Use of an early-detection strategy to improve disease control in melanoma patients

Performance-based grants management is a strategy used by public agencies to improve performance and strengthen accountability by connecting annual award amounts to performance information. This study evaluates the impacts of a performance-based grants management process implemented by the U.S. Centers for Disease Control and Prevention to strengthen the effectiveness of its National Breast and Cervical Cancer Early Detection Program. The study uses panel data and interrupted time-series analysis over 10 years for 51 grantees. Results show partial and conditional effectiveness of the performance-based grants management process in strengthening performance. In particular, the implementation of the performance-based grants management system consistently improved the performance of those grantees for whom the targets were challenging. While prior research has found, in some cases, evidence of a positive impact of performance management practices in improving programs delivered directly by public organizations at the local level, this study examines the performance management–performance relationship in a more challenging context of a federal grants program delivered through a highly decentralized system.

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Isolated same-basin lymph node recurrence after precision lymph node excision for clinically evident melanoma metastasis.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.9576 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 9576-9576

Author(s):

Kevin Lynch ◽

Yinin Hu ◽

Norma Farrow ◽

Yun Song ◽

Max Meneveau ◽

...

Keyword(s):

Lymph Node ◽

Disease Control ◽

Lymph Node Dissection ◽

Patient Preference ◽

Distant Metastases ◽

Node Dissection ◽

Melanoma Patients ◽

Regional Disease ◽

In Transit

9576 Background: While management of the nodal basin for melanoma has largely moved to observation for microscopic sentinel lymph node (SLN) metastasis, complete lymph node dissection (CLND) remains the current standard of care for melanoma patients with macroscopic, clinically detectable lymph node metastases (cLN). As CLND is associated with high surgical morbidity, we sought to study whether cLN may be safely managed by excision of only clinically abnormal nodes (precision lymph node dissection, PLND). Currently, a small subset of patients with cLN do not undergo CLND because of frailty or patient preference. We hypothesized that in these selected patients, PLND would provide acceptable regional control rates. Methods: Retrospective chart review was conducted at four academic tertiary care hospitals to identify melanoma patients who underwent PLND for cLN. cLN were defined as palpable or radiographically abnormal nodes. Recurrences were categorized as local/in-transit, same-basin lymph node, or distal lymph node/visceral. The primary outcome was isolated same-basin recurrence after PLND. Results: Twenty-one patients underwent PLND for cLN without synchronous distant metastases (characteristics of primary lesions summarized in Table). Reasons for forgoing CLND included patient preference (n=8), imaging indeterminate for distant metastases (n=2), comorbidities (n=4), loss to follow up (n=1), partial response to checkpoint blockade (n=1), or not reported (n=5). The inguinal node basin was the most common site (n=10), followed by the axillary (n=8) and cervical basins (n=3). A median of 2 nodes were resected at PLND, and 68% of resected nodes were positive for melanoma (median: 1, range: 1-3 nodes). Median follow-up was 23 months from PLND, and recurrence was observed in 28.6% of patients overall. Only 1 patient (4.8%) developed an isolated same-basin recurrence. The 3-year cumulative incidence of isolated same-basin recurrence was 5.3%, while risk of isolated local/in-transit recurrence or distant basin/visceral metastasis were 19.8% and 33.3%, respectively. Complications from PLND were reported in 1 patient (4.8%) and were limited to post-operative seroma and lymphedema. Conclusions: These pilot data suggest that PLND may offer acceptable regional disease control for cLN. Post-operative morbidity from PLND was also low, raising the possibility that PLND may provide adequate regional disease control without the morbidity associated with CLND. These data justify additional, prospective evaluation of PLND in selected patients.[Table: see text]

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Translating genomic risk into an early detection strategy for sarcoma

Genes Chromosomes and Cancer ◽

10.1002/gcc.22697 ◽

2018 ◽

Vol 58 (2) ◽

pp. 130-136 ◽

Cited By ~ 2

Author(s):

Mandy L. Ballinger ◽

Mark Pinese ◽

David M. Thomas

Keyword(s):

Early Detection ◽

Detection Strategy ◽

Genomic Risk

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Current status of mosaic disease on patchouli and its control in Indonesia

Perspektif ◽

10.21082/psp.v15n2.2016.87-95 ◽

2017 ◽

Vol 15 (2) ◽

pp. 87

Author(s):

Rita Noveriza

Keyword(s):

Early Detection ◽

Disease Control ◽

Mosaic Disease ◽

Detection Methods ◽

Current Status ◽

Citronella Oil ◽

North Sulawesi ◽

Pogostemon Cablin

ABSTRACKIn Indonesia, the patchouli plant has been developed in twenty one Province and now there are 10 provinces that would be the area of development of patchouli with an area of 150 ha and a seed garden is focused in North Sulawesi with an area of 6 hectares. Mosaic disease on patchouli has been developing very fast, within a period of 3 years have spread to the central cultivation of patchouli in Sumatera, Java and Sulawesi. This is mainly due to the multiplication of patchouli by vegetative cutting. Therefore, the use of virus-free seed patchouli and early detection methods of patchouli seed is a major concern. In addition, the maintenance of patchouli seeds in the nursery to be free of mosaic disease and its vector is very important. Sanitation and spraying the plants with formulation of clove and citronella oil needs to be done every one or two weeks to protect the seed patchouli in nursery and every four weeks in field.Keywords: Pogostemon cablin, Potyvirus, biopesticide, mosaic disease control. ABSTRAKStatus terkini penyakit mosaik pada tanaman nilan dan pengendaliannya di IndonesiaDi Indonesia, tanaman nilam telah dikembangkan di duapuluh satu Provinsi dan sekarang ada 10 provinsi yang akan menjadi daerah pengembangan nilam dengan luas 150 ha dan kebun bibit difokuskan di Sulawesi Utara dengan luas 6 hektar. Penyakit mosaik dari nilam telah berkembang sangat cepat, dalam jangka waktu 3 tahun telah menyebar ke budidaya pusat nilam di Sumatera, Jawa dan Sulawesi. Hal ini terutama disebabkan oleh perbanyakan nilam dengan memotong vegetatif. Oleh karena itu, penggunaan nilam benih bebas virus dan metode deteksi dini benih nilam merupakan perhatian utama. Selain itu, pemeliharaan bibit nilam di persemaian untuk bebas dari penyakit mosaik dan vektor yang sangat penting. Sanitasi dan penyemprotan tanaman dengan formulasi cengkeh dan minyak sereh perlu dilakukan setiap satu atau dua minggu untuk melindungi benih nilam di persemaian dan setiap empat minggu di lapangan.Kata kunci: Pogostemon cablin, Potyvirus, biopestisida, pengendalian penyakit mosaik.

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Newborn Hearing Screening — the Ultimate Early Detection Strategy for Hearing Loss

Hearing Impairment ◽

10.1007/978-4-431-68397-1_20 ◽

2004 ◽

pp. 105-112

Author(s):

Harvey Coates ◽

Kim Gifkins

Keyword(s):

Hearing Loss ◽

Early Detection ◽

Hearing Screening ◽

Newborn Hearing Screening ◽

Detection Strategy ◽

Newborn Hearing

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A randomized trial to improve early detection and prevention practices among siblings of melanoma patients

Cancer ◽

10.1002/cncr.22050 ◽

2006 ◽

Vol 107 (4) ◽

pp. 806-814 ◽

Cited By ~ 50

Author(s):

Alan C. Geller ◽

Karen M. Emmons ◽

Daniel R. Brooks ◽

Catherine Powers ◽

Zi Zhang ◽

...

Keyword(s):

Early Detection ◽

Randomized Trial ◽

Melanoma Patients ◽

Early Detection And Prevention

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Epidemiological, Clinical, Molecular Features and Early Detection Strategy of Most Frequent Hereditary Cancers in Latvia

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/v10046-009-0042-5 ◽

2009 ◽

Vol 63 (4-5) ◽

pp. 131-140

Author(s):

Jānis Gardovskis ◽

Ilze Štrumfa ◽

Edvīns Miklaševičs ◽

Arvīds Irmejs ◽

Genādijs Trofimovičs ◽

...

Keyword(s):

Ovarian Cancer ◽

Pancreatic Cancer ◽

Early Detection ◽

Gene Mutation ◽

Brca1 Gene ◽

Founder Mutations ◽

Hereditary Cancers ◽

Molecular Features ◽

Detection Strategy ◽

First Time

Epidemiological, Clinical, Molecular Features and Early Detection Strategy of Most Frequent Hereditary Cancers in Latvia The aim of the study was to determine epidemiological, clinical and molecular features of hereditary breast-ovarian, colorectal, endometrial, prostate and pancreatic cancer in Latvia. The study was performed from 2006 to 2009. Family cancer histories and DNA samples from 5,040 cancer cases were collected, and more than 6,000 molecular tests were performed including multiplex PCR, direct sequencing, denaturing high performance liquid chromatography and others. For the first time, a BRCA2 gene mutation positive hereditary breast cancer family was identified. The necessity of 2 BRCA1 gene founder mutations testing, irrespective of family cancer history for breast and ovarian cancer patients, was confirmed on a large number of positive cases. Regarding hereditary ovarian cancer, every ninth case affected with this malignancy was associated with the BRCA1 gene mutation. For the first time, positive familial adenomatous polyposis cases positive for APC gene mutation were reported and data on the clinical frequency of hereditary endometrial and prostate cancer were provided. In pancreatic cancer patients there was a 3.5% frequency of BRCA1 gene founder mutations.

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Survival of patients (pts) treated with high-dose radiotherapy (RT) and concurrent chemotherapy for unresectable non-small cell lung cancer (NSCLC)

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.7544 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 7544-7544

Author(s):

S. Schild ◽

D. Graham ◽

S. Hillman ◽

S. Vora ◽

G. Yolanda ◽

...

Keyword(s):

Disease Control ◽

Standard Dose ◽

Secondary Analysis ◽

Concurrent Chemotherapy ◽

Phase Iii ◽

High Dose ◽

Entire Cohort ◽

Prior Therapy ◽

Technological Improvements ◽

Improve Disease Control

7544 Background: NCCTG N0028 was a trial that determined the MTD of RT that could be given with carboplatin & paclitaxel was 74 Gy/34 fractions. This secondary analysis was performed to determine the survival of pts treated on this trial. Methods: Eligible pts had medically or surgically unresectable NSCLC, PS=0–1, weight loss <10% in the prior 3 months(mo), no prior therapy, adequate laboratory & pulmonary functions. Included were 25 pts with clinical stages I (4pts), II (1 pt), IIIa (12 pts), & IIIb (8 pts). Treatment included: weekly I.V. paclitaxel (50mg/m2) & carboplatin (AUC=2) during RT. The RT included 2 Gy daily to an initial dose of 70 Gy. The total dose was increased in 4 Gy increments until the MTD was determined. RT was delivered with 3-D treatment planning but no elective nodal RT. Three pts received 70 Gy, 18 pts received 74 Gy, & 4 pts received 78Gy. Results: Pts were followed until death or from 10–67 mo (median: 28mo) in those alive at last evaluation. The median survival (MS) of the entire cohort was 42mo. The 5 stages I-II pts had a MS of 53 mo & the 20 stage III pts had MS of 42mo. Conclusions: Standard dose RT is unable to sterilize disease in the majority of pts with unresectable NSCLC. While the addition of chemotherapy has significantly improved survival of these pts, the MS is generally 15–24 mo. These preliminary results suggest higher than standard doses of RT may improve disease control & prolong survival. A phase III trial comparing standard-dose RT(60Gy) to high-dose RT (74Gy) is open and should more definitively address the issue of RT dose with concurrent chemotherapy for unresectable NSCLC. Future technological improvements in imaging & targeting will provide methods to safely administer even greater RT doses which will likely further improve disease control. No significant financial relationships to disclose.

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