The Effect of Increasing Two-Week Wait Referrals for Head and Neck Cancer in East Kent

2011 ◽  
Vol 93 (6) ◽  
pp. 217-220 ◽  
Author(s):  
S Haikel ◽  
N Dawe ◽  
G Lekakis ◽  
M Black ◽  
D Mitchell
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Late Stage ◽  
Early Stage ◽  
White Paper ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Late Stage Disease ◽  
The Uk

In 1998 the UK government published its white paper The New NHS: Modern and Dependable, in which it first suggested that patients being referred with a suspicion of cancer should have a maximum wait of two weeks to see a specialist. The rationale for this was that outcomes for late-stage disease are significantly worse when compared with outcomes for early-stage disease (Table 1). It was assumed that reducing the wait to see a specialist would reduce the stage of disease at presentation.

scholarly journals Treatment and Outcome of Patients with Uterine Carcinosarcoma in a Comprehensive Cancer Network

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
K. Hapsari ◽  
C. Bhugwandass ◽  
G. W. J. van Rijn ◽  
A. A. M. van der Wurff ◽  
M. van ‘t Veer ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Adjuvant Chemotherapy ◽  
Late Stage ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Uterine Carcinosarcoma ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Late Stage Disease ◽  
Cancer Network

Abstract Aim To determine clinical characteristics, treatment modalities and survival of uterine carcinosarcoma (UCS). Methods Data on treatment of UCS patients in the Comprehensive Cancer Network south region in the Netherlands between 2004 and 2014 were retrospectively evaluated. Results Data of 62 patients with UCS were retrieved. Mean age at diagnosis was 69.2 years (45–95 years). Data of six patients were excluded because they did not receive any treatment. Of the 56 patients included in this study, 57.1% presented with early-stage (FIGO I–II) disease and 42.9% with late-stage (FIGO III–IV) disease. 46.9% of the patients with FIGO early-stage disease received only surgical treatment, whereas 9.4% received adjuvant chemotherapy and 43.8% received adjuvant radiotherapy. Median DFS in patients with early-stage disease was 47.0 months (17.5–72.0). Adjuvant therapy did not seem to alter prognosis (p = 0.261). 16.7% of the patients with late-stage disease received only surgical treatment, 12.5% received only chemotherapy, whereas 50% received adjuvant chemotherapy and 20.8% adjuvant radiotherapy after surgery. Median DFS in late-stage disease was 8.5 months (2.5–23.5). Adjuvant therapy did not seem to alter prognosis (p = 0.30). Conclusion UCS with both FIGO stages I–II and III–IV has a dismal prognosis. The addition of adjuvant treatment did not seem to increase survival.

Specific TCR gene rearrangements in mycosis fungoides: does advanced clinical stage show a preference?

2018 ◽  
Vol 71 (12) ◽  
pp. 1072-1077
Author(s):  
Etan Marks ◽  
Yanhua Wang ◽  
Yang Shi ◽  
Joseph Susa ◽  
Mark Jacobson ◽  
...  
Keyword(s):  
Mycosis Fungoides ◽  
Late Stage ◽  
Gene Rearrangement ◽  
Early Stage ◽  
Clinical Stage ◽  
Disease Stage ◽  
Gene Rearrangements ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Late Stage Disease

AimsThe relationship between the presence of specific T-cell receptor (TCR) gene rearrangements and clinical stage in mycosis fungoides (MF) has not been studied. We analysed a cohort of patients with a diagnosis of MF to determine the different types of specific TCR gene rearrangements present and their relationship to disease stage.MethodsA retrospective chart review was used to select patients with a diagnosis of MF who had a skin biopsy and a positive TCR gene rearrangement study in either blood or tissue and at least 2 years of clinical follow-up.Results43 patients were identified and divided into two groups. The first group consisted of 23 patients with early stage disease (IA-IIA) that was either stable or went into partial or complete remission with minimal intervention. None of these patients advanced to late stage disease. The second group consisted of 20 patients who had either late stage disease at diagnosis or progressed to late stage disease at some point in time. In the first group, only 4/23 (17%) patients had a single TCR gene rearrangement in the Vɣ1–8 region. In contrast, the second group had 13/20 (65%) patients with a single TCR gene rearrangement in the Vɣ1–8 region (p=0.002).ConclusionThe presence of a single TCR gene rearrangement in the Vɣ1–8 region could possibly be related to a more advanced stage of MF. However, more comprehensive studies, such as next generation sequencing, with a larger cohort is necessary for a more definitive conclusion.

scholarly journals UNRESECTABLE HEAD AND NECK CARCINOMAS

2007 ◽  
Vol 14 (01) ◽  
pp. 111-119
Author(s):  
AHMAD IJAZ MASUD ◽  
QAISER MAHMOOD ◽  
NASREEN SIDDIQUE
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Head And Neck Carcinoma ◽  
Ulcer Bleeding ◽  
Early Stage Disease ◽  
Female Ratio ◽  
Neck Carcinoma

Introduction: Cancers of the head and neck are estimated to be the most prevalent cancers in the world. Data from various cancer centers of Pakistan reveal that epithelial head and neck cancer is one of the most frequent cancers varying from 12 to 25% of the total new patients seenannually. Objectives: To see the effect of concomitant chemo-radiotherapy on the survival of patient, to assess the toxicity of different treatment arms and the effect of age, sex and bulk or tumour on survival and compare the literature. Setting: Radiotherapy Department, Nishtar Hospital, Multan. Duration: 2 years. Material and Methods: Sample Size: 200 patients. Results: Out of 130 patients, 83 were males and theremaining 47 were females. The male to female ratio being 1.8:1. The mean age of the patients included in the study was 52 years, range being 22-80 years. The patients of head and neck cancer in the trial had different sites of involvement. In the trial the patients presented with various symptoms such as pain, swelling, ulcer, bleeding, dysphagia, dyspnea, hoarseness of voice and nasal obstruction etc. No patient had early stage disease. All the patients in the trial had the experience of nausea and vomiting, it was more marked in patients having radiotherapy; either alone or in concomitant with chemotherapy. The patients having concomitant chemo-radiotherapy i.e. group-C also had diarrhoea as a side effect. The effect on the liver function test was more pronounced in patients of group-A. The renal function was seen to alter more in patients receiving chemotherapy with cisplatin, whether as induction or as a concomitant to radiotherapy. Conclusion: Concomitant chemo-radiotherapy in locally advanced, unresectable head and neck carcinoma is statistically superior to induction chemotherapy followed by radiotherapy and the standard radiotherapy alone.

scholarly journals Postoperative Radiotherapy in Head and Neck Cancer

2010 ◽  
Vol 2 (1) ◽  
pp. 43-51
Author(s):  
Vedang Murthy ◽  
Sayan Kundu ◽  
Tanweer Shahid ◽  
Ashwini Budrukkar ◽  
Tejpal Gupta ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Targeted Therapy ◽  
Head And Neck ◽  
Neck Cancer ◽  
Early Stage ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Head And Neck Cancers ◽  
Advanced Head ◽  
Locoregional Failure

Abstract Though early stage head and neck cancers can be cured either by surgery or radiation, patients with locally advanced disease continues to pose a therapeutic challenge. Locoregional failure is the major cause of death in head and neck cancers. As the outcome of locally advanced head and neck cancer is less than promising, a combined modality approach is generally undertaken in this group of patients. The combination of surgery, radiation and more recently, chemotherapy and targeted therapy can improve outcomes in locally advanced head and neck cancer patients. This overview discusses the rationale and role of postoperative radiotherapy (PORT) in advanced head and neck cancers, the radiotherapy technique in brief and methods of enhancing the efficacy of postoperative RT by altering the fractionation schedules and adding chemotherapy and targeted therapy.

scholarly journals Treatment and survival of second primary early-stage lung cancer, following treatment of head and neck cancer in the Netherlands

Lung Cancer ◽  
2016 ◽  
Vol 94 ◽  
pp. 54-60 ◽  
Author(s):  
Alexander V. Louie ◽  
Ronald A. Damhuis ◽  
Cornelis J. Haasbeek ◽  
Andrew Warner ◽  
Danielle Rodin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Head And Neck Cancer ◽  
The Netherlands ◽  
Head And Neck ◽  
Neck Cancer ◽  
Early Stage ◽  
Second Primary ◽  
Early Stage Lung Cancer ◽  
Stage Lung Cancer

Vaginal sarcoma: the Royal Marsden experience

1994 ◽  
Vol 4 (5) ◽  
pp. 337-341 ◽  
Author(s):  
H. Y.S. Ngan ◽  
J. H. Shepherd ◽  
C. Fisher ◽  
P. Blake
Keyword(s):  
Late Stage ◽  
Poor Prognosis ◽  
Recurrent Disease ◽  
Early Stage ◽  
Tumor Grade ◽  
Intermediate Grade ◽  
Early Stage Disease ◽  
The Poor ◽  
Stage Disease ◽  
Prognostic Importance

Six patients with vaginal sarcoma are reported here. This clinicopathologic review confirms the poor prognosis of this disease. However, there were three 5-year survivors, all of whom had early stage disease and low to intermediate grade tumors. Apart from tumor grade, stage was of prognostic importance. Late recurrences at 5 and 21 years were noted in two of the three 5-year survivors. Neither chemotherapy nor radiotherapy were of use in the treatment of late stage or recurrent disease.

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