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PubMed2002

AIDS and non-AIDS-related malignancies: a new vexing challenge in HIV-positive patients. Part II. Cervical and anal squamous epithelial lesions, lung cancer, testicular germ cell cancers, and skin cancers.

As the AIDS epidemic progresses, more and more HIV-infected patients will develop malignancies. The natural history of a malignancy may change dramatically in the presence of HIV infection. Among the AIDS and non-AIDS malignancies, the most frequently reported solid tumors are cervical and anal cancer, testicular germ cell tumors, lung cancer, and skin cancer. Regardless of epidemiology and outcome, the natural history of the majority of non-AIDS-defining tumors changes in the setting of HIV infection. Physicians who treat patients with AIDS and non-AIDS-related cancers need to become familiar with antiretroviral agents, drug-drug interactions, and the prophylaxis and management of opportunistic infections.

Journal Article↗

PubMed1997

Final results of a phase III clinical trial on adjuvant intraportal infusion with heparin and 5-fluorouracil (5-FU) in resectable colon cancer (EORTC GITCCG 1983-1987). European Organization for Research and Treatment of Cancer. Gastrointestinal Tract Cancer Cooperative Group.

In this phase III clinical trial conducted by the Gastrointestinal Tract Cancer Cooperative Group of the European Organization for Research and Treatment of Cancer (GITCCG-EORTC), we evaluated the effect of adjuvant intraportal infusion of heparin (HEP) and 5-fluorouracil (5-FU) on overall survival, disease-free survival and time to progression in patients with resectable colon cancer. From January 1983 to June 1987, 235 patients were randomised from 14 institutions in seven European countries: 79 patients made up the control group (control): 72 the portal vein infusion group given heparin alone (5000 IU daily x 7 consecutive days) (HEP); 84 the portal vein infusion group given heparin (5000 IU daily x 7 consecutive days) and 5-FU (500 mg/m2 daily x 7 consecutive days) (HEP/5-FU); 34 patients were considered ineligible. The 199 patients considered eligible were well balanced for age, sex, Karnofsky index, tumour location, surgery, surgical procedure and Dukes' stage. Four patients (2 control, 1 HEP, 1 HEP/5-FU) died of surgical complications. No differences were observed between control group and treatment groups (HEP, HEP/5-FU) for postoperative complications and number of hospitalisation days. Severe toxicity (grade 3-4, WHO) was found in 12% of patients in the HEP group and 8% in the HEP/5-FU group. After a median follow-up of 9 years, disease progression was reported in 40% of patients in the control group, 40% in the HEP group and 29% in the HEP/5-FU group. Five-year survival, time to progression and disease-free survival were 69%, 58% and 56%, respectively, in the control arm, 61%, 58% and 56% in the HEP arm, and 71%, 69% and 65% in the HEP/5-FU arm. Based on all randomised patients, the effect of treatment was not statistically significant with respect to any of the endpoints. It is confirmed that intraportal 5-FU infusion is safe and has a tolerable toxicity, but cannot be considered standard treatment for patients with resectable colon cancer.

Adult↗

PubMed1997

Baseline quality of life of patients with advanced prostate cancer. European Organization for Research and Treatment of Cancer (EORTC), Genito-Urinary Tract Cancer Cooperative Group (GUT-CCG)

Quality of life (QoL) is now commonly studied in prostate cancer. However, little is known about the appropriateness of the various QoL instruments in this group of patients. The purpose of this work was to study the baseline QoL assessment of patients with prostate cancer who were randomised into three EORTC phase III studies. The three trials included locoregional prostate cancer patients, poor prognosis metastatic patients and hormone resistance patients, respectively. In the three trials, patients were asked to complete a questionnaire assessing their physical and psychosocial functioning and their symptom levels. These questionnaires included questions from the EORTC QLQ-C30 (version 1): the physical functioning, role functioning, global health/QoL scales and a single pain item. The psychometric properties of the scales were assessed and an analysis was performed to investigate if differences existed in the scale scores between the three groups of patients, 638 baseline questionnaires were available for patients entered into the three trials. The Gutman coefficients of reproducibility and scalability were 0.94 and 0.71, respectively, for the physical functioning scale and 0.97 and 0.90, respectively, for the role functioning scale. The Cronbach's alpha reliability coefficients were 0.68, 0.48 and 0.90 for the physical functioning, role functioning and global health/QoL scales, respectively. The four scales were able to distinguish clearly between the patient populations under study. The physical functioning, role functioning, global health/QoL scales and the single pain item scale from the EORTC QLQ-C30 (version 1) are valid measures when used in the setting of prostate cancer.

Activities of Daily Living↗

PubMed1996

Cancer susceptibility genes and molecular carcinogenesis. American Association for Cancer Research Special Conference: Cancer Susceptibility Genes and Molecular Carcinogenesis.

As elaborated by Nobel Laureate Harold Varmus (Director of the National Institutes of Health, Bethesda, MD, USA) in his Keynote address, future studies must not only continue to expand our repertoire of genetic determinants of cancer susceptibility by identifying new cancer susceptibility genes, but most also now begin to address the function of these genes and their roles in the process of tumor development. Key areas for future investigation in this field, identified at the meeting, were: (1) understanding how susceptibility genes are altered in cancer cell physiology, (2) elucidating the function of these genes in the biochemistry of cellular signaling pathways; and (3) improving our ability to use this information to extrapolate basic oncology research to the clinic. At this meeting, the fields of molecular carcinogenesis, DNA repair and human genetics were very successfully integrated. These fields have converged in the areas of cell cycle control and genetic susceptibility, and this meeting capitalized on this convergence to highlight recent progress in these areas. Key areas for future research were also emphasized, including the need to apply the rapidly emerging information from these fields towards developing novel therapeutic modalities to treat and prevent cancer.

Aging↗

PubMed1998

Recent advances in the molecular genetics of cancer. Second joint conference of the American Association of Cancer Research and the European Association of Cancer Research, Oxford, 9-12 September 1997.

The second joint conference of the AACR and the EACR held in Oxford from 9-12 September 1997 was successful from many vantage points. While providing an optimal setting in which European and American cancer researchers could meet and exchange information, the conference had an excellent scientific programme which encompassed both methodological updates on important models used in cancer research and presentations of recent key advances in the molecular genetics of cancer. Lower eukaryotes are established model organisms used to elucidate fundamental but complex eukaryotic processes, such as those involved in tumorigenesis and cancer progression, and the progressive availability of their genome sequence makes them even more attractive. Transgenic mouse models are increasingly used not only for the study of one gene of interest but for investigation of the interactions among genes involved in the same pathway. The family of tumour suppressor genes is growing fast and several presentations were devoted to recently identified members such as the Von Hippel-Lindau gene, the FHIT gene and the PTEN gene. The systematic analysis of loss of heterozygosity on multiple loci in tumour specimens can provide the basis for preliminary models of molecular multistep progression in some tumour types, even though this is limited by the high degree of complexity found. Mechanisms of cell cycle regulation and apoptosis continue to be dissected and to constitute a fruitful area of investigation, with important recent insights on the p53-MDM2 autoregulatory loop and on the involvement of E2F-1 in apoptosis.

Animals↗

PubMed1998

Variation in the survival of women with breast cancer in Scotland. The Scottish Breast Cancer Focus Group and The Scottish Cancer Therapy Network.

We have investigated factors influencing the survival of women with early breast cancer in Scotland. In a retrospective study, clinical, treatment and 'service' factors, e.g. surgical case load, deprivation and geographical area (health board of first treatment) were recorded from hospital records. A total of 2148 women with invasive breast cancer diagnosed in 1987 were identified from the Scottish Cancer Registry, of whom 1619 without metastases at diagnosis underwent surgery as part of their primary treatment. In a multivariate analysis, clinical factors (age, clinical stage, pathological tumour size, node status and oestrogen receptor status) all influenced survival. After allowing for these clinical factors, surgical case load and deprivation did not have statistically significant effects on survival. By contrast, health board did affect survival. This was explained in part by the selection of patients for surgery. There appeared, however, to be a residual effect that may be related to differences in the use of adjuvant systemic treatment among the different health boards. We conclude that, in Scotland, geographical variation in both surgical and non-surgical treatment has a greater effect on variability in survival for women with breast cancer than surgical case load and deprivation.

Adult↗

PubMed1987

[In families of ovarian cancer patients, breast cancer in females and colorectal cancers in males are overrepresented].

A detailed tumour-related family history was obtained from 30 women with histologically verified epithelial ovarian carcinomas. 46% of the anamnestic tumour diagnoses were also verified by obtaining copies of histology reports. Breast cancer was overrepresented among the female relatives and colorectal cancer among the male relatives. This study demonstrates that persons at high cancer risk as well as tumour-prone families of interest for aetiological cancer research can be identified by the simple method of obtaining a family history.

Adult↗

PubMed2002

Molecular staging of lung cancer: real-time polymerase chain reaction estimation of lymph node micrometastatic tumor cell burden in stage I non-small cell lung cancer--preliminary results of Cancer and Leukemia Group B Trial 9761.

OBJECTIVE: The 5-year survival for patients with surgically resected stage I non-small cell lung cancer is only 60% to 70%, probably because of undetected systemic occult micrometastases. Detection of occult micrometastases in lymph nodes by reverse-transcriptase polymerase chain reaction for carcinoembryonic antigen messenger RNA in non-small cell lung cancer has not been reported. Detection of occult micrometastases by standard reverse-transcriptase polymerase chain reaction provides only yes or no answers about their presence, whereas quantitative real-time reverse-transcriptase polymerase chain reaction permits reproducible quantitation of target molecules. This study evaluated the ability of quantitative reverse-transcriptase polymerase chain reaction to quantitate lymph node occult metastases with carcinoembryonic antigen messenger RNA as a tumor marker. METHODS: Standard reverse-transcriptase polymerase chain reaction and quantitative reverse-transcriptase polymerase chain reaction for carcinoembryonic antigen messenger RNA were performed on 232 lymph nodes from 53 patients with stage I disease (node negative according to histologic examination). Quantitative reverse-transcriptase polymerase chain reaction determined carcinoembryonic antigen messenger RNA quantity by detecting fluorescence increase at a threshold polymerase chain reaction cycle. Threshold polymerase chain reaction cycle values were correlated with standard curves created from serially diluted carcinoembryonic antigen-positive HTB-174 tumor cells to estimate the number of micrometastatic tumor cells in a lymph node. RESULTS: Detection rates of occult metastases were similar for standard reverse-transcriptase polymerase chain reaction and quantitative reverse-transcriptase polymerase chain reaction at 38 of 232 (16.4 %) and 59 of 232 (25.4 %), respectively. Upstaging rates among 53 cases of stage I non-small cell lung cancer were also similar for standard reverse-transcriptase polymerase chain reaction and quantitative reverse-transcriptase polymerase chain reaction at 23 of 53 (43.4 %) and 30 of 53 (56.6%), respectively. Comparison of positive lymph node stations according to quantitative reverse-transcriptase polymerase chain reaction (threshold polymerase chain reaction cycle <45) with HTB-174 tumor cell standard curves yielded estimates of metastatic tumor cell burden of 1.07 x 10(3)to 3.24 x 10(5)cells per lymph node station (median 7190 tumor cells per lymph node station). CONCLUSIONS: Standard and quantitative real-time reverse-transcriptase polymerase chain reaction for carcinoembryonic antigen detected occult metastases in patients with stage I non-small cell lung cancer at similar rates; both upstaged about 50% of cases. Quantitative reverse-transcriptase polymerase chain reaction allows estimation of the number of metastatic cells per lymph node, however, which potentially allows greater precision in predicting recurrence risk.

Adenocarcinoma↗

PubMed2006

Relationship of Internet health information use with patient behavior and self-efficacy: experiences of newly diagnosed cancer patients who contact the National Cancer Institute's Cancer Information Service.

This study examines the relationship of Internet health information use with patient behavior and self-efficacy among 498 newly diagnosed cancer patients. Subjects were classified by types of Internet use: direct use (used Internet health information themselves), indirect use (used information accessed by friends or family), and non-use (never accessing Internet information). Subjects were recruited from callers of the National Cancer Institute's (NCI's) Cancer Information Service, Atlantic Region. They were classified by type of Internet use at enrollment and interviewed by telephone after 8 weeks. There were significant relationships among Internet use and key study variables: subject characteristics, patient task behavior, and self-efficacy. Subjects' Internet use changed significantly from enrollment to 8 week follow-up; 19% of nonusers and indirect users moved to a higher level of Internet use. Significant relationships also were found among Internet use and perceived patient-provider relationship, question asking, and treatment compliance. Finally, Internet use was also significantly associated with self-efficacy variables (confidence in actively participating in treatment decisions, asking physicians questions, and sharing feelings of concern). The results of this study show that patients who are newly diagnosed with cancer perceive the Internet as a powerful tool, both for acquiring information and for enhancing confidence to make informed decisions.

Adolescent↗

PubMed1998

Cancer incidence in Japan, 1985-89: re-estimation based on data from eight population-based cancer registries. The Research Group for Population-based Cancer Registration in Japan.

The Research Group for Population-based Cancer Registration in Japan has been conducting a cooperative study to estimate cancer incidence in Japan since 1975. Estimated incidence data calculated annually were accumulated in 1996 for 18 years. The Group has separately provided another re-calculated incidence estimate series which were prepared for 1975-79, 1980-84 and 1985-89. The former two results, each of five years were previously published elsewhere. These recalculated estimate series made more reliable observations of time trends in incidence feasible by using the same eligible registries' data throughout each 5-year period. This report presents results of the latter 5 years between 1985 and 1989; age-specific, crude and age-standardized incidence rates, as well as the number of incidence according to site and gender, under the cooperation of eight eligible population-based cancer registries in Japan: Miyagi, Yamagata, Kanagawa, Fukui, Osaka, Tottori, Hiroshima City and Nagasaki City. Incidence in Japan was estimated at 187,200 and 150,700 for all cancer sites among males and among females, respectively, in 1985 and 216,700 and 166,900, respectively, in 1989. The leading site was the stomach among both males and females from 1985 to 1989. Among males the second leading site was the lung, followed by the liver, colon and rectum. Among females, it was the breast, followed by the colon, uterus and lung in 1989. The proportion of the cases registered by a death certificate only for all sites was 14.0-15.7 and 13.7-15.3% and the ratio of incidence to mortality was 1.69-1.73 and 1.95-2.01 among males and females, respectively, during the period.

Breast Neoplasms↗

PubMed1996

Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group.

BACKGROUND: As a general rule, surgery whenever possible, followed by irradiation is considered to be the standard treatment for cancer of the hypopharynx, thus sacrificing natural speech. In most patients, surgery includes removal of the larynx. PURPOSE: A prospective, randomized phase III study was conducted by the European Organization for Research and Treatment of Cancer (EORTC) starting in 1990 to compare a larynx-preserving treatment (induction chemotherapy plus definitive, radiation therapy in patients who showed a complete response or surgery in those who did not respond) with conventional treatment (total laryngectomy with partial pharyngectomy, radical neck dissection, and postoperative irradiation) in previously untreated and operable patients with histologically proven squamous cell carcinomas of the pyriform sinus or aryepiglottic fold, but free of other cancers. METHODS: Patients were randomly assigned to one of two treatment arms: 1) immediate surgery with postoperative radiotherapy (50-70 Gy) or 2) induction chemotherapy (cisplatin [100 mg/m2] given as a bolus intravenous injection on day 1, followed by infusion of fluorouracil [1000 mg/m2 per day] on days 1-5). An endoscopic evaluation was performed after each cycle of chemotherapy. After two cycles, only partial and complete responders received a third cycle. Patients with a complete response after two or three cycles of chemotherapy were treated thereafter by irradiation (70 Gy); nonresponding patients underwent conventional surgery with postoperative radiation (50-70 Gy). Salvage surgery was also performed when patients relapsed after chemotherapy and irradiation. The trial was designed to test the equivalence of the two treatment arms; i.e., the induction chemotherapy treatment would be judged equivalent to immediate surgery if the relative risk of death for induction chemotherapy compared with immediate surgery was significantly less than 1.43 using a one-sided hypothesis test at the .05 level of significance. RESULTS: Two hundred two patients entered the trial and were randomly assigned; only 194 were eligible for treatment (94 in the immediate-surgery arm and 100 in the induction-chemotherapy arm). In the induction-chemotherapy arm, complete response was seen in 52 (54%) of 97 patients with local disease (primary tumor) and in 31 (51%) of 61 patients with regional disease (involvement of the neck). Treatment failures at local, regional, and second primary sites occurred at approximately the same frequencies in the immediate-surgery arm (12%, 19%, and 16%, respectively) and in the induction-chemotherapy arm (17%, 23%, and 13%, respectively). In contrast, there were fewer failures at distant sites in the induction-chemotherapy arm than in the immediate-surgery arm (25% versus 36%, respectively; P = .041). The median duration of survival was 25 months in the immediate-surgery arm and 44 months in the induction-chemotherapy arm and, since the observed hazard ratio was 0.86 (logrank test, P = .006), which was significantly less than 1.43, the two treatments were judged to be equivalent. The 3- and 5-year estimates of retaining a functional larynx in patients treated in the induction-chemotherapy arm were 42% (95% confidence interval = 31%-53%) and 35% (95% confidence interval = 22%-48%), respectively. CONCLUSIONS AND IMPLICATIONS: Larynx preservation without jeopardizing survival appears feasible in patients with cancer of the hypopharynx. On the basis of these observations, the EORTC has now accepted the use of induction chemotherapy followed by radiation as the new standard treatment in its future phase III larynx preservation trials.

Adult↗

PubMed1992

Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Collaborative Ovarian Cancer Group.

Data collected from 2,197 white ovarian cancer patients and 8,893 white controls in 12 US case-control studies conducted in the period 1956-1986 were used to evaluate the relation of invasive epithelial ovarian cancer to reproductive and menstrual characteristics, exogenous estrogen use, and prior pelvic surgeries. Clear trends of decreasing risk were evident with increasing number of pregnancies (regardless of outcome) and increasing duration of breast feeding and oral contraceptive use. Ovarian dysfunction leading to both infertility and malignancy is an unlikely explanation for these trends for several reasons: 1) The trends were evident even among the highly parous; 2) risk among nulliparous women did not vary by marital status or gravidity; and 3) risk among ever-married women showed little relation to length of longest pregnancy attempt or history of clinically diagnosed infertility. Risk was increased among women who had used fertility drugs and among women with long total duration of premenopausal sexual activity without birth control; these associations were particularly strong among the nulligravid. No consistent trends in risk were seen with age at menarche, age at menopause, or duration of estrogen replacement therapy. A history of tubal ligation or of hysterectomy with ovarian conservation was associated with reduced ovarian cancer risk. These observations suggest that pregnancy, breast feeding, and oral contraceptive use induce biological changes that protect against ovarian malignancy, that, at most, a small fraction of the excess ovarian cancer risk among nulliparous women is due to infertility, and that any increased risk associated with infertility may be due to the use of fertility drugs.

Adult↗

PubMed2006

Evidence-based gallbladder cancer staging: changing cancer staging by analysis of data from the National Cancer Database.

BACKGROUND: A recent revision of the American Joint Committee on Cancer (AJCC) staging for gallbladder cancer (6th Edition) involved some major changes. Most notably, T2N0M0 tumors were moved from stage II to stage IB; T3N1M0 disease was moved from stage III to stage IIB; and T4NxM0 (x = any) tumors were moved from stage IVA to stage III. METHODS: In order to determine if these changes were justified by data, an analysis of the 10,705 cases of gallbladder cancer collected between 1989 and 1996 in the NCDB was performed. All patients had >5 year follow-up. RESULTS: The staging according to the 6th Edition provided no discrimination between stage III and IV. Five-year survivals for stage IIA, IIB, III, and IV (6th Edition) were 7%, 9%, 3%, 2% respectively. The data from the National Cancer Database (NCDB) were used to derive a proposed new staging system that builds upon Edition 5 and had improved discrimination of stage groups over previous editions. CONCLUSIONS: Changes in staging systems should be justified by data. Multicenter databases, including the NCDB, represent important resources for verification of evidence-based staging systems.

Databases as Topic↗

PubMed1983

Familial cancer or cancer family syndrome. Report on a cancer family and consideration of genetic mechanisms.

We present a family with an unusually high incidence of cancer in four generations. Complete information could be obtained for the first three generations with 73 persons. Tumor incidence was 2/8 in the first generation, 14/22 in the second, and 11/44 in the third generation. A formal analysis, however, according to the four criteria of cancer family syndrome: increased frequency of adenocarcinomas of multiple anatomical sites, multiple primary malignant neoplasms, early age of onset, and autosomal dominant mode of inheritance, revealed that in this family multiple primaries are virtually absent and that tumors do not occur at a particularly early age. We therefore consider this family shows that familial clustering of tumors may follow an autosomal dominant pattern of inheritance even when the strict criteria of cancer family syndrome are not fulfilled. We conclude that the phenomenon of cancer families is not confined to one or two distinct clinical types.

Adenocarcinoma↗

PubMed1994

The effect of intravesical thiotepa on tumour recurrence after endoscopic treatment of newly diagnosed superficial bladder cancer. A further report with long-term follow-up of a Medical Research Council randomized trial. Medical Research Council Working Party on Urological Cancer, Subgroup on Superficial Bladder Cancer.

OBJECTIVE: To determine the role, if any, of one and five installations of intravesical thiotepa in the treatment of newly diagnosed superficial bladder cancer. PATIENTS AND METHODS: A multicentre randomized clinical trial was carried out involving 417 patients with newly diagnosed superficial bladder cancer. After transurethral resection the patients were randomized into one of three treatment arms: no thiotepa; one instillation of thiotepa at the time of resection; one instillation at time of resection and then at 3-monthly intervals for one year (giving a total of five instillations). In all treatment arms the dosage was 30 mg thiotepa in 50 ml saline. The main outcome measures were time to first superficial recurrence, recurrence rate (defined as the number of possible cystoscopies per annum) and failure-free interval rate (where failure was defined as the development of invasive disease, metastatic disease or death from bladder cancer). RESULTS: After a median follow-up of 8 years and 9 months analysis showed no evidence of a difference between the three groups with respect to time to first recurrence, recurrence rates or the failure-free interval rate. CONCLUSIONS: This analysis confirms that the thiotepa regimens tested cannot be recommended for use outside clinical trials for patients with newly diagnosed superficial bladder cancer.

Administration, Intravesical↗

PubMed1997

Serum concentrations of cancer antigen 125, placental alkaline phosphatase, cancer-associated serum antigen and free beta human chorionic gonadotrophin as prognostic markers for epithelial ovarian cancer.

OBJECTIVE: To investigate the prognostic significance of elevated levels of cancer antigen 125 (CA125), placental alkaline phosphatase (PLAP), free beta human chorionic gonadotrophin (hCG) and cancer-associated serum antigen (CASA) in women with primary epithelial ovarian carcinoma. DESIGN: A two year follow up study of survival. SETTING: A tertiary care gynaecological oncology unit. PARTICIPANTS: One hundred and eleven women with histologically confirmed epithelial ovarian cancer. MAIN OUTCOME MEASURES: Survival over a two year period. RESULTS: Stage corrected log-rank chi 2 tests demonstrated a significant effect on survival for all four tumour markers (CA125 P = 0.0142; PLAP P < 0.0001; CASA P = 0.0098; hCG P = 0.0002). This was confirmed when each variable was fitted together with disease stage in Cox proportional hazard models. When fitted as multiple variables in a Cox proportional hazard model, the addition of free beta-hCG and CASA to disease stage, PLAP concentrations and CA125 levels did not demonstrate further prognostic value. CONCLUSIONS: Levels of all four markers correlate with survival in patients with epithelial ovarian cancer. The combination of PLAP and CA125 concentrations together with disease stage may be used to predict survival but the addition of hCG and CASA levels do not give additional prognostic information.

Adult↗

PubMed1984

Co-carcinogens of the initiation-(or tumor)promoter type as environmental risk factors of cancer in man, experimental analysis of an etiologic model situation of life style cancer and current problems of assessment of cancer risk in multifactorial carcinogenesis.

The identification of so-called co-carcinogens i.e. "per se essentially non-carcinogenic amplifiers" of carcinogenesis - especially promoters of initiation(or tumors) - as a new, non-classical group of risk factors has added a new dimension to the etiology of cancer in man. Indeed, in real human life, multifactorial causation of cancer may be considered the rule and classical unifactorial causation the exception. This comprehensive and current concept of the etiology of cancer in man and certain prototype experimental models of multifactorial carcinogenesis allow for proposals of a standardized terminology which may be adequate for common use in both, experimental and epidemiological oncology. On the background of a recent experimental analysis of life style esophageal cancer the current situation regarding the scientific basis of classification and grading of carcinogenic risk factors will be reviewed. It may be helpful in legislation aiming at more environmental safety.

Beverages↗

PubMedDate not supplied

Evaluation of clinical efficacy of new medical treatments in advanced colorectal cancer. Results of a workshop organized by the EORTC GITCCG. European Organization for Research and Treatment of Cancer. Gastrointestinal Tract Cancer Cooperative Group.

During the last few years several factors have contributed to an increasing change in the medical treatment of advanced colorectal cancer. Among them are the more general acceptance of the impact of chemotherapy on quality of life and survival in first as well as in second-line treatment, the introduction of new drugs and the definition of novel endpoints which can roughly be defined as "patient benefit". For this reason the European Organization for Research and Treatment of Cancer (EORTC) Gastrointestinal Tract Cancer Cooperative Group (GITCCG) felt it was appropriate to organize a workshop with experts from different countries and national groups to discuss in depth several aspects concerning the treatment of patients with advanced colorectal cancer.

Clinical Trials as Topic↗