Purpose
Accurate frozen section diagnosis is necessary for appropriate surgical management. In this study, we planned to determine the accuracy of frozen section diagnosis in our center and to study ...the factors which may influence the accuracy of frozen section diagnosis of ovarian tumors.
Methods
In the present study, frozen section diagnosis of adnexal masses in 282 patients was compared with permanent section diagnosis as the gold standard.
Results
The overall accuracy of frozen section diagnosis was 95.7%. The sensitivity of frozen section diagnosis for benign, borderline and malignant lesions was 99, 60, and 92%, respectively. The tumor size in discrepant cases was larger than the concordant cases, however no association between mucinous histology and inaccurate diagnosis was found. The sensitivities of gross examination and clinical data in distinguishing benign from non-benign lesions were 93 and 70%, respectively.
Conclusion
Frozen section is a reliable method for surgical management of patients with adnexal masses. Gross examination and clinical data are two valuable parts of intraoperative consultation.
About 160 palliative care units with 1228 beds or 15 beds / 1 million inhabitants were available in German hospitals in the year 2008. Demand analyses consider 35 beds / 1 million inhabitants as ...necessary. Whether the additional demand could be reduced by a greater use of home- and hospice-based end-of-life care is discussed. For general hospitals the establishment of an acute palliative care unit within a medical (oncology) ward is recommended due to costs, organisation facilities and attitudes of physicians toward referral. The establishment of an acute palliative care unit may be costly for the hospital, nevertheless, outpatient palliative medicine and hospices are a cost-effective health service from a socioeconomic point of view, avoiding unnecessary hospital admissions and freeing up hospital beds by early discharge. An analysis of consultants demonstrates a minor interest of surgeons in specialisation in palliative medicine. However, data suggest that prior experience in palliative care alters the selection of treatment recommendations by surgeons with respect to more supportive or aggressive interventions in patients with advanced cancer. Ethical decision-making regarding therapy and counselling of patients at the end of life and discussing the prognosis with patients and their families require education in palliative medicine. A core curriculum to teach palliative care for surgical residents therefore has been presented.
To be clinically useful, an instrument assessing health-related quality of life (HRQOL) should be easy to understand and quick to answer. Few instruments have been designed to be short, simple, and ...easily understandable by patients from all educational levels. The aim of the present study was to evaluate the psychometric properties of a brief general instrument developed to assess HRQOL.
Results from a preliminary study regarding the initial development of the Barretos Short Instrument for Assessment of Quality of Life (BSIqol) with 80 cancer patients are presented. Out of all the patients, 59 completed the BSIqol on two occasions in order to evaluate the reproducibility test-retest. Validity analyses were done comparing scores from BSIqol with EORTC QLQ-C30 and Edmonton Symptom Assessment System (ESAS). In addition, BSIqol scores were analyzed in function of ECOG-PS, work activity, and financial income.
BSIqol demonstrated good internal consistency (Cronbach's α = 0.79) and adequate test-retest reliability, with intraclass coefficient correlation (ICC) varying from 0.736 to 0.946. There were adequate correlations between scores of BSIqol, EORTC QLQ-C30 and ESAS. The BSIqol was capable of discriminating between clinical subgroups, with different ECOG-PS and work activity. Patients completed the BSIqol in a median time <2 min. Only one patient reported some difficulty to answer the instrument.
BSIqol seems to be a straightforward and useful instrument for rapidly assessing HRQOL from cancer patients. Further studies are necessary to evaluate BSIqol in different populations and also to assess its responsiveness and define its minimal clinically important differences.
Objective: To gain an understanding of current attitudes among oncologists and pathologists to prospective HER2 testing in breast cancer and to gauge whether a national consensus exists regarding ...extent and quality of testing. Design: Qualitative study, with semi-quantitative components, using emailed questionnaires and open-ended discussion documents. Participants: 186 relevant specialists, including 76 breast oncologists and 99 pathologists, representing all but three of the UK cancer networks. Results: A strong consensus was seen in favour of universal, non-selective testing for HER2 at the point of breast cancer diagnosis. Similarly, an overwhelming majority of participants agreed that, to optimise the quality of test results, all laboratories undertaking HER2 testing should be CPA-accredited, participate in the recognised national external quality assessment scheme (UK NEQAS), and carry out a formal annual audit of its testing service. A further recommendation that testing be restricted to laboratories undertaking a minimum 250 tests per annum for immunohistochemistry and 100 tests per annum for in situ hybridisation techniques met with majority support. However, this was not a clear consensus; a significant minority of participants favoured continued use of local services falling short of these criteria. Conclusion: This study was successful in gauging national specialist opinion regarding the extent and quality assurance of HER2 testing in the UK.
Purpose
To explore the perspectives of cancer care centre users on participation in psychosocial research to inform research design and ethics.
Methods
The study is based on a qualitative research ...design. Fourteen semistructured interviews were carried in people diagnosed with cancer and carers. The interview included four main questions about practical barriers to participation, types of research design, motivating factors and the conduct of research in a cancer care support setting. The data were analysed using qualitative content analysis.
Results
Interviewees demonstrated a willingness to participate in psychosocial research within certain circumstances. There were no practical barriers identified, although they considered payment for research-related travel important. The most acceptable research design was the face-to-face interview and the least preferred was the randomised control trial. The factors that motivated participation were altruism, valuing research, and making a contribution to the centre. Interviewees supported the conduct of research in cancer care support centres conditional upon delaying recruitment during the initial months of users’ visits and its need to be discreet to avoid deterring visitors from accessing the centre.
Conclusions
The study concludes that the personal interaction between participants and researchers is the most important feature of decision-making by patients/carers to join studies. Taking into account the perspectives of people affected by cancer during the early stages of research design may enhance recruitment and retention and can contribute to the development of research protocols and ethics.
Further survival improvements of adolescents and young adults (AYA) with cancer are clearly affected by biological characteristics of the malignancies and age-specific needs. Multidisciplinary teams ...drawing expertice from both pediatric and adult cancer teams as well as clinical trials are required to meet the age specific needs of AYA patients with cancer. In 2011, the first AYA unit was established at the University Hospital Halle (Saale), where patients with newly-diagnosed cancer aged 15-25 are treated interdisciplinary by pediatric and adult oncologists. The enrollment into pediatric or adult clinical trials is controlled by age 18. Over the last 2 years, 19 AYA with cancer have been treated at the unit; and, in turn patients and their relatives reflected a high satisfaction with the offered novel health care approach. In the scope of the future Comprehensive Cancer Center at the University Hospital Halle (Saale), a complete ward is planned for all admitted AYA up to 25 years with cancer. The patients will be treated by a tumor-specialized multidisciplinary team of adult or pediatric oncologists and oncological surgeons. Therefore, we intend to establish a special teaching curriculum for physicians, nurses and psychosocial health care staff. Rather than age, cancer biology of a malignancy, surveillance data of late side effects as well as the age-specific needs of AYA patients will be crucial for best treatment options.
PDF
