Home About us Contact
|
Home About us Contact | ||
|
|
||
Stage Migration (stage + migration)
Selected AbstractsStage Migration in Dogs with LymphomaJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2007Andrea B. Flory Background: Various diagnostic tests have been used to assign a clinical stage to dogs with lymphoma. As more sensitive staging methods are introduced, dogs are reclassified as having a higher disease stage, thereby affecting comparisons of dogs across differently staged clinical trials, and possibly, prognosis. Hypothesis: The addition of more sensitive staging tests causes stage migration in dogs with lymphoma. Animals: Fifty-nine client-owned dogs with previously untreated cytologically or histologically confirmed lymphoma Methods: For every dog, the World Health Organization stage classification (I-V) was based on 5 groupings of various diagnostic tests: A (physical examination [PE] and quantitative blood count [QBC]), B (PE, QBC, thoracic and abdominal radiographs), C (PE, complete blood count with blood-smear evaluation [CBC], thoracic and abdominal radiographs), D (PE, CBC, thoracic radiographs, abdominal ultrasound), and E (PE, CBC, thoracic radiographs, abdominal ultrasound, and bone-marrow cytology). Dogs were treated with doxorubicin-based protocols. Results: There was migration between all of the staging methods except D to E. However, the stage was not a predictor of remission rate, remission duration, or survival, regardless of staging method used. Conclusions and Clinical Importance: These data emphasized the need for standardized methods to determine the clinical stage in dogs with lymphoma. [source] Transthoracic vs. transhiatal esophagectomy: Stage migration muddies the waterJOURNAL OF SURGICAL ONCOLOGY, Issue 7 2006Mark I. Block MDArticle first published online: 16 MAY 200 No abstract is available for this article. [source] Stage migration in localized prostate cancer has no effect on the post-radical prostatectomy Kattan nomogramBJU INTERNATIONAL, Issue 5 2010Ruban Thanigasalam Study Type , Prognosis (case series) Level of Evidence 4 OBJECTIVE To investigate the effect of prostate-specific antigen (PSA) testing on stage migration in an Australian population, and its consequences on the prognostic accuracy of the post-radical prostatectomy (RP) Kattan nomogram, as in North America widespread PSA testing has resulted in prostate cancer stage migration, questioning the utility of prognostic nomograms in this setting. PATIENTS AND METHODS The study comprised 1008 men who had consecutive RP for localized prostate cancer between 1991 and 2001 at one institution. Two groups were assessed, i.e. those treated in 1991,96 (group 1, the early PSA era), and 1997,2001 (group 2, the contemporary PSA era). Differences in clinicopathological features between the groups were analysed by chi-squared testing and survival modelling. Individual patient data were entered into the post-RP Kattan nomogram and the efficacy assessed by receiver- operating characteristic curve analysis. RESULTS Patients in group 2 had lower pathological stage disease (P = 0.01) and fewer cancers with Gleason score ,8 (P < 0.001) than group 1. Multivariate analysis identified preoperative serum PSA level (P < 0.01) and Gleason score (P < 0.01) as strong predictors of biochemical relapse in both groups. In group 2 pathological stage was not significant, but margin involvement became highly significant (P = 0.004). There was no difference in the predictive accuracy of the Kattan nomogram between the groups (P = 0.253). CONCLUSIONS These findings show a downward stage migration towards organ-confined disease after the introduction of widespread PSA testing in an Australian cohort. Despite this, the Kattan nomogram remains a robust prognostic tool in clinical practice. [source] Stage Migration in Dogs with LymphomaJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2007Andrea B. Flory Background: Various diagnostic tests have been used to assign a clinical stage to dogs with lymphoma. As more sensitive staging methods are introduced, dogs are reclassified as having a higher disease stage, thereby affecting comparisons of dogs across differently staged clinical trials, and possibly, prognosis. Hypothesis: The addition of more sensitive staging tests causes stage migration in dogs with lymphoma. Animals: Fifty-nine client-owned dogs with previously untreated cytologically or histologically confirmed lymphoma Methods: For every dog, the World Health Organization stage classification (I-V) was based on 5 groupings of various diagnostic tests: A (physical examination [PE] and quantitative blood count [QBC]), B (PE, QBC, thoracic and abdominal radiographs), C (PE, complete blood count with blood-smear evaluation [CBC], thoracic and abdominal radiographs), D (PE, CBC, thoracic radiographs, abdominal ultrasound), and E (PE, CBC, thoracic radiographs, abdominal ultrasound, and bone-marrow cytology). Dogs were treated with doxorubicin-based protocols. Results: There was migration between all of the staging methods except D to E. However, the stage was not a predictor of remission rate, remission duration, or survival, regardless of staging method used. Conclusions and Clinical Importance: These data emphasized the need for standardized methods to determine the clinical stage in dogs with lymphoma. [source] Stage migration in localized prostate cancer has no effect on the post-radical prostatectomy Kattan nomogramBJU INTERNATIONAL, Issue 5 2010Ruban Thanigasalam Study Type , Prognosis (case series) Level of Evidence 4 OBJECTIVE To investigate the effect of prostate-specific antigen (PSA) testing on stage migration in an Australian population, and its consequences on the prognostic accuracy of the post-radical prostatectomy (RP) Kattan nomogram, as in North America widespread PSA testing has resulted in prostate cancer stage migration, questioning the utility of prognostic nomograms in this setting. PATIENTS AND METHODS The study comprised 1008 men who had consecutive RP for localized prostate cancer between 1991 and 2001 at one institution. Two groups were assessed, i.e. those treated in 1991,96 (group 1, the early PSA era), and 1997,2001 (group 2, the contemporary PSA era). Differences in clinicopathological features between the groups were analysed by chi-squared testing and survival modelling. Individual patient data were entered into the post-RP Kattan nomogram and the efficacy assessed by receiver- operating characteristic curve analysis. RESULTS Patients in group 2 had lower pathological stage disease (P = 0.01) and fewer cancers with Gleason score ,8 (P < 0.001) than group 1. Multivariate analysis identified preoperative serum PSA level (P < 0.01) and Gleason score (P < 0.01) as strong predictors of biochemical relapse in both groups. In group 2 pathological stage was not significant, but margin involvement became highly significant (P = 0.004). There was no difference in the predictive accuracy of the Kattan nomogram between the groups (P = 0.253). CONCLUSIONS These findings show a downward stage migration towards organ-confined disease after the introduction of widespread PSA testing in an Australian cohort. Despite this, the Kattan nomogram remains a robust prognostic tool in clinical practice. [source] | ||||||||||