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Top results for cancer

8441. Mastectomy or lumpectomy? The choice of operation for clinical stages I and II breast cancer

Mastectomy or lumpectomy? The choice of operation for clinical stages I and II breast cancer [Full Guidelines] Information for… Search for Keyword: Submit Clinical practice guidelines for the care and treatment of breast cancer: Mastectomy or lumpectomy? The choice of operation for clinical stages I and II breast cancer (summary of the 2002 update) This item has the following additional materials available: Guideline 3. Mastectomy or lumpectomy? The choice of operation for clinical stages I (...) and II breast cancer Mastectomy or lumpectomy? Choosing the most appropriate operation for early invasive breast cancer For a complete index to the clinical practice guidelines for the care and treatment of breast cancer, . Pour consulter l'index complet des guides de pratique clinique pour la prise en charge et le traitement du cancer du sein, . This Article » [Full Guidelines] Connect with CMAJ Classified ads CMAJ in the news ISSN 1488-2329 (e) 0820-3946 (p) All editorial matter in CMAJ represents

CMA Infobase (Canada)2002

8444. Prostate Cancer: Screening

Prostate Cancer: Screening Screening: Prostate Cancer U.S. Preventive Services Task Force Prostate Cancer for Screening Release Date: December 2002 / Summary of Recommendations The U.S. Preventive Services Task Force (USPSTF) concludes that the evidence is insufficient to recommend for or against routine screening for prostate cancer using prostate specific antigen (PSA) testing or digital rectal examination (DRE). Rating: . Rationale : The USPSTF found good evidence that PSA screening can (...) detect early-stage prostate cancer but mixed and inconclusive evidence that early detection improves health outcomes. Screening is associated with important harms, including frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient's health. The USPSTF concludes that evidence is insufficient to determine whether the benefits outweigh the harms for a screened population. Supporting Documents

Publication 3262002

8445. Breast Cancer: Preventive Medication

Breast Cancer: Preventive Medication Chemoprevention: Breast Cancer U.S. Preventive Services Task Force Chemoprevention for Breast Cancer Release Date: July 2002 / Summary of Recommendations The U.S. Preventive Services Task Force (USPSTF) recommends against routine use of tamoxifen or raloxifene for the primary prevention of breast cancer in women at low or average risk for breast cancer. (Select for a discussion of risk.) Rating: . Rationale : The USPSTF found fair evidence that tamoxifen (...) and raloxifene may prevent some breast cancers in women at low or average risk for breast cancer, based on extrapolation from studies of women at higher risk. The USPSTF concluded, however, that the potential harms of chemoprevention may outweigh the potential benefits in women who are not at high risk for breast cancer. The USPSTF recommends that clinicians discuss chemoprevention with women at high risk for breast cancer and at low risk for adverse effects of chemoprevention. (Select for a discussion

Publication 3262002

8446. Colorectal Cancer: Screening

Colorectal Cancer: Screening Screening: Colorectal Cancer U.S. Preventive Services Task Force Screening for Colorectal Cancer Release Date: July 2002 / Summary of Recommendations The USPSTF strongly recommends that clinicians screen men and women 50 years of age or older for colorectal cancer. Rating: . Rationale : The USPSTF found fair to good evidence that several screening methods are effective in reducing mortality from colorectal cancer. The USPSTF concluded that the benefits from (...) screening substantially outweigh potential harms, but the quality of evidence, magnitude of benefit, and potential harms vary with each method. The USPSTF found good evidence that periodic fecal occult blood testing (FOBT) reduces mortality from colorectal cancer and fair evidence that sigmoidoscopy alone or in combination with FOBT reduces mortality. The USPSTF did not find direct evidence that screening colonoscopy is effective in reducing colorectal cancer mortality; efficacy of colonoscopy

Publication 3262002

8447. Breast Cancer: Screening

Breast Cancer: Screening Breast Cancer: Screening U.S. Preventive Services Task Force Screening for Breast Cancer Release Date: February 2002 / Summary of Recommendations The U.S. Preventive Services Task Force (USPSTF) recommends screening mammography, with or without clinical breast examination (CBE), every 1-2 years for women aged 40 and older. Rating: . Rationale: The USPSTF found fair evidence that mammography screening every 12-33 months significantly reduces mortality from breast cancer (...) . Evidence is strongest for women aged 50-69, the age group generally included in screening trials. For women aged 40-49, the evidence that screening mammography reduces mortality from breast cancer is weaker, and the absolute benefit of mammography is smaller, than it is for older women. Most, but not all, studies indicate a mortality benefit for women undergoing mammography at ages 40-49, but the delay in observed benefit in women younger than 50 makes it difficult to determine the incremental benefit

Publication 3262002

8448. Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial.

Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. 12090977 2002 07 01 2002 07 11 2015 06 16 0140-6736 359 9324 2002 Jun 22 Lancet (London, England) Lancet Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. 2131-9 (...) In the adjuvant setting, tamoxifen is the established treatment for postmenopausal women with hormone-sensitive breast cancer. However, it is associated with several side-effects including endometrial cancer and thromboembolic disorders. We aimed to compare the safety and efficacy outcomes of tamoxifen with those of anastrozole alone and the combination of anastrozole plus tamoxifen for 5 years. Participants were postmenopausal patients with invasive operable breast cancer who had completed primary therapy

Lancet2002

8449. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial.

Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. 12126818 2002 07 19 2002 07 30 2015 06 16 0140-6736 360 9327 2002 Jul 13 Lancet (London, England) Lancet Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. 103-6 We did a randomised phase III (...) trial comparing external irradiation alone and external irradiation combined with an analogue of luteinising-hormone releasing hormone (LHRH) to investigate the added value of long-term androgen suppression in locally advanced prostate cancer. Between 1987 and 1995, 415 patients were randomly assigned radiotherapy alone or radiotherapy plus immediate androgen suppression. Eligible patients had T1-2 tumours of WHO grade 3 or T3-4 N0-1 M0 tumours; the median age of participants was 71 years (range 51

Lancet2002

8450. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer.

Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. 12393819 2002 10 23 2002 11 04 2007 11 15 1533-4406 347 16 2002 Oct 17 The New England journal of medicine N. Engl. J. Med. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. 1227-32 We conducted 20 years of follow-up of women enrolled in a randomized trial to compare the efficacy of radical (...) (Halsted) mastectomy with that of breast-conserving surgery. From 1973 to 1980, 701 women with breast cancers measuring no more than 2 cm in diameter were randomly assigned to undergo radical mastectomy (349 patients) or breast-conserving surgery (quadrantectomy) followed by radiotherapy to the ipsilateral mammary tissue (352 patients). After 1976, patients in both groups who had positive axillary nodes also received adjuvant chemotherapy with cyclophosphamide, methotrexate, and fluorouracil. Thirty

NEJM2002

8451. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer.

Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. 12393820 2002 10 23 2002 11 04 2007 11 15 1533-4406 347 16 2002 Oct 17 The New England journal of medicine N. Engl. J. Med. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. 1233-41 In 1976, we initiated a randomized trial (...) to determine whether lumpectomy with or without radiation therapy was as effective as total mastectomy for the treatment of invasive breast cancer. A total of 1851 women for whom follow-up data were available and nodal status was known underwent randomly assigned treatment consisting of total mastectomy, lumpectomy alone, or lumpectomy and breast irradiation. Kaplan-Meier and cumulative-incidence estimates of the outcome were obtained. The cumulative incidence of recurrent tumor in the ipsilateral breast

NEJM2002

8452. A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer.

A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. 12226148 2002 09 12 2002 09 19 2006 11 15 1533-4406 347 11 2002 Sep 12 The New England journal of medicine N. Engl. J. Med. A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. 781-9 Radical prostatectomy is widely used in the treatment of early prostate cancer. The possible survival benefit of this treatment, however, is unclear. We conducted (...) a randomized trial to address this question. From October 1989 through February 1999, 695 men with newly diagnosed prostate cancer in International Union against Cancer clinical stage T1b, T1c, or T2 were randomly assigned to watchful waiting or radical prostatectomy. We achieved complete follow-up through the year 2000 with blinded evaluation of causes of death. The primary end point was death due to prostate cancer, and the secondary end points were overall mortality, metastasis-free survival, and local

NEJM2002

8453. First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial.

First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial. 12243915 2002 09 23 2002 10 09 2016 11 24 0140-6736 360 9336 2002 Sep 14 Lancet (London, England) Lancet First results from the International Breast Cancer Intervention Study (IBIS-I): a randomised prevention trial. 817-24 Three clinical trials on the use of tamoxifen to prevent breast cancer have reported mixed results. The overall evidence supports a reduction in the risk of breast (...) cancer, but whether this benefit outweighs the risks and side-effects associated with tamoxifen is unclear. We undertook a double-blind placebo-controlled randomised trial of tamoxifen, 20 mg/day for 5 years, in 7152 women aged 35-70 years, who were at increased risk of breast cancer. The primary outcome measure was the frequency of breast cancer (including ductal carcinoma in situ). Analyses were by intention to treat after exclusion of 13 women found to have breast cancer at baseline mammography

Lancet2002

8454. Serum estradiol level and risk of breast cancer during treatment with raloxifene.

Serum estradiol level and risk of breast cancer during treatment with raloxifene. 11779264 2002 01 07 2002 02 05 2016 10 17 0098-7484 287 2 2002 Jan 09 JAMA JAMA Serum estradiol level and risk of breast cancer during treatment with raloxifene. 216-20 As endogenous estradiol increases, risk of breast cancer increases. Raloxifene competes with endogenous estrogen for binding to estrogen receptors in breast tissue. A woman's estradiol level may alter the effects of raloxifene on breast cancer (...) and other outcomes. To test the hypothesis that raloxifene reduces breast cancer risk more in women with relatively high estradiol levels than in women with very low estradiol levels. Analysis of the Multiple Outcomes of Raloxifene Evaluation, a randomized, double-blind, placebo-controlled trial conducted from 1994 to 1999. One hundred eighty community settings and medical practices in 25 countries including the United States. A total of 7290 postmenopausal women aged 80 years or younger

JAMA2002

8455. Tamoxifen for breast cancer among hysterectomised women.

Tamoxifen for breast cancer among hysterectomised women. 11943263 2002 04 10 2002 04 25 2015 06 16 0140-6736 359 9312 2002 Mar 30 Lancet (London, England) Lancet Tamoxifen for breast cancer among hysterectomised women. 1122-4 Tamoxifen is a candidate drug for prevention of breast cancer, although findings from trials have not been consistent. In our extended follow-up (median 81.2 months, IQR 66.0-87.2) of the Italian Tamoxifen Trial, this drug did not significantly protect against breast (...) cancer in women at usual or slightly reduced risk of the disease (p=0.215). Use of hormone replacement therapy increased risk of breast cancer, and users of such treatment who were randomly allocated to tamoxifen had a rate of breast cancer that was close to that of never-users. So far, no woman has died from breast cancer in this study. Decisions about introduction of tamoxifen to reduce risk of breast cancer remain important and open questions. Veronesi U U Divisions of Senology, European Institute

Lancet2002

8456. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer.

Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. 11784874 2002 01 10 2002 01 24 2016 11 24 1533-4406 346 2 2002 Jan 10 The New England journal of medicine N. Engl. J. Med. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. 85-91 Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against small-cell lung cancer. In a phase 2 study of irinotecan plus cisplatin in patients (...) with extensive small-cell lung cancer, there was a high response rate and a promising median survival time. We conducted a multicenter, randomized, phase 3 study in which we compared irinotecan plus cisplatin with etoposide plus cisplatin in patients with extensive (metastatic) small-cell lung cancer. The planned size of the study population was 230 patients, but enrollment was terminated early because an interim analysis found a statistically significant difference in survival between the patients assigned

NEJM2002

8457. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.

Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. 11784875 2002 01 10 2002 01 24 2015 11 19 1533-4406 346 2 2002 Jan 10 The New England journal of medicine N. Engl. J. Med. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. 92-8 We conducted a randomized study to determine whether any of three chemotherapy regimens was superior to cisplatin and paclitaxel in patients with advanced non-small-cell lung cancer. A total of 1207 patients (...) with advanced non-small-cell lung cancer were randomly assigned to a reference regimen of cisplatin and paclitaxel or to one of three experimental regimens: cisplatin and gemcitabine, cisplatin and docetaxel, or carboplatin and paclitaxel. The response rate for all 1155 eligible patients was 19 percent, with a median survival of 7.9 months (95 percent confidence interval, 7.3 to 8.5), a 1-year survival rate of 33 percent (95 percent confidence interval, 30 to 36 percent), and a 2-year survival rate of 11

NEJM2002

8458. Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial.

Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. 11978336 2002 04 29 2002 05 08 2016 11 24 0140-6736 359 9315 2002 Apr 20 Lancet (London, England) Lancet Effectiveness of positron emission tomography in the preoperative assessment of patients with suspected non-small-cell lung cancer: the PLUS multicentre randomised trial. 1388-93 Up to 50% of curative surgery for suspected (...) non-small-cell lung cancer is unsuccessful. Accuracy of positron emission tomography (PET) with 18-fluorodeoxyglucose (18FDG) is thought to be better than conventional staging for diagnosis of this malignancy. Up to now however, there has been no evidence that PET leads to improved management of patients in routine clinical practice. We did a randomised controlled trial in patients with suspected non-small-cell lung cancer, who were scheduled for surgery after conventional workup, to test whether

Lancet2002

8459. Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial.

Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. 11790211 2002 01 15 2002 01 30 2016 10 17 0098-7484 287 3 2002 Jan 16 JAMA JAMA Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. 321-8 Laparoscopic-assisted colectomy (LAC) has emerged as the preferred minimally invasive surgical strategy for diseases of the colon. The safety (...) and efficacy of LAC for colon cancer are unknown, and the nature and magnitude of any quality-of-life (QOL) benefit resulting from LAC for colon cancer is also unknown. To compare short-term QOL outcomes after LAC vs open colectomy for colon cancer. Multicenter, randomized controlled trial (Clinical Outcomes of Surgical Therapy [COST]). Between September 1994 and February 1999, 37 of 48 centers provided data for the QOL component of the trial for 449 consecutive patients with clinically resectable colon

JAMA2002

8460. Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial.

Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. 11965274 2002 04 19 2002 04 30 2016 11 24 0140-6736 359 9314 2002 Apr 13 Lancet (London, England) Lancet Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. 1291-300 This randomised controlled trial is examining the hypothesis that a single flexible sigmoidoscopy screening offered at around age 60 (...) years can lower the incidence and mortality of colorectal cancer. We report here on acceptability, safety, feasibility, and yield. Men and women aged 55-64 years, in 14 UK centres, who responded to a mailed questionnaire that they would attend for flexible sigmoidoscopy screening if invited, were randomly assigned screening or control (ratio one to two). The control group was not contacted. Small polyps were removed during screening, and colonoscopy was undertaken if high-risk polyps (three or more

Lancet2002