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- BookKarl Y. Bilimoria, Christina A. Minami, David M. Mahvi, editors.Summary: Despite tremendous recent advances in the treatment of most malignancies, there remain several critical questions for each cancer. This particularly true for the surgical management of solid-organ malignancies. Comparative effectiveness is a relatively new term which encompasses the age-old concepts of how best to treat cancer patients. Comparative effectiveness is defined as the direct comparison of healthcare interventions to determine which work best for which patients when considering the benefits and risks. The Institute of Medicine has defined comparative effectiveness research (CER) as the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. CER is certainly best done with well-conducted randomized controlled trials. Unfortunately, clinical trials are not always feasible owing to the impracticality of conducting the trial, the considerable cost, and the time required to complete the trial. These challenges are even more pronounced with respect to surgical treatment. Thus alternative approaches may need to be considered in order to address pressing questions in the care of the oncology patient. These approaches may include well-conducted retrospective cohort studies from cancer registries and other data sources, decision and cost-effectiveness analyses, and other novel methodologies. This book lays out the current critical questions for each major malignancy and proposes approaches to gain answers to these pressing questions.
Contents:
Approaches to Answering Critical CER Questions
Leveraging Comparative Effectiveness Research to Improve the Quality of Multidisciplinary Care for Breast Cancer Patients
Comparative Effectiveness in Melanoma
Comparative Effectiveness Research for Sarcoma
Comparative Effectiveness in Thyroid Cancer
Comparative Effectiveness in Head and Neck Malignancies
Comparative Effectiveness Issues in Lung Cancer
Comparative Effectiveness in Esophagogastric Cancer
Comparative Effectiveness in Colon and Rectal Cancer
Research Gaps in Pancreatic Cancer Research and Comparative Effectiveness Research Methodologies
Comparative Effectiveness in Surgical Oncology: Hepatic Malignancies
Comparative Effectiveness Research in Urologic Cancers
Comparative Effectiveness Research in Gynecologic Oncology.Digital Access Springer 2015 - ArticleFraser DJ, Font RL.Arch Ophthalmol. 1979 Jul;97(7):1311-4.A consecutive series of 450 eyes enucleated because of a malignant melanoma of the choroid or ciliary body was reviewed in an effort to establish the incidence of ocular inflammation or intraocular hemorrhage as the initial clinical manifestation. Thirty-five patients had these clinical signs initially. Twenty-two (4.9%) initially had ocular inflammations. Eight of these had an episcleritis, and the remaining 14 had some form of uveitis, endophthalmitis, or panophthalmitis. Five of those with episcleritis had tumors in the ciliary body, and all six patients who developed panophthalmitis had necrotic choroidal melanomas. Thirteen patients (2.9%) were initially observed with some form of intraocular hemorrhage. Follow-up information was available for 26 of the 35 patients selected for detailed study. Fourteen patients died of metastatic disease. We believe the relatively poor prognosis of these tumors depends on three factors: cell type, maximal diameter of the tumor, and extraocular extension.