BACKGROUND Clinical workup and treatment guidelines have been published by the National Comprehensive Cancer Network(NCCN)to ensure patients are treated uniformly and appropriately.This study sought to retrospectively...BACKGROUND Clinical workup and treatment guidelines have been published by the National Comprehensive Cancer Network(NCCN)to ensure patients are treated uniformly and appropriately.This study sought to retrospectively review patients with a new diagnosis of sarcoma who were treated in a National Cancer Institute(NCI)designated center and determine compliance rates with guidelines for sarcoma.AIM To evaluate our compliance of NCCN sarcoma guidelines at a major NCI designated center and to report instances of deviation that could be used for future studies to improve patient care.METHODS Data was collected retrospectively as an internal review and quality assessment of 35 newly diagnosed and treated patients.Demographic data were recorded and information concerning whether patients had appropriate imaging,biopsy and management.Variables of interest were expressed as raw numbers and percentages.RESULTS Primary site imaging was obtained in 100%of cases.Chest and full-body imaging were obtained in 97%and 100%of indicated cases,respectively.Tissue was obtained preoperatively in 97%of cases.Imaging was reviewed at multidisciplinary Treatment Planning Conference(TPC)in 97%of cases.Pathology was reviewed in 94%of cases in TPC.Both tumor,node,metastasis staging and plan of care were reviewed in 100%of cases in TPC.Treatment guidelines were followed in 94%of cases reviewed.CONCLUSION This study evaluated the workup and treatment provided by a single NCI designated sarcoma service to a series of patients with pathologies defined with the NCCN sarcoma treatment guidelines.Although adherence to NCCN was reported to be very high future prospective studies are required to investigate whether NCCN guidelines impact patient outcomes.展开更多
Biliary tract cancers(BTCs)constitute a heterogeneous group of hepatobiliary malignancies originating along the biliary tree.Approximately up to 20%of primary hepatobiliary tumors consist of BTCs(1).The primary risk f...Biliary tract cancers(BTCs)constitute a heterogeneous group of hepatobiliary malignancies originating along the biliary tree.Approximately up to 20%of primary hepatobiliary tumors consist of BTCs(1).The primary risk factors include cholelithiasis,chronic inflammatory diseases of the bile ducts,non-alcoholic steatohepatitis(NASH),liver cirrhosis,tobacco use,and chronic viral hepatitis B and C infections(2).展开更多
胰腺癌是预后极差的消化系统恶性肿瘤。美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)结合最新高质量循证医学证据不断更新推出胰腺癌的临床实践指南以指导胰腺癌的规范化诊疗。2023年5月4日与6月19日《NCCN胰腺...胰腺癌是预后极差的消化系统恶性肿瘤。美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)结合最新高质量循证医学证据不断更新推出胰腺癌的临床实践指南以指导胰腺癌的规范化诊疗。2023年5月4日与6月19日《NCCN胰腺癌临床实践指南》分别进行了两次更新。相较于2022年第2版,这两次更新主要集中于最新的免疫/靶向治疗进展、NALIRIFOX方案的引入以及体能状态中等病人治疗方案的补充。本文结合相关循证医学证据对最新《NCCN胰腺癌临床实践指南》的更新进行解读。展开更多
This study aimed to assess the role of the National Comprehensive Cancer Network （NCCN） risk classification in predicting biochemical recurrence （BCR） after radical prostatectomy （RP） in Chinese prostate cancer ...This study aimed to assess the role of the National Comprehensive Cancer Network （NCCN） risk classification in predicting biochemical recurrence （BCR） after radical prostatectomy （RP） in Chinese prostate cancer patients. We included a consecutive cohort of 385 patients with prostate cancer who underwent RP at Fudan University Shanghai Cancer Center （Shanghai, China） from March 2011 to December 2014. Gleason grade groups were applied at analysis according to the 2014 International Society of Urological Pathology Consensus. Risk groups were stratified according to the NCCN Clinical Practice Guidelines in Oncology： Prostate Cancer version 1, 2017. All 385 patients were divided into BCR and non-BCR groups. The clinicopathological characteristics were compared using an independent sample t-test, Chi-squared test, and Fisher＇s exact test. BCR-free survival was compared using the log-rank test and multivariable Cox proportional hazard analysis. During median follow-up of 48 months （range： 1-78 months）, 31 （8.05%） patients experienced BCR. The BCR group had higher prostate-specific antigen level at diagnosis （46.54 ± 39.58 ng m1-1 vs 21.02 ± 21.06 ng ml-1, P= 0.001）, more advanced pT stage （P= 0.002）, and higher pN1 rate （P〈 0.001）. NCCN risk classification was a significant predictor of BCR {P = 0.0006） and BCR-free survival （P = 0.003） after RP. As NCCN risk level increased, there was a significant decreasing trend in BCR-free survival rate （Ptrend = 0.0002）. This study confirmed and validated that NCCN risk classification was a significant predictor of BCR and BCR-free survival after RP.展开更多
Esophageal carcinoma is one of the most common malignant tumors, especially in China which is the high incidence area. As a result of mild symptoms of early-stage esophageal cancer, the majority of patients cannot be ...Esophageal carcinoma is one of the most common malignant tumors, especially in China which is the high incidence area. As a result of mild symptoms of early-stage esophageal cancer, the majority of patients cannot be diagnosed until they develop to advanced cancer, and the treatment outcome of surgery or chemoradiotherapy is still unsatisfactory at present. The guidelines of esophageal cancer issued by National Comprehensive Cancer Network (NCCN) are regarded as important reference tools by clinical oncologists, and provide uniform criteria for the diagnosis and treatment of esophageal carcinoma. However, the guidelines are not always suitable for Chinese patients because the data come from European and American population which have significant ethnical difference from Chinese. We retrospectively analyzed the changes of treatment strategy of esophageal cancer in NCCN guidelines and the advance of treatment for esophageal carcinoma in China, aiming to provide our oncologists with new research ideas. We also hope to set up clinical cancer cooperation organizations, and release our own cancer guidelines to serve Chinese patients and oncologists.展开更多
目的探讨与分析美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)指南结合多学科协作诊疗模式(multi-disciplinary team,MDT)在住培学员结直肠癌诊疗教学中的应用价值。方法研究对象选取2017年7月—2021年12月在广州...目的探讨与分析美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)指南结合多学科协作诊疗模式(multi-disciplinary team,MDT)在住培学员结直肠癌诊疗教学中的应用价值。方法研究对象选取2017年7月—2021年12月在广州医科大学附属第一医院进行住培的139名学员,其中2017年7月—2020年6月的住培学员69名(对照组),2020年7月—2021年12月的住培学员70名(多学科协作诊疗模式组)。对照组给予NCCN指南的常规结直肠癌诊疗教学,多学科协作诊疗模式组在对照组教学的基础上给予基于多学科协作诊疗模式的结直肠癌诊疗教学,两组教学时间持续3个月。比较两组的教学效果。结果教学后多学科协作诊疗模式组的自我动机信念、任务分析、自我监控及调节、自我评价等自我学习能力评分都高于对照组,差异有统计学意义(P<0.05)。两组教学前后的理论成绩与操作成绩都高于教学前,差异有统计学意义(P<0.05),多学科协作诊疗模式组也高于对照组,差异有统计学意义(P<0.05)。教学后多学科协作诊疗模式组对于教学方法、教学效果、教学氛围的满意度为100%、100%、98.57%,均明显高于对照组的81.16%、81.61%、79.71%,差异有统计学意义(P<0.05)。结论NCCN指南结合MDT模式在住培学员结直肠癌诊疗教学中的应用能提高自我学习能力,也可提高学员的理论成绩与操作成绩,提高住培学员的满意度。展开更多
文摘BACKGROUND Clinical workup and treatment guidelines have been published by the National Comprehensive Cancer Network(NCCN)to ensure patients are treated uniformly and appropriately.This study sought to retrospectively review patients with a new diagnosis of sarcoma who were treated in a National Cancer Institute(NCI)designated center and determine compliance rates with guidelines for sarcoma.AIM To evaluate our compliance of NCCN sarcoma guidelines at a major NCI designated center and to report instances of deviation that could be used for future studies to improve patient care.METHODS Data was collected retrospectively as an internal review and quality assessment of 35 newly diagnosed and treated patients.Demographic data were recorded and information concerning whether patients had appropriate imaging,biopsy and management.Variables of interest were expressed as raw numbers and percentages.RESULTS Primary site imaging was obtained in 100%of cases.Chest and full-body imaging were obtained in 97%and 100%of indicated cases,respectively.Tissue was obtained preoperatively in 97%of cases.Imaging was reviewed at multidisciplinary Treatment Planning Conference(TPC)in 97%of cases.Pathology was reviewed in 94%of cases in TPC.Both tumor,node,metastasis staging and plan of care were reviewed in 100%of cases in TPC.Treatment guidelines were followed in 94%of cases reviewed.CONCLUSION This study evaluated the workup and treatment provided by a single NCI designated sarcoma service to a series of patients with pathologies defined with the NCCN sarcoma treatment guidelines.Although adherence to NCCN was reported to be very high future prospective studies are required to investigate whether NCCN guidelines impact patient outcomes.
文摘Biliary tract cancers(BTCs)constitute a heterogeneous group of hepatobiliary malignancies originating along the biliary tree.Approximately up to 20%of primary hepatobiliary tumors consist of BTCs(1).The primary risk factors include cholelithiasis,chronic inflammatory diseases of the bile ducts,non-alcoholic steatohepatitis(NASH),liver cirrhosis,tobacco use,and chronic viral hepatitis B and C infections(2).
文摘胰腺癌是预后极差的消化系统恶性肿瘤。美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)结合最新高质量循证医学证据不断更新推出胰腺癌的临床实践指南以指导胰腺癌的规范化诊疗。2023年5月4日与6月19日《NCCN胰腺癌临床实践指南》分别进行了两次更新。相较于2022年第2版,这两次更新主要集中于最新的免疫/靶向治疗进展、NALIRIFOX方案的引入以及体能状态中等病人治疗方案的补充。本文结合相关循证医学证据对最新《NCCN胰腺癌临床实践指南》的更新进行解读。
基金This study was sponsored by the National Natural Science Foundation of China （No. 81472377） and the Natural Science Foundation of Shanghai （No. 16ZR1406500）. The authors also thank Wei-Yi Yang, Cui-Zhu Zhang, and Ying Shen for helping with follow-up of patients.
文摘This study aimed to assess the role of the National Comprehensive Cancer Network （NCCN） risk classification in predicting biochemical recurrence （BCR） after radical prostatectomy （RP） in Chinese prostate cancer patients. We included a consecutive cohort of 385 patients with prostate cancer who underwent RP at Fudan University Shanghai Cancer Center （Shanghai, China） from March 2011 to December 2014. Gleason grade groups were applied at analysis according to the 2014 International Society of Urological Pathology Consensus. Risk groups were stratified according to the NCCN Clinical Practice Guidelines in Oncology： Prostate Cancer version 1, 2017. All 385 patients were divided into BCR and non-BCR groups. The clinicopathological characteristics were compared using an independent sample t-test, Chi-squared test, and Fisher＇s exact test. BCR-free survival was compared using the log-rank test and multivariable Cox proportional hazard analysis. During median follow-up of 48 months （range： 1-78 months）, 31 （8.05%） patients experienced BCR. The BCR group had higher prostate-specific antigen level at diagnosis （46.54 ± 39.58 ng m1-1 vs 21.02 ± 21.06 ng ml-1, P= 0.001）, more advanced pT stage （P= 0.002）, and higher pN1 rate （P〈 0.001）. NCCN risk classification was a significant predictor of BCR {P = 0.0006） and BCR-free survival （P = 0.003） after RP. As NCCN risk level increased, there was a significant decreasing trend in BCR-free survival rate （Ptrend = 0.0002）. This study confirmed and validated that NCCN risk classification was a significant predictor of BCR and BCR-free survival after RP.
文摘Esophageal carcinoma is one of the most common malignant tumors, especially in China which is the high incidence area. As a result of mild symptoms of early-stage esophageal cancer, the majority of patients cannot be diagnosed until they develop to advanced cancer, and the treatment outcome of surgery or chemoradiotherapy is still unsatisfactory at present. The guidelines of esophageal cancer issued by National Comprehensive Cancer Network (NCCN) are regarded as important reference tools by clinical oncologists, and provide uniform criteria for the diagnosis and treatment of esophageal carcinoma. However, the guidelines are not always suitable for Chinese patients because the data come from European and American population which have significant ethnical difference from Chinese. We retrospectively analyzed the changes of treatment strategy of esophageal cancer in NCCN guidelines and the advance of treatment for esophageal carcinoma in China, aiming to provide our oncologists with new research ideas. We also hope to set up clinical cancer cooperation organizations, and release our own cancer guidelines to serve Chinese patients and oncologists.
文摘目的探讨与分析美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)指南结合多学科协作诊疗模式(multi-disciplinary team,MDT)在住培学员结直肠癌诊疗教学中的应用价值。方法研究对象选取2017年7月—2021年12月在广州医科大学附属第一医院进行住培的139名学员,其中2017年7月—2020年6月的住培学员69名(对照组),2020年7月—2021年12月的住培学员70名(多学科协作诊疗模式组)。对照组给予NCCN指南的常规结直肠癌诊疗教学,多学科协作诊疗模式组在对照组教学的基础上给予基于多学科协作诊疗模式的结直肠癌诊疗教学,两组教学时间持续3个月。比较两组的教学效果。结果教学后多学科协作诊疗模式组的自我动机信念、任务分析、自我监控及调节、自我评价等自我学习能力评分都高于对照组,差异有统计学意义(P<0.05)。两组教学前后的理论成绩与操作成绩都高于教学前,差异有统计学意义(P<0.05),多学科协作诊疗模式组也高于对照组,差异有统计学意义(P<0.05)。教学后多学科协作诊疗模式组对于教学方法、教学效果、教学氛围的满意度为100%、100%、98.57%,均明显高于对照组的81.16%、81.61%、79.71%,差异有统计学意义(P<0.05)。结论NCCN指南结合MDT模式在住培学员结直肠癌诊疗教学中的应用能提高自我学习能力,也可提高学员的理论成绩与操作成绩,提高住培学员的满意度。
