Publications by authors named "Daniel P Mckellar"
Article Synopsis
- Guidelines for breast cancer follow-up recommend imaging for distant metastases only when patients show symptoms, but new research suggests better imaging methods could improve survival rates.
- In a study of 10,076 women with stage II-III breast cancer, it was found that 23.3% of distant recurrences were detected through imaging, while the majority were symptomatic detections.
- Asymptomatic imaging was linked to a lower risk of death in patients with triple-negative and HER2-positive cancers, indicating a need for updated clinical recommendations and a randomized trial to explore these findings further.
Background: Many quality measures in cancer care are process measures. The rates of compliance for these measures over time have not been well described, and the relationships between measure compliance and survival are not well understood.
Methods: The National Cancer Database, representing cancer registry data from approximately 1500 Commission on Cancer (CoC) cancer programs, was queried to determine the rates of compliance, with the CoC's colon cancer quality measure requiring 12 regional lymph nodes be removed at resection.
Article Synopsis
- Accurate measurement of comorbidities is essential in cancer research, and this study compares the National Cancer Database's (NCDB) code-based Charlson-Deyo Comorbidity Index (CCI) with a chart-based CCI for breast, colorectal, and lung cancer patients.
- The analysis involved re-abstracting data from over 31,000 patients to assess how well these CCI versions predict 5-year overall survival after surgery.
- Results showed the NCDB CCI often underestimated comorbidity rates, particularly in lung cancer patients, but its predictive power for survival was similar to that of the more detailed chart-based CCI.
Article Synopsis
- The study aimed to evaluate the relationship between the frequency of post-surgical surveillance for non-small cell lung cancer (NSCLC) and patient survival rates.
- An analysis of 4,463 NSCLC patients showed that although higher-stage patients received more frequent surveillance, there was no significant correlation between the increased frequency of imaging and improved overall or postrecurrence survival rates.
- The findings suggest that increasing the frequency of post-surgical check-ups does not lead to better survival outcomes, highlighting the need for reevaluation of current surveillance strategies as lung cancer survivor rates continue to rise.
Importance: The National Cancer Database (NCDB), a joint quality improvement initiative of the American College of Surgeons Commission on Cancer and the American Cancer Society, has created a shared research file that has changed the study of cancer care in the United States. A thorough understanding of the nuances, strengths, and limitations of the database by both readers and investigators is of critical importance. This review describes the use of the NCDB to study cancer care, with a focus on the advantages of using the database and important considerations that affect the interpretation of NCDB studies.
View Article and Find Full Text PDFObjective: Older patients with non-small cell lung cancer (NSCLC) are less likely to receive guideline-recommended treatment at diagnosis, independent of comorbidity. However, national data on treatment of postoperative recurrence are limited. We evaluated the associations between age, comorbidity, and other patient factors and treatment of postoperative NSCLC recurrence in a national cohort.
View Article and Find Full Text PDFThe multidisciplinary Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (NAPBC), administered by the American College of Surgeons (ACoS), defines evidence and consensus-based standards, require an operational infrastructure, collect high quality cancer data, and validate compliance with standards through external peer review. A survey of our constituents confirms a high level of agreement that accreditation is regarded as important in improving oncologic outcomes through compliance with standards that include continuous quality improvement.
View Article and Find Full Text PDFLymphoma presenting as a breast mass is rare, although well documented. Although recurrence rates can reach approximately 50%, recurrence in the contralateral breast is rare. We report a case of recurrent primary breast lymphoma (PBL), which was discovered on screening mammography after a 5-year disease-free interval from initial diagnosis.
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