The Journal of urology
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The Journal of urology · Feb 2006
Multicenter StudyEvaluation of functional outcome and local control after radiotherapy for metastatic spinal cord compression in patients with prostate cancer.
Patients with prostate cancer with metastatic spinal cord compression have better survival prognosis than other patients with MSCC and may live long enough to develop a local recurrence of MSCC. This study investigates prognostic factors and radiation schedules for functional outcome and local control of MSCC after radiotherapy in patients with prostate cancer. ⋯ Functional outcome after RT was significantly influenced by the time of developing motor deficits before RT and number of involved vertebra. Local control was significantly better after application of long course RT. Patients with a poor expected survival could be treated with short course RT, because a short treatment time means less discomfort for the patient. For patients with good survival prognosis, long course RT should be applied to achieve better local control.
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The Journal of urology · Feb 2006
Multicenter StudyUse of nephrectomy at select medical centers--a case of follow the crowd?
Regionalization of high risk surgical procedures to larger, teaching hospitals has been suggested as a means to improve the quality of care. We determined the extent to which the regionalization of nephrectomy has occurred and describe the potential causes and implications of any observed regionalization. ⋯ Regionalization of nephrectomy to teaching and high volume (nephrectomy and all diagnoses) hospitals is currently under way. Although the implications are not entirely clear, this study provides further evidence for the crowding of complex surgical procedures into these institutions.