Mechanisms underlying plant sexual dimorphism in multi-trophic arthropod communities.

A growing body of research documents the importance of plant genetic effects on arthropod community structure. However, the mechanisms underlying these effects are often unclear. Additionally, plant genetic effects have largely been quantified in common gardens, thus inflating the estimates of their importance by minimizing levels of natural variation.

Patterns of care for metastatic carcinoma of the prostate gland: results of the American College of Surgeons' patient care evaluation study.

The annual incidence of prostate cancer more than doubled between 1984 and 1990, increasing from an estimated 76 000-200 000 cases respectively. Part of this increase may have been the result of increased detection. This study utilizes data from an American College of Surgeons Patient Care Evaluation (PCE) study to report on changes in the management of metastatic disease.

Childhood cancer: patterns of protocol participation in a national survey.

Cancer is still the chief cause of death by disease in children, ages one to 14. As improved survival rates have been reported for pediatric cancer patients who are treated on controlled clinical trials, it is important to understand the national utilization of such protocols. In 1993, a survey of childhood cancer was conducted by the Commission on Cancer of the American College of Surgeons.

Evaluating the implications of clinical practice guidelines for patient care.

Patient care evaluation studies have been developed by the Commission on Cancer of the American College of Surgeons. The studies were primarily designed to monitor trends in diagnosis, therapy, and outcome of specific oncologic diseases in hospitals and cancer centers. As they reflect the current standards of patient care, patient care evaluation studies have become valid tools of quality management in medicine.

Analysis of medical-decision making and the use of standards of care in oncology.

Guidelines in medicine have been proposed as a way to assist physicians in the clinical decision-making process. Increasingly, they form the basis for assessing accountability in the delivery of healthcare services. However, experiences with their evaluation, as the most important step in the continuous guidelines process, are rare.

Initial results from a prospective cohort study of 5583 cases of thyroid carcinoma treated in the united states during 1996. U.S. and German Thyroid Cancer Study Group. An American College of Surgeons Commission on Cancer Patient Care Evaluation study.

Background: The American College of Surgeons Commission on Cancer (CoC) has conducted national Patient Care Evaluation (PCE) studies since 1976.

Methods: Over 1500 hospitals with CoC-approved cancer programs were invited to participate in this prospective cohort study of U.S.

Esophageal cancer: results of an American College of Surgeons Patient Care Evaluation Study.

Background: The last two decades have seen changes in the prevalence, histologic type, and management algorithms for patients with esophageal cancer. The purpose of this study was to evaluate the presentation, stage distribution, and treatment of patients with esophageal cancer using the National Cancer Database of the American College of Surgeons.

Study Design: Consecutively accessed patients (n = 5,044) with esophageal cancer from 828 hospitals during 1994 were evaluated in 1997 for case mix, diagnostic tests, and treatment modalities.

Hodgkin's disease survival by stage and age.

Objective: Prior reports on Hodgkin's disease have suggested a biologic behavior difference between young and old patients. A study of 35,033 patients could confirm that older patients do not do as well as young patients regardless of age.

Methods: The National Cancer Data Base provided data from U.

Clinical highlights from the National Cancer Data Base, 1999.

The National Cancer Data Base (NCDB), a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society, collects and analyzes data from a wide variety of sources throughout the United States, including small community hospitals. Due to this unique reporting system, individual facilities can compare their own data with the aggregate data from the NCDB, using their findings to evaluate local patient care practices. This article highlights the principal findings of the NCDB and Patient Care Evaluation articles published in 1998 on breast, prostate, cervical, endometrial, gallbladder, head and neck, nasopharyngeal, rectal, thyroid, and vaginal cancers, as well as on melanoma, brain tumors, and Hodgkin's disease.

Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985-1995: a National Cancer Data Base Report. The American College of Surgeons Commission on Cancer and the American Cancer Society.

Background: In combination with other Commission on Cancer programs, the National Cancer Data Base (NCDB), a national electronic registry system currently capturing > 60% of incident cancers in the U. S., offers a working example of voluntary, accurate, cost-effective "outcomes management" on a both a local and national scale.

Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985-1995, using the National Cancer Database.

Background: The National Cancer Database is an electronic registry system sponsored jointly by the American College of Surgeons Commission on Cancer and the American Cancer Society. Patients diagnosed with pancreatic adenocarcinoma from 1985 to 1995 were analyzed for trends in stage of disease, treatment patterns, and outcomes.

Study Design: Seven annual requests for data were issued by the National Cancer Database from 1989 through 1995.

A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995 [see commetns].

Background: The National Cancer Data Base (NCDB) represents a national electronic registry system now capturing nearly 60% of incident cancers in the U. S. In combination with other Commission on Cancer programs, the NCDB offers a working example of voluntary, accurate, cost-effective "outcomes management" on a both a local and national scale.

The National Cancer Data Base report on Hodgkin's disease for 1985-1989 and 1990-1994.

Background: A national survey of the management of Hodgkin's disease patients based on cases in the National Cancer Data Base (NCDB) provides a basis for evaluating the results of educational and therapeutic programs. These patients are believed to have been drawn from all nationalities, native and migrant, and were reported by hospital cancer registries throughout the United States, including large and small community hospitals, university and other teaching hospitals, military and Veterans Administration (VA) hospitals, and National Cancer Institute (NCI)-Designated Centers.

Methods: Data submitted voluntarily to the NCDB were used to determine trends in patterns of patient care across time.

Clinical highlights from the National Cancer Data Base, 1998.

The National Cancer Data Base is a community-oriented cancer management and outcomes database that is the joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. This article provides a first look at highlights from the 1998 summary.

Trends in the use of radiation and chemotherapy in the initial management of patients with carcinoma of the uterine cervix.

Purpose: The Commission on Cancer of the American College of Surgeons conducts Patient Care Evaluation studies to describe practice patterns and trends in disease management. This report surveys changing strategies in the initial treatment of patients with invasive cancer of the uterine cervix.

Methods And Materials: Using a standard data collection form designed by a multidisciplinary committee of specialists, cancer registrars at 703 hospitals submitted anonymous data on 11,721 total cervical cancer patients diagnosed in 1984 and 1990.

The National Cancer Data Base report on patterns of childhood cancers in the United States.

Background: Patterns of and progress against childhood cancer have been reported on multi-institution, regional, national, and international bases by several sources in the past. These sources have included clinical cooperative group trials and population-based registries. In general, the population-based surveys have excluded brain tumors of either benign or uncertain behavior.

Hypopharyngeal cancer patient care evaluation.

A survey was conducted to identify demographics and standards of care for treatment of hypopharyngeal squamous cell carcinoma in the United States. Data were accrued from voluntary submission of cancer registry and medical chart information from 769 hospitals representing 2939 cases diagnosed from 1980 to 1985 and 1990 to 1992. Clinical findings, diagnostic procedures employed, treatment practices, and outcome are presented.

Role of splenectomy in gastric cancer surgery: adverse effect of elective splenectomy on longterm survival.

Background: Splenectomy, and in some cases pancreatico splenectomy, has been advocated by surgeons in an effort to improve clearance of metastatic nodes to splenic hilum (node 10) and splenic artery (node 11). Although splenectomy has known effects on increasing morbidity and even mortality after a variety of surgical maneuvers including gastrectomy, the longterm effect on survival is controversial. The purpose of this study is to review and analyze the effect of splenectomy on survival in patients having curative gastrectomy for stomach cancer.

Patterns of care for cancer of the larynx in the United States.

Objective: To assess case-mix characteristics, treatment patterns, and outcomes for laryngeal cancer using the largest series of patients to date.

Design: Analyses performed on retrospectively collected survey data submitted by hospitals for diagnostic periods 1980 through 1985 and 1990 through 1992 (with a 9-year follow-up for the long-term group).

Setting: Broad spectrum of US hospitals (N = 769).

Clinical highlights from the National Cancer Data Base: 1997.

The following highlights summarize the principle findings of the NCDB, which are presented in more detail in other reports, some of which have been published and others of which are in press or submitted awaiting review. Collectively, these findings present a broad pattern of NCDB assessment of cancer patterns of care. In addition to the resulting journal publications, 1,600 NCDB participating hospitals receive a customized summary of similar patterns of care and outcome at their facility compared with national norms, which is then used for quality assurance purposes.

Diagnosing colorectal carcinoma: clinical and molecular approaches.

In summary, the ability to decrease the mortality of colorectal carcinoma is increasingly within the grasp of clinicians. With accurate family and personal history, it is possible to estimate the risk of colorectal cancer and initiate FOBT and colonoscopy where appropriate. In the future, germline and even somatic genetic testing will further increase our ability to diagnose cancers before they become widely invasive.

The National Cancer Data Base and physician network.

The National Cancer Data Base (NCDB) is a nationwide outcomes database for oncology presently including 1,600 hospitals in 50 states. Half of all U.S.

Gastric carcinoma: does lymph node dissection alter survival?

Background: Extragastric lymphadenectomy (D2 node dissection) is strongly supported by Japanese data to have survival benefit. Randomized trial data are either inconclusive or nonsupportive of this view. We have reviewed a prospectively gathered database of 18,346 cases of gastric carcinoma from a gastric cancer patient care evaluation study conducted by the American College of Surgeons to assess whether the performance of extragastric node dissection was associated with improved survival in patients who had resection with curative intent (all margins microscopically clear).

Diagnostic assessments in patients with invasive cancer of the cervix: a national patterns of care study of the American College of Surgeons.

Using a standard collection form designed by a multidisciplinary committee of specialists, cancer registrars at 703 hospitals submitted anonymous data on 11,721 patients with cervical cancer diagnosed during 2 study years, 1984 and 1990. Information concerning the initial use of diagnostic assessments was analyzed with respect to the potential influences of clinical stage, patient age, race/ethnicity, insurance status, and modalities of therapy employed. Estimates of the yield of diagnostic information for each test were correlated with clinical stage and patient age.