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Badar M. Mian

: 2168 – 2175 . 20 Presti JC Jr Chang JJ Bhargava V . The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trial . J Urol 2000 ; 163 : 163 – 166 . 21 Gore JL

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Justin M. M. Cates

Considerable changes in the clinical and pathologic staging of soft tissue sarcoma (STS) are presented in the 8th edition of the AJCC Cancer Staging Manual. 1 There are some obvious improvements, such as the creation of separate staging schemes

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Gregory P. Kalemkerian and Shirish M. Gadgeel

prognostic information but also determines appropriate treatment strategies. Staging Systems The Veterans Administration Lung Study Group (VALSG) 2-stage classification scheme has been routinely used for the clinical staging of SCLC for at least 40

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Elizabeth A. Nardi, James McCanney, Katy Winckworth-Prejsnar, Alyssa A. Schatz, Kerin Adelson, Marcus Neubauer, Mary Lou Smith, Ronald Walters and Robert W. Carlson

Executive Summary Quality measurement in oncology is an iterative process that continues to evolve. The importance of meaningful quality measures is increasing as payment schemes shift from volume to value. Further, there exists a need to

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Rajmohan Murali, Deborah F. Delair, Sarah M. Bean, Nadeem R. Abu-Rustum and Robert A. Soslow

present with abnormal bleeding and undergo initial evaluation with pelvic ultrasonography and endometrial biopsy/curettage. Histopathologic evaluation of the biopsy/curettage specimen is performed to confirm the diagnosis. 2 , 3 Early staging schemes were

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Catriona Parker, Raymond Snyder, Michael Jefford, David Dilts, Rory Wolfe and Jeremy Millar

-for-profit cancer charity, has financially supported clinical trials through its Cancer Trials Management Scheme (CTMS) since 1988. The CTMS collects annual data about patients enrolled into therapeutic cancer clinical trials and provides funding to sites (health

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Susan Urba

Radiation-induced nausea and vomiting is a common problem for cancer patients. The emetogenic potential of radiation depends greatly on the location of the radiation field, the size of the radiation field, and the fractionation scheme. Radiation fields can be categorized as having high, moderate, low, or minimal emetogenic risk, and treatment differs accordingly. The National Comprehensive Cancer Network, the Multinational Association of Supportive Care in Cancer, and the American Society of Clinical Oncology publish clinical practice guidelines addressing the issue of radiation-induced nausea and vomiting. This article reviews the treatment recommendations for each category of radiation-induced nausea and vomiting from these national and international guideline committees and provides the rationale for these recommendations.

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Gary S. Rogers

A principal factor in determining the biologic consequences of photodynamic therapy (PDT) is the light fluence rate. Preclinical and, more recently, clinical studies have focused on low-irradiance schemes, suggesting that prolonged light exposure, better known as CLIPT (continuous low-irradiance PDT), may improve tumor control while reducing morbidity. After a brief look at the origin of light therapy and photosensitizers, this article turns to the promising animal research supporting the use of low- and ultra-low fluence rate PDT, which serves as the basis of the ongoing CLIPT dosimetry trials for patients with chest wall progression of breast cancer. The future of CLIPT seems to be a home-based therapy using a portable, self-contained energy delivery system.

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Michael R. Loken and Denise A. Wells

Flow cytometry quantifies the gene product expression on hematopoietic cells, permitting the identification of all cells within a bone marrow aspirate and classifying them according to lineage and maturational stage. The relationships in the expression of multiple markers on myeloblasts, maturing monocytes, and myeloid cells suggests that development of these cells is a stepwise process in which genes are not only turned on or off, but are up- and down-regulated at the junctions between stages. In neoplastic processes, a loss of coordination of these steps is seen, resulting in the abnormal relationships identified by flow cytometry. In myelodysplastic syndromes, the abnormal patterns can be identified on both the immature myeloblasts and maturing myeloid cells and monocytes. The detection of these abnormalities is useful in diagnosing myelodysplasia but requires a detailed understanding of the expression of these gene products to discriminate neoplastic transformation from a stressed marrow. Although the patterns of antigen expression for normal hematopoiesis are precisely defined, each patient with a neoplastic transformation has a unique repertoire of abnormalities that may evolve as the disease progresses. Therefore, scoring systems, in which the abnormalities are counted, provide a means for determining the extent of dysregulation at all the maturational steps, thereby determining a “distance from normal” for a patient at a specific time in the disease course. This is useful, not only to facilitate diagnosis, but to provide prognostic information that may be complementary to the conventional classification schemes and scoring systems.

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Harold J. Burstein

In November 2008, the journal Nature published 2 extraordinary articles revealing the potential utility for genomics. Each contribution was a gargantuan task and technical tour de force. One article described the reconstruction of the woolly mammoth genome, using ancient DNA salvaged from the hair of an extinct mammoth frozen in permafrost for over 100,000 years. The other described the first complete sequencing of a cancer cell—a cytogenetically “normal” acute leukemia cell. Each of these contributions was reported on by major media outlets, and these reports led to grandiose, futuristic predictions of what to make of this vast if repetitive genetic information. In the case of the mammoth, the frequently voiced hope was that the DNA sequence could lead to regeneration of a living woolly mammoth—presumably for research purposes and not to serve as the ultimate fur coat. For the cancer cell, the hope was that the full coding DNA sequence of the malignant cell could tell clinicians how to uniquely treat each patient with cancer. For now, both those dreams are science fiction, but the latter scheme seems far more approachable than the former. In probing more than 2.5 million single nucleotide variants, investigators found more than 97% concordance with the “normal” genome of the same individual, based on sequencing DNA from healthy skin. In fact, leukemic cells had acquired mutations in only 10 named genes across the human genome, a new standard for needle-in-the-haystack searches. Intriguingly, 2 of the mutated genes were FLT3 and NPM1, loci implicated in previous...