Importance of surgeons in cooperative groups: Perspectives from the medical oncologists

2021 ◽  
Vol 125 (1) ◽  
pp. 93-94
Author(s):  
George Fisher ◽  
Peter O'Dwyer
Keyword(s):  
Cooperative Groups ◽  
Medical Oncologists

Enrollment barriers of adolescents and young adults (AYA) on the non-chemotherapy arm of ARST1321.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19214-e19214
Author(s):  
Lisa M. Kopp ◽  
Damon R. Reed ◽  
Safia K. Ahmed ◽  
Wendy Allen-Rhoades ◽  
Viswatej Avutu ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Adolescent And Young Adult ◽  
Preoperative Radiation ◽  
Cooperative Groups ◽  
Online Questionnaire ◽  
Enrollment Patterns ◽  
Medical Oncologists ◽  
Adults And Children ◽  
Barriers To Enrollment ◽  
A Site

e19214 Background: ARST1321(PAZNTIS): A Phase II/III Randomized Trial of Preoperative Chemoradiation or Preoperative Radiation Plus or Minus Pazopanib (NCT02180867) was the first National Clinical Trials Network (NCTN) study co-developed by pediatric (COG) and adult (NRG Oncology) consortia anticipating enrollment of adolescent and young adult (AYA) cancer patients. ARST1321 had two treatment cohorts, enrolling patients ≥ 2 years of age to either chemotherapy (C) (chemoradiation ± pazopanib) or non-chemotherapy (NC) (radiation ± pazopanib) arms. It was anticipated adults would contribute the majority of enrollments on the NC arm based on prior enrollment patterns. While the C arm accrued as anticipated (with high enrollment of adults and children), the NC arm had low enrollment leading to premature closure. We report on AYA accrual (defined as 15-39 years) to the NC arm and a survey aiming to identify barriers to enrolling AYA patients onto ARST1321. Methods: Our survey was emailed to 161 adult, surgical, and radiation oncologists at large sarcoma centers. A link was sent to an online questionnaire via SurveyMonkey Inc. and responses were reviewed on their platform. Results: 33 patients enrolled on the ARST1321 NC arm, of which 24% were AYA. 25% of AYA enrollments were from non-COG adult cooperative groups. This trial arm was closed in October 2017 after 3.25 years of accrual below anticipated rates. The survey response rate was 31% with a 70% completion rate. Almost half of respondents were medical oncologists with most seeing 50-200 new sarcoma cases/year at an academic institution and 30% in a pediatric environment (divided equally between radiation and surgical oncologists). 70% of respondents have a joint collaboration with their pediatric oncology team with 23% having a joint clinic. 70% of respondents’ sites opened ARST1321 and anticipated 1-5 patients would be eligible for the NC cohort. However, 42% of respondents’ sites had zero patients enrolled on that arm. The most common reasons for not opening the study and/or not enrolling patients on the NC arm included: lack of interest, disagreement with the therapy, lack of a site investigator, premature study closure, patient/family decision, competing trials, insufficient reimbursement, and regulatory delays. Conclusions: Our survey highlights multiple barriers to enrollment of AYA onto cross-NCTN consortia clinical trials spanning the age spectrum. The information obtained will help inform investigators aiming to effectively design, enroll, and conduct similar trial efforts for AYA in the future.

Productive Helping in Cooperative Groups

2001 ◽  
Author(s):  
Noreen M. Webb ◽  
Sydney H. Farivar ◽  
Ann M. Mastergeorge
Keyword(s):  
Cooperative Groups

Lymph nodes detection and the mesorectal excision quality evaluation

2019 ◽  
Vol 98 (5) ◽  
pp. 200-206
Keyword(s):  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Quality Evaluation ◽  
Rectal Resection ◽  
Age Groups ◽  
Cooperative Groups ◽  
Mesorectal Excision ◽  
Proper Number ◽  
Before And After ◽  
And Gender

ntroduction: Detection and examination of proper number of lymph nodes in patients after rectal resection is important for next treatment and management of patients with rectal carcinoma. There are no clear guideliness for minimal count of lymph nodes, variant recommendations agree on the number of 12 (10−14) nodes. There are situations, when is not easy to reach this count, mainly in older age groups and in patients after neoadjuvant, especially radiation therapy. As a modality for improvement of lymph nodes harvesting seems to be establishing of defined protocols originally designed for mesorectal excision quality evaluation. Methods: The investigation group was formed by patients examined in 2 three-years intervals before and after implementation of the protocol. Elevation in count of harvested lymph nodes was rated generaly and in relation to age groups and gender. Results: The average count of lymph nodes increased from 10 to 15 nodes, in subset of patients whose received neoadjuvant therapy from 7 to al- most 14 nodes. The recommended number of lymph nodes was obtained in all investigated age groups. By the increased number of lymph nodes, rises also possibility of positive nodes found, that can lead to upstaging of the disease, in subset of patients whose received neoadjuvant therapy it is more than 4%. Conclusion: Our conclusions show, that forming of multidisciplinary cooperative groups (chiefly surgeon-pathologist), implementation of defined protocol of surgery, specimen manipulation and investigation by detached specialists lead to benefit consequences for further management and treatment of the patients with colorectal cancer.

A Cooperative Species

2011 ◽  
Author(s):  
Samuel Bowles ◽  
Herbert Gintis
Keyword(s):  
Common Good ◽  
Cooperative Groups ◽  
Social Emotions ◽  
Large Numbers ◽  
Group Competition ◽  
Self Interest ◽  
Shame And Guilt ◽  
Group Members ◽  
The Common ◽  
Ethnographic Data

Why do humans, uniquely among animals, cooperate in large numbers to advance projects for the common good? Contrary to the conventional wisdom in biology and economics, this generous and civic-minded behavior is widespread and cannot be explained simply by far-sighted self-interest or a desire to help close genealogical kin. This book shows that the central issue is not why selfish people act generously, but instead how genetic and cultural evolution has produced a species in which substantial numbers make sacrifices to uphold ethical norms and to help even total strangers. The book describes how, for thousands of generations, cooperation with fellow group members has been essential to survival. Groups that created institutions to protect the civic-minded from exploitation by the selfish flourished and prevailed in conflicts with less cooperative groups. Key to this process was the evolution of social emotions such as shame and guilt, and our capacity to internalize social norms so that acting ethically became a personal goal rather than simply a prudent way to avoid punishment. Using experimental, archaeological, genetic, and ethnographic data to calibrate models of the coevolution of genes and culture as well as prehistoric warfare and other forms of group competition, the book provides a compelling and novel account of human cooperation.

Competitive Members in Cooperative Groups

2005 ◽  
Author(s):  
Andrea B. Hollingshead ◽  
Gwen Wittenbaum ◽  
Gwen Costa Jacobsohn ◽  
Samuel N. Fraidin
Keyword(s):  
Cooperative Groups

Breast Cancer and Anesthesia

2019 ◽  
Vol 25 (28) ◽  
pp. 2998-3004 ◽  
Author(s):  
Aida Raigon-Ponferrada ◽  
María E.D. Recio ◽  
Jose L. Guerrero-Orriach ◽  
Alfredo Malo-Manso ◽  
Juan J. Escalona-Belmonte ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multidisciplinary Approach ◽  
Biological Therapy ◽  
Comprehensive Treatment ◽  
Medical Oncologists

: Breast cancer is a complex heterogeneous disease that is categorized into several histological and genomic subtypes with relevant prognostic and therapeutical implications. Such diversity requires a multidisciplinary approach for a comprehensive treatment that will involve surgeons, radiotherapists and medical oncologists. Breast cancer is classified as either local (or locoregional), which stands for 90-95% of cases, or metastatic, representing 5% of cases. : The management of breast cancer will be determined by the stage of the disease. The treatment of local breast cancer is based on surgery and/or radiotherapy. Systemic breast cancer requires chemotherapy and/or endocrine and/or biological therapy.

scholarly journals Social distress among medical oncologists and other healthcare professionals during the first wave of COVID-19 pandemic in Italy

ESMO Open ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 100053
Author(s):  
R. Berardi ◽  
M. Torniai ◽  
M.S. Cona ◽  
F.L. Cecere ◽  
R. Chiari ◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Social Distress ◽  
Medical Oncologists
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