Community Oncology

Volume 6, Number 7 (July 2009)

Letter from the Editor

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The two-way street of accountability

Lee S. Schwartzberg, MD, FACP, Editor-in-Chief

The West Clinic, Memphis, TN

Accountability in the culture of oncology is a two-way street that must be utilized by both funders and providers alike.

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Dr. David Henry discusses this month's issue:

Community Translations

295

  

Rivaroxaban for thromboprophylaxis in major orthopedic surgery

Three recently reported randomized, double-blind phase III trials have shown the oral direct factor Xa inhibitor rivaroxaban (BAY 59-7939) to be superior to enoxaparin (Lovenox) anticoagulant therapy as thromboprophylaxis in patients undergoing total hip or knee arthroplasty.

  

FROM THE ONCOLOGIST'S PERSPECTIVE
Promising alternative to current drugs for thromboprophylaxis, but studies in cancer patients are lacking

Christy Joy Stotler, DO

Cleveland Clinic Foundation, Cleveland, OH

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Original Contribution

304

  

Advances in neoadjuvant therapies for early breast cancer

Edgardo Rivera, MD

The Methodist Hospital/Weill Cornell University, Houston, TX

Various studies, both current and recent, have evaluated novel chemotherapy regimens and agents, as well as hormonal and targeted agents, for neoadjuvant systemic therapy for early breast cancer.

abstract full text 100 kb tables 92 kb

Review Article

310

  

Novel therapies in metastatic head and neck squamous cell cancer

Anne S. Tsao, MD

Department of Thoracic/Head & Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX

The addition of novel biologic agents has provided new options for the management of head and neck squamous cell cancer (HNSCC). This review highlights the major studies that are reshaping the therapeutic landscape of HNSCC.

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Challenging Cases/Rare Cancers

318

  

Primary signet-ring cell carcinoma of the ileum

Cesar V. Reyes, MD

Pathology & Laboratory Medicine Service, Veterans Affairs Hospital, Hines, IL, and Department of Clinical Laboratories, Morris Hospital, Morris, IL

Signet-ring cell carcinoma (SRCC) of the ileum is rare and usually considered a metastasis from elsewhere until proven otherwise. SRCC developing in a cutaneoileostomy has not been previously documented, although there are a few reported instances of SRCC in the urinary bladder and female urethra associated with an ileal conduit.

abstract full text 124 kb

Practical Biostatistics

322

  

Power tripping: alpha errors, beta errors, and power

Geoffrey R. Norman, PhD, and David L. Streiner, PhD, CPsych

Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Psychiatry, University of Toronto, Senior Scientist, Kunin-Lunenfeld Applied Research Unit Baycrest Centre, Toronto, Ontario, Canada

Frequently, studies don’t find a statistically significant difference. The inevitable question then is whether there really was no clinically important treatment effect or the study was simply too small to detect an important difference.

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Implementing Clinical Trials

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The centralized network model: an efficient and logical approach

Lee S. Scheible, RPh

Eli Lilly and Company, Lilly Oncology, Indianapolis, IN

The single-site clinical research model for clinical trial participation has become increasingly inefficient for sponsors, investigators, and patients alike. In this article, an alternative system is described.

  

COMMENTARY
When constructing a network, trust must be built locally

Lori Minasian, MD

Community Oncology and Prevention Trials Research Group, Division of Cancer Prevention National Cancer Institute, Rockville, MD

  

Making quality research a community priority

Ralph V. Boccia, MD, FACP

Veeda (ION) Oncology Clinical Research Network, International Oncology Network, Center for Cancer and Blood Disorders, Bethesda, MD

abstract full text 76 kb

Economics/Practice Management

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Increasing patient satisfaction, part 3: office design and quality care

Patrick Young

Office décor may influence patients’ opinion of your practice and the quality of their care. We discuss upgrading the look and flow of your office, something that can be done even on a tight budget.

abstract full text 84 kb

Quality Care

331

  

Embedding palliative care and geriatric oncology within a private oncology practice

David M. Mintzer, MD, Clara Granda-Cameron, CMP, Barbara Tobin, CMP, Dana Marcone, MSW, Mary Pat Lynch, CRNP, Lee Hartner, MD, and Arthur Staddon, MD

Pennsylvania Oncology-Hematology Associates and Joan Karnell Cancer Center of Pennsylvania Hospital, Philadelphia, PA

Palliative care is being increasingly recognized as an integral part of oncology practice. This article describes the development of a successful palliative care program as part of a private practice.

abstract full text 82 kb

Brief Communications

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Malignant peripheral nerve sheath tumor with angiosarcomatous differentiation

Fahad M. Iqbal, MD, Bobby Chawla, DO, Atiq Syed, MD, Kenneth P. Wind, MD, Alan Gilman, MD, Rajat Malhotra, MD

St. Joseph Hospital, Chicago, IL

A 55-year-old male presented with a 5-cm lesion encroaching on the right lung apex. The patient underwent thoracotomy with resection. Pathologic examination of the surgical specimen was consistent with malignant peripheral nerve sheath tumors (MPNSTs) with high-grade angiosarcoma. Angiosarcomatous differentiation of a primary MPNST is an exceedingly rare occurrence, with most cases described in the literature occurring in association with neurofibromatosis. Most patients have a mean survival time of 11 months following diagnosis.

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