– April 1, 2008
April 1, 2008
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Defining Minimal Therapy for Localized Breast Cancer in Older Women
In a series of 354 elderly breast cancer patients treated with conservative surgery and tamoxifen but without axillary dissection or radiotherapy followed for 15 years, the cumulative incidence of developing axillary disease was 4.2%, and of developing local recurrence was 8.3%. Of the 354 subjects, 268 had died over the 15-year period, 17% of breast cancer and (83%) from causes other than breast cancer. -
Pet Scan Surveillance for Early Detection of Colorectal Cancer
In a prospective randomized trial comparing post-surgical follow-up for patients with Stage III and IV colon cancer, PET-CT was found to detect recurrence earlier and to result in a greater number of patients eligible for surgical resection of isolated metastases when compared to conventional follow-up schedules that include CT scanning. -
Cytogenetics Predict Outcome in Adult ALL
The prognostic importance of cytogenetics was evaluated in 200 adults between 15 and 65 years of age treated on a single ALL cooperative group protocol. Among the 140 having evaluable cytogenetic data, four risk categories were devised. Philadelphia chromosome positive t(9;22), unfavorable (monosomy 7, trisomy 8 or an 11q23 rearrangement), miscellaneous and normal. Overall survival of the miscellaneous group was similar to the normal karyotype patients whereas survival was considerably worse for both unfavorable and Ph + cytogenetic groups. The traditional adverse risk factors of older age and higher presenting white blood cell count were not associated with worse survival after adjusting for cytogenetics. In adult ALL, cytogenetics categories may be the strongest factor in predicting outcome. -
Prognostic Significance of Circulating Breast Cancer Cells in Patients with Known Metastatic Disease
In a series of patients with metastatic breast cancer peripheral blood and bone marrow were assayed for the detection of breast cancer cells. Breast cancer cells were found in the bone marrow in 59% of patients but their presence did not provide prognostic information with regard to survival. In contrast, survival was significantly worse for the 41% of patients with detectable circulating breast cancer cells. -
R-CHOP Schedules for Older Patients with NHL
In this large, multi-site randomized clinical trial in older patients with non-Hodgkin lymphoma (NHL), R-CHOP-14 proved superior to CHOP-14 and 8 cycles offered no advantage compared with 6. -
Pharmacology Watch
Does erythropoietin worsen cancer death rates? Most hypothyroid patients can be replaced with levothyroxine alone without additional T3. Does aggressive control in type 2 diabetes save lives? -
Clinical Briefs in Primary Care Supplement