Urologic oncology
-
The objective of this study was to retrospectively investigate clinical outcomes of combined immunotherapy with interferon-alpha (IFN-alpha) and low-dose interleukin-2 (IL-2) in Japanese patients with metastatic renal cell carcinoma (RCC). This study included a total of 52 patients with metastatic RCC who were treated by combined immunotherapy with IFN-alpha and low-dose IL-2 following radical nephrectomy. These patients received a subcutaneous injection of IFN-alpha (5 to 6 million U/d) three times per week and intravenous injection of IL-2 (1.4 million U/d) twice per week. ⋯ Furthermore, cancer-specific survival was significantly associated with performance status, presence of metastases at diagnosis, metastatic organ and CRP level on univariate analysis; however, only performance status and presence of metastases at diagnosis appeared to be independent predictors of cancer-specific death by multivariate analysis. Toxicities related to this therapy were generally mild and tolerable, limited to World Health Organization (WHO) grade 1 or 2 in the majority of patients. Collectively, these findings suggest that combined immunotherapy with IFN-alpha and low-dose IL-2 could achieve comparatively acceptable oncological outcomes in patients with metastatic RCC; however, other therapeutic options should be considered in patients with unfavorable performance status and/or those positive for metastatic diseases at diagnosis.
-
Randomized Controlled Trial Multicenter Study
Screening for prostate cancer (PC)--an update on recent findings of the European Randomized Study of Screening for Prostate Cancer (ERSPC).
Introduction for screening for prostate cancer as a healthcare policy is desirable provided its effectiveness can be shown in terms of decreasing prostate cancer mortality at an acceptable price in terms of quality of life and costs. The European Randomized Study of Screening for Prostate Cancer (ERSPC) was initiated in 1993 and should in 2008 have the power to produce the required information. The structure and status of ERSPC. ⋯ The application of this nomogram to screen detected cases allows the the advice "active observation" to about 30% of such patients. ERSPC is set to show or exclude at least a 25% reduction in prostate cancer mortality through screening. Many pending problems still have to be resolved prior to the introduction of populations based screening as a worldwide healthcare policy.
-
The role of radiotherapy (RT) for rising PSA after radical prostatectomy (RP) is debatable. We analyzed a large database of men to evaluate for predictors of prostate-specific antigen (PSA) failure after salvage RT. ⋯ Salvage RT provided the greatest benefit in PSA control in men with the lowest pre-RT PSA levels. Post-RP PSA doubling time >12 months trended toward predicting for PSA failure but was not significant likely owing to limited sample size. Together, these findings would suggest that salvage RT is optimal at low pre-RT PSA and long doubling times with favorable pathologic features.
-
Meta-analysis, the statistical combination of results from several studies to produce a single estimate of a treatment effect or size of an association, continues to attract controversy. We illustrate and discuss the promises and limitations of meta-analysis. ⋯ The biases and confounding factors that threaten the validity of individual studies will also affect meta-analyses of observational studies. We argue that meta-analyses should only be performed within the framework of systematic reviews that have been prepared using methods that minimize bias and address the combinability of studies.
-
Doug Ulman is the President of the Lance Armstrong Foundation and founder of the Ulman Cancer Fund for Young Adults. He is a three-time cancer survivor, diagnosed with chondrosarcoma in 1996 and subsequently diagnosed twice with melanoma. I was diagnosed with cancer in the "athletic prime" of my life. ⋯ My love of exercise first provided me with a context in which to understand the gravity of my diagnosis. Early in my survivorship, exercise served as a guide down a gradual, and sometimes very painful, path to physical recovery. Now, exercise in some of its most extreme forms-marathons and endurance mountain runs-is the vehicle through which I choose to celebrate my survivorship.