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  • A review of cancer immunotherapy toxicity
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2020-01-16
    Lucy Boyce Kennedy; April K. S. Salama

    Cancer immunotherapies, including checkpoint inhibitors and adoptive cell therapy, manipulate the immune system to recognize and attack cancer cells. These therapies have the potential to induce durable responses in multiple solid and hematologic malignancies and thus have transformed treatment algorithms for numerous tumor types. Cancer immunotherapies lead to unique toxicity profiles distinct from the toxicities of other cancer therapies, depending on their mechanism of action. These toxicities often require specific management, which can include steroids and immune‐modulating therapy and for which consensus guidelines have been published. This review will focus on the toxicities of checkpoint inhibitors and chimeric antigen receptor T cells, including pathophysiology, diagnosis, and management.

    更新日期:2020-01-16
  • Issue Information ‐ Cover
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2020-01-10
    更新日期:2020-01-11
  • Cancer statistics, 2020
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2020-01-08
    Rebecca L. Siegel; Kimberly D. Miller; Ahmedin Jemal

    Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on population‐based cancer occurrence. Incidence data (through 2016) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2017) were collected by the National Center for Health Statistics. In 2020, 1,806,590 new cancer cases and 606,520 cancer deaths are projected to occur in the United States. The cancer death rate rose until 1991, then fell continuously through 2017, resulting in an overall decline of 29% that translates into an estimated 2.9 million fewer cancer deaths than would have occurred if peak rates had persisted. This progress is driven by long‐term declines in death rates for the 4 leading cancers (lung, colorectal, breast, prostate); however, over the past decade (2008‐2017), reductions slowed for female breast and colorectal cancers, and halted for prostate cancer. In contrast, declines accelerated for lung cancer, from 3% annually during 2008 through 2013 to 5% during 2013 through 2017 in men and from 2% to almost 4% in women, spurring the largest ever single‐year drop in overall cancer mortality of 2.2% from 2016 to 2017. Yet lung cancer still caused more deaths in 2017 than breast, prostate, colorectal, and brain cancers combined. Recent mortality declines were also dramatic for melanoma of the skin in the wake of US Food and Drug Administration approval of new therapies for metastatic disease, escalating to 7% annually during 2013 through 2017 from 1% during 2006 through 2010 in men and women aged 50 to 64 years and from 2% to 3% in those aged 20 to 49 years; annual declines of 5% to 6% in individuals aged 65 years and older are particularly striking because rates in this age group were increasing prior to 2013. It is also notable that long‐term rapid increases in liver cancer mortality have attenuated in women and stabilized in men. In summary, slowing momentum for some cancers amenable to early detection is juxtaposed with notable gains for other common cancers.

    更新日期:2020-01-11
  • Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-10-29
    Kassandra I. Alcaraz; Tracy L. Wiedt; Elvan C. Daniels; K. Robin Yabroff; Carmen E. Guerra; Richard C. Wender

    Although cancer mortality rates declined in the United States in recent decades, some populations experienced little benefit from advances in cancer prevention, early detection, treatment, and survivorship care. In fact, some cancer disparities between populations of low and high socioeconomic status widened during this period. Many potentially preventable cancer deaths continue to occur, and disadvantaged populations bear a disproportionate burden. Reducing the burden of cancer and eliminating cancer‐related disparities will require more focused and coordinated action across multiple sectors and in partnership with communities. This article, part of the American Cancer Society's Cancer Control Blueprint series, introduces a framework for understanding and addressing social determinants to advance cancer health equity and presents actionable recommendations for practice, research, and policy. The article aims to accelerate progress toward eliminating disparities in cancer and achieving health equity.

    更新日期:2020-01-11
  • The rapidly changing landscape in mature T‐cell lymphoma (MTCL) biology and management
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-12-09
    Enrica Marchi; Owen A. O’Connor

    Historical advances in the care of patients with non‐Hodgkin lymphoma (NHL) have been restricted largely to patients with B‐cell lymphoma. The peripheral T‐cell lymphomas (PTCLs), which are rare and heterogeneous in nature, have yet to experience the same degree of improvement in outcome over the past 20 to 30 years. It is estimated that there are approximately 80,000 and 14,000 cases, respectively, of NHL and Hodgkin lymphoma per year in the United States. As a subgroup of NHL, the PTCLs account for 6% to 10% of all cases of NHL, making them exceedingly rare. In addition, the World Health Organization 2017 classification describes 29 distinct subtypes of PTCL. This intrinsic diversity, coupled with its rarity, has stymied progress in the disease. In addition, most subtypes carry an inferior prognosis compared with their B‐cell counterparts, an outcome largely attributed to the fact that most treatment paradigms for patients with PTCL have been derived from B‐cell neoplasms, a radically different disease. In fact, the first drug ever approved for patients with PTCL was approved only a decade ago. The plethora of recent drug approvals in PTCL, coupled with a deeper understanding of the molecular pathogenesis of the disease, has stimulated the field to pursue new avenues of research that are now largely predicated on the development of novel, targeted small molecules, which include a host of epigenetic modifiers and biologics. There is an expectation these advances may begin to favorably challenge the chemotherapy paradigms that have been used in the T‐cell malignancies.

    更新日期:2020-01-11
  • Issue Information ‐ Cover
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-11-07
    更新日期:2019-11-07
  • Breast cancer statistics, 2019
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-10-02
    Carol E. DeSantis, Jiemin Ma, Mia M. Gaudet, Lisa A. Newman, Kimberly D. Miller, Ann Goding Sauer, Ahmedin Jemal, Rebecca L. Siegel

    This article is the American Cancer Society’s biennial update on female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Over the most recent 5‐year period (2012‐2016), the breast cancer incidence rate increased slightly by 0.3% per year, largely because of rising rates of local stage and hormone receptor‐positive disease. In contrast, the breast cancer death rate continues to decline, dropping 40% from 1989 to 2017 and translating to 375,900 breast cancer deaths averted. Notably, the pace of the decline has slowed from an annual decrease of 1.9% during 1998 through 2011 to 1.3% during 2011 through 2017, largely driven by the trend in white women. Consequently, the black–white disparity in breast cancer mortality has remained stable since 2011 after widening over the past 3 decades. Nevertheless, the death rate remains 40% higher in blacks (28.4 vs 20.3 deaths per 100,000) despite a lower incidence rate (126.7 vs 130.8); this disparity is magnified among black women aged <50 years, who have a death rate double that of whites. In the most recent 5‐year period (2013‐2017), the death rate declined in Hispanics (2.1% per year), blacks (1.5%), whites (1.0%), and Asians/Pacific Islanders (0.8%) but was stable in American Indians/Alaska Natives. However, by state, breast cancer mortality rates are no longer declining in Nebraska overall; in Colorado and Wisconsin in black women; and in Nebraska, Texas, and Virginia in white women. Breast cancer was the leading cause of cancer death in women (surpassing lung cancer) in four Southern and two Midwestern states among blacks and in Utah among whites during 2016‐2017. Declines in breast cancer mortality could be accelerated by expanding access to high‐quality prevention, early detection, and treatment services to all women.

    更新日期:2019-11-07
  • Cancer statistics for adults aged 85 years and older, 2019
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-08-07
    Carol E. DeSantis, Kimberly D. Miller, William Dale, Supriya G. Mohile, Harvey J. Cohen, Corinne R. Leach, Ann Goding Sauer, Ahmedin Jemal, Rebecca L. Siegel

    Adults aged 85 years and older, the “oldest old,” are the fastest‐growing age group in the United States, yet relatively little is known about their cancer burden. Combining data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the National Center for Health Statistics, the authors provide comprehensive information on cancer occurrence in adults aged 85 years and older. In 2019, there will be approximately 140,690 cancer cases diagnosed and 103,250 cancer deaths among the oldest old in the United States. The most common cancers in these individuals (lung, breast, prostate, and colorectum) are the same as those in the general population. Overall cancer incidence rates peaked in the oldest men and women around 1990 and have subsequently declined, with the pace accelerating during the past decade. These trends largely reflect declines in cancers of the prostate and colorectum and, more recently, cancers of the lung among men and the breast among women. We note differences in trends for some cancers in the oldest age group (eg, lung cancer and melanoma) compared with adults aged 65 to 84 years, which reflect elevated risks in the oldest generations. In addition, cancers in the oldest old are often more advanced at diagnosis. For example, breast and colorectal cancers diagnosed in patients aged 85 years and older are about 10% less likely to be diagnosed at a local stage compared with those diagnosed in patients aged 65 to 84 years. Patients with cancer who are aged 85 years and older have the lowest relative survival of any age group, with the largest disparities noted when cancer is diagnosed at advanced stages. They are also less likely to receive surgical treatment for their cancers; only 65% of breast cancer patients aged 85 years and older received surgery compared with 89% of those aged 65 to 84 years. This difference may reflect the complexities of treating older patients, including the presence of multiple comorbidities, functional declines, and cognitive impairment, as well as competing mortality risks and undertreatment. More research on cancer in the oldest Americans is needed to improve outcomes and anticipate the complex health care needs of this rapidly growing population.

    更新日期:2019-11-07
  • Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-10-16
    Kathryn H. Schmitz, Anna M. Campbell, Martijn M. Stuiver, Bernardine M. Pinto, Anna L. Schwartz, G. Stephen Morris, Jennifer A. Ligibel, Andrea Cheville, Daniel A. Galvão, Catherine M. Alfano, Alpa V. Patel, Trisha Hue, Lynn H. Gerber, Robert Sallis, Niraj J. Gusani, Nicole L. Stout, Leighton Chan, Fiona Flowers, Colleen Doyle, Susan Helmrich, William Bain, Jonas Sokolof, Kerri M. Winters‐Stone, Kristin L. Campbell, Charles E. Matthews

    Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health‐related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home‐based or community‐based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.

    更新日期:2019-11-07
  • Adolescent and young adult oncology—past, present, and future
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-10-08
    Allison G. Close, Alexandra Dreyzin, Kimberly D. Miller, Brittani K.N. Seynnaeve, Louis B. Rapkin

    There are nearly 70,000 new cancer diagnoses made annually in adolescents and young adults (AYAs) in the United States. Historically, AYA patients with cancer, aged 15 to 39 years, have not shown the same improved survival as older or younger cohorts. This article reviews the contemporary cancer incidence and survival data through 2015 for the AYA patient population based on the National Cancer Institute's Surveillance, Epidemiology, and End Results registry program and the North American Association of Central Cancer Registries. Mortality data through 2016 from the Centers for Disease Control and Prevention's National Center for Health Statistics are also described. Encouragingly, absolute and relative increases in 5‐year survival for AYA cancers have paralleled those of childhood cancers since the year 2000. There has been increasing attention to these vulnerable patients and improved partnerships and collaboration between adult and pediatric oncology; however, obstacles to the care of this population still occur at multiple levels. These vulnerabilities fall into 3 significant categories: research efforts and trial enrollment directed toward AYA malignancies, access to care and insurance coverage, and AYA‐specific psychosocial support. It is critical for providers and health care delivery systems to recognize that the AYA population remains vulnerable to provider and societal complacency.

    更新日期:2019-11-07
  • Tools to facilitate communication during physician‐patient consultations in cancer care: An overview of systematic reviews
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-07-24
    Sharon M. Licqurish, Olivia Y. Cook, Loyal P. Pattuwage, Christobel Saunders, Michael Jefford, Bogda Koczwara, Claire E. Johnson, Jon D. Emery

    Tools have been developed to facilitate communication and support information exchange between people diagnosed with cancer and their physicians. Patient‐reported outcome measures, question prompt lists, patient‐held records, tape recordings of consultations, decision aids, and survivorship care plans have all been promoted as potential tools, and there is extensive literature exploring their impact on patient outcomes. Eleven systematic reviews of studies evaluating tools to facilitate patient‐physician communication were reviewed and summarized in this overview of systematic reviews. Across the systematic reviews, 87 publications reported on 84 primary studies involving 15,381 participants. Routine use of patient‐reported outcome measures and feedback of results to clinicians can improve pain management, physician‐patient communication, and symptom detection and control; increase utilization of supportive care; and increase patient involvement in care. Question prompt lists can increase the number of questions asked by patients without increasing consultation length and may encourage them to reflect and plan questions before the consultation. There is limited benefit in audio recording consultations or using patient‐held records during consultations. Physicians should be supported by adequately resourced health services to respond effectively to the range of clinical and broader patient needs identified through the routine use of tools to facilitate communication.

    更新日期:2019-11-07
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  • Reviewer acknowledgment 2019.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2019-09-04

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  • Prostate cancer - major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2017-02-22
    Mark K Buyyounouski,Peter L Choyke,Jesse K McKenney,Oliver Sartor,Howard M Sandler,Mahul B Amin,Michael W Kattan,Daniel W Lin

    Answer questions and earn CME/CNE The eighth edition of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) Staging Manual has been updated and improved to ensure the highest degree of clinical relevance and to improve its utility for patient evaluation and clinical research. Major changes include: 1) pathologically organ-confined disease is now considered pT2 and is no longer subclassified by extent of involvement or laterality, 2) tumor grading now includes both the Gleason score (as in the seventh edition criteria) and the grade group (introduced in the eighth edition criteria), 3) prognostic stage group III includes select, organ-confined disease based on prostate-specific antigen and Gleason/grade group status, and 4) 2 statistical prediction models are included in the staging manual. The AJCC will continue to critically analyze emerging prostate cancer biomarkers and tools for their ability to prognosticate and guide treatment decision making with the highest level of accuracy and confidence for patients and physicians. CA Cancer J Clin 2017;67:245-253. © 2017 American Cancer Society.

    更新日期:2019-11-01
  • State of the science on prevention and screening to reduce melanoma incidence and mortality: The time is now.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2016-05-28
    Mary K Tripp,Meg Watson,Sophie J Balk,Susan M Swetter,Jeffrey E Gershenwald

    Answer questions and earn CME/CNE Although overall cancer incidence rates are decreasing, melanoma incidence rates continue to increase about 3% annually. Melanoma is a significant public health problem that exacts a substantial financial burden. Years of potential life lost from melanoma deaths contribute to the social, economic, and human toll of this disease. However, most cases are potentially preventable. Research has clearly established that exposure to ultraviolet radiation increases melanoma risk. Unprecedented antitumor activity and evolving survival benefit from novel targeted therapies and immunotherapies are now available for patients with unresectable and/or metastatic melanoma. Still, prevention (minimizing sun exposure that may result in tanned or sunburned skin and avoiding indoor tanning) and early detection (identifying lesions before they become invasive or at an earlier stage) have significant potential to reduce melanoma incidence and melanoma-associated deaths. This article reviews the state of the science on prevention and early detection of melanoma and current areas of scientific uncertainty and ongoing debate. The US Surgeon General's Call to Action to Prevent Skin Cancer and US Preventive Services Task Force reviews on skin cancer have propelled a national discussion on melanoma prevention and screening that makes this an extraordinary and exciting time for diverse disciplines in multiple sectors-health care, government, education, business, advocacy, and community-to coordinate efforts and leverage existing knowledge to make major strides in reducing the public health burden of melanoma in the United States. CA Cancer J Clin 2016;66:460-480. © 2016 American Cancer Society.

    更新日期:2019-11-01
  • Reply to Increased cancer burden among pesticide applicators and others due to pesticide exposure.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2013-06-01
    Michael C R Alavanja,Matthew K Ross,Matthew R Bonner

    更新日期:2019-11-01
  • American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2012-03-17
    Debbie Saslow,Diane Solomon,Herschel W Lawson,Maureen Killackey,Shalini L Kulasingam,Joanna Cain,Francisco A R Garcia,Ann T Moriarty,Alan G Waxman,David C Wilbur,Nicolas Wentzensen,Levi S Downs,Mark Spitzer,Anna-Barbara Moscicki,Eduardo L Franco,Mark H Stoler,Mark Schiffman,Philip E Castle,Evan R Myers,

    An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from 6 working groups, and a recent symposium cosponsored by the ACS, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology, which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (eg, the management of screen positives and screening intervals for screen negatives) of women after screening, the age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.

    更新日期:2019-11-01
  • Cancer risks associated with external radiation from diagnostic imaging procedures.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2012-02-07
    Martha S Linet,Thomas L Slovis,Donald L Miller,Ruth Kleinerman,Choonsik Lee,Preetha Rajaraman,Amy Berrington de Gonzalez

    The 600% increase in medical radiation exposure to the US population since 1980 has provided immense benefit, but increased potential future cancer risks to patients. Most of the increase is from diagnostic radiologic procedures. The objectives of this review are to summarize epidemiologic data on cancer risks associated with diagnostic procedures, describe how exposures from recent diagnostic procedures relate to radiation levels linked with cancer occurrence, and propose a framework of strategies to reduce radiation from diagnostic imaging in patients. We briefly review radiation dose definitions, mechanisms of radiation carcinogenesis, key epidemiologic studies of medical and other radiation sources and cancer risks, and dose trends from diagnostic procedures. We describe cancer risks from experimental studies, future projected risks from current imaging procedures, and the potential for higher risks in genetically susceptible populations. To reduce future projected cancers from diagnostic procedures, we advocate the widespread use of evidence-based appropriateness criteria for decisions about imaging procedures; oversight of equipment to deliver reliably the minimum radiation required to attain clinical objectives; development of electronic lifetime records of imaging procedures for patients and their physicians; and commitment by medical training programs, professional societies, and radiation protection organizations to educate all stakeholders in reducing radiation from diagnostic procedures.

    更新日期:2019-11-01
  • Angiogenesis inhibitors: current strategies and future prospects.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2010-06-18
    Kristina M Cook,William D Figg

    Angiogenesis has become an attractive target for drug therapy because of its key role in tumor growth. An extensive array of compounds is currently in preclinical development, with many now entering the clinic and/or achieving approval from the US Food and Drug Administration. Several regulatory and signaling molecules governing angiogenesis are of interest, including growth factors (eg, vascular endothelial growth factor, platelet-derived growth factor, fibroblast growth factor, and epidermal growth factor), receptor tyrosine kinases, and transcription factors such as hypoxia inducible factor, as well as molecules involved in mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K) signaling. Pharmacologic agents have been identified that target these pathways, yet for some agents (notably thalidomide), an understanding of the specific mechanisms of antitumor action has proved elusive. The following review describes key molecular mechanisms and novel therapies that are on the horizon for antiangiogenic tumor therapy.

    更新日期:2019-11-01
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  • Progress in cancer care: a rational call to do better.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2010-01-26
    Alan G Thorson

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  • Economic evaluations of medical care interventions for cancer patients: how, why, and what does it mean?
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2008-07-04
    Ya-Chen Tina Shih,Michael T Halpern

    While the past decade has seen the development of multiple new interventions to diagnose and treat cancer, as well as to improve the quality of life for cancer patients, many of these interventions have substantial costs. This has resulted in increased scrutiny of the costs of care for cancer, as well as the costs relative to the benefits for cancer treatments. It is important for oncologists and other members of the cancer community to consider and understand how economic evaluations of cancer interventions are performed and to be able to use and critique these evaluations. This review discusses the components, main types, and analytic issues of health economic evaluations using studies of cancer interventions as examples. We also highlight limitations of these economic evaluations and discuss why members of the cancer community should care about economic analyses.

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  • Young adult oncology: the patients and their survival challenges.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-07-13
    Archie Bleyer

    One in every 168 Americans develops invasive cancer between age 15 to 30 years. During this age interval, cancer is unique in the distribution of types that occur and rarely related to either environmental carcinogens, a recognizable inherited predisposition, or a family cancer syndrome. Patients in this age group have the lowest rate of health insurance coverage, frequent delays in diagnosis, and the lowest accrual to clinical trials. Their psychosocial needs are unique and generally less well attended to than in any other age group. Despite an intrinsically equal ability to tolerate chemotherapy, older adolescents and young adults frequently receive lower dose intensities than do younger patients, and at times less than in older patients. Whereas the 15- to 29-year age group once had a better overall survival rate than either younger or older patients, a relative lack of progress has resulted in the majority of cancers in the age group having a worse overall survival rate than in younger patients, and several of these having a worse prognosis than in older patients. Against this background, young adults with cancer have unique survival challenges--medically, psychosocially, and economically--that are now beginning to be appreciated and addressed with a national initiative.

    更新日期:2019-11-01
  • The lethal phenotype of cancer: the molecular basis of death due to malignancy.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-07-13
    Robert D Loberg,Deborah A Bradley,Scott A Tomlins,Arul M Chinnaiyan,Kenneth J Pienta

    The last decade has seen an explosion in knowledge of the molecular basis and treatment of cancer. The molecular events that define the lethal phenotype of various cancers--the genetic and cellular alterations that lead to a cancer with a poor or incurable prognosis--are being defined. While these studies describe the cellular events of the lethal phenotype of cancer in detail, how these events result in the common clinical syndromes that kill the majority of cancer patients is not well understood. It is clear that the central step that makes most cancers incurable is metastasis. Understanding the traits that a cancer acquires to successfully grow and metastasize to distant sites gives insight into how tumors produce multiple factors that result in multiple different clinical syndromes that are lethal for the patient.

    更新日期:2019-11-01
  • Functional imaging of cancer with emphasis on molecular techniques.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-07-13
    Drew A Torigian,Steve S Huang,Mohamed Houseni,Abass Alavi

    A multitude of noninvasive, quantitative, functional imaging techniques are currently in use to study tumor physiology, to probe tumor molecular processes, and to study tumor molecules and metabolites in vitro and in vivo using computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography (US), positron emission tomography (PET), single-photon emission computed tomography (SPECT), and optical imaging (OI). Such techniques can be used in conjunction with structural imaging techniques to detect, diagnose, characterize, or monitor tumors before and after therapeutic intervention. These can also be used to study tumor gene expression, to track cells and therapeutic drugs, to optimize individualized treatment planning for patients with tumors, and to foster new oncologic drug development. In this article, we review the rich variety of functional imaging techniques that are available for these purposes, which are becoming increasingly important for optimal individualized patient treatment in this day and age of "personalized medicine."

    更新日期:2019-11-01
  • Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-07-13
    Melissa McCracken,Miho Olsen,Moon S Chen,Ahmedin Jemal,Michael Thun,Vilma Cokkinides,Dennis Deapen,Elizabeth Ward

    Many studies demonstrate that cancer incidence and mortality patterns among Asian Americans are heterogeneous, but national statistics on cancer for Asian ethnic groups are not routinely available. This article summarizes data on cancer incidence, mortality, risk factors, and screening for 5 of the largest Asian American ethnic groups in California. California has the largest Asian American population of any state and makes special efforts to collect health information for ethnic minority populations. We restricted our analysis to the 4 most common cancers (prostate, breast, lung, colon/rectum) and for the 3 sites known to be more common in Asian Americans (stomach, liver, cervix). Cancer incidence and mortality were summarized for 5 Asian American ethnic groups in California in order of population size (Chinese, Filipino, Vietnamese, Korean, and Japanese). Chinese Americans had among the lowest incidence and death rate from all cancer combined; however, Chinese women had the highest lung cancer death rate. Filipinos had the highest incidence and death rate from prostate cancer and the highest death rate from female breast cancer. Vietnamese had among the highest incidence and death rates from liver, lung, and cervical cancer. Korean men and women had by far the highest incidence and mortality rates from stomach cancer. Japanese experienced the highest incidence and death rates from colorectal cancer and among the highest death rates from breast and prostate cancer. Variations in cancer risk factors were also observed and were for the most part consistent with variations in cancer incidence and mortality. Differences in cancer burden among Asian American ethnic groups should be considered in the clinical setting and in cancer control planning.

    更新日期:2019-11-01
  • Adjuvant treatment of colorectal cancer.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-05-18
    Brian M Wolpin,Jeffrey A Meyerhardt,Harvey J Mamon,Robert J Mayer

    Colorectal cancer is the fourth most common noncutaneous malignancy in the United States and the second most frequent cause of cancer-related death. Approximately three quarters of patients are diagnosed with disease limited to the bowel wall or surrounding lymph nodes. Over the past decade, significant progress has been made in the treatment of localized colorectal cancer due to advances in surgery, radiotherapy, and chemotherapy. For patients with Stage III colon cancer, an overall survival benefit for fluorouracil-based chemotherapy has been firmly established, and recent data have shown further efficacy through the inclusion of oxaliplatin into adjuvant treatment programs. For patients with Stage II colon cancer, the use of adjuvant chemotherapy remains controversial, but may be appropriate in a subset of individuals at high risk for disease recurrence. In the treatment of patients with rectal cancer, improved outcomes have been noted with the use of total mesorectal excision and preoperative concurrent chemoradiotherapy. Current randomized clinical trials in the adjuvant therapy of colorectal cancer are examining the value of adding agents known to be active in metastatic disease, including those that modify specific molecular targets.

    更新日期:2019-11-01
  • Cancer risk elicitation and communication: lessons from the psychology of risk perception.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-05-18
    William M P Klein,Michael E Stefanek

    Cancer risk perceptions are a key predictor of risk-reduction practices, health behaviors, and processing of cancer information. Nevertheless, patients and the general public (as well as health care providers) exhibit a number of errors and biases in the way they think about risk, such that their risk perceptions and decisions deviate greatly from those prescribed by normative decision models and by experts in risk assessment. For example, people are more likely to engage in screening behaviors such as mammography when faced with loss-based messages than gain-framed messages, and they often ignore the base rate of a given disease when assessing their own risk of obtaining this disease. In this article, we review many of the psychological processes that underlie risk perception and discuss how these processes lead to such deviations. Among these processes are difficulties with use of numerical information (innumeracy), cognitive processes (eg, use of time-saving heuristics), motivational factors (eg, loss and regret aversion), and emotion. We conclude with suggestions for future research in the area, as well as implications for improving the elicitation and communication of personal cancer risk.

    更新日期:2019-11-01
  • Minimal access cancer management.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-05-18
    Frederick L Greene,Kent W Kercher,Heidi Nelson,Chris M Teigland,Anne-Marie Boller

    Minimal access approaches in the treatment of a variety of solid tumors of the stomach, large bowel, and genitourinary system are now being advocated in several surgical specialty areas. The laparoscope has evolved from a diagnostic tool to a modality that allows for removal of tumors using small incisions and the application of pneumoperitoneum with carbon dioxide. Through studies using animal models and patient investigation, the immunologic benefits of laparoscopic cancer procedures appear to be beneficial when compared with conventional laparotomy. Overall benefits of analgesic reduction, more rapid postoperative recovery, and patient satisfaction are the byproducts of minimal access approaches. Patients with cancers of the stomach, colon, and kidney show similar long-term outcomes when compared with conventional open techniques. Caution, however, should be exercised in recommending laparoscopic approaches for routine management of primary tumors of the rectum and adrenal gland.

    更新日期:2019-11-01
  • Recent progress in the management of advanced renal cell carcinoma.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-03-30
    Jorge A Garcia,Brian I Rini

    A better understanding of the molecular biology of renal cell carcinoma (RCC) has led to a dramatic paradigm shift in the treatment of patients with metastatic disease. Historically, a nonspecific immune approach using cytokines was employed, but recently this has transitioned to a molecularly-targeted approach against vascular endothelial growth factor (VEGF) and related pathways. Several anti-VEGF agents, including ligand-binding agents such as bevacizumab and the small molecule inhibitors of VEGF and related receptors such as sunitinib and sorafenib, have demonstrated clinical activity in patients with metastatic RCC. Other agents that inhibit alternative targets such as the mammalian target of rapamycin (mTOR) have also demonstrated activity. This generation of novel molecular targeted therapies continues to show great promise. The purpose of this review is to summarize the current management and to discuss potential future directions in the management of metastatic RCC.

    更新日期:2019-11-01
  • Cervical cancer screening rates in the United States and the potential impact of implementation of screening guidelines.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-03-30
    Diane Solomon,Nancy Breen,Timothy McNeel

    The remarkable success achieved in cervical cancer prevention is largely attributable to cervical cytology screening, also known as the Papanicolaou (Pap) test. The American Cancer Society (ACS) revised screening guidelines for Pap testing in 2002. The impact of these changes on future numbers of Pap tests has not been assessed. Using National Health Interview Survey (NHIS) data to determine historical screening patterns, we extrapolate the numbers of Pap tests that would be performed through 2010, under 5 different scenarios of implementation of screening guidelines. From 1993 to 2003, there was a steady increase in the number of Pap tests, with an estimated 65.6 million Pap tests performed in 2003. Approximately two thirds of women born after 1930 reported having been screened within the previous year, and 85% within the previous 3 years. Fifteen percent of Pap tests were performed in hysterectomized women, most of whom, according to current guidelines, should not be screened. Based on population projections, if screening behavior remains unchanged, 75 million Pap tests will be performed in 2010. Full compliance with ACS guidelines would approximately halve the total number of tests to 34 million. Potentially, with more appropriate allocation of resources according to guidelines, all women could be screened and the total number of Pap tests reduced, despite projected increases in the population.

    更新日期:2019-11-01
  • Cancer screening in the United States, 2007: a review of current guidelines, practices, and prospects.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-03-30
    Robert A Smith,Vilma Cokkinides,Harmon J Eyre

    Each year, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screening rates for US adults. In 2006, there were no updates to ACS guidelines for early cancer detection. In this issue of the journal, we describe criteria for successful screening, discuss recent evidence and policy changes that have implications for cancer screening, summarize the ACS guidelines and describe guidelines reviews that are underway, and provide an update of the most recent data pertaining to participation rates in cancer screening from the Centers for Disease Control and Prevention's (CDC's) Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS).

    更新日期:2019-11-01
  • American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-03-30
    Debbie Saslow,Carla Boetes,Wylie Burke,Steven Harms,Martin O Leach,Constance D Lehman,Elizabeth Morris,Etta Pisano,Mitchell Schnall,Stephen Sener,Robert A Smith,Ellen Warner,Martin Yaffe,Kimberly S Andrews,Christy A Russell,

    New evidence on breast Magnetic Resonance Imaging (MRI) screening has become available since the American Cancer Society (ACS) last issued guidelines for the early detection of breast cancer in 2003. A guideline panel has reviewed this evidence and developed new recommendations for women at different defined levels of risk. Screening MRI is recommended for women with an approximately 20-25% or greater lifetime risk of breast cancer, including women with a strong family history of breast or ovarian cancer and women who were treated for Hodgkin disease. There are several risk subgroups for which the available data are insufficient to recommend for or against screening, including women with a personal history of breast cancer, carcinoma in situ, atypical hyperplasia, and extremely dense breasts on mammography. Diagnostic uses of MRI were not considered to be within the scope of this review.

    更新日期:2019-11-01
  • Cancer control opportunities in low- and middle-income countries.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-03-30
    Elmer Huerta,Nathan Grey

    更新日期:2019-11-01
  • Cancer statistics, 2007.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-01-24
    Ahmedin Jemal,Rebecca Siegel,Elizabeth Ward,Taylor Murray,Jiaquan Xu,Michael J Thun

    Each year, the American Cancer Society (ACS) estimates the number of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. This report considers incidence data through 2003 and mortality data through 2004. Incidence and death rates are age-standardized to the 2000 US standard million population. A total of 1,444,920 new cancer cases and 559,650 deaths for cancers are projected to occur in the United States in 2007. Notable trends in cancer incidence and mortality rates include stabilization of the age-standardized, delay-adjusted incidence rates for all cancers combined in men from 1995 through 2003; a continuing increase in the incidence rate by 0.3% per year in women; and a 13.6% total decrease in age-standardized cancer death rates among men and women combined between 1991 and 2004. This report also examines cancer incidence, mortality, and survival by site, sex, race/ethnicity, geographic area, and calendar year, as well as the proportionate contribution of selected sites to the overall trends. While the absolute number of cancer deaths decreased for the second consecutive year in the United States (by more than 3,000 from 2003 to 2004) and much progress has been made in reducing mortality rates and improving survival, cancer still accounts for more deaths than heart disease in persons under age 85 years. Further progress can be accelerated by supporting new discoveries and by applying existing cancer control knowledge across all segments of the population.

    更新日期:2019-11-01
  • A new method of estimating United States and state-level cancer incidence counts for the current calendar year.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-01-24
    Linda W Pickle,Yongping Hao,Ahmedin Jemal,Zhaohui Zou,Ram C Tiwari,Elizabeth Ward,Mark Hachey,Holly L Howe,Eric J Feuer

    The American Cancer Society (ACS) has published the estimated number of new cancer cases and deaths in the current year for the United States that are commonly used by cancer control planners and the media. The methods used to produce these estimates have changed over the years as data (incidence) and statistical models improved. In this paper we present a new method that uses statistical models of cancer incidence that incorporate potential predictors of spatial and temporal variation of cancer occurrence and that account for delay in case reporting and then projects these estimated numbers of cases ahead 4 years using a piecewise linear (joinpoint) regression method. Based on evidence presented here that the new method produces more accurate estimates of the number of new cancer cases for years and areas for which data are available for comparison, the ACS has elected to use it to estimate the number of new cancer cases in Cancer Facts & Figures 2007 and in Cancer Statistics, 2007.

    更新日期:2019-11-01
  • American Cancer Society Guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2007-01-24
    Debbie Saslow,Philip E Castle,J Thomas Cox,Diane D Davey,Mark H Einstein,Daron G Ferris,Sue J Goldie,Diane M Harper,Walter Kinney,Anna-Barbara Moscicki,Kenneth L Noller,Cosette M Wheeler,Terri Ades,Kimberly S Andrews,Mary K Doroshenk,Kelly Green Kahn,Christy Schmidt,Omar Shafey,Robert A Smith,Edward E Partridge,,Francisco Garcia

    The American Cancer Society (ACS) has developed guidelines for the use of the prophylactic human papillomavirus (HPV) vaccine for the prevention of cervical intraepithelial neoplasia and cervical cancer. These recommendations are based on a formal review of the available evidence. They address the use of prophylactic HPV vaccines, including who should be vaccinated and at what age, as well as a summary of policy and implementation issues. Implications for screening are also discussed.

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  • Staging of primary malignancies of bone.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-12-01
    Robert K Heck,Terrance D Peabody,Michael A Simon

    Staging of bone sarcomas is the process whereby patients are evaluated with regard to histology, as well as the local and distant extent, of disease. Bone sarcomas are staged based on grade, size, and the presence and location of metastases. The system is designed to help stratify patients according to known risk factors. Proper staging helps define the prognosis for patients and helps guide their treatment. Furthermore, staging allows meaningful comparisons to be done among groups of patients.

    更新日期:2019-11-01
  • Preventing occupational exposures to antineoplastic drugs in health care settings.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-12-01
    Thomas H Connor,Melissa A McDiarmid

    The toxicity of antineoplastic drugs has been well known since they were introduced in the 1940s. Because most antineoplastic drugs are nonselective in their mechanism of action, they affect noncancerous as well as cancerous cells, resulting in well-documented side effects. During the 1970s, evidence came to light indicating health care workers may be at risk of harmful effects from antineoplastic drugs as a result of occupational exposure. Since that time, reports from several countries have documented drug contamination of the workplace, identified drugs in the urine of health care workers, and measured genotoxic responses in workers. Evidence also exists of teratogenic and adverse reproductive outcomes and increased cancers in health care workers. During the past 30 years, professional organizations and government agencies have developed guidelines to protect health care workers from adverse effects from occupational exposure to antineoplastic drugs. Although many safety provisions were advanced to reduce worker exposure in the 1980s, recent studies have shown that workers continue to be exposed to these drugs despite safety policy improvements. In 2004, the National Institute for Occupational Safety and Health (NIOSH) published an alert reviewing the most recent information available and promoting a program of safe handling during their use.

    更新日期:2019-11-01
  • Nutrition and physical activity during and after cancer treatment: an American Cancer Society guide for informed choices.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-12-01
    Colleen Doyle,Lawrence H Kushi,Tim Byers,Kerry S Courneya,Wendy Demark-Wahnefried,Barbara Grant,Anne McTiernan,Cheryl L Rock,Cyndi Thompson,Ted Gansler,Kimberly S Andrews,,

    Cancer survivors are often highly motivated to seek information about food choices, physical activity, and dietary supplement use to improve their treatment outcomes, quality of life, and survival. To address these concerns, the American Cancer Society (ACS) convened a group of experts in nutrition, physical activity, and cancer to evaluate the scientific evidence and best clinical practices related to optimal nutrition and physical activity after the diagnosis of cancer. This report summarizes their findings and is intended to present health care providers with the best possible information from which to help cancer survivors and their families make informed choices related to nutrition and physical activity. The report discusses nutrition and physical activity issues during the phases of cancer treatment and recovery, living after recovery from treatment, and living with advanced cancer; select nutrition and physical activity issues such as body weight, food choices, and food safety; issues related to select cancer sites; and common questions about diet, physical activity, and cancer survivorship.

    更新日期:2019-11-01
  • Food and Drug Administration, partner in drug development.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-12-01
    Jerome W Yates

    更新日期:2019-11-01
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  • A call for more vitamin D research.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-10-31

    更新日期:2019-11-01
  • HPV vaccine fights cervical cancer.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-10-31

    更新日期:2019-11-01
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  • Lymphatic mapping and sentinel node analysis: current concepts and applications.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-09-29
    Steven L Chen,Douglas M Iddings,Randall P Scheri,Anton J Bilchik

    Since the introduction of sentinel node biopsy in 1990 as a minimally invasive surgical technique for the diagnosis of melanoma lymphatic metastases, the number of applications has expanded. We review applications and the current status of sentinel node biopsy in melanoma, breast, colon, gastric, esophageal, head and neck, thyroid, and lung cancer. Variations on techniques specific to each organ are explained, and the current role of sentinel node biopsy in diagnosis and treatment is discussed.

    更新日期:2019-11-01
  • Staging soft tissue sarcoma: evolution and change.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-09-29
    Dhanasekaran Kotilingam,Dina Chelouche Lev,Alexander J F Lazar,Raphael E Pollock

    Soft tissue sarcoma (STS) is an extremely heterogeneous group of rare tumors that share a putative mesenchymal cell origin. STS can occur in any soft tissue in the body, yet all share a common feature of primarily disseminating hematogenously, particularly to the lungs. Staging for STS is particularly useful in prognosis, design of effective multimodality treatment programs, and comparing treatment outcomes from different centers and different eras. The current iteration of AJCC STS staging includes Tumor, Grade, Node, and Metastasis with "a" indicating superficial and "b" indicating deep designations. Further opportunities to improve this process exist, particularly as molecular considerations become more apparent, and future evolution into an even more useful STS staging system can be anticipated.

    更新日期:2019-11-01
  • American Cancer Society Guidelines on Nutrition and Physical Activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-09-29
    Lawrence H Kushi,Tim Byers,Colleen Doyle,Elisa V Bandera,Marji McCullough,Anne McTiernan,Ted Gansler,Kimberly S Andrews,Michael J Thun,

    The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and as such, they represent the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines include recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or interferes with healthy behaviors. Community efforts are essential to create a social environment that promotes healthy food choices and physical activity. Therefore, this committee presents one key recommendation for community action to accompany the four recommendations for individual choices to reduce cancer risk. This recommendation for community action recognizes that a supportive social environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the Department of Health and Human Services' 2005 Dietary Guidelines for Americans.

    更新日期:2019-11-01
  • Targeted therapy of cancer: new prospects for antibodies and immunoconjugates.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-07-28
    Robert M Sharkey,David M Goldenberg

    Immunotherapy of cancer has been explored for over a century, but it is only in the last decade that various antibody-based products have been introduced into the management of patients with diverse cancers. At present, this is one of the most active areas of clinical research, with eight therapeutic products already approved in oncology. Antibodies against tumor-associated markers have been a part of medical practice in immunohistology and in vitro immunoassays for several decades, have even been used as radioconjugates in diagnostic imaging, and are now becoming increasingly recognized as important biological agents for the detection and treatment of cancer. Molecular engineering has improved the prospects for such antibody-based therapeutics, resulting in different constructs and humanized/human antibodies that can be administered frequently. Consequently, a renewed interest in the development of antibodies conjugated with radionuclides, drugs, and toxins has emerged. We review how antibodies and immunoconjugates have influenced cancer detection and therapy, and also describe promising new developments and challenges for broader applications.

    更新日期:2019-11-01
  • Diagnostic approach and management of Lynch syndrome (hereditary nonpolyposis colorectal carcinoma): a guide for clinicians.
    CA: Cancer J. Clin. (IF 223.679) Pub Date : 2006-07-28
    Yvonne M C Hendriks,Andrea E de Jong,Hans Morreau,Carli M J Tops,Hans F Vasen,Juul Th Wijnen,Martijn H Breuning,Annette H J T Bröcker-Vriends

    ABSTRACT diagnostic workup of familial colorectal cancer is an elaborate and time consuming process in which the family and several medical specialists closely collaborate. However, establishing a diagnosis can be very rewarding. If a mutation is detected in the family, a satisfactory explanation can be provided for an accumulation of tumors at young age, and often of untimely death. Appropriate presymptomatic testing can be offered to reduce mortality among at-risk family members, and relatives not at risk can avoid uncertainty and needlessly intensive surveillance. We show the differential diagnostic considerations when an individual with a family history of colorectal carcinoma is encountered, with emphasis on Lynch syndrome (Hereditary Nonpolyposis Colorectal Carcinoma [HNPCC]). Practical recommendations for laboratory workup of suspected Lynch syndrome, including analysis of tumor tissue by microsatellite instability analysis and immunohistochemistry, and germline DNA analysis are given. Furthermore, the clinical management after a molecular diagnosis has been made is described. The diagnostic scheme presented here allows efficient and effective analysis of colorectal carcinoma cases with (suspected) Lynch syndrome, making optimal use of currently available technology.

    更新日期:2019-11-01
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