Single-institutional analysis of clinicopathologic features and overall survival (OS) in melanoma patients (pts).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14023-e14023
Author(s):  
Ding Wang ◽  
Jonathan Wang ◽  
Richard Krajenta ◽  
Liping Zhu
Keyword(s):  
Overall Survival ◽  
Cancer Care ◽  
Clinical Care ◽  
Care Facility ◽  
Tumor Board ◽  
National Database ◽  
Survival Outcomes ◽  
Tumor Registry ◽  
Care Pattern

e14023 Background: Melanoma is ranked 5th commonest malignancy in United States and SEER has projected 3,290 new skin melanoma cases in Michigan in 2020. Diagnosis of recurrent & metastatic melanoma has associated with poor prognosis and survival. Henry Ford Cancer Institute (HFCI) is a tertiary cancer care facility serves cancer patients from communities throughout metropolitan Detroit tri-county areas where a higher melanoma presentation (1.56%) in black pts than this group at national database (0.6%). A subgroup of white Michiganders travel to Southern sunshine states in winter months known as “snowbirds” have contributed to melanoma incidences in Michigan. We aim to review our institute tumor registry data to analyze the clinicopathological features, care pattern and correlated survival outcomes. Methods: We have identified adult melanoma pts through institute tumor registry between 2007 – 2017, who had demographics, initial diagnosis, recurrence, then death or last follow-up for overall survival (OS) outcome. Data were analyzed using IBM SPSS, R-statistical and log-rank test. Results: Of 1327 eligible pts, median age was 63, and 874 (65.86%) pts were invasive at onset diagnosis. 1298 (97.81%) pts were white, 23 (1.73%) pts were black. Slightly more females (55.54%) over males and overall 301 deaths (22.68%) were observed. 1277 pts with cutaneous melanoma had better 5- and 10-year (yr) OS at 78.14%, and 68.32% compared to 50 (3.77%) non-cutaneous pts at 13.31% and 8.87%, respectively. Black pts carried a poor 5-yr OS at 34.68% vs white at 76.4%. 116 (17.9%) pts presented with recurrences, had 5-yr OS at 34.58%. Of 121 (9.1%) pts who never had been disease-free, showed worse 5-yr OS at 15.87%, with trend of improvement since FDA-approval of immune checkpoint inhibitor therapies. Conclusions: We have analyzed our melanoma care pattern, experience and survival outcomes at 5-yr and/or 10-yr from a tertiary community cancer care facility. We have assessed our current practice benchmarks with plan to improve our care delivery by having built a multidisciplinary team, and launched Melanoma & Skin Cancer Clinical Care Pathway through Tumor Board to improve care access, to decrease care disparity, then to standardize quality of care including encouraging clinical trial enrollments which will enhance quality of melanoma care and survival outcomes of advanced and metastatic cases.

scholarly journals Considerations for the Management of Women with Breast Cancer during the COVID-19 Pandemic

2020 ◽  
Vol 5 (03) ◽  
pp. 260-263
Author(s):  
Monica Irukulla ◽  
Palwai Vinitha Reddy
Keyword(s):  
Breast Cancer ◽  
Resource Allocation ◽  
Patient Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Clinical Care ◽  
Current Availability ◽  
The Individual

AbstractOutcomes in cancer patients are strongly influenced by timeliness and quality of multidisciplinary interventions. The COVID-19 pandemic has led to severe disruption in cancer care in many countries. This has necessitated several changes in clinical care and workflow, including resource allocation, team segregation and deferment of many elective procedures. Several international oncological societies have proposed guidelines for the care of patients afflicted with breast cancer during the pandemic with a view to optimize resource allocation and maximize risk versus benefit for the individual and society. Clinicians may utilize these recommendations to adapt patient care, based on the current availability of resources and severity of the COVID-19 pandemic in each region. This article discusses the guidelines for care of patients afflicted with breast cancer during the pandemic.

scholarly journals Implementation of a Hospital-Based Quality Assessment Program for Rectal Cancer

2014 ◽  
Vol 10 (3) ◽  
pp. e120-e129 ◽  
Author(s):  
Samantha Hendren ◽  
Ellen McKeown ◽  
Arden M. Morris ◽  
Sandra L. Wong ◽  
Mary Oerline ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Quality Improvement ◽  
Quality Assessment ◽  
Cancer Care ◽  
Registry Data ◽  
Tumor Registry ◽  
Assessment Program

A program linking tumor registry data to quality-improvement data for rectal cancer quality assessment was successfully implemented in 10 hospitals. This program can serve as a template for organizations interested in improving the quality of rectal cancer care.

scholarly journals Integrated Analysis of Immune Infiltration Features for Cervical Carcinoma and Their Associated Immunotherapeutic Responses

2021 ◽  
Vol 9 ◽  
Author(s):  
Yanan Kang ◽  
Jin Huang ◽  
Yang Liu ◽  
Nan Zhang ◽  
Quan Cheng ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Tumor Recurrence ◽  
Preliminary Evidence ◽  
Integrated Analysis ◽  
Survival Outcomes ◽  
Cervical Cancers ◽  
Tcga Dataset ◽  
The Relationship

Cervical cancer is the fourth most prevalent cancer in women, which decreases quality of life of the patients. Traditional interventions have failed to improve the overall survival period of patients due to high tumor recurrence after treatment or late diagnosis. Fortunately, preliminary evidence suggests that anti-angiogenic and immunotherapy can efficiently treat against cervical cancer. However, there is no clear evidence on the efficacy of immunotherapy in cervical cancer. Therefore, in this study, we classified cervical cancers in the TCGA dataset using various algorithms and explored the relationship between the immune profile and corresponding sensitivity of the tumors to immunotherapy. Results showed that patients with tumors had higher expression of immunocytes and longer overall survival time. In addition, we build a scoring system based on the immune landscape of the tumor microenvironment of cervical cancer. Tumors with higher scores exhibited better survival outcomes and were more sensitive to immunotherapy. In this study, the immune landscape of cervical cancer was analyzed, and the subtype of cervical cancer based on that difference was proposed. Besides, the subtype of cervical cancer showed different sensitivity to immunotherapeutic response which further confirmed its relationship with tumor immune landscape.

Transoral Laser Excision of Base of Tongue Cancer

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P47-P47
Author(s):  
April A. Camp ◽  
Guy J Petruzzelli ◽  
Christopher Fundakowski
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Survival Data ◽  
Tertiary Care ◽  
Care Facility ◽  
Base Of Tongue ◽  
Tertiary Care Facility ◽  
Laser Excision ◽  
Disease Specific

Objective Recently, the use of laser in head and neck surgery has increased, consequent to technical advances in laser technology and visualization techniques. The objective of this study was to determine survival and qualitative results in patients who have undergone transoral laser excision of base of tongue (BOT) squamous cell carcinoma (SCCA). Methods A retrospective chart review was performed of patients with previously untreated, biopsy proven SCCA of the BOT treated with transoral laser excision at a tertiary care facility. All patients had follow-up for at least 24 months. Disease specific and overall survival data was determined using Kaplan-Meier approximations. Quality of life (QOL) data was obtained via interview using a well established questionnaire. Results Between 1995 and 2005, 71 patients, ages 38–85, were treated with transoral laser excision for BOT SCCA; 1.4, 12.7, 9.9, and 75% were stage I, II, III, and IV, respectively, at diagnosis. At 24 months, overall survival was 90%, while disease-specific survival was 94%. No correlation was found between survival and gender, overall stage, tumor size, nodal status, or adjuvant therapy. Local-regional recurrence occurred in 10% of patients. QOL data was obtained for 46 patients and yielded acceptable results, with 52% of patients reporting mild or no pain, 98% reporting minimal impairment to normal swallowing, and 70% reporting normal speech. Conclusions Transoral laser excision is an innovative method for excision of BOT SCCA and offers an improved approach in terms of survival and quality of life for treatment of these lesions.

scholarly journals Physician and Practice Characteristics Influencing Tumor Board Attendance: Results From the Provider Survey of the Los Angeles Women's Health Study

2011 ◽  
Vol 7 (2) ◽  
pp. 103-110 ◽  
Author(s):  
Kevin S. Scher ◽  
Diana M. Tisnado ◽  
Danielle E. Rose ◽  
John Lloyd Adams ◽  
Clifford Y. Ko ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Los Angeles ◽  
Treatment Planning ◽  
Cancer Care ◽  
Tumor Board ◽  
Health Study ◽  
Practice Characteristics ◽  
Planning Approach ◽  
Provider Survey

Multidisciplinary approaches to cancer care have shown improvements in the quality of care. The tumor board treatment planning approach provides a structure for engaging providers in discussions of cancer cases that are designed to enhance the quality of care.

scholarly journals Development of National Cancer Database for Cost and Quality of Life (CaDCQoL) in India: a protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048513
Author(s):  
Shankar Prinja ◽  
Jyoti Dixit ◽  
Nidhi Gupta ◽  
Nikita Mehra ◽  
Ashish Singh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Care ◽  
Healthcare Costs ◽  
National Level ◽  
National Database ◽  
Cancer Site ◽  
Economic Evaluations ◽  
National Cancer Database ◽  
Study Results

IntroductionThe rising economic burden of cancer on healthcare system and patients in India has led to the increased demand for evidence in order to inform policy decisions such as drug price regulation, setting reimbursement package rates under publicly financed health insurance schemes and prioritising available resources to maximise value of investments in health. Economic evaluations are an integral component of this important evidence. Lack of existing evidence on healthcare costs and health-related quality of life (HRQOL) makes conducting economic evaluations a very challenging task. Therefore, it is imperative to develop a national database for health expenditure and HRQOL for cancer.Methods and analysisThe present study proposes to develop a National Cancer Database for Cost and Quality of Life (CaDCQoL) in India. The healthcare costs will be estimated using a patient perspective. A cross-sectional study will be conducted to assess the direct out-of-pocket expenditure (OOPE), indirect cost and HRQOL among cancer patients who will be recruited at seven leading cancer centres from six states in India. Mean OOPE and HRQOL scores will be estimated by cancer site, stage of disease and type of treatment. Economic impact of cancer care on household financial risk protection will be assessed by estimating prevalence of catastrophic health expenditures and impoverishment. The national database would serve as a unique open access data repository to derive estimates of cancer-related OOPE and HRQOL. These estimates would be useful in conducting future cost-effectiveness analyses of management strategies for value-based cancer care.Ethics and disseminationApproval was granted by Institutional Ethics Committee vide letter no. PGI/IEC-03/2020-1565 of Post Graduate Institute of Medical Education and Research, Chandigarh, India. The study results will be published in peer-reviewed journals and presented to the policymakers at national level.

A single-center experience of modified FOLFOX-6 in locally advanced and metastatic pancreatic adenocarcinomas.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 303-303
Author(s):  
Bradley Thomas Sumrall ◽  
Chang O Son ◽  
Jyotsna Fuloria ◽  
Suma Satti
Keyword(s):  
Overall Survival ◽  
Pancreatic Adenocarcinoma ◽  
Locally Advanced ◽  
Retrospective Chart Review ◽  
Standard Of Care ◽  
Tumor Registry ◽  
Single Center Experience ◽  
Locally Advanced Pancreatic Adenocarcinoma ◽  
Modified Folfox6

303 Background: Pancreatic adenocarcinoma has historically been as a disease with a poor prognosis with a 5 year survival rate of about 6%. The recently published ACCORD 11 trial demonstrated an improved overall survival utilizing FOLFIRINOX versus gemcitabine which has been the standard of care. However, FOLFIRINOX was associated with a significantly higher incidence of both hematologic and nonhematologic toxicities at the expense of increased toxicity. At our institution, FOLFIRINOX has been found to have a very similar toxicity profile with a significant impact on quality of life. For that reason, many patients at our institution have been treated with mFOLFOX6 with better tolerability instead of FOLFIRINOX in the palliative setting. Methods: We performed a retrospective chart review to analyze overall survival in patients withof unresectable pancreatic cancer (locally advanced and metastatic). Institutional tumor registry database was used to identify patients with unresectable pancreatic adenocarcinoma from January 2009 to March 2012. Medical records were reviewed to identify patients who were treated with at least 1 cycle of modified FOLFOX-6 as a line of treatment during their disease course. Overall survival was calculated for this cohort of patients. Results: 26 patients (15 male, 11 female) with unresectable pancreatic adenocarcinoma were identified. Mean age was 65.3 years. 19 patients had metastatic disease whereas 7 patients had locally advanced disease at diagnoses. Modified FOLFOX6 as a 1st line, 2nd line and 3rd line therapy was given in 17, 6 and 3 patients respectively. The median overall survival was 9 month while the mean survival was 10.6 months. 7 patients were treated with FOLFIRI as 2nd or 3rd line treatment. Nine patients are still alive. Conclusions: Modified FOLFOX-6 is an acceptable treatment for metastatic and locally advanced pancreatic adenocarcinoma. Even though our sample size is small, overall survival is comparable to that of FOLFIRINOX. A multi-institutional, randomized trial evaluating sequencing of mFOLFOX6 and FOLFIRI and comparing it with FOLFIRINOX would be useful.

Effect of digital tumor board solutions on “failure-to-discuss” rates for patient cases during tumor boards.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 308-308 ◽  
Author(s):  
Donna Fowler ◽  
Lincoln R Sheets ◽  
Matthew S Prime ◽  
Chaohui Guo ◽  
Athanasios Siadimas ◽  
...  
Keyword(s):  
Clinical Care ◽  
Interdisciplinary Approach ◽  
Clinical Information ◽  
Clinical Decision ◽  
Tumor Board ◽  
Tumor Boards ◽  
Rate Of Failure ◽  
Implementation Data ◽  
The Impact

308 Background: A multidisciplinary tumor board (MTB) provides an interdisciplinary approach for decision-making in cancer care. Efficient conduction of MTBs is importantfor optimal patient management. It is, however, often observed that prepared patient cases are not discussed during tumor boards due to limited time or incomplete information, which could cause delaytocaredecisions and/or the initiation of treatments. It remains unknown whether digital technologies canreduce the rate of failure to discuss during MTBs. Methods: A prospective cohort study was undertaken to evaluate the preparation & conduction of MTBs pre- & post-implementation of the NAVIFY Tumor Board (NTB) solution at Missouri University Health Care (MU), including the Ear, Nose & Throat (ENT) MTB. The NTB is a cloud-based workflow product, integrated with the hospital EMR, that aggregates and displays relevant clinical information. NTB was introduced to theMUENT MTB on Oct 10, 2018. Results: Pre-NTB implementation, data was collected from 42 ENT MTBs. A total of 551 patient cases were prepared for MTBs, but only 423 patient cases were discussed. This was an average “failure-to-discuss” rate of 19.4% per meeting (SD = 15.6%). After NTB implementation, data was collected from 7 MTBs where a total of 70 patient cases were prepared and discussed. There were no instances of failure to discuss, and as such, was significantlyreduced after the implementation of NTB (Mann-Whitney U test, p = 0.0004). The average number of patient cases discussed per meeting pre- and post-NTB implementation did not change (Mann-Whitney U test, p > 0.1) and meeting duration was the same. Conclusions: Introduction of the NTB did not change the weekly number of cases discussed, but did significantly reduce the failure to discuss rates for ENT MTB cases. Reducing failure to discuss rates could decrease the overall time to clinical decision and the initiation of treatment, which could potentially improve patient outcomes. Additional studies are needed to examine the impact of digital solutions on the quality of clinical care.

scholarly journals Measuring the Impact of Academic Cancer Network Development on Clinical Integration, Quality of Care, and Patient Satisfaction

2018 ◽  
Vol 14 (12) ◽  
pp. e823-e833 ◽  
Author(s):  
Anne C. Chiang ◽  
Jessica Lake ◽  
Naralys Sinanis ◽  
Debra Brandt ◽  
Jane Kanowitz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Clinical Care ◽  
Care Center ◽  
Tumor Board ◽  
Clinical Trial Accrual ◽  
Oncology Practice ◽  
The Impact

Purpose: Many US academic centers have acquired community practices to expand their clinical care and research footprint. The objective of this assessment was to determine whether the acquisition and integration of community oncology practices by Yale/Smilow Cancer Hospital improved outcomes in quality of care, disease team integration, clinical trial accrual, and patient satisfaction at network practice sites. Methods: We evaluated quality of care by testing the hypothesis that core Quality Oncology Practice Initiative measures at network sites that were acquired in 2012 were significantly different after their 2016 integration into the network. Clinical and research integration were measured using the number of tumor board case presentations and total accruals in clinical trials. We used Press-Ganey scores to measure patient satisfaction pre- and postintegration. Results: Mean Quality Oncology Practice Initiative scores at Smilow Care Centers were significantly higher in 2016 than in 2012 for core measures related to improvement in tumor staging ( z = 1.33; P < .05), signed consent and documentation plans for antineoplastic treatment ( z = 2.69; P < .01; and z = 2.36; P < .05, respectively), and appropriately quantifying and addressing pain during office visits ( z = 2.95; P < .05; and z = 3.1; P < .01, respectively). A total of 493 cases were presented by care center physicians at the tumor board in 2017 compared with 45 presented in 2013. Compared with 2012, Smilow Care Center clinical trial accrual increased from 25 to 170 patients in 2017. Last, patient satisfaction has remained at greater than the 90th percentile pre- and postintegration. Conclusion: The process of integration facilitates the ability to standardize cancer practice and provides a platform for quality improvement.

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