Critical reviews in oncology/hematology
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Crit. Rev. Oncol. Hematol. · May 2011
ReviewThe evolving role of adjuvant therapy in endometrial cancer.
Extra-fascial total hysterectomy and bilateral salpingo-oophorectomy with or without lymph node dissection is the initial treatment for endometrial cancer. Unresolved scientific controversy exists regarding the selection of patients who may benefit from lymphadenectomy, the magnitude of such benefit, and the role of adjuvant therapy. External pelvic irradiation has been shown to reduce loco-regional recurrences without improving survival. ⋯ Chemotherapy seems to prevent or delay distant spread more than radiotherapy, while radiotherapy appears to prevent or delay local relapses more than chemotherapy, although these trends fail to achieve statistical significance. Recent evidence from a randomized trial indicates that sequential external pelvic irradiation with or without brachytherapy and platinum-based chemotherapy result in significantly better progression-free survival than radiotherapy alone in patients with high-risk endometrial cancer. Reliable surgical/pathological variables predictive of high risk of distant failure may be used to identify a subset of patients suitable for randomized trials of adjuvant chemotherapy with or without external irradiation.
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Crit. Rev. Oncol. Hematol. · Dec 2010
Comparative StudyComprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: a prospective observational cohort study.
To examine the association between the outcomes of a pre-operative comprehensive geriatric assessment (CGA) and the risk of severe post-operative complications in elderly patients electively operated for colorectal cancer. ⋯ CGA can identify frail patients who have a significantly increased risk of severe complications after elective surgery for colorectal cancer.
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Crit. Rev. Oncol. Hematol. · Nov 2010
The influences of age and co-morbidities on treatment decisions for patients with HER2-positive early breast cancer.
To investigate the influences of age and co-morbidities on the use of adjuvant chemotherapy and trastuzumab in patients with HER2-positive early breast cancer. ⋯ National variation in the use of adjuvant chemotherapy in women aged ≥70 years with high-risk breast cancer is substantial. Practice audits or clinical trials addressing the outcomes of systemic adjuvant therapy are needed for this ever-increasing population of patients.
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Crit. Rev. Oncol. Hematol. · Oct 2010
Randomized Controlled Trial Comparative StudyClinical outcome of elderly patients with metastatic colorectal cancer treated with FOLFOXIRI versus FOLFIRI: Subgroup analysis of a randomized phase III trial from the Hellenic Oncology Research Group (HORG).
A subgroup analysis of oxaliplatin (LOHP)+irinotecan (CPT-11)+5-fluorouracil (5FU) and leucovorin (LV) (FOLFOXIRI regimen) versus irinotecan+5FU/LV (FOLFIRI regimen) as first-line treatment of patients >65 years old with metastatic colorectal cancer is presented. ⋯ FOLFOXIRI does not seem to offer substantial benefit compared to FOLFIRI regimen in elderly patients with metastatic colorectal cancer.