaret Hospital, Toronto, Ontario (Canada); Benedict, Stanley H. [Department of Radiation Oncology, University of California – Davis Cancer Center, Sacramento, California (United States); Hahn, Stephen M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Berbeco, Ross [Department of Radiation Oncology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Deye, James [Radiation Research Programs, National Cancer Institute, Bethesda, Maryland (United States); Jeraj, Robert [Department of Medical Physics, University of Wisconsin, Madison, Wisconsin (United States); Kavanagh, Brian [Department of Radiation Oncology, University of Colorado, Aurora, Colorado (United States); Krishnan, Sunil [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lee, Nancy [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York (United States); Low, Daniel A. [Department of Radiation Oncology, University of California – Los Angeles, Los Angeles, California (United States); Mankoff, David [Department of Radiology, University of Washington Medical School, Seattle, Washington (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina Hospitals, Chapel Hill, North Carolina (United States); Ollendorf, Daniel [Institute for Clinical and Economic Review, Boston, Massachusetts (United States); and others

    2015-11-01

    Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology,” which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic.

  14. Technology for Innovation in Radiation Oncology.

    Science.gov (United States)

    Chetty, Indrin J; Martel, Mary K; Jaffray, David A; Benedict, Stanley H; Hahn, Stephen M; Berbeco, Ross; Deye, James; Jeraj, Robert; Kavanagh, Brian; Krishnan, Sunil; Lee, Nancy; Low, Daniel A; Mankoff, David; Marks, Lawrence B; Ollendorf, Daniel; Paganetti, Harald; Ross, Brian; Siochi, Ramon Alfredo C; Timmerman, Robert D; Wong, John W

    2015-11-01

    Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled "Technology for Innovation in Radiation Oncology," which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Technology for Innovation in Radiation Oncology

    International Nuclear Information System (INIS)

    Chetty, Indrin J.; Martel, Mary K.; Jaffray, David A.; Benedict, Stanley H.; Hahn, Stephen M.; Berbeco, Ross; Deye, James; Jeraj, Robert; Kavanagh, Brian; Krishnan, Sunil; Lee, Nancy; Low, Daniel A.; Mankoff, David; Marks, Lawrence B.; Ollendorf, Daniel

    2015-01-01

    Radiation therapy is an effective, personalized cancer treatment that has benefited from technological advances associated with the growing ability to identify and target tumors with accuracy and precision. Given that these advances have played a central role in the success of radiation therapy as a major component of comprehensive cancer care, the American Society for Radiation Oncology (ASTRO), the American Association of Physicists in Medicine (AAPM), and the National Cancer Institute (NCI) sponsored a workshop entitled “Technology for Innovation in Radiation Oncology,” which took place at the National Institutes of Health (NIH) in Bethesda, Maryland, on June 13 and 14, 2013. The purpose of this workshop was to discuss emerging technology for the field and to recognize areas for greater research investment. Expert clinicians and scientists discussed innovative technology in radiation oncology, in particular as to how these technologies are being developed and translated to clinical practice in the face of current and future challenges and opportunities. Technologies encompassed topics in functional imaging, treatment devices, nanotechnology, and information technology. The technical, quality, and safety performance of these technologies were also considered. A major theme of the workshop was the growing importance of innovation in the domain of process automation and oncology informatics. The technologically advanced nature of radiation therapy treatments predisposes radiation oncology research teams to take on informatics research initiatives. In addition, the discussion on technology development was balanced with a parallel conversation regarding the need for evidence of efficacy and effectiveness. The linkage between the need for evidence and the efforts in informatics research was clearly identified as synergistic.

  16. Integration of oncology and palliative care: a systematic review.

    Science.gov (United States)

    Hui, David; Kim, Yu Jung; Park, Ji Chan; Zhang, Yi; Strasser, Florian; Cherny, Nathan; Kaasa, Stein; Davis, Mellar P; Bruera, Eduardo

    2015-01-01

    Both the American Society of Clinical Oncology and the European Society for Medical Oncology strongly endorse integrating oncology and palliative care (PC); however, a global consensus on what constitutes integration is currently lacking. To better understand what integration entails, we conducted a systematic review to identify articles addressing the clinical, educational, research, and administrative indicators of integration. We searched Ovid MEDLINE and Ovid EMBase between 1948 and 2013. Two researchers independently reviewed each citation for inclusion and extracted the indicators related to integration. The inter-rater agreement was high (κ = 0.96, p oncology journals (59%) and in or after 2010 (64%, p oncology and PC. ©AlphaMed Press.

  17. The Economics of Academic Advancement Within Surgery.

    Science.gov (United States)

    Baimas-George, Maria; Fleischer, Brian; Korndorffer, James R; Slakey, Douglas; DuCoin, Christopher

    The success of an academic surgeon's career is often viewed as directly related to academic appointment; therefore, the sequence of promotion is a demanding, rigorous process. This paper seeks to define the financial implication of academic advancement across different surgical subspecialties. Data was collected from the Association of American Medical College's 2015 report of average annual salaries. Assumptions included 30 years of practice, 5 years as assistant professor, and 10 years as associate professor before advancement. The base formula used was: (average annual salary) × (years of practice [30 years - fellowship/research years]) + ($50,000 × years of fellowship/research) = total adjusted lifetime salary income. There was a significant increase in lifetime salary income with advancement from assistant to associate professor in all subspecialties when compared to an increase from associate to full professor. The greatest increase in income from assistant to associate professor was seen in transplant and cardiothoracic surgery (35% and 27%, respectively). Trauma surgery and surgical oncology had the smallest increases of 8% and 9%, respectively. With advancement to full professor, the increase in lifetime salary income was significantly less across all subspecialties, ranging from 1% in plastic surgery to 8% in pediatric surgery. When analyzing the economics of career advancement in academic surgery, there is a substantial financial benefit in lifetime income to becoming an associate professor in all fields; whereas, advancement to full professor is associated with a drastically reduced economic benefit. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. The impact of robotic surgery in urology.

    Science.gov (United States)

    Giedelman, C A; Abdul-Muhsin, H; Schatloff, O; Palmer, K; Lee, L; Sanchez-Salas, R; Cathelineau, X; Dávila, H; Cavelier, L; Rueda, M; Patel, V

    2013-01-01

    More than a decade ago, robotic surgery was introduced into urology. Since then, the urological community started to look at surgery from a different angle. The present, the future hopes, and the way we looked at our past experience have all changed. Between 2000 and 2011, the published literature was reviewed using the National Library of Medicine database and the following key words: robotic surgery, robot-assisted, and radical prostatectomy. Special emphasis was given to the impact of the robotic surgery in urology. We analyzed the most representative series (finished learning curve) in each one of the robotic approaches regarding perioperative morbidity and oncological outcomes. This article looks into the impact of robotics in urology, starting from its background applications before urology, the way it was introduced into urology, its first steps, current status, and future expectations. By narrating this journey, we tried to highlight important modifications that helped robotic surgery make its way to its position today. We looked as well into the dramatic changes that robotic surgery introduced to the field of surgical training and its consequence on its learning curve. Basic surgical principles still apply in Robotics: experience counts, and prolonged practice provides knowledge and skills. In this way, the potential advantages delivered by technology will be better exploited, and this will be reflected in better outcomes for patients. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  19. The context of oncology nursing practice: an integrative review.

    Science.gov (United States)

    Bakker, Debra; Strickland, Judith; Macdonald, Catherine; Butler, Lorna; Fitch, Margaret; Olson, Karin; Cummings, Greta

    2013-01-01

    In oncology, where the number of patients is increasing, there is a need to sustain a quality oncology nursing workforce. Knowledge of the context of oncology nursing can provide information about how to create practice environments that will attract and retain specialized oncology nurses. The aims of this review were to determine the extent and quality of the literature about the context of oncology nursing, explicate how "context" has been described as the environment where oncology nursing takes place, and delineate forces that shape the oncology practice environment. The integrative review involved identifying the problem, conducting a structured literature search, appraising the quality of data, extracting and analyzing data, and synthesizing and presenting the findings. Themes identified from 29 articles reflected the surroundings or background (structural environment, world of cancer care), and the conditions and circumstances (organizational climate, nature of oncology nurses' work, and interactions and relationships) of oncology nursing practice settings. The context of oncology nursing was similar yet different from other nursing contexts. The uniqueness was attributed to the dynamic and complex world of cancer control and the personal growth that is gained from the intense therapeutic relationships established with cancer patients and their families. The context of healthcare practice has been linked with patient, professional, or system outcomes. To achieve quality cancer care, decision makers need to understand the contextual features and forces that can be modified to improve the oncology work environment for nurses, other providers, and patients.

  20. Attempt of peripheral nerve reconstruction during lung cancer surgery.

    Science.gov (United States)

    Li, Hanyue; Hu, Yingjie; Huang, Jia; Yang, Yunhai; Xing, Kaichen; Luo, Qingquan

    2018-05-01

    Vagus nerve and recurrent laryngeal nerve (RLN) injury are not rare complications of lung cancer surgery and can cause lethal consequences. Until now, no optimal method other than paying greater attention during surgery has been available. Four patients underwent lung surgery that involved RLN or vagus nerve injury. The left RLN or vagus nerve was cut off and then reconstructed immediately during surgery. Two patients underwent direct anastomosis, while the remaining two underwent phrenic nerve replacing tension-relieving anastomosis. All patients were able to speak immediately after recovery. No or minimal glottal gap was observed during laryngoscopy conducted on the second day after surgery. Most patients achieved full recovery of voice quality. Immediate reconstruction of RLN is technically feasible and can be carried out with satisfying short-term and long-term outcomes. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

  1. Do high-volume hospitals and surgeons provide better care in urologic oncology?

    Science.gov (United States)

    Eastham, James A

    2009-01-01

    Studies focusing primarily on hospital or surgical volume as a surrogate for surgical experience have found substantial variations in outcomes. Increasing surgical experience has been shown to improve outcomes after multiple procedures, including esophagectomy, pancreatectomy, and primary surgery for colon and breast cancer. More recently, evidence has been presented that surgical volume/experience affects quality of life and cancer control outcomes after urologic oncology procedures. Although most of these data pertain to radical prostatectomy, similar conclusions have been reached for radical cystectomy, retroperitoneal lymph node dissection, and management of renal cell carcinoma. This review highlights data indicating that high-volume surgeons and hospitals provide better care for radical prostatectomy.

  2. Paediatric Radiation Oncology. Chapter 21

    International Nuclear Information System (INIS)

    Anacak, Y.; Zaghloul, M.; Laskar, S.

    2017-01-01

    Although cancer is a typical disease of ageing adults, it can be seen at any age and cancer diagnosis in a child is not a rare situation. Every day around the world, many teenagers, young children and even infants are diagnosed with cancer. Cancer in children is an important health care problem, not only for the individual patient and medical staff, but also for families, teachers, friends and society as a whole. In every culture, children are considered innocent human beings and the diagnosis of such an ‘evil’ disease in a young child always induces feelings of unfairness and anguish. Most childhood cancers are curable; using the best treatment options, more than 80% of children with cancer may survive to adulthood. However, cure alone is not the ultimate goal for paediatric cancer treatment; late effects of treatment impact the quality of life of patients. Cure from cancer in a child means adding at least 50–60 years to his or her life, which is long enough to develop serious late effects of the treatment and the induction of secondary cancers. Thus, treatment should be tailored to minimize the exposure of healthy tissues to chemotherapy drugs and radiation. Cancer treatment can be a painful process, often involving surgery, radiotherapy and chemotherapy, and requiring very long treatment periods, which impair the motor and mental development of the child, and his or her educational activities and relations with society. Childhood cancer survivors sometimes have modest to severe sequelae of the disease itself and the treatment used, which may disrupt their development to a healthy adulthood. These cancer survivors should be fully integrated into society and be allowed to live productive lives even when lifelong rehabilitation is required to keep them active.

  3. Metabolic Surgery

    DEFF Research Database (Denmark)

    Pareek, Manan; Schauer, Philip R; Kaplan, Lee M

    2018-01-01

    The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown...... the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity....... Moreover, observational data suggest that the reduction in cardiovascular risk factors translates to better patient outcomes. This review describes commonly used metabolic surgical procedures and their current indications and summarizes the evidence related to weight loss and glycemic outcomes. It further...

  4. Preparing for Surgery

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  5. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

  6. Corrective Jaw Surgery

    Science.gov (United States)

    ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  8. Facial Cosmetic Surgery

    Science.gov (United States)

    ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  9. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  10. Pulmonary complication associated with head and neck cancer surgery

    International Nuclear Information System (INIS)

    Manzoor, T.; Ahmed, Z.; Sheikh, N.A.; Khan, M.M.

    2007-01-01

    To evaluate the frequency of short-term pulmonary complications in the patients undergoing various head and neck cancer surgeries in our setup and to assess possible risk factors responsible for these complications. Seventy patients of age group 20 to 80 years, regardless of gender, treated surgically for head and neck cancers were enrolled. Main outcome measures included development of pulmonary complications following 15 days of oncological surgery. The complications studied were pneumothorax, bronchopneumonia, atelectasis, pulmonary embolism and cardiopulmonary arrest. A total of 24.28% patients suffered from postoperative pulmonary complications; 17.14% developed bronchopneumonia, 5.71% pulmonary embolism, and 1.42% went into cardiopulmonary arrest, none developed pneumothorax or pulmonary atelectasis. A significant correlation of postoperative bronchopneumonia was seen with heavy smoking and assisted ventilation. Pulmonary embolism was associated with extended assisted ventilation and prolonged surgery. Cardiopulmonary arrest was associated with comorbidity and assisted ventilation after surgery. The frequency of bronchopneumonia supersedes all of the postoperative pulmonary complications in head and neck oncological surgery. Patients at risk of developing postoperative complications are heavy smokers, diabetics, those undergoing prolonged surgery, tracheostomy, and extended assisted ventilation. (author)

  11. Laparoscopic rectal cancer surgery: Where do we stand?

    Institute of Scientific and Technical Information of China (English)

    Mukta K Krane; Alessandro Fichera

    2012-01-01

    Large comparative studies and multiple prospective randomized control trials (RCTs) have reported equivalence in short and long-term outcomes between the open and laparoscopic approaches for the surgical treatment of colon cancer which has heralded widespread acceptance for laparoscopic resection of colon cancer.In contrast,laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer has been welcomed with significantly less enthusiasm.While it is likely that patients with rectal cancer will experience the same benefits of early recovery and decreased postoperative pain from the laparoscopic approach,whether the same oncologic clearance,specifically an adequate TME can be obtained is of concern.The aim of the current study is to review the current level of evidence in the literature on laparoscopic rectal cancer surgery with regard to short-term and long-term oncologic outcomes.The data from 8 RCTs,3 metaanalyses,and 2 Cochrane Database of Systematic Reviews was reviewed.Current data suggests that laparoscopic rectal cancer resection may benefit patients with reduced blood loss,earlier retum of bowel function,and shorter hospital length of stay.Concerns that laparoscopic rectal cancer surgery compromises shortterm oncologic outcomes including number of lymph nodes retrieved and circumferential resection margin and jeopardizes long-term oncologic outcomes has not conclusively been refuted by the available literature.Laparoscopic rectal cancer resection is feasible but whether or not it compromises short-term or long-term results still needs to be further studied.

  12. Standardizing Naming Conventions in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Santanam, Lakshmi [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Hurkmans, Coen [Department of Radiation Oncology, Catharina Hospital, Eindhoven (Netherlands); Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Vliet-Vroegindeweij, Corine van [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Brame, Scott; Straube, William [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Galvin, James [Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA (United States); Tripuraneni, Prabhakar [Department of Radiation Oncology, Scripps Clinic, LaJolla, CA (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Bosch, Walter, E-mail: wbosch@radonc.wustl.edu [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO (United States); Advanced Technology Consortium, Image-guided Therapy QA Center, St. Louis, MO (United States)

    2012-07-15

    Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were

  13. Standardizing Naming Conventions in Radiation Oncology

    International Nuclear Information System (INIS)

    Santanam, Lakshmi; Hurkmans, Coen; Mutic, Sasa; Vliet-Vroegindeweij, Corine van; Brame, Scott; Straube, William; Galvin, James; Tripuraneni, Prabhakar; Michalski, Jeff; Bosch, Walter

    2012-01-01

    Purpose: The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. Materials and Methods: The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. Results: In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were

  14. Standardizing naming conventions in radiation oncology.

    Science.gov (United States)

    Santanam, Lakshmi; Hurkmans, Coen; Mutic, Sasa; van Vliet-Vroegindeweij, Corine; Brame, Scott; Straube, William; Galvin, James; Tripuraneni, Prabhakar; Michalski, Jeff; Bosch, Walter

    2012-07-15

    The aim of this study was to report on the development of a standardized target and organ-at-risk naming convention for use in radiation therapy and to present the nomenclature for structure naming for interinstitutional data sharing, clinical trial repositories, integrated multi-institutional collaborative databases, and quality control centers. This taxonomy should also enable improved plan benchmarking between clinical institutions and vendors and facilitation of automated treatment plan quality control. The Advanced Technology Consortium, Washington University in St. Louis, Radiation Therapy Oncology Group, Dutch Radiation Oncology Society, and the Clinical Trials RT QA Harmonization Group collaborated in creating this new naming convention. The International Commission on Radiation Units and Measurements guidelines have been used to create standardized nomenclature for target volumes (clinical target volume, internal target volume, planning target volume, etc.), organs at risk, and planning organ-at-risk volumes in radiation therapy. The nomenclature also includes rules for specifying laterality and margins for various structures. The naming rules distinguish tumor and nodal planning target volumes, with correspondence to their respective tumor/nodal clinical target volumes. It also provides rules for basic structure naming, as well as an option for more detailed names. Names of nonstandard structures used mainly for plan optimization or evaluation (rings, islands of dose avoidance, islands where additional dose is needed [dose painting]) are identified separately. In addition to its use in 16 ongoing Radiation Therapy Oncology Group advanced technology clinical trial protocols and several new European Organization for Research and Treatment of Cancer protocols, a pilot version of this naming convention has been evaluated using patient data sets with varying treatment sites. All structures in these data sets were satisfactorily identified using this

  15. [Rethinking clinical research in surgical oncology. From comic opera to quality control].

    Science.gov (United States)

    Evrard, Serge

    2016-01-01

    The evidence base for the effectiveness of surgical interventions is relatively poor and data from large, randomized prospective studies are rare with often a poor quality. Many efforts have been made to increase the number of high quality randomized trials in surgery and theoretical proposals have been put forward to improve the situation, but practical implementation of these proposals is seriously lacking. The consequences of this policy are not trivial; with very few patients included in surgical oncology trials, this represents wasted opportunity for advances in cancer treatment. In this review, we cover the difficulties inherent to clinical research in surgical oncology, such as quality control, equipoise, accrual, and funding and promote alternative designs to the randomized controlled trial. Although the classic randomized controlled trial has a valid but limited place in surgical oncology, other prospective designs need to be promoted as a new deal. This new deal not only implicates surgeons but also journal editors, tender jury, as well as regulatory bodies to cover legal gaps currently surrounding surgical innovation. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  16. 7th annual congress of the Swiss Society of Nuclear Medicine (SGNM/SSMN). Main topic: imaging in oncology. Abstracts

    International Nuclear Information System (INIS)

    2006-01-01

    Program chart and compiled abstracts of the 7th annual congress of the Swiss Society of Nuclear Medicine (SGNM/SSMN). Session headers are: imaging in oncology: PET-CT; oncology: therapy; imaging in oncology: treatment response; oncology: peptides; oncology: basic scinence; imaging in oncology: bone and soft tissue tumors; instrumentation; oncology: imaging. (uke)

  17. Treatment of endometrial cancer in Tartu Oncology hospital in 1981-1991

    International Nuclear Information System (INIS)

    Ojamaa, A.

    1998-01-01

    Aim of study: to analyse the treatment results of patients with endometrial cancer (EC) in Tartu Oncology Hospital in 1981-1991. EC affects mostly postmenopausal women. Materials and methods: treatment results of 302 patients with EC (age range 31-87 years, mean age 62 years) were studied. Treatment modalities in individual cases were chosen considering the stage of the disease and prognostic factors - e.g. myometrial invasion, histologic grade, histotype ect. Particular treatments were as follows: 1) surgery; 2) radiotherapy; 3) systemic (hormono- and chemo-) therapy; 4) combined therapy. Results: surgery was performed in 293 cases. We used FIGO NEWS 1989 classification. 252 (83,4%) patients were in stage I. 5 years survival was as follows: 1) surgical treatment (24 patients) - 73%; 2) surgery + hormonotherapy (70 patients) - 86%; 3) surgery + post surgical adjuvant radiotherapy (42 patients) - 79%; 4) surgery + radiotherapy + hormonotherapy - 78%. 12 (4%) patients were in stage II. Combined therapy was performed. 5 years survival in this group was 42%. 35 (11,6%) patients were in stage III or IV. Combined treatment with surgery was performed in 91% of cases, radiotherapy in 77% of cases, hormonotherapy in 83% of cases and chemotherapy in 23% of cases. 5 years survival in stage III was 42% and in stage IV 22%. Conclusion: Surgical treatment combined with hormonotherapy in early stages (0 and 1) of EC revealed significantly better 5-years for patients, with lower risk for recurrence, compared with patients treated with surgery alone. Surgical treatment and / or combination therapy with surgery for patients having advanced stage of EC showed better outcome than radiotherapy or systemic therapy alone. (Full text)

  18. 21st Century Cardio-Oncology

    Directory of Open Access Journals (Sweden)

    Calvin Chen Sheng, MD

    2016-08-01

    Full Text Available Cardiotoxicity is a well-established complication of oncology therapies. Cardiomyopathy resulting from anthracyclines is a classic example. In the past decade, an explosion of novel cancer therapies, often targeted and more specific than conventional therapies, has revolutionized oncology therapy and dramatically changed cancer prognosis. However, some of these therapies have introduced an assortment of cardiovascular (CV complications. At times, these devastating outcomes have only become apparent after drug approval and have limited the use of potent therapies. There is a growing need for better testing platforms, both for CV toxicity screening and for elucidating mechanisms of cardiotoxicities of approved cancer therapies. This review discusses the utility of available nonclinical models (in vitro, in vivo, and in silico and highlights recent advancements in modalities like human stem cell-derived cardiomyocytes for developing more comprehensive cardiotoxicity testing and new means of cardioprotection with targeted anticancer therapies.

  19. Radiolabeled antibodies in cancer. Oncology Overview

    International Nuclear Information System (INIS)

    1984-11-01

    Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories through the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Radiolabeled antibodies--labeling and imaging techniques; Radiolabeled antibodies--carcinoembryonic antigen; Radiolabeled antibodies--alpha-fetoprotein; Radiolabeled antibodies--human chorionic gonadotropin; Radiolabeled antibodies--ferritin; Radiolabeled antibodies--imaging of colorectal tumors; Radiolabeled antibodies--imaging of malignant melanoma; Radiolabeled antibodies--imaging of urogenital tumors; Radiolabeled antibodies--imaging of thyroid tumors; Radiolabeled antibodies--other clinical studies; Radiolabeled antibodies--selected preclinical studies; Radiolabeled antibodies--reviews

  20. Radiation oncology a physicist's-eye view

    CERN Document Server

    Goitein, Michael

    2007-01-01

    Radiation Oncology: A Physicist's-Eye View was written for both physicists and medical oncologists with the aim of helping them approach the use of radiation in the treatment of cancer with understanding, confidence, and imagination. The book will let practitioners in one field understand the problems of, and find solutions for, practitioners in the other. It will help them to know "why" certain approaches are fruitful while, at the same time, encouraging them to ask the question "Why not?" in the face of assertions that some proposal of theirs is impractical, unreasonable, or impossible. Unlike a textbook, formal and complete developments of the topics are not among the goals. Instead, the reader will develop a foundation for understanding what the author has found to be matters of importance in radiation oncology during over thirty years of experience. Presentations cover, in largely non-technical language, the principal physical and biological aspects of radiation treatment and address practical clinical c...

  1. Improving patient safety in radiation oncology

    International Nuclear Information System (INIS)

    Hendee, William R.; Herman, Michael G.

    2011-01-01

    Beginning in the 1990s, and emphasized in 2000 with the release of an Institute of Medicine report, healthcare providers and institutions have dedicated time and resources to reducing errors that impact the safety and well-being of patients. But in January 2010 the first of a series of articles appeared in the New York Times that described errors in radiation oncology that grievously impacted patients. In response, the American Association of Physicists in Medicine and the American Society of Radiation Oncology sponsored a working meeting entitled ''Safety in Radiation Therapy: A Call to Action''. The meeting attracted 400 attendees, including medical physicists, radiation oncologists, medical dosimetrists, radiation therapists, hospital administrators, regulators, and representatives of equipment manufacturers. The meeting was cohosted by 14 organizations in the United States and Canada. The meeting yielded 20 recommendations that provide a pathway to reducing errors and improving patient safety in radiation therapy facilities everywhere.

  2. PET/CT applications in oncology

    International Nuclear Information System (INIS)

    Oliva González, Juan Perfecto; Martínez Ramírez, Aldo; Baum, Richard Paul

    2017-01-01

    PET means Positron Emission Tomography, it is a nuclear medicine technique in which radiopharmaceuticals labeled with positron emitters are used to obtain biochemical-metabolic images of the human body. The use of PET / CT contributes to obtain multimodal images that combine anatomical and metabolic information, allowing a more reliable diagnosis of a tumor or local or distant metastases in an organ or tissue. Other multimodal devices combine metabolic imaging with nuclear magnetic resonance. PET/CT is mainly used in Oncology (85-90%), Neurology, Cardiology, Inflammation and Infection although it is currently also used in different medical and surgical pathologies. The present work is aimed at showing what PET/CT is and how useful it is in Oncology. (author)

  3. Psycho-Oncology: A Patient's View.

    Science.gov (United States)

    Garcia-Prieto, Patricia

    2018-01-01

    Culturally the most important, valued, and less stigmatized part of cancer care is the medical part: The surgeon cutting the tumors out and the oncologist leading the strategic decision-making of the medical treatments available. The least valued and stigmatized part of cancer remains the psychosocial care. This chapter describes-through the eyes of an academic, psychologist, stage IV melanoma patient, and patient advocate-how one patient navigated changing psycho-oncological needs from early stage-to-stage IV through a whole range of psychological interventions available. Her voice joins that of all cancer patients around the world whom are urgently calling for psycho-oncological care to be fully recognized as a central part of cancer treatment.

  4. MOSFET dosimetry on modern radiation oncology modalities

    International Nuclear Information System (INIS)

    Rosenfeld, A.B.

    2002-01-01

    The development of MOSFET dosimetry is presented with an emphasis on the development of a scanning MOSFET dosimetry system for modern radiation oncology modalities. Fundamental aspects of MOSFETs in relation to their use as dosemeters are briefly discussed. The performance of MOSFET dosemeters in conformal radiotherapy, hadron therapy, intensity-modulated radiotherapy and microbeam radiation therapy is compared with other dosimetric techniques. In particular the application of MOSFET dosemeters in the characterisation and quality assurance of the steep dose gradients associated with the penumbra of some modern radiation oncology modalities is investigated. A new in vivo, on-line, scanning MOSFET read out system is also presented. The system has the ability to read out multiple MOSFET dosemeters with excellent spatial resolution and temperature stability and minimal slow border trapping effects. (author)

  5. Value: A Framework for Radiation Oncology

    Science.gov (United States)

    Teckie, Sewit; McCloskey, Susan A.; Steinberg, Michael L.

    2014-01-01

    In the current health care system, high costs without proportional improvements in quality or outcome have prompted widespread calls for change in how we deliver and pay for care. Value-based health care delivery models have been proposed. Multiple impediments exist to achieving value, including misaligned patient and provider incentives, information asymmetries, convoluted and opaque cost structures, and cultural attitudes toward cancer treatment. Radiation oncology as a specialty has recently become a focus of the value discussion. Escalating costs secondary to rapidly evolving technologies, safety breaches, and variable, nonstandardized structures and processes of delivering care have garnered attention. In response, we present a framework for the value discussion in radiation oncology and identify approaches for attaining value, including economic and structural models, process improvements, outcome measurement, and cost assessment. PMID:25113759

  6. Psycho-oncology in Australia: a descriptive review.

    Science.gov (United States)

    Butow, P; Dhillon, H; Shaw, J; Price, M

    2017-01-01

    Australia has a thriving Psycho-Oncology research and clinical community. In this article, the Australian health system in which Psycho-Oncology is embedded is described. Clinical Psycho-Oncology services are outlined, in terms of their composition, processes and reach. The development of the internationally ground-breaking Australian Psychosocial guidelines for the care of adults with cancer is described. Two large Psycho-Oncology organisations which are strongly linked to mainstream Oncology organisations are discussed: the Australian Psycho-Oncology Society (OzPos, a primarily clinician-led and focused organisation) and the Psycho-Oncology Co-operative Research Group (PoCoG, a national cancer clinical trial group). OzPos is a special interest group within the Clinical Oncology Society of Australia, while PoCoG is one of 14 cancer clinical trial groups funded by the national government. It is these strong connections with major multidisciplinary cancer organisations, and a culture of collaboration and co-operation, that have made Psycho-Oncology grow and thrive in Australia. Examples of large collaborative programs of Psycho-Oncology research are provided, as well as the mechanisms used to achieve these outcomes.

  7. Do Women With Breast Cancer Who Choose Adjunctive Integrative Oncology Care Receive Different Standard Oncologic Treatment?

    Science.gov (United States)

    Standish, Leanna J; Dowd, Fred; Sweet, Erin; Dale, Linda; Andersen, M Robyn

    2018-04-01

    To determine if women with breast cancer who choose adjunctive naturopathic oncology (NO) specialty care receive different standard oncologic treatment when compared with breast cancer patients who receive only standard care. Women with breast cancer stages 0 to 4, aged 18+ who spoke English and sought care from outpatient naturopathic doctor clinics were enrolled in an observational study of clinical and quality of life outcomes. Women who sought NO care 2 or more times within the first 2 years postdiagnosis were identified as NO cases. A matched comparison group of breast cancer patients were identified using the Western Washington Cancer Surveillance System(CSS). A longitudinal cohort design. In addition to self-report data, the CSS provided data on demographics, stage at the time of diagnosis, and initial treatment. Oncology medical records were abstracted in order to provide additional information on standard oncologic treatment for all participants. Cohorts were well matched with regard to demographic, histologic, and prognostic indicators at the time of diagnosis. Approximately 70% of women in both cohorts received standard oncologic care that met the National Comprehensive Cancer Network guidelines. There were no statistically significant differences between the cohorts in treatment received. Fewer women in the NO cohort with estrogen receptor-positive breast cancer appear to have received antiestrogen therapy. Women in both cohorts appear to receive guideline-concordant care. However, women who receive adjunctive NO care may be less likely to receive antiestrogen therapy.

  8. Radiotherapy and immune reaction of oncologic patients

    International Nuclear Information System (INIS)

    Pankina, V.Kh.; Sarkisyan, Yu.KH.

    1978-01-01

    Represented is a review of data accumulated in literature (1970-1976) on oppression of protection of oncologic patients and more oppression of immune reactions during radiotherapy. Underlined is the significance of studying immune homeostasis in a clinic of radiotherapy to evaluate total resistance of patients before the beginning and in the process of treatment. The prognostic significance of immunodepressive disturbances in patients with malignant tumors is elucidated

  9. The Danish Neuro-Oncology Registry

    Directory of Open Access Journals (Sweden)

    Hansen S

    2016-10-01

    Full Text Available Steinbjørn Hansen Department of Oncology, Odense University Hospital and Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark Aim of database: The Danish Neuro-Oncology Registry (DNOR was established by the Danish Neuro-Oncology Group as a national clinical database. It was established for the purpose of supporting research and development in adult patients with primary brain tumors in Denmark. Study population: DNOR has registered clinical data on diagnostics and treatment of all adult patients diagnosed with glioma since January 1, 2009, which numbers approximately 400 patients each year. Main variables: The database contains information about symptoms, presurgical magnetic resonance imaging (MRI characteristics, performance status, surgical procedures, residual tumor on postsurgical MRI, postsurgical complications, diagnostic and histology codes, radiotherapy, and chemotherapy. Descriptive data: DNOR publishes annual reports on descriptive data. During the period of registration, postoperative MRI is performed in a higher proportion of the patients (Indicator II, and a higher proportion of patients have no residual tumor after surgical resection of the primary tumor (Indicator IV. Further data are available in the annual reports. The indicators reflect only minor elements of handling brain tumor patients. Another advantage of reporting indicators is the related multidisciplinary discussions giving a better understanding of what actually is going on, thereby facilitating the work on adjusting the national guidelines in the Danish Neuro-Oncology Group. Conclusion: The establishment of DNOR has optimized the quality in handling primary brain tumor patients in Denmark by reporting indicators and facilitating a better multidisciplinary collaboration at a national level. DNOR provides a valuable resource for research. Keywords: brain neoplasms, brain cancer, glioma, clinical quality indicators

  10. Importance of nutrition in pediatric oncology

    OpenAIRE

    P C Rogers

    2015-01-01

    A nutritional perspective within pediatric oncology is usually just related to the supportive care aspect during the management of the underlying malignancy. However, nutrition has a far more fundamental importance with respect to a growing, developing child who has cancer as well as viewing cancer from a nutritional cancer control perspective. Nutrition is relevant to all components of cancer control including prevention, epidemiology, biology, treatment, supportive care, rehabilitation, and...

  11. Program for Critical Technologies in Breast Oncology

    Science.gov (United States)

    1999-07-01

    the tissues, and in a ethical manner that respects the patients’ rights . The Program for Critical Technologies in Breast Oncology helps address all of...diagnosis, database 15. NUMBER OF PAGES 148 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT Unclassified 18. SECURITY CLASSIFICATION OF THIS...closer to clinical utility. Page 17 References Adida C. Crotty PL. McGrath J. Berrebi D. Diebold J. Altieri DC. Developmentally regulated

  12. Dose-response relationship in clinical oncology

    International Nuclear Information System (INIS)

    Gehan, E.A.

    1984-01-01

    The relationship of dose (and dose rate) to response and toxicity in clinical oncology is reviewed. The concepts expressed by some authors in dose-response studies in animal and human systems are reviewed briefly. Dose rate and tactics of conducting clinical studies are reviewed for both radiotherapy and various types of chemotherapeutic treatment. Examples are given from clinical studies in Hodgkin's disease, acute leukemia, and breast cancer that may prove useful in planning future clinical studies

  13. Molecular Targets for Radiation Oncology in Prostate Cancer

    International Nuclear Information System (INIS)

    Wang, Tao; Languino, Lucia R.; Lian, Jane; Stein, Gary; Blute, Michael; FitzGerald, Thomas J.

    2011-01-01

    Recent selected developments of the molecular science of prostate cancer (PrCa) biology and radiation oncology are reviewed. We present potential targets for molecular integration treatment strategies with radiation therapy (RT), and highlight potential strategies for molecular treatment in combination with RT for patient care. We provide a synopsis of the information to date regarding molecular biology of PrCa, and potential integrated research strategy for improved treatment of PrCa. Many patients with early-stage disease at presentation can be treated effectively with androgen ablation treatment, surgery, or RT. However, a significant portion of men are diagnosed with advanced stage/high-risk disease and these patients progress despite curative therapeutic intervention. Unfortunately, management options for these patients are limited and are not always successful including treatment for hormone refractory disease. In this review, we focus on molecules of extracellular matrix component, apoptosis, androgen receptor, RUNX, and DNA methylation. Expanding our knowledge of the molecular biology of PrCa will permit the development of novel treatment strategies integrated with RT to improve patient outcome

  14. Laparoscopic colorectal surgery: Current status and implementation of the latest technological innovations.

    Science.gov (United States)

    Pascual, Marta; Salvans, Silvia; Pera, Miguel

    2016-01-14

    The introduction of laparoscopy is an example of surgical innovation with a rapid implementation in many areas of surgery. A large number of controlled studies and meta-analyses have shown that laparoscopic colorectal surgery is associated with the same benefits than other minimally invasive procedures, including lesser pain, earlier recovery of bowel transit and shorter hospital stay. On the other hand, despite initial concerns about oncological safety, well-designed prospective randomized multicentre trials have demonstrated that oncological outcomes of laparoscopy and open surgery are similar. Although the use of laparoscopy in colorectal surgery has increased in recent years, the percentages of patients treated with surgery using minimally invasive techniques are still reduced and there are also substantial differences among centres. It has been argued that the limiting factor for the use of laparoscopic procedures is the number of surgeons with adequate skills to perform a laparoscopic colectomy rather than the tumour of patients' characteristics. In this regard, future efforts to increase the use of laparoscopic techniques in colorectal surgery will necessarily require more efforts in teaching surgeons. We here present a review of recent controversies of the use of laparoscopy in colorectal surgery, such as in rectal cancer operations, the possibility of reproducing complete mesocolon excision, and the benefits of intra-corporeal anastomosis after right hemicolectomy. We also describe the results of latest innovations such as single incision laparoscopic surgery, robotic surgery and natural orifice transluminal endoscopic surgery for colon and rectal diseases.

  15. Robot-assisted Partial Nephrectomy: 5-yr Oncological Outcomes at a Single European Tertiary Cancer Center.

    Science.gov (United States)

    Vartolomei, Mihai Dorin; Matei, Deliu Victor; Renne, Giuseppe; Tringali, Valeria Maria; Crisan, Nicolae; Musi, Gennaro; Mistretta, Francesco Alessandro; Russo, Andrea; Cozzi, Gabriele; Cordima, Giovani; Luzzago, Stefano; Cioffi, Antonio; Di Trapani, Ettore; Catellani, Michele; Delor, Maurizio; Bottero, Danilo; Imbimbo, Ciro; Mirone, Vincenzo; Ferro, Matteo; de Cobelli, Ottavio

    2017-10-27

    tumors. Robot-assisted partial nephrectomy seems to be the most promising minimally invasive approach in the treatment of renal masses suitable for organ-sparing surgery as midterm (5 yr) oncological outcomes are excellent. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  16. View and review on viral oncology research

    Directory of Open Access Journals (Sweden)

    Parolin Cristina

    2010-05-01

    Full Text Available Abstract To date, almost one and a half million cases of cancer are diagnosed every year in the US and nearly 560,000 Americans are expected to die of cancer in the current year, more than 1,500 people a day (data from the American Cancer Society at http://www.cancer.org/. According to the World Health Organization (WHO, roughly 20% of all cancers worldwide results from chronic infections; in particular, up to 15% of human cancers is characterized by a viral aetiology with higher incidence in Developing Countries. The link between viruses and cancer was one of the pivotal discoveries in cancer research during the past Century. Indeed, the infectious nature of specific tumors has important implications in terms of their prevention, diagnosis, and therapy. In the 21st Century, the research on viral oncology field continues to be vigorous, with new significant and original studies on viral oncogenesis and translational research from basic virology to treatment of cancer. This review will cover different viral oncology aspects, starting from the history of viral oncology and moving to the peculiar features of oncogenic RNA and DNA viruses, with a special focus on human pathogens.

  17. [The role of emotional labour in oncology].

    Science.gov (United States)

    Szluha, Kornélia; Lazányi, Kornélia; Molnár, Péter

    2007-01-01

    Oncologists and related health care professionals (HCPs) do not only have to follow professional protocols in their everyday work, but also have to communicate proper attitudes towards patients suffering from malignant diseases. This task is often a heavier load than the implementation of professional activities themselves. The present article is based on a survey on HCP work motivation, employment parameters and correlations with emotional labour. Fifty oncology HCPs at Debrecen University Medical Health Sciences Centre volunteered to participate in this survey containing 20 simple-choice questions. More than 90 percent of HCPs make an effort to hide their emotional state, giving way to possible negative side effects. The survey showed significant differences between the level of emotional labour of those working in the field of oncology longer or shorter than ten years. Surface and deep emotional labour is more frequent among professionals already working in oncology for a longer period of time. This can serve us with explanation to the burn-out syndrome so frequent in this profession. To diminish the load of emotional labour, healthcare institutes have to aim at hiring employees that spontaneously fit the emotional and behavioural norms facing them, and do not need officially prescribed behavioural norms for everyday work. Their constant need for respect and appreciation of their values must be kept in mind, because the capability of genuine emotional labour diminishes parallel to the number of years spent in work.

  18. Workplace Bullying in Radiology and Radiation Oncology.

    Science.gov (United States)

    Parikh, Jay R; Harolds, Jay A; Bluth, Edward I

    2017-08-01

    Workplace bullying is common in health care and has recently been reported in both radiology and radiation oncology. The purpose of this article is to increase awareness of bullying and its potential consequences in radiology and radiation oncology. Bullying behavior may involve abuse, humiliation, intimidation, or insults; is usually repetitive; and causes distress in victims. Workplace bullying is more common in health care than in other industries. Surveys of radiation therapists in the United States, student radiographers in England, and physicians-in-training showed that substantial proportions of respondents had been subjected to workplace bullying. No studies were found that addressed workplace bullying specifically in diagnostic radiology or radiation oncology residents. Potential consequences of workplace bullying in health care include anxiety, depression, and health problems in victims; harm to patients as a result of victims' reduced ability to concentrate; and reduced morale and high turnover in the workplace. The Joint Commission has established leadership standards addressing inappropriate behavior, including bullying, in the workplace. The ACR Commission on Human Resources recommends that organizations take steps to prevent bullying. Those steps include education, including education to ensure that the line between the Socratic method and bullying is not crossed, and the establishment of policies to facilitate reporting of bullying and support victims of bullying. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study--Milan-Paris-Lyon experience of 646 lipofilling procedures.

    Science.gov (United States)

    Petit, Jean Yves; Lohsiriwat, Visnu; Clough, Krishna B; Sarfati, Isabelle; Ihrai, Tarik; Rietjens, Mario; Veronesi, Paolo; Rossetto, Fabio; Scevola, Anna; Delay, Emmanuel

    2011-08-01

    Lipofilling is now performed to improve the breast contour, after both breast-conserving surgery and breast reconstruction. However, injection of fat into a previous tumor site may create a new environment for cancer and adjacent cells. There is also no international agreement regarding lipofilling after breast cancer treatment. The authors included three institutions specializing in both breast cancer treatment and breast reconstruction (European Institute of Oncology, Milan, Italy; Paris Breast Center, Paris, France; and Leon Berard Centre, Lyon, France) for a multicenter study. A collective chart review of all lipofilling procedures after breast cancer treatment was performed. From 2000 to 2010, the authors reviewed 646 lipofilling procedures from 513 patients. There were 370 mastectomy patients and 143 breast-conserving surgery patients. There were 405 patients (78.9 percent) with invasive carcinoma and 108 (21.1 percent) with carcinoma in situ. The average interval between oncologic surgical interventions and lipofilling was 39.7 months. Average follow-up after lipofilling was 19.2 months. The authors observed a complication rate of 2.8 percent (liponecrosis, 2.0 percent). Twelve radiologic images appeared after lipofilling in 119 breast-conserving surgery cases (10.1 percent). The overall oncologic event rate was 5.6 percent (3.6 percent per year). The locoregional event rate was 2.4 percent (1.5 percent per year). Lipofilling after breast cancer treatment leads to a low complication rate and does not affect radiologic follow-up after breast-conserving surgery. A prospective clinical registry including high-volume multicenter data with a long follow-up is warranted to demonstrate the oncologic safety. Until then, lipofilling should be performed in experienced hands, and a cautious oncologic follow-up protocol is advised. Therapeutic, IV [corrected].

  20. Video-Teleconferencing in Pediatric Neuro-Oncology: Ten Years of Experience

    Directory of Open Access Journals (Sweden)

    Nisreen Amayiri

    2017-04-01

    Full Text Available Purpose: The management of central nervous system tumors is challenging in low- and middle-income countries. Little is known about applicability of twinning initiatives with high-income countries in neuro-oncology. In 2004, a monthly neuro-oncology video-teleconference program was started between King Hussein Cancer Center (Amman, Jordan and the Hospital for Sick Children (Toronto, Ontario, Canada. More than 100 conferences were held and > 400 cases were discussed. The aim of this work was to assess the sustainability of such an initiative and the evolution of the impact over time. Methods: We divided the duration in to three eras according to the initial 2 to 3 years of work of three consecutive oncologists in charge of the neuro-oncology program at King Hussein Cancer Center. We retrospectively reviewed the written minutes and compared the preconference suggested plans with the postconference recommendations. Impact of changes on the patient care was recorded. Results: Thirty-three sets of written minutes (covering 161 cases in the middle era and 32 sets of written minutes (covering 122 cases in the last era were compared with the initial experience (20 meetings, 72 cases. Running costs of these conferences has dropped from $360/h to < $40/h. Important concepts were introduced, such as multidisciplinary teamwork, second-look surgery, and early referral. Suggestions for plan changes have decreased from 44% to 30% and 24% in the respective consecutive eras. Most recommendations involved alternative intervention modalities or pathology review. Most of these recommendations were followed. Conclusion: Video-teleconferencing in neuro-oncology is feasible and sustainable. With time, team experience is built while the percentage and the type of treatment modifications change. Commitment and motivation helped maintain this initiative rather than availability of financial resources. Improvement in patients’ care was achieved, in particular, with the

  1. The surgery of peripheral nerves (including tumors)

    DEFF Research Database (Denmark)

    Fugleholm, Kåre

    2013-01-01

    Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved...... surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral...... nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter...

  2. Minimal invasive gastric surgery: A systematic review

    Directory of Open Access Journals (Sweden)

    Kirti Bushan

    2015-01-01

    Full Text Available Background: As an alternate to open surgery, laparoscopic gastrectomy (LG is currently being performed in many centers, and has gained a wide clinical acceptance. The aim of this review article is to compare oncologic adequacy and safety of LG with open surgery for gastric adenocarcinomas with respect to lymphadenectomy, short-term outcomes (postoperative morbidity and mortality and long-term outcome (5 years overall survival and disease-free survival. Materials and Methods: PubMed was searched using query “LG” for literature published in English from January 2000 to April 2014. A total of 875 entries were retrieved. These articles were screened and 59 manuscripts ultimately formed the basis of current review. Results: There is high-quality evidence to support short-term efficacy, safety and feasibility of LG for gastric adenocarcinomas, although accounts on long-term survivals are still infrequent.

  3. Ureterocystoneostomy in complex oncological cases with an "Uebelhoer" modified Boari bladder flap.

    Science.gov (United States)

    Radtke, Jan P; Korzeniewski, Nina; Huber, Johannes; Alt, Celine D; Pahernik, Sascha; Hadaschik, Boris A; Hohenfellner, Markus; Teber, Dogu

    2017-12-01

    The study aims to describe the technique and analyze the outcome of an arcuated bladder incision with building of a triangular flap, first described by Uebelhoer (UBBF), as a modification of the classical rectangular Boari bladder flap (BBF), that is often viable, but can present difficulties, such as reduced flap vascularization and mobility in pretreated patients. Twelve consecutive patients with distal or mid ureteral leakage or stenosis, that underwent UBBF, were retrospectively analyzed. We assessed postoperative morbidity using Clavien-Dindo classification. Short- and long-term functional outcomes were assessed using glomerular filtration rate (GFR), ultrasound, and renal scintigraphy. Patients underwent UBBF during initial oncological surgery in five cases and due to ureteral defects following oncological surgery or radiotherapy in seven cases. Median patient age was 57 (interquartile range (IQR) 46-72), defect length was 7.5 cm (IQR 5-8 cm), and median follow-up period was 41 (IQR 36-48) months. In short-term follow-up, 11/13 postoperative morbidities were Clavien-Dindo level I-II complications, mostly infections. Two level IIIa complications occurred. One anastomotic leakage was treated sufficiently with temporarily ureteral stenting and one voiding disorder needed intervention. In the long-term follow-up, 84% of patients had improved or constant GFR. In the one-year renal scintigraphy, no urodynamically relevant voiding disorder occurred. The UBBF is a reliable procedure to reconstruct ureteral trauma even in complex oncological, pretreated patients suffering from distal or mid ureteral defects. It can be performed easily by a modified arcuate incision and provides good long-term functional outcomes.

  4. Does Cancer Literature Reflect Multidisciplinary Practice? A Systematic Review of Oncology Studies in the Medical Literature Over a 20-Year Period

    Energy Technology Data Exchange (ETDEWEB)

    Holliday, Emma B. [Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ahmed, Awad A. [Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Yoo, Stella K. [Department of Radiation Oncology, University of Southern California, Los Angeles, California (United States); Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Hoffman, Karen E., E-mail: KHoffman1@mdanderson.org [Division of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-07-15

    Purpose: Quality cancer care is best delivered through a multidisciplinary approach requiring awareness of current evidence for all oncologic specialties. The highest impact journals often disseminate such information, so the distribution and characteristics of oncology studies by primary intervention (local therapies, systemic therapies, and targeted agents) were evaluated in 10 high-impact journals over a 20-year period. Methods and Materials: Articles published in 1994, 2004, and 2014 in New England Journal of Medicine, Lancet, Journal of the American Medical Association, Lancet Oncology, Journal of Clinical Oncology, Annals of Oncology, Radiotherapy and Oncology, International Journal of Radiation Oncology, Biology, Physics, Annals of Surgical Oncology, and European Journal of Surgical Oncology were identified. Included studies were prospectively conducted and evaluated a therapeutic intervention. Results: A total of 960 studies were included: 240 (25%) investigated local therapies, 551 (57.4%) investigated systemic therapies, and 169 (17.6%) investigated targeted therapies. More local therapy trials (n=185 [77.1%]) evaluated definitive, primary treatment than systemic (n=178 [32.3%]) or targeted therapy trials (n=38 [22.5%]; P<.001). Local therapy trials (n=16 [6.7%]) also had significantly lower rates of industry funding than systemic (n=207 [37.6%]) and targeted therapy trials (n=129 [76.3%]; P<.001). Targeted therapy trials represented 5 (2%), 38 (10.2%), and 126 (38%) of those published in 1994, 2004, and 2014, respectively (P<.001), and industry-funded 48 (18.9%), 122 (32.6%), and 182 (54.8%) trials, respectively (P<.001). Compared to publication of systemic therapy trial articles, articles investigating local therapy (odds ratio: 0.025 [95% confidence interval: 0.012-0.048]; P<.001) were less likely to be found in high-impact general medical journals. Conclusions: Fewer studies evaluating local therapies, such as surgery and radiation, are published in

  5. Does Cancer Literature Reflect Multidisciplinary Practice? A Systematic Review of Oncology Studies in the Medical Literature Over a 20-Year Period

    International Nuclear Information System (INIS)

    Holliday, Emma B.; Ahmed, Awad A.; Yoo, Stella K.; Jagsi, Reshma; Hoffman, Karen E.

    2015-01-01

    Purpose: Quality cancer care is best delivered through a multidisciplinary approach requiring awareness of current evidence for all oncologic specialties. The highest impact journals often disseminate such information, so the distribution and characteristics of oncology studies by primary intervention (local therapies, systemic therapies, and targeted agents) were evaluated in 10 high-impact journals over a 20-year period. Methods and Materials: Articles published in 1994, 2004, and 2014 in New England Journal of Medicine, Lancet, Journal of the American Medical Association, Lancet Oncology, Journal of Clinical Oncology, Annals of Oncology, Radiotherapy and Oncology, International Journal of Radiation Oncology, Biology, Physics, Annals of Surgical Oncology, and European Journal of Surgical Oncology were identified. Included studies were prospectively conducted and evaluated a therapeutic intervention. Results: A total of 960 studies were included: 240 (25%) investigated local therapies, 551 (57.4%) investigated systemic therapies, and 169 (17.6%) investigated targeted therapies. More local therapy trials (n=185 [77.1%]) evaluated definitive, primary treatment than systemic (n=178 [32.3%]) or targeted therapy trials (n=38 [22.5%]; P<.001). Local therapy trials (n=16 [6.7%]) also had significantly lower rates of industry funding than systemic (n=207 [37.6%]) and targeted therapy trials (n=129 [76.3%]; P<.001). Targeted therapy trials represented 5 (2%), 38 (10.2%), and 126 (38%) of those published in 1994, 2004, and 2014, respectively (P<.001), and industry-funded 48 (18.9%), 122 (32.6%), and 182 (54.8%) trials, respectively (P<.001). Compared to publication of systemic therapy trial articles, articles investigating local therapy (odds ratio: 0.025 [95% confidence interval: 0.012-0.048]; P<.001) were less likely to be found in high-impact general medical journals. Conclusions: Fewer studies evaluating local therapies, such as surgery and radiation, are published in

  6. Tumor Slice Culture: A New Avatar in Personalized Oncology

    Science.gov (United States)

    2017-09-01

    AWARD NUMBER: W81XWH-16-1-0149 TITLE: Tumor Slice Culture: A New Avatar in Personalized Oncology PRINCIPAL INVESTIGATOR: Raymond Yeung...CONTRACT NUMBER Tumor Slice Culture: A New Avatar in Personalized Oncology 5b. GRANT NUMBER W81XWH-16-1-0149 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...10 Annual Report 2017: Tumor Slice Culture: A new avatar for personalized oncology 1. INTRODUCTION: The goal of this research is to advance our

  7. Radiation Oncology in Undergraduate Medical Education: A Literature Review

    International Nuclear Information System (INIS)

    Dennis, Kristopher E.B.; Duncan, Graeme

    2010-01-01

    Purpose: To review the published literature pertaining to radiation oncology in undergraduate medical education. Methods and Materials: Ovid MEDLINE, Ovid MEDLINE Daily Update and EMBASE databases were searched for the 11-year period of January 1, 1998, through the last week of March 2009. A medical librarian used an extensive list of indexed subject headings and text words. Results: The search returned 640 article references, but only seven contained significant information pertaining to teaching radiation oncology to medical undergraduates. One article described a comprehensive oncology curriculum including recommended radiation oncology teaching objectives and sample student evaluations, two described integrating radiation oncology teaching into a radiology rotation, two described multidisciplinary anatomy-based courses intended to reinforce principles of tumor biology and radiotherapy planning, one described an exercise designed to test clinical reasoning skills within radiation oncology cases, and one described a Web-based curriculum involving oncologic physics. Conclusions: To the authors' knowledge, this is the first review of the literature pertaining to teaching radiation oncology to medical undergraduates, and it demonstrates the paucity of published work in this area of medical education. Teaching radiation oncology should begin early in the undergraduate process, should be mandatory for all students, and should impart knowledge relevant to future general practitioners rather than detailed information relevant only to oncologists. Educators should make use of available model curricula and should integrate radiation oncology teaching into existing curricula or construct stand-alone oncology rotations where the principles of radiation oncology can be conveyed. Assessments of student knowledge and curriculum effectiveness are critical.

  8. A local-area-network based radiation oncology microcomputer system

    International Nuclear Information System (INIS)

    Chu, W.K.; Taylor, T.K.; Kumar, P.P.; Imray, T.J.

    1985-01-01

    The application of computerized technology in the medical specialty of radiation oncology has gained wide acceptance in the past decade. Recognizing that most radiation oncology department personnel are familiar with computer operations and terminology, it appears reasonable to attempt to expand the computer's applications to other departmental activities, such as scheduling, record keeping, billing, treatment regimen and status, etc. Instead of sharing the processing capability available on the existent treatment minicomputer, the radiation oncology computer system is based upon a microcomputer local area network (LAN). The system was conceptualized in 1984 and completed in March 1985. This article outlines the LAN-based radiation oncology computer system

  9. Neuro-oncology: a selected review of ASCO 2016 abstracts.

    Science.gov (United States)

    Chamberlain, Marc C

    2016-10-01

    ASCO 2016, 29 May-2 June 2016, Chicago, IL, USA The largest annual clinical oncology conference the American Society of Clinical Oncology is held in the USA and gives researchers and other key opinion leaders the opportunity to present new cancer clinical trials and research data. The CNS tumors section of the American Society of Clinical Oncology 2016 covered various aspects of neuro-oncology including metastatic CNS diseases and primary brain tumors, presented via posters, oral talks and over 100 abstracts. This brief review selectively highlights presentations from this meeting in an organizational manner that reflects clinically relevant aspects of a large and multifaceted meeting.

  10. Subspecialist training in surgical gynecological oncology in the nordic countries

    DEFF Research Database (Denmark)

    Antonsen, Sofie L; Avall-Lundqvist, Elisabeth; Salvesen, Helga B

    2011-01-01

    To survey the centers that can provide subspecialty surgical training and education in gynecological oncology in the Nordic countries we developed an online questionnaire in cooperation with the Nordic Society of Gynecological Oncology. The link to the survey was mailed to 22 Scandinavian...... (74%) centers were interested in being listed for exchange of fellows. Our data show a large Nordic potential and interest in improving the gynecologic oncology standards and can be used to enhance the awareness of gynecological oncology training in Scandinavia and to facilitate the exchange...

  11. Improving the quality of colon cancer surgery through a surgical education program

    DEFF Research Database (Denmark)

    West, Nicholas P; Sutton, Kate M; Ingeholm, Peter

    2010-01-01

    Recent evidence has demonstrated the importance of dissection in the correct tissue plane for the resection of colon cancer. We have previously shown that meticulous mesocolic plane surgery yields better outcomes and that the addition of central vascular ligation produces an oncologically superior...

  12. A comparative study on the short-term clinicopathologic outcomes of laparoscopic surgery versus conventional open surgery for transverse colon cancer.

    Science.gov (United States)

    Kim, H J; Lee, I K; Lee, Y S; Kang, W K; Park, J K; Oh, S T; Kim, J G; Kim, Y H

    2009-08-01

    The long-term oncologic stability of laparoscopic surgery for colon cancer was established, and laparoscopic surgery was accepted as an alternative to conventional open surgery for colon cancer. However, transverse colon cancer was excluded from the majority of the previous prospective studies. As a result, debate on laparoscopic surgery for transverse colon cancer continues. This study aimed to compare the clinicopathologic outcome of laparoscopic surgery with that of conventional open surgery for transverse colon cancer. From August 2004 to December 2007, 106 cases of transverse colon cancer were managed by resection at our institution, and 89 of these cases were included in this study. Age, sex, body mass index (BMI), operation time, blood loss, time to first flatus, time to start of diet, hospital stay, complications, tumor size, distal resection margin, proximal resection margin, and number of nodes harvested were compared between the two groups. No significant differences were found between the laparoscopic and conventional groups in terms of age, sex, BMI, operation time, or hospital stay. The mean blood loss during the operations was significantly less in the laparoscopic group (113.8 +/- 128.9 ml) than in the conventional group (278.8 +/- 268.7 ml; p transverse colon cancer, and the oncologic quality of laparoscopic surgery was found to be acceptable compared with conventional open surgery.

  13. [Donatori di Musica: when oncology meets music].

    Science.gov (United States)

    Graiff, Claudio

    2014-10-01

    Donatori di Musica is a network of musicians - both physicians and volunteers - that was initially founded in 2009 with the aim to set up and coordinate classical music concerts in hospitals. This activity was initially started and led by the Oncology Departments at Carrara and Bolzano Hospitals, where high profile professional musicians make themselves available for concerts in support of Oncological in/out-patients of that specific Hospital. A live classical music performance is a deeply touching experience - particularly for those who live a critical condition like cancer. Main characteristics of Donatori di Musica concerts are: continuity (concerts are part of a regular and non-stopping music season); quality (concerts are held by well-established professional musicians); philanthropic attitude (musicians do not wear a suit and usually chat with patients; they also select an easy-to-listen program; a convivial event is usually organized after the performance with the aim of overcoming distinctions and barriers between physician and patient); no profit: musicians perform for free - travel expenses and/or overnight staying only can be claimed; concerts have free access for patients, their families and hospital staff.Patients and musicians therefore do get in close contact and music is able to merge each other experiences - with patients being treated by the beauty of music and musicians being treated theirselves by patients daily-life feedback. The Donatori di Musica experience is therefore able to help Medicine to retrieve its very first significance - the medical act regain that human and cultural dimension that seems to be abandoned in the last decades in favour of a mere technicism. This is the spirit and the deep significance of Donatori di Musica - «[…] the hope that Music can become a key support to medical treatments in every Oncology department» (by Gian Andrea Lodovici).

  14. [Oncological emergencies in the emergency department].

    Science.gov (United States)

    Cimpoeşu, Diana; Dumea, Mihaela; Durchi, Simona; Apostoae, F; Olaru, G; Ciolan, Mioara; Popa, O; Corlade-Andrei, Mihaela

    2011-01-01

    to assess the profile and the characteristic of oncological patients, establishing management in patients with neoplasia presented in the emergency department (ED), the analysis of short-term movements in patients with neoplasia whilst in the ED. we performed a retrospective study on nonrandomized consecutive cases. The lot analysis included 1315 oncological patients admitted in the Emergency Department of the Clinical Emergency Hospital "St. Spiridon" Iaşi, in the period June 1st, 2009 - May 31st, 2010. 23.12% of the patients had high suspicion of neoplasia at the first visit to the ED. 67.07% of patients were in metastatic stage disease located as follows: liver metastasis 37.59%, lung metastasis 18.36%, lymph node metastasis 13, 29%. After processing the data there were found statistically significant correlations between the age of patients and the documented/suspected diagnosis of neoplasia (p = 0.01) in the sense that a neoplasia diagnosis in emergency was more frequent in people of young age. It should be mentioned that other studies rarely mention first diagnosis of neoplasia in emergency department with presence of complications. 1315 oncological patients presented in ED, almost a quarter of which presented high suspicion of neoplasia (still without histopathological confirmation) when in ED (23.12%). Most of them were aged male patients (over 65 years old), with tumors of the digestive system. A significant proportion (almost 60%) of these patients ended up in emergency due to complications and the therapy intended life support and pain management. Some of these patients were directed to further exploring and emergency outpatient therapy while 75% of patients were hospitalized after stabilization. Although we expected that the frequency of complications to be higher in patients previously diagnosed with cancer, data analysis showed no statistically significant differences (p = NS) between the rate of complications in patients previously diagnosed with

  15. Establishment of Database System for Radiation Oncology

    International Nuclear Information System (INIS)

    Kim, Dae Sup; Lee, Chang Ju; Yoo, Soon Mi; Kim, Jong Min; Lee, Woo Seok; Kang, Tae Young; Back, Geum Mun; Hong, Dong Ki; Kwon, Kyung Tae

    2008-01-01

    To enlarge the efficiency of operation and establish a constituency for development of new radiotherapy treatment through database which is established by arranging and indexing radiotherapy related affairs in well organized manner to have easy access by the user. In this study, Access program provided by Microsoft (MS Office Access) was used to operate the data base. The data of radiation oncology was distinguished by a business logs and maintenance expenditure in addition to stock management of accessories with respect to affairs and machinery management. Data for education and research was distinguished by education material for department duties, user manual and related thesis depending upon its property. Registration of data was designed to have input form according to its subject and the information of data was designed to be inspected by making a report. Number of machine failure in addition to its respective repairing hours from machine maintenance expenditure in a period of January 2008 to April 2009 was analyzed with the result of initial system usage and one year after the usage. Radiation oncology database system was accomplished by distinguishing work related and research related criteria. The data are arranged and collected according to its subjects and classes, and can be accessed by searching the required data through referring the descriptions from each criteria. 32.3% of total average time was reduced on analyzing repairing hours by acquiring number of machine failure in addition to its type in a period of January 2008 to April 2009 through machine maintenance expenditure. On distinguishing and indexing present and past data upon its subjective criteria through the database system for radiation oncology, the use of information can be easily accessed to enlarge the efficiency of operation, and in further, can be a constituency for improvement of work process by acquiring various information required for new radiotherapy treatment in real time.

  16. Psychosocial Impact of Personalized Therapies in Oncology.

    Science.gov (United States)

    Schilling, Georgia; Schulz-Kindermann, Frank

    2018-01-01

    Personalized medicine is a keyword in modern oncology summarizing biomarker-driven targeted therapies. Those novel agents enhance our therapeutic portfolio and offer new options for our patients. But the term is often misleading and implicates a tailored therapy to the individual person, but it rather means a treatment stratified on genetic characteristics of the tumor. Molecular therapies raise expectations of curability or long-term treatments making former life-threatening diseases to more chronic ones but this is true only for some patients. So we have to carefully communicate with our patients about the options and limitations of those modern therapies not to trigger disappointments.

  17. Clinical oncology based upon radiation biology

    International Nuclear Information System (INIS)

    Hirata, Hideki

    2016-01-01

    This paper discussed the biological effects of radiation as physical energy, especially those of X-ray as electromagnetic radiation, by associating the position of clinical oncology with classical radiation cell biology as well as recent molecular biology. First, it described the physical and biological effects of radiation, cell death due to radiation and recovery, radiation effects at tissue level, and location information and dosage information in the radiotherapy of cancer. It also described the territories unresolved through radiation biology, such as low-dose high-sensitivity, bystander effects, etc. (A.O.)

  18. [Genetic therapy in oncology: ethical aspects].

    Science.gov (United States)

    Bucci, L M; Fazio, V M

    2001-01-01

    The more advanced oncologic therapies are directing toward new frontiers, on account of the remarkable undesirable effects of chemio- and radio-therapies. This new therapeutic experiences are of type biological (vaccines), or genic (substitution again genes with shutters meaning-tumoral). This therapies involve, to be effected, some ethical shrewdnesses: choice of the patient, the engineering modality of the genes, the transfer of the genes in cells of the exclusively somatic line, the elimination of the pathogenic risk of the vector virus, the obligatory use of sterile rooms, the attention to the administration of the drug, a legal issue of the judgment of notoriety.

  19. What do we measure in oncology PET?

    Energy Technology Data Exchange (ETDEWEB)

    Pak, Kyoung June; Kim, Seong Jang [Dept. of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of)

    2017-09-15

    Positron emission tomography (PET) has come to the practice of oncology. It is known that {sup 18}F-fluorodeoxyglucose (FDG) PET is more sensitive for the assessment of treatment response than conventional imaging. In addition, PET has an advantage in the use of quantitative analysis of the study. Nowadays, various PET parameters are adopted in clinical settings. In addition, a wide range of factors has been known to be associated with FDG uptake. Therefore, there has been a need for standardization and harmonization of protocols and PET parameters. We will introduce PET parameters and discuss major issues in this review.

  20. Nuclear oncology: From genotype to patient care

    International Nuclear Information System (INIS)

    1997-01-01

    Nuclear medicine is the medical specialty best suited to translate the exploding body of knowledge obtained from research in genetics and molecular biology into the care of patients. This fourth annual nuclear oncology conference will address how this can be done and how positron emission tomography (PET) and single photon emission tomography (SPECT) can be used in the care of patients with cancer or with increased genetic risk of developing cancer. The course will include illustrative patient studies showing how PET and SPECT can help in diagnosis, staging and treatment planning and monitoring of patients with cancer

  1. Oncology drug discovery: planning a turnaround.

    Science.gov (United States)

    Toniatti, Carlo; Jones, Philip; Graham, Hilary; Pagliara, Bruno; Draetta, Giulio

    2014-04-01

    We have made remarkable progress in our understanding of the pathophysiology of cancer. This improved understanding has resulted in increasingly effective targeted therapies that are better tolerated than conventional cytotoxic agents and even curative in some patients. Unfortunately, the success rate of drug approval has been limited, and therapeutic improvements have been marginal, with too few exceptions. In this article, we review the current approach to oncology drug discovery and development, identify areas in need of improvement, and propose strategies to improve patient outcomes. We also suggest future directions that may improve the quality of preclinical and early clinical drug evaluation, which could lead to higher approval rates of anticancer drugs.

  2. Internet utilization by radiation oncology patients

    International Nuclear Information System (INIS)

    Metz, J.M.; Devine, P.; DeNittis, A.; Stambaugh, M.; Jones, H.; Goldwein, J.; Whittington, R.

    2001-01-01

    Purpose: Studies describing the use of the Internet by radiation oncology patients are lacking. This multi-institutional study of cancer patients presenting to academic (AC), community (CO) and veterans (VA) radiation oncology centers was designed to analyze the use of the Internet, predictive factors for utilization, and barriers to access to the Internet. Materials and Methods: A questionnaire evaluating the use of the Internet was administered to 921 consecutive patients presenting to radiation oncology departments at AC, CO and VA Medical Centers. The study included 436 AC patients (47%), 284 CO patients (31%), and 201 VA patients (22%). A computer was available at home to 427 patients (46%) and 337 patients (37%) had Email access. The mean age of the patient population was 64 years (range=14-93). Males represented 70% of the patient population. The most common diagnoses included prostate cancer (33%), breast cancer (13%), and lung cancer (11%). Results: Overall, 265/921 patients (29%) were using the Internet to find cancer related information. The Internet was used by 42% of AC patients, 25% of CO patients and only 5% of VA patients (p<.0001). A computer was available at home in 62% AC vs. 45% CO vs. 12% VA patients (p<.0001). Patients < 60 years were much more likely to use the Internet than older patients (p<.0001). Most of the Internet users considered the information either very reliable (22%) or somewhat reliable (70%). Most patients were looking for information regarding treatment of their cancer (90%), management of side effects of treatment (74%), alternative/complementary treatments (65%) and clinical trials (51%). Unconventional medical therapies were purchased over the Internet by 12% of computer users. Products or services for the treatment or management of cancer were purchased online by 12% of Internet users. Conclusion: A significant number of cancer patients seen in radiation oncology departments at academic and community medical centers

  3. Medical legal aspects of radiation oncology

    International Nuclear Information System (INIS)

    Wall, Terry J.

    1996-01-01

    The theoretical basis of, and practical experience in, legal liability in the clinical practice of radiation oncology is reviewed, with a view to developing suggestions to help practitioners limit their exposure to liability. New information regarding the number, size, and legal theories of litigation against radiation oncologists is presented. The most common legal bases of liability are then explored in greater detail, including 'malpractice', and informed consent, with suggestions of improving the specialty's record of documenting informed consent. Collateral consequences of suffering a malpractice claim (i.e., the National Practitioner Data Bank) will also be briefly discussed

  4. Labeling for Big Data in radiation oncology: The Radiation Oncology Structures ontology.

    Science.gov (United States)

    Bibault, Jean-Emmanuel; Zapletal, Eric; Rance, Bastien; Giraud, Philippe; Burgun, Anita

    2018-01-01

    Leveraging Electronic Health Records (EHR) and Oncology Information Systems (OIS) has great potential to generate hypotheses for cancer treatment, since they directly provide medical data on a large scale. In order to gather a significant amount of patients with a high level of clinical details, multicenter studies are necessary. A challenge in creating high quality Big Data studies involving several treatment centers is the lack of semantic interoperability between data sources. We present the ontology we developed to address this issue. Radiation Oncology anatomical and target volumes were categorized in anatomical and treatment planning classes. International delineation guidelines specific to radiation oncology were used for lymph nodes areas and target volumes. Hierarchical classes were created to generate The Radiation Oncology Structures (ROS) Ontology. The ROS was then applied to the data from our institution. Four hundred and seventeen classes were created with a maximum of 14 children classes (average = 5). The ontology was then converted into a Web Ontology Language (.owl) format and made available online on Bioportal and GitHub under an Apache 2.0 License. We extracted all structures delineated in our department since the opening in 2001. 20,758 structures were exported from our "record-and-verify" system, demonstrating a significant heterogeneity within a single center. All structures were matched to the ROS ontology before integration into our clinical data warehouse (CDW). In this study we describe a new ontology, specific to radiation oncology, that reports all anatomical and treatment planning structures that can be delineated. This ontology will be used to integrate dosimetric data in the Assistance Publique-Hôpitaux de Paris CDW that stores data from 6.5 million patients (as of February 2017).

  5. Effectiveness of a psycho-oncology training program for oncology nurses: a randomized controlled trial.

    Science.gov (United States)

    Kubota, Yosuke; Okuyama, Toru; Uchida, Megumi; Umezawa, Shino; Nakaguchi, Tomohiro; Sugano, Koji; Ito, Yoshinori; Katsuki, Fujika; Nakano, Yumi; Nishiyama, Takeshi; Katayama, Yoshiko; Akechi, Tatsuo

    2016-06-01

    Oncology nurses are expected to play an important role in psychosocial care for cancer patients. The aim of this study was to examine whether a novel training program aimed at enhancing oncology nurses' ability to assess and manage common psychological problems in cancer patients would improve participants' self-reported confidence, knowledge, and attitudes regarding care of patients with common psychological problems (trial register: UMIN000008559). Oncology nurses were assigned randomly to either the intervention group (N = 50) or the waiting list control group (N = 46). The intervention group received a 16-h program, the content of which focused on four psychological issues: normal reactions, clinically significant distress, suicidal thoughts, and delirium. Each session included a role-play exercise, group work, and didactic lecture regarding assessment and management of each problem. Primary outcomes were changes in self-reported confidence, knowledge, and attitudes toward the common psychological problems between pre-intervention and 3 months post-intervention. Secondary outcomes were job-related stress and burnout. Intervention acceptability to participants was also assessed. In the intervention group, confidence and knowledge but not attitudes were significantly improved relative to the control group. No significant intervention effects were found for job- related stress and burnout. A high percentage (98%) of participants considered the program useful in clinical practice. This psycho-oncology training program improved oncology nurses' confidence and knowledge regarding care for patients with psychological problems. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  7. Lung surgery - discharge

    Science.gov (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  8. Gastric Sleeve Surgery

    Science.gov (United States)

    ... Videos for Educators Search English Español Gastric Sleeve Surgery KidsHealth / For Teens / Gastric Sleeve Surgery What's in ... or buying healthy food ) Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

  9. Hip Replacement Surgery

    Science.gov (United States)

    ... Outreach Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB ... PDF What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or ...

  10. Dental Implant Surgery

    Science.gov (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ... to find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ... to find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring ...

  12. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  13. Extended partial cystectomy with augmentation cystoplasty in urachal adenocarcinoma: An oncologically favorable but underutilized alternative to radical cystectomy

    Directory of Open Access Journals (Sweden)

    Rohan Satish Valsangkar

    2016-01-01

    Full Text Available Partial/extended partial cystectomy (EPC is the most common surgery done for localized urachal malignancies. However, sometimes, after EPC, patients may be left with small bladder remnant, reconstruction of which will result in very small capacity bladder with resultant severe storage voiding symptoms. We report a case of urachal adenocarcinoma, in which when a small bladder remnant was left post-EPC, instead of proceeding with radical cystectomy (RC and neobladder (the standard alternative, bladder augmentation was done with good oncological and voiding outcome. Augmentation cystoplasty has many advantages over neobladder and we suggest it as an oncologically comparable alternative to RC with neobladder, which has been underutilized in urachal malignancies as we found on literature review.

  14. Hepatic Radioembolization as a Bridge to Liver Surgery

    Directory of Open Access Journals (Sweden)

    Arthur J.A.T. Braat

    2014-07-01

    Full Text Available Treatment of oncologic disease has improved significantly in the last decades and in the future a vast majority of cancer types will continue to increase worldwide. As a result many patients are confronted with primary liver cancers or metastatic liver disease. Surgery in liver malignancies has steeply improved and curative resections are applicable in wider settings, leading to a prolonged survival. Simultaneously, radiofrequency ablation (RFA and liver transplantation (LTx have been applied more commonly in oncologic settings with improving results. To minimize adverse events in treatments of liver malignancies, locoregional minimal invasive treatments have made their appearance in this field, in which radioembolization (RE has shown promising results in recent years with few adverse events and high response rates. We discuss several other applications of radioembolization for oncologic patients, other than its use in the palliative setting, whether or not combined with other treatments. This review is focused on the role of RE in acquiring patient eligibility for radical treatments, like surgery, RFA and LTx. Inducing significant tumor reduction can downstage patients for resection or, through attaining stable disease, patients can stay on the LTx waiting list. Hereby, RE could make a difference between curative of palliative intent in oncologic patient management. Prior to surgery, the future remnant liver volume might be inadequate in some patients. In these patients, forming an adequate liver reserve through RE leads to prolonged survival without risking postoperative liver failure and minimizing tumor progression while inducing hypertrophy. In order to optimize results, developments in procedures surrounding RE are equally important. Predicting the remaining liver function after radical treatment and finding the right balance between maximum tumor irradiation and minimizing the chance of inducing radiation-related complications are still

  15. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-06-15

    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery.

  16. Overview of robotic colorectal surgery: Current and future practical developments

    Science.gov (United States)

    Roy, Sudipta; Evans, Charles

    2016-01-01

    Minimal access surgery has revolutionised colorectal surgery by offering reduced morbidity and mortality over open surgery, while maintaining oncological and functional outcomes with the disadvantage of additional practical challenges. Robotic surgery aids the surgeon in overcoming these challenges. Uptake of robotic assistance has been relatively slow, mainly because of the high initial and ongoing costs of equipment but also because of limited evidence of improved patient outcomes. Advances in robotic colorectal surgery will aim to widen the scope of minimal access surgery to allow larger and more complex surgery through smaller access and natural orifices and also to make the technology more economical, allowing wider dispersal and uptake of robotic technology. Advances in robotic endoscopy will yield self-advancing endoscopes and a widening role for capsule endoscopy including the development of motile and steerable capsules able to deliver localised drug therapy and insufflation as well as being recharged from an extracorporeal power source to allow great longevity. Ultimately robotic technology may advance to the point where many conventional surgical interventions are no longer required. With respect to nanotechnology, surgery may eventually become obsolete. PMID:26981188

  17. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings

    International Nuclear Information System (INIS)

    2008-01-01

    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery

  18. Does a robotic surgery approach offer optimal ergonomics to gynecologic surgeons?: a comprehensive ergonomics survey study in gynecologic robotic surgery.

    Science.gov (United States)

    Lee, Mija Ruth; Lee, Gyusung Isaiah

    2017-09-01

    To better understand the ergonomics associated with robotic surgery including physical discomfort and symptoms, factors influencing symptom reporting, and robotic surgery systems components recommended to be improved. The anonymous survey included 20 questions regarding demographics, systems, ergonomics, and physical symptoms and was completed by experienced robotic surgeons online through American Association of Gynecologic Laparoscopists (AAGL) and Society of Robotic Surgery (SRS). There were 289 (260 gynecology, 22 gynecology-oncology, and 7 urogynecology) gynecologic surgeon respondents regularly practicing robotic surgery. Statistical data analysis was performed using the t-test, χ² test, and logistic regression. One hundred fifty-six surgeons (54.0%) reported experiencing physical symptoms or discomfort. Participants with higher robotic case volume reported significantly lower physical symptom report rates (pergonomic settings not only acknowledged that the adjustments were helpful for better ergonomics but also reported a lower physical symptom rate (pergonomic settings (32.7%), took a break (33.3%) or simply ignored the problem (34%). Fingers and neck were the most common body parts with symptoms. Eye symptom complaints were significantly decreased with the Si robot (pergonomics were microphone/speaker, pedal design, and finger clutch. More than half of participants reported physical symptoms which were found to be primarily associated with confidence in managing ergonomic settings and familiarity with the system depending on the volume of robotic cases. Optimal guidelines and education on managing ergonomic settings should be implemented to maximize the ergonomic benefits of robotic surgery. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  19. Non-technical skills assessment in surgery.

    Science.gov (United States)

    Sharma, Bharat; Mishra, Amit; Aggarwal, Rajesh; Grantcharov, Teodor P

    2011-09-01

    Adverse events in surgery have highlighted the importance of non-technical skills, such as communication, decision-making, teamwork, situational awareness and leadership, to effective organizational performance. These skills carry particular importance to surgical oncology, as members of a multidisciplinary team must work cohesively to formulate effective patient care plans. Several non-technical skills evaluation tools have been developed for use in surgery, without adequate comparison and consensus on which should be standard for training. Eleven articles describing the use of three non-technical evaluation tools related to surgery: NOTSS (Non Technical Skills for Surgeons), NOTECHS (Non Technical Skills) and OTAS (Observational Teamwork Assessment for Surgery) were analyzed with respect to scale formulation, validity, reliability and feasibility. Furthermore, their use in training thus far and the future of non-technical rating scales in surgical curricula was discussed. Future work should focus on incorporating these assessment tools into training and into a real operating room setting to provide formative evaluations for surgical residents. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Quality of systematic reviews in pediatric oncology - A systematic review

    NARCIS (Netherlands)

    Lundh, Andreas; Knijnenburg, Sebastiaan L.; Jørgensen, Anders W.; van Dalen, Elvira C.; Kremer, Leontien C. M.

    2009-01-01

    Background: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. Methods: We identified eligible systematic reviews

  1. Pediatric Oncology Branch - training- resident electives | Center for Cancer Research

    Science.gov (United States)

    Resident Electives Select pediatric residents may be approved for a 4-week elective rotation at the Pediatric Oncology Branch. This rotation emphasizes the important connection between research and patient care in pediatric oncology. The resident is supervised directly by the Branch’s attending physician and clinical fellows. Residents attend daily in-patient and out-patient

  2. [Burnout effect on academic progress of Oncology medical residents].

    Science.gov (United States)

    González-Ávila, Gabriel; Bello-Villalobos, Herlinda

    2014-01-01

    In the formative period of the courses taken in medical specializations, new and greater responsibilities are accepted by physicians in personal and academic spheres. The interaction of several factors that encompass the practice of these physicians could surpass their capacity to cope, causing on these professionals a high level of stress and professional exhaustion, which will affect their academic development. The objective of this research was to establish if the occupational stress of these medical residents affects their academic progress. We administered the Spanish version of the Maslach Burnout Inventory (MBI) to 52 residents of three specializations in Oncology (Medical Oncology, Surgical Oncology, and Radio-Oncology). These residents accepted voluntarily at the same time of their third cognitive exam. The prevalence of burnout syndrome was 13.5 %, with a high frequency among medical residents of first degree. Medical Oncology residents showed a higher emotional exhaustion and lower personal fulfillment. Considering the three specializations, the academic progress was higher in the third year, with a significant difference to Surgical Oncology and Medical Oncology (p = 0.026 and 0.015, respectively). No significant difference was found between burnout syndrome, academic progress and sociodemographic characteristics. The presence of burnout syndrome does not affect the academic progress of Oncology medical residents.

  3. The experiential world of the oncology nurse | Van Rooyen | Health ...

    African Journals Online (AJOL)

    In her1 experiential world, the oncology nurse experiences unique, challenging and rewarding relationships in a multidimensional, dynamic way. The aim of this study was to describe, from her viewpoint and perspective, how she experiences and reacts to this world. Through this study the researcher wants the oncology ...

  4. Global Oncology; Harvard Global Health Catalyst summit lecture notes

    Science.gov (United States)

    Ngwa, Wilfred; Nguyen, Paul

    2017-08-01

    The material presented in this book is at the cutting-edge of global oncology and provides highly illuminating examples, addresses frequently asked questions, and provides information and a reference for future work in global oncology care, research, education, and outreach.

  5. Effects of Age Expectations on Oncology Social Workers' Clinical Judgment

    Science.gov (United States)

    Conlon, Annemarie; Choi, Namkee G.

    2014-01-01

    Objective: This study examined the influence of oncology social workers' expectations regarding aging (ERA) and ERA with cancer (ERAC) on their clinical judgment. Methods: Oncology social workers (N = 322) were randomly assigned to one of four vignettes describing a patient with lung cancer. The vignettes were identical except for the patent's age…

  6. 75 FR 81283 - Oncologic Drugs Advisory Committee; Cancellation

    Science.gov (United States)

    2010-12-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Oncologic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Oncologic Drugs Advisory Committee scheduled for February 9, 2011, is...

  7. 77 FR 63839 - Oncologic Drugs Advisory Committee; Cancellation

    Science.gov (United States)

    2012-10-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-N-0001] Oncologic Drugs Advisory Committee; Cancellation AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The meeting of the Oncologic Drugs Advisory Committee Meeting scheduled for November 8, 2012, is...

  8. Radical Trachelectomy for Early-Stage Cervical Cancer: A Survey of the Society of Gynecologic Oncology and Gynecologic Oncology Fellows-in-Training.

    Science.gov (United States)

    Churchill, Sara J; Armbruster, Shannon; Schmeler, Kathleen M; Frumovitz, Michael; Greer, Marilyn; Garcia, Jaime; Redworth, Glenda; Ramirez, Pedro T

    2015-05-01

    The aim of this study was to survey gynecologic oncologists and fellows-in-training regarding the role of radical trachelectomy (RT) and conservative surgery in patients with early-stage cervical cancer. From June 2012 to September 2012, the Society of Gynecologic Oncology member practitioners (n = 1353) and gynecologic oncology fellows (n = 156) were sent group-specific surveys investigating current practice, training, and the future of RT for early-stage cervical cancer management. Twenty-two percent of practitioners (n = 303) and 24.4% of fellows (n = 38) completed the surveys. Of the practitioners, 50% (n = 148) report performing RT, 98% (n = 269) support RT as treatment for squamous carcinoma, and 71% (n = 195) confirm the use of RT for adenocarcinoma. Most practitioners offer RT treatment for stages IA2 to IB1 smaller than 2 cm (n = 209, 76.8%) regardless of grade (77.7%) or lymph vascular space invasion (n = 211, 79.3%). Only 8% (n = 23) of practitioners feel that RT is appropriate for stage IBI larger than 2 cm. Respectively, both practitioners and fellows most frequently perform robotic-assisted (47.0%, n = 101 and 59.1%, n = 13) and abdominal (40.5%, n = 87 and 68.2%, n = 15) RT approaches. After training, fellows project the use of robotic-assisted (71%, n = 22) or abdominal methods (58.1%, n = 18). Overall, 75% (n = 227) of practitioners and 60% (n = 23) of fellows speculate that over the next 5 years, less radical procedures will be used to manage early-stage cervical cancer. Our findings suggest that practitioners and fellows believe RT remains an option for early-stage cervical cancer patients. However, a significant proportion of all respondents believe that less radical surgery may be a future consideration for patients with low-risk early-stage cervical cancer.

  9. Breast Reduction Surgery

    Science.gov (United States)

    ... considering breast reduction surgery, consult a board-certified plastic surgeon. It's important to understand what breast reduction surgery entails — including possible risks and complications — as ...

  10. Advances in imaging for oncology guidance

    International Nuclear Information System (INIS)

    Amies, Christopher J.

    2008-01-01

    Over the last 30 years major improvements in medical imaging have played a significant role to help advance the management of oncology diseases. These advances have covered the continuum of care from screening, diagnosis, staging, treatment planning and intervention. More recently image guided radiation therapy (IGRT) has placed sophisticated imaging closer to the treatment event. The opportunity to improve care seems obvious; however the clinical benefits of IGRT are at present not easily proven and yet contribute to the complexity of treatment and the rising costs of care. It is proposed that this is in part due to the present immaturity of IGRT technology development, which is predominantly determined by the challenge of achieving precise delivery of radiation in one or many episodes (fractions) for very different diseases. There is no single type or mode of imaging that will be suitable to address all radiotherapy guidance challenges whether defined by the general criteria identified for a specific disease or the unique characteristics encountered with an individual patient. Finally the wide adoption of this or any medical technology general requires the attainment of a sufficient degree of safety and efficiency. I present the challenges faced by industry as well as select interesting technology based solutions and concepts that may help advance the field of oncology guidance

  11. Clinical outcomes research in gynecologic oncology.

    Science.gov (United States)

    Melamed, Alexander; Rauh-Hain, J Alejandro; Schorge, John O

    2017-09-01

    Clinical outcomes research seeks to understand the real-world manifestations of clinical care. In particular, outcomes research seeks to reveal the effects of pharmaceutical, procedural, and structural aspects of healthcare on patient outcomes, including mortality, disease control, toxicity, cost, and quality of life. Although outcomes research can utilize interventional study designs, insightful use of observational data is a defining feature of this field. Many questions in gynecologic oncology are not amenable to investigation in randomized clinical trials due to cost, feasibility, or ethical concerns. When a randomized trial is not practical or has not yet been conducted, well-designed observational studies have the potential to provide the best available evidence about the effects of clinical care. Such studies may use surveys, medical records, disease registries, and a variety of administrative data sources. Even when a randomized trial has been conducted, observational studies can be used to estimate the real-world effect of an intervention, which may differ from the results obtained in the controlled setting of a clinical trial. This article reviews the goals, methodologies, data sources, and limitations of clinical outcomes research, with a focus on gynecologic oncology. Copyright © 2017. Published by Elsevier Inc.

  12. [Introduction of emotional labour into oncology].

    Science.gov (United States)

    Lazányi, Kornélia; Molnár, Péter; Szluha, Kornélia

    2007-06-03

    Health care professionals do not have emotional labour obligations in their employment contract. However, in everyday work it is often inevitable for them to change their true feelings. This is critically true for professionals treating chronic or cancer patients. The suitable emotional state of the treatment staff does not only influence the practitioner-patient relationship but the process of recovery as well. Depending on the way one might get into the appropriate emotional state, the literature distinguishes between surface, deep and genuine acting. While surface and deep emotional labour has numerous negative psychological consequences genuine acting is usually accompanied by positive side effects. For those working in the field of oncology, emotional labour is a part of the role expectations of the professionals. This is how the appropriate attitude is a fundamental part of the professionals' essence. For the in depth analysis of subjects related to emotional labour, the authors adopted ideas from L. Festinger 's cognitive dissonance theory. The best way to alleviate cognitive dissonance and the negative side effects of emotional labour is to prevent the emergence of them. Oncology professionals should fit their role expectations genuinely, without particular efforts. If this was impossible, or the particular life situations did not allow genuine acting, it is the employer's and the workmates' common duty to help professionals, to ease the load of emotional labour, to diminish the occurring cognitive dissonance with the help of appropriate recompense.

  13. Social Interaction and Collaboration among Oncology Nurses.

    Science.gov (United States)

    Moore, Jane; Prentice, Dawn; McQuestion, Maurene

    2015-01-01

    Collaboration is a complex process influenced by organizational, professional, interpersonal, and personal factors. Research has demonstrated that collaboration may also be influenced by social factors. Nurses spend much of their time working in collaborative teams, yet little is known about how they socially interact in practice. This qualitative case study explored nurse perceptions of social interaction in relation to collaboration. Data were collected using telephone interviews and documentary reviews from fourteen oncology nurses employed at one cancer center in Canada. Thematic analysis revealed two themes: knowing you is trusting you and formal and informal opportunities. Nurses reported that social interaction meant getting to know someone personally as well as professionally. Social interaction was enacted inside of work during breaks/meals and outside of work at planned events. Social interaction was facilitated by having a long-term current and/or previous professional and personal relationship. The barriers to social interaction included a lack of time to get to know each other, workload issues, and poor interpersonal skills. Findings suggest that social interaction is an important factor in the collaborative relationship among oncology nurses. Nurse leaders need to promote social interaction opportunities and facilitate educational sessions to improve social and interpersonal skills.

  14. Maintenance of Certification for Radiation Oncology

    International Nuclear Information System (INIS)

    Kun, Larry E.; Ang, Kian; Erickson, Beth; Harris, Jay; Hoppe, Richard; Leibel, Steve; Davis, Larry; Hattery, Robert

    2005-01-01

    Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements of the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development

  15. Apps for Radiation Oncology. A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    J.J. Calero

    2017-02-01

    Full Text Available Introduction: Software applications executed on a smart-phone or mobile device (“Apps” are increasingly used by oncologists in their daily work. A comprehensive critical review was conducted on Apps specifically designed for Radiation Oncology, which aims to provide scientific support for these tools and to guide users in choosing the most suited to their needs. Material and methods: A systematic search was conducted in mobile platforms, iOS and Android, returning 157 Apps. Excluding those whose purpose did not match the scope of the study, 31 Apps were methodically analyzed by the following items: Objective Features, List of Functionalities, Consistency in Outcomes and Usability. Results: Apps are presented in groups of features, as Dose Calculators (7 Apps, Clinical Calculators (4, Tools for Staging (7, Multipurpose (7 and Others (6. Each App is presented with the list of attributes and a brief comment. A short summary is provided at the end of each group. Discussion and Recommendations: There are numerous Apps with useful tools at the disposal of radiation oncologists. The most advisable Apps do not match the more expensive. Three all-in-one apps seem advisable above all: RadOnc Reference (in English, Easy Oncology (in German and iOncoR (in Spanish. Others recommendations are suggested for specific tasks: dose calculators, treatment-decision and staging.

  16. The role of PDGF in radiation oncology

    International Nuclear Information System (INIS)

    Li, Minglun; Jendrossek, Verena; Belka, Claus

    2007-01-01

    Platelet-derived growth factor (PDGF) was originally identified as a constituent of blood serum and subsequently purified from human platelets. PDGF ligand is a dimeric molecule consisting of two disulfide-bonded chains from A-, B-, C- and D-polypeptide chains, which combine to homo- and heterodimers. The PDGF isoforms exert their cellular effects by binding to and activating two structurally related protein tyrosine kinase receptors. PDGF is a potent mitogen and chemoattractant for mesenchymal cells and also a chemoattractant for neutrophils and monocytes. In radiation oncology, PDGF are important for several pathologic processes, including oncogenesis, angiogenesis and fibrogenesis. Autocrine activation of PDGF was observed and interpreted as an important mechanism involved in brain and other tumors. PDGF has been shown to be fundamental for the stability of normal blood vessel formation, and may be essential for the angiogenesis in tumor tissue. PDGF also plays an important role in the proliferative disease, such as atherosclerosis and radiation-induced fibrosis, regarding its proliferative stimulation of fibroblast cells. Moreover, PDGF was also shown to stimulate production of extracellular matrix proteins, which are mainly responsible for the irreversibility of these diseases. This review introduces the structural and functional properties of PDGF and PDGF receptors and discusses the role and mechanism of PDGF signaling in normal and tumor tissues under different conditions in radiation oncology

  17. Oncologic imaging of the genitourinary tract

    International Nuclear Information System (INIS)

    McClennan, B.L.

    1987-01-01

    Malignant neoplasms of the genitourinary (GU) tract account for a significant number of cancer-related deaths in man. For example, prostate cancer is the third leading cause of cancer-related death in adult males. Early diagnosis and treatment can have a profound effect on patient prognosis and survival. This paper examines the large body of information related to primary tumors of the kidney, bladder, and prostate, and their pattern of spread. Tumor oncology is discussed and related to the utility of available techniques, such as CT, MR imaging, and US. Imaging strategies are discussed that stress consideration of therapeutic efficacy and patient outcome. Current tumor staging and classification is presented and the various imaging strategies keyed to detection, definition, and treatment options for GU tract tumors. The strengths and limitations of modern imaging techniques are reviewed. An optimal approach to effective workup is developed with regard to availability, evolving technology, and cost efficacy. The controversies and conflicts in imaging and treatment options are explored while constructing a step-by-step approach that is both flexible and pragmatic for the clinician and radiologist faced daily with oncologic management choices

  18. The Value of Specialty Oncology Drugs

    Science.gov (United States)

    Goldman, Dana P; Jena, Anupam B; Lakdawalla, Darius N; Malin, Jennifer L; Malkin, Jesse D; Sun, Eric

    2010-01-01

    Objective To estimate patients' elasticity of demand, willingness to pay, and consumer surplus for five high-cost specialty medications treating metastatic disease or hematologic malignancies. Data Source/Study Setting Claims data from 71 private health plans from 1997 to 2005. Study Design This is a revealed preference analysis of the demand for specialty drugs among cancer patients. We exploit differences in plan generosity to examine how utilization of specialty oncology drugs varies with patient out-of-pocket costs. Data Collection/Extraction Methods We extracted key variables from administrative health insurance claims records. Principal Findings A 25 percent reduction in out-of-pocket costs leads to a 5 percent increase in the probability that a patient initiates specialty cancer drug therapy. Among patients who initiate, a 25 percent reduction in out-of-pocket costs reduces the number of treatments (claims) by 1–3 percent, depending on the drug. On average, the value of these drugs to patients who use them is about four times the total cost paid by the patient and his or her insurer, although this ratio may be lower for oral specialty therapies. Conclusions The decision to initiate therapy with specialty oncology drugs is responsive to price, but not highly so. Among patients who initiate therapy, the amount of treatment is equally responsive. The drugs we examine are highly valued by patients in excess of their total costs, although oral agents warrant further scrutiny as copayments increase. PMID:19878344

  19. [Artificial intelligence applied to radiation oncology].

    Science.gov (United States)

    Bibault, J-E; Burgun, A; Giraud, P

    2017-05-01

    Performing randomised comparative clinical trials in radiation oncology remains a challenge when new treatment modalities become available. One of the most recent examples is the lack of phase III trials demonstrating the superiority of intensity-modulated radiation therapy in most of its current indications. A new paradigm is developing that consists in the mining of large databases to answer clinical or translational issues. Beyond national databases (such as SEER or NCDB), that often lack the necessary level of details on the population studied or the treatments performed, electronic health records can be used to create detailed phenotypic profiles of any patients. In parallel, the Record-and-Verify Systems used in radiation oncology precisely document the planned and performed treatments. Artificial Intelligence and machine learning algorithms can be used to incrementally analyse these data in order to generate hypothesis to better personalize treatments. This review discusses how these methods have already been used in previous studies. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  20. Acute Thoracic Findings in Oncologic Patients.

    Science.gov (United States)

    Carter, Brett W; Erasmus, Jeremy J

    2015-07-01

    Cancer is the second most common cause of mortality in the United States, with >500,000 deaths reported annually. Acute or emergent findings in this group of patients can be a life-threatening phenomenon that results from malignancy or as a complication of therapy. In many cases, these events can be the first clinical manifestation of malignant disease. Oncologic emergencies have been classified as metabolic, hematologic, and structural emergencies. Within the thorax, most acute oncologic findings involve the lungs and airways in the form of drug toxicity, pulmonary infections, or malignant airway compression; the cardiovascular system in the form of pulmonary embolism, superior vena cava syndrome, cardiac tamponade, or massive hemoptysis; the mediastinum in the form of esophageal perforation, acute mediastinitis, or esophagorespiratory fistula; and the osseous spine and spinal cord in the form of invasion and cord compression. Given the life-threatening nature of many of these disease processes, awareness of such complications is critical to making an accurate diagnosis and formulating appropriate treatment strategies.

  1. R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology.

    Science.gov (United States)

    Verkooijen, Helena M; Kerkmeijer, Linda G W; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

    2017-01-01

    The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence

  2. Continuous wound infiltration system for postoperative pain management in gynecologic oncology patients.

    Science.gov (United States)

    Lee, Banghyun; Kim, Kidong; Ahn, Soyeon; Shin, Hyun-Jung; Suh, Dong Hoon; No, Jae Hong; Kim, Yong Beom

    2017-05-01

    Major open surgery for gynecologic cancer usually involves a long midline skin incision and induces severe postoperative surgical site pain (POSP) that may not be effectively controlled with the conventional management. We investigated whether combining a continuous wound infiltration system (CWIS, ON-Q PainBuster ® ) and intravenous patient-controlled analgesia (IV PCA) effectively decreases POSP, compared with IV PCA alone, in gynecologic oncology patients. This retrospective study included 62 Korean patients who received a long midline skin incision during gynecologic cancer surgery. The combined therapy group (n = 31), which received CWIS (0.5% ropivacaine infused over 72 h) and IV PCA (fentanyl citrate), and the IV PCA only group (n = 31) were determined using 1:1 matching. POSP was assessed using resting numeric rating scale (NRS) scores measured for 96 h after surgery, which were analyzed using a linear mixed model. The slopes of the predicted NRS values from the linear mixed model were significantly different between the groups. Compared with the control group, the combined therapy group had lower predicted NRS scores for the first 72 h, but higher predicted scores between 72 and 96 h. Moreover, the mean NRS scores over the first 48 h postoperation were significantly lower in the combined therapy group than in the control group; the scores were similar in both groups during the remaining period. With the exception of a higher body mass index in the CWIS group, the other variables, such as the dosage and usage time of fentanyl citrate, use of additional painkillers, and side effects, including wound complications, did not differ between groups. Combined therapy using CWIS and IV PCA may be a useful strategy for POSP management in gynecologic oncology patients.

  3. Oncologic effectiveness of nerve-sparing radical hysterectomy in cervical cancer.

    Science.gov (United States)

    Ditto, Antonino; Bogani, Giorgio; Leone Roberti Maggiore, Umberto; Martinelli, Fabio; Chiappa, Valentina; Lopez, Carlos; Perotto, Stefania; Lorusso, Domenica; Raspagliesi, Francesco

    2018-05-01

    Nerve-sparing radical hysterectomy (NSRH) was introduced with the aim to reduce pelvic dysfunctions related to conventional radical hysterectomy (RH). Here, we sought to assess the effectiveness and safety of NSRH in a relatively large number of the patients of cervical cancer (CC) patients undergoing either primary surgery or neoadjuvant chemotherapy (NACT) followed by surgery. Outcomes of consecutive patients undergoing NSRH and of a historical cohort of patients undergoing conventional RH were retrospectively reviewed. This study included 325 (49.8%) and 327 (50.2%) undergoing NSRH and RH, respectively. Via a multivariable model, nodal status was the only factor predicting for DFS (hazard ratio [HR]=2.09; 95% confidence interval [CI]=1.17-3.73; p=0.01). A trend towards high risk of recurrence was observed for patients affected by locally advanced cervical cancer (LACC) undergoing NACT followed by surgery (HR=2.57; 95% CI=0.95-6.96; p=0.06). Type of surgical procedures (NSRH vs. RH) did not influence risk of recurrence (p=0.47). Similarly, we observed that the execution of NSRH rather than RH had not a detrimental effect on OS (HR=1.19; 95% CI=0.16-9.01; p=0.87). Via multivariable model, no factor directly correlated with OS. No difference in early complication rates was observed between the study groups. Conversely, a significant higher number of late complications was reported in RH versus NSRH groups (p=0.02). Our data suggested that NSRH upholds effectiveness of conventional RH, without increasing recurrence and complication rates but improving pelvic dysfunction rates. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  4. Updates from the 2013 Society for Neuro-Oncology annual and World Federation for Neuro-Oncology quadrennial meeting.

    Science.gov (United States)

    Lukas, Rimas V; Amidei, Christina

    2014-01-01

    We present an overview of a number of key clinical studies in infiltrating gliomas presented at the 2013 Society for Neuro-Oncology and World Federation of Neuro-Oncology joint meeting. This review focuses on efficacy results, including quality of life studies, from larger clinical trials in both high- and low-grade infiltrating gliomas.

  5. A Research Agenda for Radiation Oncology: Results of the Radiation Oncology Institute's Comprehensive Research Needs Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Bekelman, Justin E. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States); Brawley, Otis W. [Department of Hematology and Oncology, Emory University, and American Cancer Society, Atlanta, Georgia (United States); Deasy, Joseph O. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Le, Quynh-Thu [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Michalski, Jeff M. [Department of Radiation Oncology, Washington University, St. Louis, MO (United States); Movsas, Benjamin [Department of Radiation Oncology, Henry Ford Health System, Detroit, MI (United States); Thomas, Charles R. [Department of Radiation Oncology, Oregon Health and Sciences University, Portland, OR (United States); Lawton, Colleen A. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Lawrence, Theodore S. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Hahn, Stephen M. [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)

    2012-10-01

    Purpose: To promote the rational use of scarce research funding, scholars have developed methods for the systematic identification and prioritization of health research needs. The Radiation Oncology Institute commissioned an independent, comprehensive assessment of research needs for the advancement of radiation oncology care. Methods and Materials: The research needs assessment used a mixed-method, qualitative and quantitative social scientific approach, including structured interviews with diverse stakeholders, focus groups, surveys of American Society for Radiation Oncology (ASTRO) members, and a prioritization exercise using a modified Delphi technique. Results: Six co-equal priorities were identified: (1) Identify and develop communication strategies to help patients and others better understand radiation therapy; (2) Establish a set of quality indicators for major radiation oncology procedures and evaluate their use in radiation oncology delivery; (3) Identify best practices for the management of radiation toxicity and issues in cancer survivorship; (4) Conduct comparative effectiveness studies related to radiation therapy that consider clinical benefit, toxicity (including quality of life), and other outcomes; (5) Assess the value of radiation therapy; and (6) Develop a radiation oncology registry. Conclusions: To our knowledge, this prioritization exercise is the only comprehensive and methodologically rigorous assessment of research needs in the field of radiation oncology. Broad dissemination of these findings is critical to maximally leverage the impact of this work, particularly because grant funding decisions are often made by committees on which highly specialized disciplines such as radiation oncology are not well represented.

  6. A Research Agenda for Radiation Oncology: Results of the Radiation Oncology Institute’s Comprehensive Research Needs Assessment

    International Nuclear Information System (INIS)

    Jagsi, Reshma; Bekelman, Justin E.; Brawley, Otis W.; Deasy, Joseph O.; Le, Quynh-Thu; Michalski, Jeff M.; Movsas, Benjamin; Thomas, Charles R.; Lawton, Colleen A.; Lawrence, Theodore S.; Hahn, Stephen M.

    2012-01-01

    Purpose: To promote the rational use of scarce research funding, scholars have developed methods for the systematic identification and prioritization of health research needs. The Radiation Oncology Institute commissioned an independent, comprehensive assessment of research needs for the advancement of radiation oncology care. Methods and Materials: The research needs assessment used a mixed-method, qualitative and quantitative social scientific approach, including structured interviews with diverse stakeholders, focus groups, surveys of American Society for Radiation Oncology (ASTRO) members, and a prioritization exercise using a modified Delphi technique. Results: Six co-equal priorities were identified: (1) Identify and develop communication strategies to help patients and others better understand radiation therapy; (2) Establish a set of quality indicators for major radiation oncology procedures and evaluate their use in radiation oncology delivery; (3) Identify best practices for the management of radiation toxicity and issues in cancer survivorship; (4) Conduct comparative effectiveness studies related to radiation therapy that consider clinical benefit, toxicity (including quality of life), and other outcomes; (5) Assess the value of radiation therapy; and (6) Develop a radiation oncology registry. Conclusions: To our knowledge, this prioritization exercise is the only comprehensive and methodologically rigorous assessment of research needs in the field of radiation oncology. Broad dissemination of these findings is critical to maximally leverage the impact of this work, particularly because grant funding decisions are often made by committees on which highly specialized disciplines such as radiation oncology are not well represented.

  7. Oncological outcome after laparoscopic abdominoperineal excision of the rectum.

    Science.gov (United States)

    Jefferies, M T; Evans, M D; Hilton, J; Chandrasekaran, T V; Beynon, J; Khot, U

    2012-08-01

    Abdominoperineal excision of the rectum (APER) for cancer has been associated with higher circumferential resection margin (CRM) involvement and failure of local disease control. The aim of this study was to investigate whether the introduction of laparoscopic APER altered the incidence of CRM involvement. Consecutive patients undergoing open or laparoscopic APER for adenocarcinomas of the rectum were studied. Patient demographics, preoperative staging, neoadjuvant treatment, operative findings, length of stay and pathological details were collected from operative and radiology databases and compared. There were 16 laparoscopic and 25 open APER performed over a 3-year period. Neoadjuvant therapy was given to 43.8% (7/16) of the laparoscopic group and 56.0% (14/25) of the open group. Complete laparoscopic resection was possible in 14 (87.5%) of 16 patients. The median harvested number of nodes was 14 (4-33) in both groups. The median length of stay was 7 (3-13) and 15 (9-40) days in the laparoscopic and open groups (P CRM was clear in all cases. There was no local recurrence in either group at a median follow-up of 23 months. There were no in-hospital deaths and no significant differences in overall survival. There were no significant differences in preoperative or postoperative histopathological T stage between the two groups (P = 0.057 and P = 0.121). Laparoscopic APER for selected rectal cancers can achieve comparable oncological outcome to open surgery but is associated with a much shorter length of stay. Patient and tumour characteristics must be taken into consideration when deciding on a laparoscopic approach for low rectal cancer. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  8. Is there a role for radiation therapists within veterinary oncology?

    Energy Technology Data Exchange (ETDEWEB)

    Surjan, Yolanda, E-mail: Yolanda.Surjan@newcastle.edu.au [Medical Radiation Science (MRS), School of Health Sciences, University of Newcastle, Callaghan, NSW 2308 (Australia); Warren-Forward, Helen [Medical Radiation Science (MRS), School of Health Sciences, University of Newcastle, Callaghan, NSW 2308 (Australia); Milross, Christopher [Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, Sydney (Australia)

    2011-08-15

    Role expansion recognises enlargement of existing scope of practice within radiation therapy (RT). Over the past decade, there has been increasing involvement and movement towards advanced practice in the form of role extension in specialised areas of practice including brachytherapy, image fusion and quality assurance. It is also recognised that radiation therapy expert practitioners exist in the areas of imaging immobilisation, treatment, education and research. The acquisition of additional skills has hastened the need for autonomy within the RT profession and with this comes the responsibility to share our knowledge and specialist abilities with the wider community. Radiation therapy is a highly specialised profession working to treat a commonly encountered ailment like cancer and we should ask ourselves what other community members could benefit from our knowledge and skills. Cancer is not limited to the human population but affects animals as readily and severely. Particular types of cancers have been identified as being comparable with that of humans; one such tumour is squamous cell carcinoma (SCC). Squamous cell carcinoma is the most commonly found tumour of the eye and adnexa in horses. Comparatively, SCC in humans is the most common cancer in Australia. Whilst human treatment is well established with surgery and radiation therapy offering comparable control rates, the treatment within Australia's Veterinary Oncology field is currently at a standstill. It is reported, however, that the use of interstitial brachytherapy has been shown to be highly effective and thoroughly practiced and established within the United States of America (USA). This paper reviews current literature in readiness for the potential for radiation therapy cross-over into the veterinary sphere with regard to the implementation of treatment and radiation safety protocols for the use of interstitial brachytherapy in horses.

  9. Is there a role for radiation therapists within veterinary oncology?

    International Nuclear Information System (INIS)

    Surjan, Yolanda; Warren-Forward, Helen; Milross, Christopher

    2011-01-01

    Role expansion recognises enlargement of existing scope of practice within radiation therapy (RT). Over the past decade, there has been increasing involvement and movement towards advanced practice in the form of role extension in specialised areas of practice including brachytherapy, image fusion and quality assurance. It is also recognised that radiation therapy expert practitioners exist in the areas of imaging immobilisation, treatment, education and research. The acquisition of additional skills has hastened the need for autonomy within the RT profession and with this comes the responsibility to share our knowledge and specialist abilities with the wider community. Radiation therapy is a highly specialised profession working to treat a commonly encountered ailment like cancer and we should ask ourselves what other community members could benefit from our knowledge and skills. Cancer is not limited to the human population but affects animals as readily and severely. Particular types of cancers have been identified as being comparable with that of humans; one such tumour is squamous cell carcinoma (SCC). Squamous cell carcinoma is the most commonly found tumour of the eye and adnexa in horses. Comparatively, SCC in humans is the most common cancer in Australia. Whilst human treatment is well established with surgery and radiation therapy offering comparable control rates, the treatment within Australia's Veterinary Oncology field is currently at a standstill. It is reported, however, that the use of interstitial brachytherapy has been shown to be highly effective and thoroughly practiced and established within the United States of America (USA). This paper reviews current literature in readiness for the potential for radiation therapy cross-over into the veterinary sphere with regard to the implementation of treatment and radiation safety protocols for the use of interstitial brachytherapy in horses.

  10. Antimicrobial prophylaxis related to otorhinolaryngology elective major surgery

    International Nuclear Information System (INIS)

    Perez Lopez, Gladys; Morejon Garcia, Moises; Alvarez Cespedes, Belkis

    2010-01-01

    INTRODUCTION. Antimicrobial prophylaxis decreases the surgical infections, but its indiscriminate use to favors the increment of infection rates and the bacterial resistance is much more probable in presence of antibiotics. The aim of present research was to evaluate the results of antibiotic prophylaxis in the otorhinolaryngology elective major surgery. METHODS. A retrospective-descriptive research was made on the prophylactic use of antibiotics in this type of surgery in the Otorhinolaryngology Service of the ''Comandant Manuel Fajardo'' during 6 years (2001-2006). Sample included 661 patients and the following variables were studied: sex, age and therapeutic response criteria (satisfactory and non-satisfactory). According to the intervention complexity oral antibiotic or parenteral prophylaxis was administered carrying out a surgical hound site culture. RESULTS. There was a predominance of male sex (54,1%) and the 31 and 62 age group. The 41,90% of patients operated on required antibiotic prophylaxis. The was a 7,9% of surgical wound infections. The more frequent microorganisms were Pseudomonas aeruginosa, Enterobacter and Escherichia. In head and neck oncology surgeries infection average was high (42,3%). Torpid course was due to concurrence of infection risk factors. There were neither adverse events nor severe complications. CONCLUSIONS. In Otorhinolaryngology, antimicrobial prophylaxis works against a wide variety of microorganisms but not in the Oncology surgeries. (author)

  11. Minimal invasive single-site surgery in colorectal procedures: Current state of the art

    Directory of Open Access Journals (Sweden)

    Diana Michele

    2011-01-01

    Full Text Available Background: Minimally invasive single-site (MISS surgery has recently been applied to colorectal surgery. We aimed to assess the current state of the art and the adequacy of preliminary oncological results. Methods: We performed a systematic review of the literature using Pubmed, Medline, SCOPUS and Web of Science databases. Keywords used were "Single Port" or "Single-Incision" or "LaparoEndoscopic Single Site" or "SILS™" and "Colon" or "Colorectal" and "Surgery". Results: Twenty-nine articles on colorectal MISS surgery have been published from July 2008 to July 2010, presenting data on 149 patients. One study reported analgesic requirement. The final incision length ranged from 2.5 to 8 cm. Only two studies reported fascial incision length. There were two port site hernias in a series of 13 patients (15.38%. Two "fully laparoscopic" MISS procedures with preparation and achievement of the anastomosis completely intracorporeally are reported. Future site of ileostomy was used as the sole access for the procedures in three studies. Lymph node harvesting, resection margins and length of specimen were sufficient in oncological cases. Conclusions: MISS colorectal surgery is a challenging procedure that seems to be safe and feasible, but the existing clinical evidence is limited. In selected cases, and especially when an ileostomy is planned, colorectal surgery may be an ideal indication for MISS surgery leading to a no-scar surgery. Despite preliminary oncological results showing the feasibility of MISS surgery, we want to stress the need to standardize the technique and carefully evaluate its application in oncosurgery under ethical committee control.

  12. American Society of Clinical Oncology Strategic Plan for Increasing Racial and Ethnic Diversity in the Oncology Workforce.

    Science.gov (United States)

    Winkfield, Karen M; Flowers, Christopher R; Patel, Jyoti D; Rodriguez, Gladys; Robinson, Patricia; Agarwal, Amit; Pierce, Lori; Brawley, Otis W; Mitchell, Edith P; Head-Smith, Kimberly T; Wollins, Dana S; Hayes, Daniel F

    2017-08-01

    In December 2016, the American Society of Clinical Oncology (ASCO) Board of Directors approved the ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce. Developed through a multistakeholder effort led by the ASCO Health Disparities Committee, the purpose of the plan is to guide the formal efforts of ASCO in this area over the next three years (2017 to 2020). There are three primary goals: (1) to establish a longitudinal pathway for increasing workforce diversity, (2) to enhance ASCO leadership diversity, and (3) to integrate a focus on diversity across ASCO programs and policies. Improving quality cancer care in the United States requires the recruitment of oncology professionals from diverse backgrounds. The ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce is designed to enhance existing programs and create new opportunities that will move us closer to the vision of achieving an oncology workforce that reflects the demographics of the US population it serves.

  13. Laparoscopic surgery for benign and malign diseases of the digestive system: indications, limitations, and evidence.

    Science.gov (United States)

    Küper, Markus Alexander; Eisner, Friederike; Königsrainer, Alfred; Glatzle, Jörg

    2014-05-07

    The laparoscopic technique was introduced in gastrointestinal surgery in the mid 1980s. Since then, the development of this technique has been extraordinary. Triggered by technical innovations (stapling devices or coagulation/dissecting devices), nowadays any type of gastrointestinal resection has been successfully performed laparoscopically and can be performed laparoscopically dependent on the patient's condition. This summary gives an overview over 30 years of laparoscopic surgery with focus on today's indications and evidence. Main indications remain the more common procedures, e.g., appendectomy, cholecystectomy, bariatric procedures or colorectal resections. For all these indications, the laparoscopic approach has become the gold standard with less perioperative morbidity. Regarding oncological outcome there have been several high-quality randomized controlled trials which demonstrated equivalency between laparoscopic and open colorectal resections. Less common procedures like esophagectomy, oncological gastrectomy, liver and pancreatic resections can be performed successfully as well by an experienced surgeon. However, the evidence for these special indications is poor and a general recommendation cannot be given. In conclusion, laparoscopic surgery has revolutionized the field of gastrointestinal surgery by reducing perioperative morbidity without disregarding surgical principles especially in oncological surgery.

  14. The Growth of Academic Radiation Oncology: A Survey of Endowed Professorships in Radiation Oncology

    International Nuclear Information System (INIS)

    Wasserman, Todd H.; Smith, Steven M.; Powell, Simon N.

    2009-01-01

    Purpose: The academic health of a medical specialty can be gauged by the level of university support through endowed professorships. Methods and Materials: We conducted a survey of the 86 academic programs in radiation oncology to determine the current status of endowed chairs in this discipline. Results: Over the past decade, the number of endowed chairs has more than doubled, and it has almost tripled over the past 13 years. The number of programs with at least one chair has increased from 31% to 65%. Conclusions: Coupled with other indicators of academic growth, such as the proportion of graduating residents seeking academic positions, there has been clear and sustained growth in academic radiation oncology.

  15. Nonspecialty Nurse Education: Evaluation of the Oncology Intensives Initiative, an Oncology Curriculum to Improve Patient Care

    Science.gov (United States)

    Bagley, Kimberly A; Dunn, Sarah E; Chuang, Eliseu Y; Dorr, Victoria J; Thompson, Julie A; Smith, Sophia K

    2018-04-01

    A community hospital combined its medical and surgical patients with cancer on one unit, which resulted in nurses not trained in oncology caring for this patient population. The Oncology Intensives Initiative (ONCii) involved the (a) design and implementation of a daylong didactic boot camp class and a four-hour simulation session and (b) the examination of nurses' worries, attitudes, self-efficacy, and perception of interdisciplinary teamwork. A two-group, pre-/post-test design was implemented. Group 1 consisted of nurses who attended the didactic boot camp classes alone, whereas group 2 was comprised of nurses who attended the didactic boot camp classes and the simulation sessions. Results of data analysis showed a decrease in worries and an increase in positive attitudes toward chemotherapy administration in both groups, as well as an increase in self-efficacy among members of group 2.

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

  17. Customizable orthopaedic oncology implants: one institution's experience with meeting current IRB and FDA requirements.

    Science.gov (United States)

    Willis, Alexander R; Ippolito, Joseph A; Patterson, Francis R; Benevenia, Joseph; Beebe, Kathleen S

    2016-01-01

    Customizable orthopaedic implants are often needed for patients with primary malignant bone tumors due to unique anatomy or complex mechanical problems. Currently, obtaining customizable orthopaedic implants for orthopaedic oncology patients can be an arduous task involving submitting approval requests to the Institutional Review Board (IRB) and the Food and Drug Administration (FDA). There is great potential for the delay of a patient's surgery and unnecessary paperwork if the submission pathways are misunderstood or a streamlined protocol is not in place. The objective of this study was to review the existing FDA custom implant approval pathways and to determine whether this process was improved with an institutional protocol. An institutional protocol for obtaining IRB and FDA approval for customizable orthopaedic implants was established with the IRB at our institution in 2013. This protocol was approved by the IRB, such that new patients only require submission of a modification to the existing protocol with individualized patient information. During the two-year period of 2013-2014, eight patients were retrospectively identified as having required customizable implants for various orthopaedic oncology surgeries. The dates of request for IRB approval, request for FDA approval, and total time to surgery were recorded, along with the specific pathway utilized for FDA approval. The average patient age was 12 years old (7-21 years old). The average time to IRB approval of a modification to the pre-approved protocol was 14 days (7-21 days). Average time to FDA approval after submission of the IRB approval to the manufacturer was 12.5 days (7-19 days). FDA approval was obtained for all implants as compassionate use requests in accordance with Section 561 of the Federal Food Drug and Cosmetic Act's expanded access provisions. Establishment of an institutional protocol with pre-approval by the IRB can expedite the otherwise time-consuming and complicated

  18. Assessment Tools for Peripheral Neuropathy in Pediatric Oncology: A Systematic Review From the Children's Oncology Group.

    Science.gov (United States)

    Smolik, Suzanne; Arland, Lesley; Hensley, Mary Ann; Schissel, Debra; Shepperd, Barbara; Thomas, Kristin; Rodgers, Cheryl

    Peripheral neuropathy is a known side effect of several chemotherapy agents, including vinca alkaloids and platinum-based chemotherapy. Early recognition and monitoring of this side effect is an important role of the pediatric oncology nurse. There are a variety of peripheral neuropathy assessment tools currently in use, but the usefulness of these tools in identifying and grading neuropathy in children varies, and there is currently no standardized tool in place to evaluate peripheral neuropathy in pediatric oncology. A systematic review was performed to identify the peripheral neuropathy assessment tools that best evaluate the early onset and progression of peripheral neuropathy in pediatric patients receiving vincristine. Because of the limited information available in pediatric oncology, this review was extended to any pediatric patient with neuropathy. A total of 8 studies were included in the evidence synthesis. Based on available evidence, the pediatric-modified Total Neuropathy Scale (ped-m TNS) and the Total Neuropathy Score-pediatric version (TNS-PV) are recommended for the assessment of vincristine-induced peripheral neuropathy in children 6 years of age and older. In addition, several studies demonstrated that subjective symptoms alone are not adequate to assess for vincristine-induced peripheral neuropathy. Nursing assessment of peripheral neuropathy should be an integral and regular part of patient care throughout the course of chemotherapy treatment.

  19. Integrating the Healthcare Enterprise in Radiation Oncology Plug and Play-The Future of Radiation Oncology?

    International Nuclear Information System (INIS)

    Abdel-Wahab, May; Rengan, Ramesh; Curran, Bruce; Swerdloff, Stuart; Miettinen, Mika; Field, Colin; Ranjitkar, Sunita; Palta, Jatinder; Tripuraneni, Prabhakar

    2010-01-01

    Purpose: To describe the processes and benefits of the integrating healthcare enterprises in radiation oncology (IHE-RO). Methods: The IHE-RO process includes five basic steps. The first step is to identify common interoperability issues encountered in radiation treatment planning and the delivery process. IHE-RO committees partner with vendors to develop solutions (integration profiles) to interoperability problems. The broad application of these integration profiles across a variety of vender platforms is tested annually at the Connectathon event. Demonstration of the seamless integration and transfer of patient data to the potential users are then presented by vendors at the public demonstration event. Users can then integrate these profiles into requests for proposals and vendor contracts by institutions. Results: Incorporation of completed integration profiles into requests for proposals can be done when purchasing new equipment. Vendors can publish IHE integration statements to document the integration profiles supported by their products. As a result, users can reference integration profiles in requests for proposals, simplifying the systems acquisition process. These IHE-RO solutions are now available in many of the commercial radiation oncology-related treatment planning, delivery, and information systems. They are also implemented at cancer care sites around the world. Conclusions: IHE-RO serves an important purpose for the radiation oncology community at large.

  20. Information technology resource management in radiation oncology.

    Science.gov (United States)

    Siochi, R Alfredo; Balter, Peter; Bloch, Charles D; Bushe, Harry S; Mayo, Charles S; Curran, Bruce H; Feng, Wenzheng; Kagadis, George C; Kirby, Thomas H; Stern, Robin L

    2009-09-02

    The ever-increasing data demands in a radiation oncology (RO) clinic require medical physicists to have a clearer understanding of the information technology (IT) resource management issues. Clear lines of collaboration and communication among administrators, medical physicists, IT staff, equipment service engineers and vendors need to be established. In order to develop a better understanding of the clinical needs and responsibilities of these various groups, an overview of the role of IT in RO is provided. This is followed by a list of IT related tasks and a resource map. The skill set and knowledge required to implement these tasks are described for the various RO professionals. Finally, various models for assessing one's IT resource needs are described. The exposition of ideas in this white paper is intended to be broad, in order to raise the level of awareness of the RO community; the details behind these concepts will not be given here and are best left to future task group reports.

  1. The Future of Precision Medicine in Oncology.

    Science.gov (United States)

    Millner, Lori M; Strotman, Lindsay N

    2016-09-01

    Precision medicine in oncology focuses on identifying which therapies are most effective for each patient based on genetic characterization of the cancer. Traditional chemotherapy is cytotoxic and destroys all cells that are rapidly dividing. The foundation of precision medicine is targeted therapies and selecting patients who will benefit most from these therapies. One of the newest aspects of precision medicine is liquid biopsy. A liquid biopsy includes analysis of circulating tumor cells, cell-free nucleic acid, or exosomes obtained from a peripheral blood draw. These can be studied individually or in combination and collected serially, providing real-time information as a patient's cancer changes. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Clinical quality assurance in radiation oncology

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    A quality assurance program in radiation oncology monitors and evaluates any departmental functions which have an impact on patient outcome. The ultimate purpose of the program is to maximize health benefit to the patient without a corresponding increase in risk. The foundation of the program should be the credo: at least do no harm, usually do some good and ideally realize the greatest good. The steep dose response relationships for tumor control and complications require a high degree of accuracy and precision throughout the entire process of radiation therapy. It has been shown that failure to control local disease with radiation may result in decreased survival and may increase the cost of care by a factor of 3. Therefore, a comprehensive quality assurance program which seeks to optimize dose delivery and which encompasses both clinical and physics components, is needed

  3. The Rise of Big Data in Oncology.

    Science.gov (United States)

    Fessele, Kristen L

    2018-05-01

    To describe big data and data science in the context of oncology nursing care. Peer-reviewed and lay publications. The rapid expansion of real-world evidence from sources such as the electronic health record, genomic sequencing, administrative claims and other data sources has outstripped the ability of clinicians and researchers to manually review and analyze it. To promote high-quality, high-value cancer care, big data platforms must be constructed from standardized data sources to support extraction of meaningful, comparable insights. Nurses must advocate for the use of standardized vocabularies and common data elements that represent terms and concepts that are meaningful to patient care. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. The oncologic and the geriatric patient

    International Nuclear Information System (INIS)

    Philotheou, Geraldine M

    2002-01-01

    The oncologic and the geriatric patient have special needs in the nuclear medicine department. The nuclear medicine technologists must be knowledgeable and compassionate when dealing with these patients. The diagnosis of cancer will have a sociological and psychological impact on the patient, to which the technologist must relate in an empathetic way. Furthermore, the technologist should take cognisance of the patient's physical condition and be able to modify the examination accordingly. Dealing with the geriatric patient should be correctly placed on the continuum between a gerontological and geriatric approach taking into consideration normal changes due to aging. The patient experience when undergoing the high technology nuclear medicine diagnostic procedure is unique and all effort must be made to ensure the success of the examination and the satisfaction of the patient (Au)

  5. Phantom Limb Pain in Pediatric Oncology

    Directory of Open Access Journals (Sweden)

    Patrick DeMoss

    2018-04-01

    Full Text Available Phantom limb pain (PLP is a prevalent problem for children and adolescents undergoing amputation due to cancer treatment. The symptoms are wide ranging from sharp to tingling. PLP in children typically lasts for a few minutes but can be almost constant and can be highly distressing. This focused review describes the characteristics, epidemiology, mechanisms, and evidence-based treatment of PLP in pediatric populations, focusing on pediatric cancer. In pediatric oncology, the administration of chemotherapy is a risk factor that potentially sensitizes the nervous system and predisposes pediatric cancer patients to develop PLP after amputation. Gabapentin, tricyclic antidepressants, opiates, nerve blocks, and epidural catheters have shown mixed success in adults and case reports document potential utility in pediatric patients. Non-pharmacologic treatments, such as mirror therapy, psychotherapy, and acupuncture have also been used in pediatric PLP with success. Prospective controlled trials are necessary to advance care for pediatric patients with PLP.

  6. Innovative radiopharmaceuticals in oncology and neurology

    CERN Document Server

    Barbet, Jacques; Chérel, Michel; Guilloteau, Denis

    2017-01-01

    The aim of this Research Topic was to assemble a series of articles describing basic, preclinical and clinical research studies on radiopharmaceuticals and nuclear medicine. The articles were written by attendees of the third Nuclear Technologies for Health Symposium (NTHS, 10th-11th March 2015, Nantes, Frances) under the auspices of the IRON LabEx (Innovative Radiopharmaceuticals for Oncology and Neurology Laboratory of Excellence). This French network, gathering approximately 160 scientists from 12 academic research teams (Funded by “investissements d’Avenir”), fosters transdisciplinary projects between teams with expertise in chemistry, radiochemistry, radiopharmacy, formulation, biology, nuclear medicine and medical physics. The 12 articles within this resulting eBook present a series of comprehensive reviews and original research papers on multimodality imaging and targeted radionuclide therapy; illustrating the different facets of studies currently conducted in these domains.

  7. Use of electronic medical records in oncology outcomes research

    Directory of Open Access Journals (Sweden)

    Gena Kanas

    2010-02-01

    Full Text Available Gena Kanas1, Libby Morimoto1, Fionna Mowat1, Cynthia O’Malley2, Jon Fryzek3, Robert Nordyke21Exponent, Inc., Menlo Park, CA, USA; 2Amgen, Inc., Thousand Oaks, CA, USA; 3MedImmune, Gaithersburg, MD, USAAbstract: Oncology outcomes research could benefit from the use of an oncology-specific electronic medical record (EMR network. The benefits and challenges of using EMR in general health research have been investigated; however, the utility of EMR for oncology outcomes research has not been explored. Compared to current available oncology databases and registries, an oncology-specific EMR could provide comprehensive and accurate information on clinical diagnoses, personal and medical histories, planned and actual treatment regimens, and post-treatment outcomes, to address research questions from patients, policy makers, the pharmaceutical industry, and clinicians/researchers. Specific challenges related to structural (eg, interoperability, data format/entry, clinical (eg, maintenance and continuity of records, variety of coding schemes, and research-related (eg, missing data, generalizability, privacy issues must be addressed when building an oncology-specific EMR system. Researchers should engage with medical professional groups to guide development of EMR systems that would ultimately help improve the quality of cancer care through oncology outcomes research.Keywords: medical informatics, health care, policy, outcomes

  8. Attitudes of Chinese Oncology Physicians Toward Death with Dignity.

    Science.gov (United States)

    Chen, Hui-Ping; Huang, Bo-Yan; Yi, Ting-Wu; Deng, Yao-Tiao; Liu, Jie; Zhang, Jie; Wang, Yu-Qing; Zhang, Zong-Yan; Jiang, Yu

    2016-08-01

    Death with dignity (DWD) refers to the refusal of life-prolonging measures for terminally ill patients by "living wills" forms in advance. More and more oncology physicians are receiving DWD requests from advance cancer patients in mainland China. The study objective was to investigate the attitudes of Chinese oncology physicians toward the legalization and implementation of DWD. A questionnaire investigating the understanding and attitudes toward DWD was administered to 257 oncology physicians from 11 hospitals in mainland China. The effective response rate was 86.8% (223/257). The majority of oncology physicians (69.1%) had received DWD requests from patients. Half of the participants (52.5%) thought that the most important reason was the patients' unwillingness to maintain survival through machines. One-third of participants (33.0%) attributed the most important reason to suffering from painful symptoms. Most oncology physicians (78.9%) had knowledge about DWD. A fifth of respondents did not know the difference between DWD and euthanasia, and a few even considered DWD as euthanasia. The majority of oncology physicians supported the legalization (88.3%) and implementation (83.9%) of DWD. Many Chinese oncology physicians have received advanced cancer patients' DWD requests and think that DWD should be legalized and implemented. Chinese health management departments should consider the demands of physicians and patients. It is important to inform physicians about the difference between DWD and euthanasia, as one-fifth of them were confused about it.

  9. A Nationwide Medical Student Assessment of Oncology Education.

    Science.gov (United States)

    Mattes, Malcolm D; Patel, Krishnan R; Burt, Lindsay M; Hirsch, Ariel E

    2016-12-01

    Cancer is the second leading cause of death in the USA, but there is minimal data on how oncology is taught to medical students. The purpose of this study is to characterize oncology education at US medical schools. An electronic survey was sent between December 2014 and February 2015 to a convenience sample of medical students who either attended the American Society for Radiation Oncology annual meeting or serve as delegates to the American Association of Medical Colleges. Information on various aspects of oncology instruction at participants' medical schools was collected. Seventy-six responses from students in 28 states were received. Among the six most common causes of death in the USA, cancer reportedly received the fourth most curricular time. During the first, second, and third years of medical school, participants most commonly reported 6-10, 16-20, and 6-10 h of oncology teaching, respectively. Participants were less confident in their understanding of cancer treatment than workup/diagnosis or basic science/natural history of cancer (p oncology-oriented clerkship. During each mandatory rotation, Oncology education is often underemphasized and fragmented with wide variability in content and structure between medical schools, suggesting a need for reform.

  10. Physical Activity Promotion, Beliefs, and Barriers Among Australasian Oncology Nurses.

    Science.gov (United States)

    Keogh, Justin W L; Pühringer, Petra; Olsen, Alicia; Sargeant, Sally; Jones, Lynnette M; Climstein, Mike

    2017-03-01

    To describe the physical activity (PA) promotion practices, beliefs, and barriers of Australasian oncology nurses and gain preliminary insight into how PA promotion practices may be affected by the demographics of the nurses.
. Cross-sectional survey.
. Australia and New Zealand.
. 119 registered oncology nurses.
. Self-reported online survey completed once per participant.
. Questions assessed the PA promotion beliefs (e.g., primary healthcare professionals responsible for PA promotion, treatment stage), PA benefits (e.g., primary benefits, evidence base), and PA promotion barriers of oncology nurses.
. Oncology nurses believed they were the major providers of PA advice to their patients. They promoted PA prior to, during, and post-treatment. The three most commonly cited benefits of PA for their patients were improved quality of life, mental health, and activities of daily living. Lack of time, lack of adequate support structures, and risk to patient were the most common barriers to PA promotion. Relatively few significant differences in the oncology nurses' PA promotion practices, beliefs, and barriers were observed based on hospital location or years of experience.
. Despite numerous barriers, Australasian oncology nurses wish to promote PA to their patients with cancer across multiple treatment stages because they believe PA is beneficial for their patients.
. Hospitals may need to better support oncology nurses in promoting PA to their patients and provide better referral pathways to exercise physiologists and physiotherapists.

  11. The Role of Oncology Nurses in Discussing Clinical Trials.

    Science.gov (United States)

    Flocke, Susan A; Antognoli, Elizabeth; Daly, Barbara J; Jackson, Brigid; Fulton, Sarah E; Liu, Tasnuva M; Surdam, Jessica; Manne, Sharon; Meropol, Neal J

    2017-09-01

    To describe oncology nurses' experiences discussing clinical trials with their patients, and to assess barriers to these discussions.
. A qualitative study designed to elicit narratives from oncology nurses. 
. Community- and academic-based oncology clinics throughout the United States.
. 33 oncology nurses involved in direct patient care in community-based and large hospital-based settings. The sample was drawn from members of the Oncology Nursing Society. 
. In-depth interviews were conducted and analyzed using a 
immersion/crystallization approach to identify themes and patterns. The analyses highlight specific issues, examples, and contexts that present challenges to clinical trial discussions with patients.
. Oncology nurses view their roles as patient educators and advocates to be inclusive of discussion of clinical trials. Barriers to such discussions include lack of knowledge and strategies for addressing patients' common misconceptions and uncertainty about the timing of discussions.
. These data indicate that enabling nurses to actively engage patients in discussions of clinical trials requires educational interventions to build self-efficacy and close knowledge gaps. 
. Oncology nurses can play a critical role in advancing cancer care by supporting patients in decision making about clinical trial participation. This will require training and education to build their knowledge, reduce barriers, and increase their self-efficacy to fulfill this responsibility in various clinical settings.

  12. It takes chutzpah: oncology nurse leaders.

    Science.gov (United States)

    Green, E

    1999-01-01

    Chutzpah, according to the Oxford Dictionary of Current English (1996) is a slang term from the Yiddish language which means shameless audacity. Chutzpah has been used to identify people with courage who take on situations that others avoid and somehow achieve the impossible. Tim Porter-O'Grady (1997) recently wrote that management is dead, and has been replaced by process leadership. Health care organizations have made shifts from hierarchical structures to process or program models where people have dual/multiple reporting/communication relationship. In this new orientation, management functions of controlling, directing, organizing and disciplining are replaced by process leadership functions of coordinating, facilitating, linking and sustaining (Porter O'Grady, 1997). Herein lies the challenge for oncology nurse leaders: "what lies behind us and what lies before us are tiny matters compared to what lies within us" (Ralph Waldo Emerson). Leadership is not a function of job title. The evidence for this is clear in current practice.... There are no/few positions of nurse leaders. Titles have changed to eliminate the professional discipline, and reflect a non-descript orientation. The new titles are process leaders, program leaders, professional practice leaders. Nurse leaders need new points of reference to take in the challenges of influencing, facilitating and linking. Those points of reference are: principle-centered leadership, integrity and chutzpah. This presentation will focus on examining current thinking, defining key characteristics and attributes, and using scenarios to illustrate the impact of leadership. We, as leaders in oncology nursing, must use chutzpah to make positive change and long-term gains for patient care and the profession of nursing.

  13. Faculty of Radiation Oncology 2010 workforce survey.

    Science.gov (United States)

    Leung, John; Vukolova, Natalia

    2011-12-01

    This paper outlines the key results of the Faculty of Radiation Oncology 2010 workforce survey and compares these results with earlier data. The workforce survey was conducted in mid-2010 using a custom-designed 17-question survey. The overall response rate was 76%. The majority of radiation oncologist respondents were male (n = 212, 71%), but the majority of trainee respondents were female (n = 59, 52.7%). The age range of fellows was 32-92 years (median: 47 years; mean: 49 years) and that of trainees was 27-44 years (median: 31 years; mean: 31.7 years). Most radiation oncologists worked at more than one practice (average: two practices). The majority of radiation oncologists worked in the public sector (n = 169, 64.5%), with some working in 'combination' of public and private sectors (n = 65, 24.8%) and a minority working in the private sector only (n = 28, 10.7%). The hours worked per week ranged from 1 to 85 (mean: 44 h; median: 45 h) for radiation oncologists, while for trainees the range was 16-90 (mean: 47 h; median: 45 h). The number of new cases seen in a year ranged from 1 to 1100 (mean: 275; median: 250). Most radiation oncologists considered themselves generalists with a preferred sub-specialty (43.3%) or specialists (41.9%), while a minority considered themselves as generalists (14.8%). There are a relatively large and increasing number of radiation oncologists and trainees compared with previous years. The excessive workloads evident in previous surveys appear to have diminished. However, further work is required on assessing the impact of ongoing feminisation and sub-specialisation. © 2011 The Authors. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.

  14. Voluntary Informed Consent in Paediatric Oncology Research.

    Science.gov (United States)

    Dekking, Sara A S; Van Der Graaf, Rieke; Van Delden, Johannes J M

    2016-07-01

    In paediatric oncology, research and treatments are often closely combined, which may compromise voluntary informed consent of parents. We identified two key scenarios in which voluntary informed consent for paediatric oncology studies is potentially compromised due to the intertwinement of research and care. The first scenario is inclusion by the treating paediatric oncologist, the second scenario concerns treatments confined to the research context. In this article we examine whether voluntary informed consent of parents for research is compromised in these two scenarios, and if so whether this is also morally problematic. For this, we employ the account of voluntary consent from Nelson and colleagues, who assert that voluntary consent requires substantial freedom from controlling influences. We argue that, in the absence of persuasion or manipulation, inclusion by the treating physician does not compromise voluntariness. However, it may function as a risk factor for controlling influence as it narrows the scope within which parents make decisions. Furthermore, physician appeal to reciprocity is not controlling as it constitutes persuasion. In addition, framing information is a form of informational manipulation and constitutes a controlling influence. In the second scenario, treatments confined to the research context qualify as controlling if the available options are restricted through manipulation of options. Although none of the influences is morally problematic in itself, a combination of influences may create morally problematic instances of involuntary informed consent. Therefore, safeguards should be implemented to establish an optimal environment for parents to provide voluntary informed consent in an integrated research-care context. © 2015 John Wiley & Sons Ltd.

  15. Oncological Outcomes After Robotic Proctectomy for Rectal Cancer: Analysis of a Prospective Database.

    Science.gov (United States)

    Sammour, Tarik; Malakorn, Songphol; Bednarski, Brian K; Kaur, Harmeet; Shin, Ui Sup; Messick, Craig; You, Yi-Qian Nancy; Chang, George J

    2018-03-01

    The aim of this study is to evaluate the oncological outcomes of robotic total mesorectal excision (TME) at an NCI designated cancer center. The effectiveness of laparoscopic TME could not be established, but the robotic-assisted approach may hold some promise, with improved visualization and ergonomics for pelvic dissection. Oncological outcome data is presently lacking. Patients who underwent total mesorectal excision or tumor-specific mesorectal excision for rectal cancer between April 2009 and April 2016 via a robotic approach were identified from a prospective single-institution database. The circumferential resection margin (CRM), distal resection margin, and TME completeness rates were determined. Kaplan-Meier analysis of disease-free survival and overall survival was performed for all patients treated with curative intent. A total of 276 patients underwent robotic proctectomy during the study period. Robotic surgery was performed initially by 1 surgeon with 3 additional surgeons progressively transitioning from open to robotic during the study period with annual increase in the total number of cases performed robotically. Seven patients had involved circumferential resection margins (2.5%), and there were no positive distal or proximal resection margins. One hundred eighty-six patients had TME quality assessed, and only 1 patient (0.5%) had an incomplete TME. Eighty-three patients were followed up for a minimum of 3 years, with a local recurrence rate of 2.4%, and a distant recurrence rate of 16.9%. Five-year disease-free survival on Kaplan-Meier analysis was 82%, and 5-year overall survival was 87%. Robotic proctectomy for rectal cancer can be performed with good short and medium term oncological outcomes in selected patients.

  16. Ischemic Gastric Conditioning by Preoperative Arterial Embolization Before Oncologic Esophagectomy: A Single-Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Ghelfi, Julien, E-mail: JGhelfi@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Radiologie et Imagerie Médicale (France); Brichon, Pierre-Yves, E-mail: PYBrichon@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Chirurgie Thoracique, Vasculaire et Endocrinienne (France); Frandon, Julien, E-mail: Julien.frandon@chu-nimes.fr [CHU de Nîmes, Clinique Universitaire de Radiologie et Imagerie Médicale (France); Boussat, Bastien, E-mail: BBoussat@chu-grenoble.fr [CHU de Grenoble, Département d’Information Médicale, Pôle de Santé Publique (France); Bricault, Ivan, E-mail: IBricault@chu-grenoble.fr; Ferretti, Gilbert, E-mail: GFerretti@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Radiologie et Imagerie Médicale (France); Guigard, Sébastien, E-mail: SGuigard@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Chirurgie Thoracique, Vasculaire et Endocrinienne (France); Sengel, Christian, E-mail: CSengel@chu-grenoble.fr [CHU de Grenoble, Clinique Universitaire de Radiologie et Imagerie Médicale (France)

    2017-05-15

    PurposeSurgical esophagectomy is the gold standard treatment of early-stage esophageal cancer. The procedure is complicated with significant morbidity; the most severe complication being the anastomotic leakage. Anastomotic fistulas are reported in 5–25% of cases and are mainly due to gastric transplant ischemia. Here, we report our experience of ischemic pre-conditioning using preoperative arterial embolization (PreopAE) before esophagectomy.Materials and MethodsThe medical records of all patients who underwent oncologic esophagectomy from 2008 to 2015 were retrospectively reviewed. Patients were divided into two groups: patients who received PreopAE, and a control group of patients who did not benefit from ischemic pre-conditioning. The target arteries selected for PreopAE were the splenic artery, left gastric artery, and right gastric artery. Evaluation of the results was based on anastomotic leakage, postoperative mortality, technical success of PreopAE, and complications related to the embolization procedure.ResultsForty-six patients underwent oncologic esophagectomy with PreopAE and 13 patients did not receive ischemic conditioning before surgery. Thirty-eight PreopAE were successfully performed (83%), but right gastric artery embolization failed for 8 patients. Anastomotic leakage occurred in 6 PreopAE patients (13%) and in 6 patients (46%) in the control group (p = 0.02). The mortality rate was 2% in the PreopAE group and 23% in the control group (p = 0.03). Eighteen patients suffered from partial splenic infarction after PreopAE, all treated conservatively.ConclusionPreoperative ischemic conditioning by arterial embolization before oncologic esophagectomy seems to be effective in preventing anastomotic leakage.

  17. Integrative oncology for breast cancer patients: introduction of an expert-based model

    International Nuclear Information System (INIS)

    Dobos, Gustav J; Voiss, Petra; Schwidde, Ilka; Choi, Kyung-Eun; Paul, Anna; Kirschbaum, Barbara; Saha, Felix J; Kuemmel, Sherko

    2012-01-01

    Malignant breast neoplasms are among the most frequent forms of cancer in the Western world. Conventional treatment of breast cancer may include surgery, hormonal therapy, chemotherapy, radiation and/or immunotherapy, all of which are often accompanied by severe side effects. Complementary and alternative medicine (CAM) treatments have been shown to be effective in alleviating those symptoms. Furthermore, with patient survival rates increasing, oncologists, psychologists and other therapists have to become more sensitive to the needs of cancer survivors that go beyond than the mere alleviation of symptoms. Many CAM methods are geared to treat the patient in a holistic manner and thus are also concerned with the patient’s psychological and spiritual needs. The use of certain CAM methods may become problematic when, as frequently occurs, patients use them indiscriminately and without informing their oncologists. Herbal medicines and dietary supplements, especially, may interfere with primary cancer treatments or have other detrimental effects. Thus, expertise in this highly specialized field of integrative medicine should be available to patients so that they can be advised about the benefits and negative effects of such preparations and practices. Being a beneficial combination of conventional and CAM care, integrative oncology makes possible the holistic approach to cancer care. The concept of integrative oncology for breast cancer is jointly practiced by the Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, academic teaching hospital of the University of Duisburg-Essen, and the Breast Center at Kliniken Essen-Mitte in Germany. This model is introduced here; its scope is reviewed, and its possible implications for the practice of integrative medicine are discussed. Evidence-based integrative care is crucial to the field of oncology in establishing state-of-the-art care for breast cancer patients

  18. The need for psycho-oncological support for melanoma patients

    Science.gov (United States)

    Mayer, Simone; Teufel, Martin; Schaeffeler, Norbert; Keim, Ulrike; Garbe, Claus; Eigentler, Thomas Kurt; Zipfel, Stephan; Forschner, Andrea

    2017-01-01

    Abstract Despite an increasing number of promising treatment options, only a limited number of studies concerning melanoma patients’ psycho-oncological distress have been carried out. However, multiple screening tools are in use to assess the need for psycho-oncological support. This study aimed first to identify parameters in melanoma patients that are associated with a higher risk for being psycho-oncologically distressed and second to compare patients’ self-evaluation concerning the need for psycho-oncological support with the results of established screening tools. We performed a cross-sectional study including 254 melanoma patients from the Center for Dermatooncology at the University of Tuebingen. The study was performed between June 2010 and February 2013. Several screening instruments were included: the Distress Thermometer (DT), Hospital Anxiety and Depression Scale and the patients’ subjective evaluation concerning psycho-oncological support. Binary logistic regression was performed to identify factors that indicate the need for psycho-oncological support. Patients’ subjective evaluation concerning the need for psycho-oncological support, female gender, and psychotherapeutic or psychiatric treatment at present or in the past had the highest impact on values above threshold in the DT. The odds ratio of patients’ self-evaluation (9.89) was even higher than somatic factors like female gender (1.85), duration of illness (0.99), or increasing age (0.97). Patients’ self-evaluation concerning the need for psycho-oncological support indicated a moderate correlation with the results of the screening tools included. In addition to the results obtained by screening tools like the DT, we could demonstrate that patients’ self-evaluation is an important instrument to identify patients who need psycho-oncological support. PMID:28906378

  19. [Advantages and disadvantages of minimally invasive surgery in colorectal cancer surgery].

    Science.gov (United States)

    Zheng, Minhua; Ma, Junjun

    2017-06-25

    Since the emergence of minimally invasive technology twenty years ago, as a surgical concept and surgical technique for colorectal cancer surgery, its obvious advantages have been recognized. Laparoscopic technology, as one of the most important technology platform, has got a lot of evidence-based support for the oncological safety and effectiveness in colorectal cancer surgery Laparoscopic technique has advantages in terms of identification of anatomic plane and autonomic nerve, protection of pelvic structure, and fine dissection of vessels. But because of the limitation of laparoscopic technology there are still some deficiencies and shortcomings, including lack of touch and lack of stereo vision problems, in addition to the low rectal cancer, especially male, obese, narrow pelvis, larger tumors, it is difficult to get better view and manipulating triangle in laparoscopy. However, the emergence of a series of new minimally invasive technology platform is to make up for the defects and deficiencies. The robotic surgical system possesses advantages, such as stereo vision, higher magnification, manipulator wrist with high freedom degree, filtering of tremor and higher stability, but still has disadvantages, such as lack of haptic feedback, longer operation time, high operation cost and expensive price. 3D system of laparoscopic surgery has similar visual experience and feelings as robotic surgery in the 3D view, the same operating skills as 2D laparoscopy and a short learning curve. The price of 3D laparoscopy is also moderate, which makes the 3D laparoscopy more popular in China. Transanal total mesorectal excision (taTME) by changing the traditional laparoscopic pelvic surgery approach, may have certain advantages for male cases with narrow pelvic and patients with large tumor, and it is in accordance with the technical concept of natural orifice, with less minimally invasive and better cosmetics, which can be regarded as a supplemental technique of the

  20. Exploring oncology nurses' grief: A self-study

    Directory of Open Access Journals (Sweden)

    Lisa C Barbour

    2016-01-01

    Full Text Available Oncology nursing, like many other nursing fields, often provides nurses with the opportunity to get to know their patients and their families well. This familiarity allows oncology nurses to show a level of compassion and empathy that is often helpful to the patient and their family during their struggle with cancer. However, this familiarity can also lead to a profound sense of grief if the patient loses that struggle. This self-study provided me the opportunity to systematically explore my own experience with grief as an oncology nurse, helping me to identify specific stressors and also sources of stress release.