Cancer
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The purpose of the current study was to evaluate the locoregional recurrence rate after treatment of patients with operable breast carcinoma with a modification of the Halsted radical mastectomy and the selective use of radiotherapy and to identify risk factors for locoregional recurrence. ⋯ Excellent locoregional control can be achieved with a modified technique of radical mastectomy in patients with negative apical biopsy and the selective use of comprehensive radiotherapy. These results may serve as a reference outcome for comparison with other locoregional treatment strategies.
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Advances in the assessment and management of pain have made it possible for over 90% of oncology patients to have a pain free death at home. Oncologists have a unique opportunity, as clinical role models, teachers, and participants in research, to insure proper management of patients' symptoms at diagnosis, during treatment, and as death approaches.
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A small sample size, a high rate of exclusions, inadequate follow-up in different settings, and a lack of comparison with previous levels of analgesia have recently been reported to be the principal limitations of the World Health Organization (WHO) guidelines regarding cancer pain. ⋯ This study demonstrates that a managed home care system enables patients to receive adequate pain treatment, according to WHO guidelines, in the comfort of their own homes.
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Comparative Study Clinical Trial
Comparison of clinical staging algorithms and 111indium-capromab pendetide immunoscintigraphy in the prediction of lymph node involvement in high risk prostate carcinoma patients.
The pretherapy prediction of occult lymph node involvement and the avoidance of otherwise futile and potentially morbid definitive local therapy is paramount in men with newly diagnosed prostate carcinoma. To identify patients with prostate carcinoma who likely have lymph node involvement and would benefit from staging lymphadenectomy prior to definitive local therapy, the authors compared the ability of several predictive staging algorithms and a radiolabeled monoclonal antibody scan to predict lymphatic metastases prior to treatment. ⋯ These data suggest that the PPVs for the clinical predictive algorithms are similar and that the PPV of the radiolabeled monoclonal antibody scan alone or in combination with the algorithms has additional value in predicting lymph node involvement in prostate carcinoma patients at high risk of regional disease spread. These algorithms and the 111In-capromab pendetide scan may be used for the appropriate selection of candidates for definitive local therapy in men with clinically localized prostate carcinoma and significant risk of lymph node involvement.