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Behera A, Awasthi S. Anticarcinogenic Potentials of Silver Oxide Nanoparticles Synthesized from Lagerstroemia Indica. INTERNATIONAL JOURNAL OF NANOSCIENCE 2022. [DOI: 10.1142/s0219581x21500605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In this study, a novel medicinal plant, Lagerstroemia indica, was used to extract Silver Oxide Nanoparticles (Ag2O-NPs) and the in vitro anticancer potentials of synthesized Ag2O-NPs were evaluated on human cancer cell lines. Ultraviolet–Visible (UV-Vis) spectroscopy confirmed the formation of Ag2O and the particle size of 9.98[Formula: see text]nm was confirmed by X-Ray Diffraction (XRD) analysis. Scanning Electron Microscope (SEM) images showed spherical-shaped NPs. The anticancer potential determined by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay showed significant cytotoxic potential against breast cancer (MCF-7) and cervical cancer (HeLa) cell lines with the IC50 concentrations at 46.22[Formula: see text][Formula: see text]g/ml and 39.39[Formula: see text][Formula: see text]g/ml, respectively. Ag2O-NPs showed a subsequent reduction in Mitochondrial Membrane Potential (MMP) and increased level of Reactive Oxygen Species (ROS). The dual staining of Ag2O-NPs showed a greater number of early apoptotic and late apoptotic cells as compared to the standard drug camptothecin. Real-Time quantitative Polymerase Chain Reaction (RT-qPCR) determined an upregulated level of Caspase3 and p53. Thus, the present study indicates that Ag2O-NPs synthesized from L. indica may be used as an anti-cancer drug after further in vivo trials.
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Affiliation(s)
- Ambika Behera
- Department of Life Science, Garden City University, Bengaluru 560093, India
| | - Shruti Awasthi
- Department of Life Science, Garden City University, Bengaluru 560093, India
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Behera A, Awasthi S. Anticancer, Antimicrobial and Hemolytic Assessment of Zinc Oxide Nanoparticles Synthesized from Lagerstroemia indica. BIONANOSCIENCE 2021. [DOI: 10.1007/s12668-021-00889-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keikes L, Koopman M, Tanis PJ, Lemmens VE, Punt CJ, van Oijen MG. Evaluating the scientific basis of quality indicators in colorectal cancer care: A systematic review. Eur J Cancer 2017; 86:166-177. [DOI: 10.1016/j.ejca.2017.08.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/22/2017] [Accepted: 08/30/2017] [Indexed: 12/31/2022]
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5
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Li C, Peng W, Song X, Wang Q, Wang W. Anticancer effect of icaritin inhibits cell growth of colon cancer through reactive oxygen species, Bcl-2 and cyclin D1/E signaling. Oncol Lett 2016; 12:3537-3542. [PMID: 27900033 DOI: 10.3892/ol.2016.5089] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 08/09/2016] [Indexed: 01/04/2023] Open
Abstract
Icaritin has an advantage in enhancing immunity. Besides, with its anticancer effect, it may be of great help in cancer treatment and recovery of cancer patients. As a result, icaritin is likely to become a novel anticancer drug. However, the anticancer effect of icaritin against colon cancer has not been elucidated thus far. The present study investigated the latent anticancer effect of icaritin on the inhibition of colon cancer cell growth by regulating reactive oxygen species (ROS), B-cell lymphoma (Bcl)-2 and cyclin D1/E signaling. The COLO-205 colon cancer cell line was used as a colon cancer cell model in the present study. First, cell growth and apoptosis were measured to analyze the anticancer effect of icaritin against colon cancer. Next, the possible mechanism of icaritin against colon cancer, including ROS, Bcl-2, cyclin D1, cyclin E and caspase-3/9, was explored. The results revealed that icaritin could inhibit cell growth and induce the apoptosis of COLO-205 cells. In addition, icaritin significantly induced ROS generation, suppressed Bcl-2, cyclin D1 and cyclin E protein expression, and activated caspase-3/9 activity in COLO-205 cells. The present findings demonstrated that icaritin exerted antiproliferative and anticancer effects against colon cancer through the activation of ROS generation and the suppression of Bcl-2, cyclin D1 and cyclin E signaling.
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Affiliation(s)
- Chaofeng Li
- Department of Gastrointestinal Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Weichao Peng
- Department of Breast and Thyroid Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Xin Song
- Department of Gastrointestinal Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
| | - Qian Wang
- Department of Cardiology, Beijing Anzhen Hospital, Beijing 100029, P.R. China
| | - Wenyue Wang
- Department of Gastrointestinal Surgery, China-Japan Friendship Hospital, Beijing 100029, P.R. China
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Zhang Q, Yang J, Qian Q. Evidence-based treatment of patients with rectal cancer. Oncol Lett 2016; 11:1631-1634. [PMID: 26998054 PMCID: PMC4774437 DOI: 10.3892/ol.2016.4100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/11/2016] [Indexed: 01/15/2023] Open
Abstract
Rectal cancer is a worldwide disease whose incidence has increased significantly. Evidence-based medicine is a category of medicine that optimizes decision making by using evidence from well-designed and conducted research. Evidence-based medicine can be used to formulate a reasonable treatment plan for newly diagnosed rectal cancer patients. The current review focuses on the application of evidence-based treatment on patients with rectal cancer. The relationship between perioperative blood transfusion and recurrence of rectal cancer after surgery, the selection between minimally invasive laparoscopic surgery and traditional laparotomy, choice of chemotherapy for patients with rectal cancer prior to surgery, selection between stapled and hand-sewn methods for colorectal anastomosis during rectal cancer resection, and selection between temporary ileostomy and colostomy during the surgery were addressed. Laparoscopy is considered to have more advantages but is time-consuming and has high medical costs. In addition, laparoscopic rectal cancer radical resection is preferred to open surgery. In radical resection surgery, use of a stapling device for anastomosis can reduce postoperative anastomotic fistula, although patients should be informed of possible anastomotic stenosis.
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Affiliation(s)
- Qiang Zhang
- Department of General Surgery, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Jie Yang
- Department of General Surgery, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Qun Qian
- Department of General Surgery, Xiangyang Hospital Affiliated to Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
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Campanella C, Rappa F, Sciumè C, Marino Gammazza A, Barone R, Bucchieri F, David S, Curcurù G, Caruso Bavisotto C, Pitruzzella A, Geraci G, Modica G, Farina F, Zummo G, Fais S, Conway de Macario E, Macario AJL, Cappello F. Heat shock protein 60 levels in tissue and circulating exosomes in human large bowel cancer before and after ablative surgery. Cancer 2015; 121:3230-9. [PMID: 26060090 DOI: 10.1002/cncr.29499] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 04/24/2015] [Accepted: 05/12/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Heat shock protein 60 (Hsp60) is a chaperonin involved in tumorigenesis, but its participation in tumor development and progression is not well understood and its value as a tumor biomarker has not been fully elucidated. In the current study, the authors presented evidence supporting the theory that Hsp60 has potential as a biomarker as well as a therapeutic target in patients with large bowel cancer. METHODS The authors studied a population of 97 subjects, including patients and controls. Immunomorphology, Western blot analysis, and quantitative real-time polymerase chain reaction were performed on tissue specimens. Exosomes were isolated from blood and characterized by electron microscopy, biochemical tests, and Western blot analysis. RESULTS Hsp60 was found to be increased in cancerous tissue, in which it was localized in the tumor cell plasma membrane, and in the interstitium associated with cells of the immune system, in which it was associated with exosomes liberated by tumor cells and, as such, circulated in the blood. An interesting finding was that these parameters returned to normal shortly after tumor removal. CONCLUSIONS The data from the current study suggested that Hsp60 is a good candidate for theranostics applied to patients with large bowel carcinoma and encourage similar research among patients with other tumors in which Hsp60 has been implicated.
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Affiliation(s)
- Claudia Campanella
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Francesca Rappa
- Euro-Mediterranean Institute of Science and Technology, Palermo, Italy.,Department of Legal Science, Society and Sports, University of Palermo, Palermo, Italy
| | - Carmelo Sciumè
- Department of Oncological Surgery, University of Palermo, Palermo, Italy
| | - Antonella Marino Gammazza
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Rosario Barone
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Fabio Bucchieri
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Sabrina David
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Giuseppe Curcurù
- Department of Chemical, Management, Informatics and Mechanical Engineering, University of Palermo, Palermo, Italy
| | - Celeste Caruso Bavisotto
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Alessandro Pitruzzella
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Girolamo Geraci
- Department of Oncological Surgery, University of Palermo, Palermo, Italy
| | - Giuseppe Modica
- Department of Oncological Surgery, University of Palermo, Palermo, Italy
| | - Felicia Farina
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Giovanni Zummo
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy
| | - Stefano Fais
- Department of Therapeutic Research and Medicines Evaluation, National Institute of Health, Rome, Italy
| | - Everly Conway de Macario
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland.,Institute of Marine and Environmental Technology, Baltimore, Maryland
| | - Alberto J L Macario
- Euro-Mediterranean Institute of Science and Technology, Palermo, Italy.,Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland.,Institute of Marine and Environmental Technology, Baltimore, Maryland
| | - Francesco Cappello
- Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
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Turner NH, Wong HL, Field K, Wong R, Shapiro J, Yip D, Nott L, Tie J, Kosmider S, Tran B, Desai J, McKendrick J, Zimet A, Richardson G, Iddawela M, Gibbs P. Novel quality indicators for metastatic colorectal cancer management identify significant variations in these measures across treatment centers in Australia. Asia Pac J Clin Oncol 2015; 11:262-71. [DOI: 10.1111/ajco.12355] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Natalie Heather Turner
- The Walter and Eliza Hall Institute of Medical Research; Melbourne Victoria Australia
- Department of Medical Oncology; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Hui-li Wong
- The Walter and Eliza Hall Institute of Medical Research; Melbourne Victoria Australia
| | - Kathryn Field
- Department of Medical Oncology; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Rachel Wong
- Department of Medical Oncology; Eastern Health; Melbourne Victoria Australia
- Eastern Health Medical School; Monash University; Melbourne Victoria Australia
| | | | - Desmond Yip
- The Canberra Hospital; Canberra Australian Capital Territory Australia
- Calvary Hospital; Canberra Australian Capital Territory Australia
- ANU Medical School; Australian National University; Canberra Australian Capital Territory Australia
| | - Louise Nott
- Royal Hobart Hospital; Hobart Tasmania Australia
| | - Jeanne Tie
- The Walter and Eliza Hall Institute of Medical Research; Melbourne Victoria Australia
- Department of Medical Oncology; Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Medical Oncology; Western Hospital; Melbourne Victoria Australia
| | - Suzanne Kosmider
- Department of Medical Oncology; Western Hospital; Melbourne Victoria Australia
| | - Ben Tran
- The Walter and Eliza Hall Institute of Medical Research; Melbourne Victoria Australia
- Department of Medical Oncology; Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Medical Oncology; Western Hospital; Melbourne Victoria Australia
| | - Jayesh Desai
- The Walter and Eliza Hall Institute of Medical Research; Melbourne Victoria Australia
- Department of Medical Oncology; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Joseph McKendrick
- Department of Medical Oncology; Eastern Health; Melbourne Victoria Australia
| | - Allan Zimet
- Epworth Hospital; Melbourne Victoria Australia
| | | | - Mahesh Iddawela
- Goulburn Valley Health; Shepparton Victoria Australia
- University of Melbourne Rural Health Academic Centre; Shepparton Victoria Australia
| | - Peter Gibbs
- The Walter and Eliza Hall Institute of Medical Research; Melbourne Victoria Australia
- Department of Medical Oncology; Royal Melbourne Hospital; Melbourne Victoria Australia
- Royal Hobart Hospital; Hobart Tasmania Australia
- BioGrid Australia; Melbourne Victoria Australia
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Bilchik AJ, Wainberg ZA, Nissan A, Slamon DJ, Protic M, Avital I, Chen HW, Chen D, Sim M, Elashoff D, Stojadinovic A. Value of primary tumor gene signatures in colon cancer when national quality standards are adhered to: preliminary results of an international prospective multicenter trial. Ann Surg Oncol 2014; 22:535-42. [PMID: 25190115 DOI: 10.1245/s10434-014-4013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to determine if gene signatures are informative in colon cancer (CC) when National Quality Standards (NQS) are adhered to. Several studies have demonstrated the prognostic potential of gene signatures in primary CC. This has never been evaluated prospectively with adherence to NQS. METHODS This was a prospective, international, multicenter trial. Eligibility criteria were: no distant metastasis, ≥12 lymph nodes (LNs), and no adjuvant chemotherapy for LN-negative CC. RNA from frozen tumor samples was considered reliable if RNA Integrity Number >9. Using an Agilent whole human genome array, 44,000 genes were analyzed in primary tumors for differential gene expression (DGE). ANOVA applied at 2-fold expression level was performed in at least 8 experiments to obtain the DGEs. RESULTS Molecular analysis was completed in 113 of 128 patients. With median follow-up of 27 months, 11.5 % recurred within 3 years after surgery. Significant DGE was identified in recurrent tumors reflected by upregulation (UR) in cellular proliferation and by downregulation (DR) in prodifferentiating panel of 9 genes, independent of T or N classification. By multivariate analysis 3-year disease-free survival was 12.5 % in the UR/DR group versus 93.4 % in the non-UR/DR group (p < .0001; HR = 24.2; 95 % CI 4.8-120.4). CONCLUSIONS This is the first prospective trial to evaluate gene signatures in CC with adherence to a 12-node minimum quality standard. Certain molecular pathways may be prognostically relevant if both surgery and pathology are standardized, regardless of T or N classification. Careful consideration should be made to include surgical quality measures when planning clinical trials to evaluate the true effect of molecular markers in CC.
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Affiliation(s)
- Anton J Bilchik
- John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA,
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Porter G, Urquhart R, Kendell C, Bu J, McConnell Y, Grunfeld E. Timely access and quality of care in colorectal cancer: a population-based cohort study using administrative data. BMC Res Notes 2013; 6:355. [PMID: 24010527 PMCID: PMC3847107 DOI: 10.1186/1756-0500-6-355] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 08/28/2013] [Indexed: 01/13/2023] Open
Abstract
Background While efforts to improve cancer outcomes have typically focused on improving quality of care, recently, a growing emphasis has been placed on timely access to quality cancer care. This retrospective cohort study examines, at a population level, the relationship between quality and timeliness of colorectal cancer (CRC) care in a single Canadian province (Nova Scotia). Through the provincial cancer registry, we identified all residents diagnosed with invasive CRC between 2001 and 2005 that underwent a non-emergent resection. Using anonymized administrative databases that are individually linked at the patient level, we obtained clinicodemographic, diagnostic, and treatment event data. Selected charts were reviewed to ensure completeness of chemotherapy data. Performance on six quality indicators and the percentage of patients achieving wait-time benchmarks for diagnosis, surgery, and adjuvant therapy were calculated. The relationship between quality indicators and wait-time benchmarks was examined using logistic regression. Results Where an association was identified, patients who received ‘higher quality care’ had longer wait times. Individuals who received a complete preoperative colonoscopy were less likely to meet benchmarks for time from presentation to diagnosis and from diagnosis to surgery. Those who received an appropriate radiation oncology consultation were less likely to meet benchmarks for time from diagnosis to surgery and from surgery to adjuvant therapy. Conclusions As governments and other organizations move forward with strategies to reduce wait times, they must also focus on how to define and monitor quality care, and consider the relationship between these two dimensions of health care. Similarly, when developing quality improvement initiatives, the impact on resource utilization and potential to create longer waits for care must be considered.
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Affiliation(s)
- Geoffrey Porter
- Cancer Outcomes Research Program, Cancer Care Nova Scotia, Halifax, Nova Scotia, Canada.
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Quality assurance and quality control for radiotherapy/medical oncology in Europe: guideline development and implementation. Eur J Surg Oncol 2013; 39:938-44. [PMID: 23830983 DOI: 10.1016/j.ejso.2013.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 05/22/2013] [Accepted: 06/06/2013] [Indexed: 11/22/2022] Open
Abstract
The past two decades have brought tremendous changes to the practice of radiation oncology and medical oncology. To manage all the complexities related to the new technologies and the new drugs, the radiation and medical oncologists have to enhance their clinical action and professional skill profile. To accomplish this they have to find reliable tools in the quality of their medical practice and in future research activities. Quality assurance (QA) and quality control (QC) for radiation and medical oncologists mean to clarify the different components of the clinical decision, to supervise with proper methodology the required steps needed to accomplish the agreed outcomes and to control them. Quality for radiation and medical oncology means to supervise each clinical and technical component of the whole process to guarantee that all steps together will arrive at the final and best possible outcome. Key components are guidelines, specialization and a multidisciplinary approach. The research of global quality could represent a further complexity, but it is the best tool to give a perspective and a chance to further improvements of our disciplines and to promote better outcome in all cancer patients.
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Ludt S, Urban E, Eckardt J, Wache S, Broge B, Kaufmann-Kolle P, Heller G, Miksch A, Glassen K, Hermann K, Bölter R, Ose D, Campbell SM, Wensing M, Szecsenyi J. Evaluating the quality of colorectal cancer care across the interface of healthcare sectors. PLoS One 2013; 8:e60947. [PMID: 23658684 PMCID: PMC3641026 DOI: 10.1371/journal.pone.0060947] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 03/04/2013] [Indexed: 12/05/2022] Open
Abstract
Background Colorectal cancer (CRC) has a high prevalence in western countries. Diagnosis and treatment of CRC is complex and requires multidisciplinary collaboration across the interface of health care sectors. In Germany, a new nationwide established program aims to provide quality information of healthcare delivery across different sectors. Within this context, this study describes the development of a set of quality indicators charting the whole pathway of CRC-care including data specifications that are necessary to operationalize these indicators before practice testing. Methods Indicators were developed following a systematic 10 step modified ‘RAND/UCLA Appropriateness Method’ which involved a multidisciplinary panel of thirteen participants. For each indicator in the final set, data specifications relating to sources of quality information, data collection procedures, analysis and feedback were described. Results The final indicator set included 52 indicators covering diagnostic procedures (11 indicators), therapeutic management (28 indicators) and follow-up (6 indicators). In addition, 7 indicators represented patient perspectives. Primary surgical tumor resection and pre-operative radiation (rectum carcinoma only) were perceived as most useful tracer procedures initiating quality data collection. To assess the quality of CRC care across sectors, various data sources were identified: medical records, administrative inpatient and outpatient data, sickness-funds billing code systems and patient survey. Conclusion In Germany, a set of 52 quality indicators, covering necessary aspects across the interfaces and pathways relevant to CRC-care has been developed. Combining different sectors and sources of health care in quality assessment is an innovative and challenging approach but reflects better the reality of the patient pathway and experience of CRC-care.
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Affiliation(s)
- Sabine Ludt
- Department of General Practice and Health Services Research, University of Heidelberg Hospital, Heidelberg, Germany.
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Evaluation of ¹⁸F-FDG and ¹⁸F-FLT for monitoring therapeutic responses of colorectal cancer cells to radiotherapy. Eur J Radiol 2013; 82:e484-91. [PMID: 23639776 DOI: 10.1016/j.ejrad.2013.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 03/19/2013] [Accepted: 03/20/2013] [Indexed: 01/27/2023]
Abstract
In order to compare the efficacy of (18)F-fluorothymidine (FLT) and (18)F-fluorodeoxyglucose (FDG) for monitoring early responses to irradiation, two human colorectal cancer (CRC) cell lines SW480 and SW620, which were derived from the primary lesions and the metastatic lymph node, underwent X-ray irradiation of 0, 10, or 20 Gy and were examined at 0, 24 and 72 h After irradiation, reduced proliferation of both SW480 and SW620 cells was observed in a dose-dependent manner (P<0.001), G0-G1 arrest was also noted in both cell types after 72 h in the 20 Gy group (P<0.001). Although increased apoptosis was observed in both cell lines after irradiation (P<0.001), a greater percentage of SW480 cells underwent apoptosis in response to irradiation than SW620 cells. Increased Hsp27 and decreased integrin β3, Ki67 and VEGFR2 expression was observed over time via immunocytochemistry and Western blot analysis (P<0.001), however, no significant changes were noted in response to irradiation. Finally, reduced uptake of (18)F-FLT by SW480 or SW620 cells was observed at 24-h post-irradiation, however, reduced (18)F-FDG uptake was only observed after 72 h. Therefore, we conclude that (18)F-FLT is a more suitable positron emission tomography (PET) tracer for monitoring early responses to irradiation in primary and metastatic lymph node CRC cells.
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Mathoulin-Pélissier S, Bécouarn Y, Belleannée G, Pinon E, Jaffré A, Coureau G, Auby D, Renaud-Salis JL, Rullier E. Quality indicators for colorectal cancer surgery and care according to patient-, tumor-, and hospital-related factors. BMC Cancer 2012; 12:297. [PMID: 22813349 PMCID: PMC3527146 DOI: 10.1186/1471-2407-12-297] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 07/19/2012] [Indexed: 01/08/2023] Open
Abstract
Background Colorectal cancer (CRC) care has improved considerably, particularly since the implementation of a quality of care program centered on national evidence-based guidelines. Formal quality assessment is however still needed. The aim of this research was to identify factors associated with practice variation in CRC patient care. Methods CRC patients identified from all cancer centers in South-West France were included. We investigated variations in practices (from diagnosis to surgery), and compliance with recommended guidelines for colon and rectal cancer. We identified factors associated with three colon cancer practice variations potentially linked to better survival: examination of ≥12 lymph nodes (LN), non-use and use of adjuvant chemotherapy for stage II and stage III patients, respectively. Results We included 1,206 patients, 825 (68%) with colon and 381 (32%) with rectal cancer, from 53 hospitals. Compliance was high for resection, pathology report, LN examination, and chemotherapy use for stage III patients. In colon cancer, 26% of stage II patients received adjuvant chemotherapy and 71% of stage III patients. 84% of stage US T3T4 rectal cancer patients received pre-operative radiotherapy. In colon cancer, factors associated with examination of ≥12 LNs were: lower ECOG score, advanced stage and larger hospital volume; factors negatively associated were: left sided tumor location and one hospital district. Use of chemotherapy in stage II patients was associated with younger age, advanced stage, emergency setting and care structure (private and location); whereas under-use in stage III patients was associated with advanced age, presence of comorbidities and private hospitals. Conclusions Although some changes in practices may have occurred since this observational study, these findings represent the most recent report on practices in CRC in this region, and offer a useful methodological approach for assessing quality of care. Guideline compliance was high, although some organizational factors such as hospital size or location influence practice variation. These factors should be the focus of any future guideline implementation.
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Wong RKS, Brierley J, Brouwers M. What is the Best Way to Produce Consensus and Buy in to Guidelines for Rectal Cancer? CURRENT COLORECTAL CANCER REPORTS 2012; 8:83-89. [PMID: 22611341 PMCID: PMC3343240 DOI: 10.1007/s11888-012-0121-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Evidence-based guidelines are important tools and common pathways for translating evidence into clinical practice. It is most urgently needed when significant heterogeneity in practice exist. Actively engaging opinion leaders in the process of evidence-based guidelines development is important for several reasons. These include allowing the collective views of the practice communities to be represented, resolving heterogeneity in practice through discussion, and allowing credible recommendations to be formulated. Most importantly, the process itself is a tool for facilitating dissemination and implementation. Recognizing the gap between practice pattern and guideline recommendations, and devising strategies to address it represent an important step toward maximizing concordance between guideline and practice. Evidence-based recommendations serve as important reference points, against which we can measure, debate, and innovate from.
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Affiliation(s)
- Rebecca K. S. Wong
- Princess Margaret Hospital, 610 University Avenue, Toronto, M5G 2M9 Canada
| | - James Brierley
- Princess Margaret Hospital, 610 University Avenue, Toronto, M5G 2M9 Canada
| | - Melissa Brouwers
- Juravinski Hospital Site, G Wing, 2Fl, Rm 207, 711 Concession St, Hamilton, Ontario L8V 1C3 Canada
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Caldarella A, Amunni G, Angiolini C, Crocetti E, Di Costanzo F, Di Leo A, Giusti F, Pegna AL, Mantellini P, Luzzatto L, Paci E. Feasibility of evaluating quality cancer care using registry data and electronic health records: a population-based study. Int J Qual Health Care 2012; 24:411-8. [DOI: 10.1093/intqhc/mzs020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Guadagnolo BA, Dohan D, Raich P. Metrics for evaluating patient navigation during cancer diagnosis and treatment: crafting a policy-relevant research agenda for patient navigation in cancer care. Cancer 2011; 117:3565-74. [PMID: 21780091 DOI: 10.1002/cncr.26269] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Racial and ethnic minorities as well as other vulnerable populations experience disparate cancer-related health outcomes. Patient navigation is an emerging health care delivery innovation that offers promise in improving quality of cancer care delivery to these patients who experience unique health-access barriers. Metrics are needed to evaluate whether patient navigation can improve quality of care delivery, health outcomes, and overall value in health care during diagnosis and treatment of cancer. METHODS Information regarding the current state of the science examining patient navigation interventions was gathered via search of the published scientific literature. A focus group of providers, patient navigators, and health-policy experts was convened as part of the Patient Navigation Leadership Summit sponsored by the American Cancer Society. Key metrics were identified for assessing the efficacy of patient navigation in cancer diagnosis and treatment. RESULTS Patient navigation data exist for all stages of cancer care; however, the literature is more robust for its implementation during prevention, screening, and early diagnostic workup of cancer. Relatively fewer data are reported for outcomes and efficacy of patient navigation during cancer treatment. Metrics are proposed for a policy-relevant research agenda to evaluate the efficacy of patient navigation in cancer diagnosis and treatment. CONCLUSIONS Patient navigation is understudied with respect to its use in cancer diagnosis and treatment. Core metrics are defined to evaluate its efficacy in improving outcomes and mitigating health-access barriers.
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Affiliation(s)
- B Ashleigh Guadagnolo
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Chua W, Horvath L, Beale P, Clarke SJ. Reporting clinical trial information: colorectal cancer trials at Sydney Cancer Centre. Intern Med J 2011; 42:416-21. [PMID: 21299781 DOI: 10.1111/j.1445-5994.2011.02441.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clinical trial units are integral to the functioning of a medical oncology department with patient access to clinical trials an important component in patient care. There has been a paucity of potential key performance indicators in medical oncology and clinical trial information may be utilised for this purpose. The aim of this study was to record retrospectively and collate prospectively collected information regarding basic demographics, response rate, progression and survival plus grade 3 or 4 toxicity in patients enrolled in clinical trials for metastatic colorectal cancer at the Sydney Cancer Centre between 1999 and 2007. METHODS Baseline patient demographics, clinical response, progression dates, grade 3 or 4 toxicities plus treatment-related fatalities were collected from individual clinical trials. Outcome measures were clinical response, progression-free survival and overall survival. RESULTS There was a total of 14 trials undertaken during the defined period for patients with metastatic colorectal cancer. There was available information for 243 patient trials with sufficient information regarding response rates, toxicity, progression and survival. Tumour response rates ranged from 27% to 66% for first line chemotherapy trials and 0% to 20% for non-first line chemotherapy trials. The overall progression-free survival was 6.4 months and overall survival 14.0 months for all trials. There was one treatment-related fatality on clinical trial during this period. CONCLUSIONS Results of our clinical database have been used here to illustrate the concept and value of reporting clinical trial information in medical oncology. Public reporting of such information may allow for comparisons between units and for quality improvement.
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Affiliation(s)
- W Chua
- Department of Medical Oncology, Sydney Cancer Centre, Concord Repatriation General Hospital, Concord, New South Wales, Australia
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Tankiewicz-Kwedlo A, Pawlak D, Domaniewski T, Buczko W. Effect of erythropoietin, 5-fluorouracil and SN-38 on the growth of DLD-1 cells. Pharmacol Rep 2010; 62:926-37. [DOI: 10.1016/s1734-1140(10)70353-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 02/03/2010] [Indexed: 11/15/2022]
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Harel R, Angelov L. Spine metastases: current treatments and future directions. Eur J Cancer 2010; 46:2696-707. [PMID: 20627705 DOI: 10.1016/j.ejca.2010.04.025] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 04/08/2010] [Accepted: 04/28/2010] [Indexed: 11/17/2022]
Abstract
Spinal metastases are the most frequently encountered spinal tumour and can affect up to 50% of cancer patients. Both the incidence and prevalence of metastases are thought to be rising due to better detection and treatment options of the systemic malignancy resulting in increased patient survival. Further, the development and access to newer imaging modalities have resulted in easier screening and diagnosis of spine metastases. Current evidence suggests that pain, neurological symptoms and quality of life are all improved if patients with spine metastases are treated early and aggressively. However, selection of the appropriate therapy depends on several factors including primary histology, extent of the systemic disease, existing co-morbidities, prior treatment modalities, patient age and performance status, predicted life expectancy and available resources. This article reviews the currently available therapeutic options for spinal metastases including conventional external beam radiation therapy, open surgical decompression and stabilisation, vertebral augmentation and other minimally invasive surgery (MIS) options, stereotactic spine radiosurgery, bisphosphonates, systemic radioisotopes and chemotherapy. An algorithm for the management of spine metastases is also proposed. It outlines a multidisciplinary and integrated approach to these patients and it is hoped that this along with future advances and research will result in improved patient care and outcomes.
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Affiliation(s)
- Ran Harel
- Center for Spine Health, Cleveland Clinic, 9500 Euclid Avenue, S-80, Cleveland, OH 44195, USA
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McConnell YJ, Inglis K, Porter GA. Timely access and quality of care in colorectal cancer: are they related? Int J Qual Health Care 2010; 22:219-28. [PMID: 20207714 DOI: 10.1093/intqhc/mzq010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Colorectal cancer patients want both timely access and high-quality care. The objective of this study was to explore relationships between quality indicators and access time intervals specific to colorectal cancer patients. DESIGN Prospective consecutive cohort study. SETTING Single health district. PARTICIPANTS Between February 2002 and February 2004, all patients undergoing non-emergent surgery for primary colorectal cancer were enrolled. INTERVENTION A standardized method was used to collect clinicodemographic, diagnostic and treatment event data. MAIN OUTCOME MEASURES Associations between accepted colorectal cancer-specific quality indicators and benchmarked access time intervals for diagnosis, surgery and adjuvant therapy were examined using multivariate logistic regression, controlling for clinicodemographic factors. RESULTS Among the 392 patients in the study cohort, 9.9% were diagnosed on screening examination, 53.1% underwent preoperative staging imaging and 74.5% underwent full preoperative colonic examination. On multivariate logistic regression, patients presenting via screening were more likely to move from presentation to diagnosis within the 4-week benchmark for this access time interval, compared with symptomatic patients (RR 8.1, P < 0.001). The absence of preoperative staging imaging was associated with achievement of the 4-week benchmark for the access time interval from diagnosis to surgery (RR 2.5, P < 0.001). Similarly, an absence of complete preoperative colonic examination was associated with achievement of the 8-week benchmark for the access time interval from surgery to adjuvant therapy (RR 6.6, P = 0.008). CONCLUSIONS Although several associations between quality indicators and benchmarked access time intervals for colorectal cancer patients were identified, the relationship between quality and access is complex and far from universal. It is therefore clear that quality care and timely access are not synonymous, and that both must be studied to improve colorectal cancer care.
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Affiliation(s)
- Yarrow J McConnell
- Division of General Surgery, QEII Health Sciences Centre, Dalhousie University, 1278 Tower Rd., Halifax, Nova Scotia, Canada
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Habib MR, Solomon MJ, Young JM, Armstrong BK, O'Connell D, Armstrong K. Evidence-based and clinical outcome scores to facilitate audit and feedback for colorectal cancer care. Dis Colon Rectum 2009; 52:616-22; discussion 622-3. [PMID: 19404063 DOI: 10.1007/dcr.0b013e31819edb7d] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To describe a methodology for surgical audit and feedback based on hospital-level indicators of the quality of colorectal cancer care. METHODS Process and outcome indicators were identified from a population-based database (N = 3095 patients treated by 258 surgeons at 130 hospitals across New South Wales between February 1, 2000 and January 31, 2001). Hospitals were ranked on each indicator, with those in the lowest 20th percentile receiving a score of 0 and the remainder receiving a score of 1. Scores for individual indicators were then summed for each hospital and divided by the number of relevant indicators to provide an evidence-based score (EBS) and a clinical outcome score. RESULTS Ten process and six clinical outcome indicators were identified. Hospital-level summary scores ranged from 0.14 to 1.0 for evidence-based processes and from 0.17 to 1.0 for clinical outcomes. Evidence-based score and clinical outcome score were independent (r = 0.12, P = 0.32). There was a small positive association between evidence-based score and caseload (r = 0.33, P = 0.005) but clinical outcome score and caseload were unrelated (r = 0.11, P = 0.36). CONCLUSIONS Evidence-based score and clinical outcome score address different aspects of quality of care. The wide variability of hospitals' outcome scores and an association of evidence-based score and caseload indicate that simple scores may be useful in audit and feedback.
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Affiliation(s)
- Miriam R Habib
- Surgical Outcomes Research Centre, University of Sydney, Royal Prince Alfred Hospital, Sydney, Australia
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