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In a prospective randomized trial comparing post-surgical follow-up for patients with Stage III and IV colon cancer, PET-CT was found to detect recurrence earlier and to result in a greater number of patients eligible for surgical resection of isolated metastases when compared to conventional follow-up schedules that include CT scanning.
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Does erythropoietin worsen cancer death rates? Most hypothyroid patients can be replaced with levothyroxine alone without additional T3. Does aggressive control in type 2 diabetes save lives?
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The prognostic importance of cytogenetics was evaluated in 200 adults between 15 and 65 years of age treated on a single ALL cooperative group protocol. Among the 140 having evaluable cytogenetic data, four risk categories were devised. Philadelphia chromosome positive t(9;22), unfavorable (monosomy 7, trisomy 8 or an 11q23 rearrangement), miscellaneous and normal. Overall survival of the miscellaneous group was similar to the normal karyotype patients whereas survival was considerably worse for both unfavorable and Ph + cytogenetic groups. The traditional adverse risk factors of older age and higher presenting white blood cell count were not associated with worse survival after adjusting for cytogenetics. In adult ALL, cytogenetics categories may be the strongest factor in predicting outcome.
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In a series of 354 elderly breast cancer patients treated with conservative surgery and tamoxifen but without axillary dissection or radiotherapy followed for 15 years, the cumulative incidence of developing axillary disease was 4.2%, and of developing local recurrence was 8.3%. Of the 354 subjects, 268 had died over the 15-year period, 17% of breast cancer and (83%) from causes other than breast cancer.
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A middle-aged male patient let's call him "Tom" showed up in the emergency department at Massachusetts General Hospital in Boston about a year ago complaining of pains in his chest and legs.
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When patients are medically ready to leave the acute care hospital and have no coverage for post-acute care, it's a "no-brainer" for the hospital to pay to move the patient to a lower level of care, says Jay Cayner, director of social patient and family services at the University of Iowa Hospitals and Clinics.
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As health insurance costs escalate and employers reduce coverage for employees, raise deductibles, or stop providing health insurance altogether, hospitals are providing care for an increasing number of patients who have no means to pay.
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