Melanoma nodal management in Ontario the year after the 2012 American Society of Clinical Oncology and Society of Surgical Oncology guideline.

Background: In 2012 in the United States, the American Society of Clinical Oncology and the Society of Surgical Oncology (asco/sso) published a joint guideline about indications for sentinel lymph node biopsy (slnb) in cutaneous melanoma. The guideline supported completion lymph node dissection (clnd) for all patients with positive sentinel nodes. We examined the rates and predictors of slnb and clnd for melanoma patients in Ontario (population 13.

Post-mastectomy radiation in node-positive breast cancer in Ontario.

More recent guidelines are more supportive for post-mastectomy radiation in all node-positive breast cancer patients. We examined the rate and predictors of post-mastectomy radiation receipt in Ontario Canada from 2010 to 2014. Of 6535 node-positive post-mastectomy patients, 73.

Thirty-day complication rate of percutaneous gastrojejunostomy and gastrostomy tube insertion using a single-puncture, dual-anchor technique.

Purpose: Our objective was to assess 30-day mortality and complication rates associated with percutaneous enteral feeding tube insertion using a single-puncture, dual-suture anchor gastropexy and peel-away sheath technique. We explored differences in complications based on indication and gastrostomy versus gastrojejunostomy tube.

Methods: A retrospective review was conducted of adult patients undergoing fluoroscopically guided gastrojejunostomy (GJ) and gastrostomy (G) tube insertions between July 2011 and 2014 by five interventional radiologists at a single tertiary care centre.

CJS debate: Is mammography useful in average-risk screening for breast cancer?

Given recent the debate over breast cancer screening that was reignited by the 25-year follow-up data from the Canadian National Breast Screening Study, the Canadian Journal of Surgery commissioned a group of Canadian experts to debate the value of screening mammography. We discuss the Canadian study and summarize the arguments in favour of and against screening mammography for average-risk patients. We also provide summary recommendations for the use of mammography.

Choosing Wisely Canada cancer list: ten low-value or harmful practices that should be avoided in cancer care.

Purpose: Choosing Wisely Canada, modeled after Choosing Wisely in the United States, is intended to identify low-value or potentially harmful practices relevant to the Canadian health care environment. Our objective was to use multidisciplinary, pan-Canadian, physician-based consensus to identify a list of low-value or harmful cancer practices frequently used in Canada.

Methods: A Task Force convened by the Canadian Partnership Against Cancer included physician representation from the Canadian Society of Surgical Oncology, Canadian Association of Medical Oncologists, and Canadian Association of Radiation Oncology, and an expert advisor.

In Search of a Gold Standard Scoring System for the Subjective Evaluation of Cosmetic Outcomes Following Breast-Conserving Therapy.

The absence of a widely accepted method for aesthetic evaluation following breast-conserving surgery for breast cancer limits the ability to evaluate cosmetic outcomes. In this study, two different panel scoring approaches were compared in an attempt to identify a gold standard scoring system for subjectively assessing cosmetic outcomes following breast-conserving therapy. Standardized photographs of each participant were evaluated independently by twelve health care professionals involved in breast cancer diagnosis and treatment using the Danoff four-point scale.

The interface of primary and oncology specialty care: from symptoms to diagnosis.

Symptomatic individuals presenting to their primary care providers may need further evaluation and/or testing to determine whether a cancer is present. A number of issues arise in determining who needs further testing, what tests are needed, which specialists need to be involved, and how the testing can be organized and supported within a specific health-care system within a timely, coordinated, and cost-efficient manner. This article explores the challenges in the interface of primary care providers and specialists, includes evidence from prior research, and proposes research opportunities to understand and improve this phase of care.

Wait times from presentation to treatment for colorectal cancer: a population-based study.

Background: The wait time from cancer diagnosis to treatment has been a recent focus of cancer care in Canada.

Objective: To examine the trends in wait times from patient presentation to treatment (overall health system wait time [OWT]) for colorectal cancer (CRC).

Methods: Patients with colorectal adenocarcinomas, diagnosed between 2001 and 2005, and their first definitive treatments were identified from the population-based Manitoba Cancer Registry (Winnipeg, Manitoba).

Radiation treatment waiting times for breast cancer patients in Manitoba, 2001 and 2005.

Introduction: Our study examined the wait time from ready-to-treat to radiation therapy for cohorts of breast cancer patients requiring adjuvant radiation therapy in 2001 and in 2005 after the implementation of strategies to reduce wait times for radiation treatment. We also examined the overall time from diagnosis to radiation treatment and whether distance from the cancer treatment centre or month of referral had an effect on wait times.

Methods: This population-based retrospective study looked at representative samples of women newly diagnosed with breast cancer in 2001 and 2005.

Local recurrence after rectal cancer treatment in Manitoba.

Background: By optimizing surgical and/or radiotherapy treatment, local recurrence rates of resectable rectal cancers have been reported to be less than 10% in both clinical trials and in some population-based studies. We examined patterns of care and local recurrence rates for rectal cancers in the province of Manitoba.

Methods: We used the provincial cancer registry to identify all rectal cancers diagnosed from 1994 to 1997.

The impact of margin status on local recurrence following breast conserving therapy for invasive carcinoma in Manitoba.

Background: Histologically positive margins are generally considered unacceptable with breast conserving therapy (BCT) given the increased risk of local recurrence (LR). What constitutes an adequate negative margin remains controversial. Margin status was explored as a predictor of LR post-BCT.

Survival and treatment trends of rectal cancer patients in a population with suboptimal local control.

Aim: To explore trends in rectal cancer survival in Manitoba, particularly in patients where local control was an issue.

Method: Patients diagnosed with rectal or rectosigmoid adenocarcinoma from 1985 to 1999 were included. Demographic, treatment and mortality information were abstracted from the registry.

Same question, different data source, different answers? Data source agreement for surgical procedures on women with breast cancer.

This study assessed the accuracy of the Manitoba Cancer Registry (MCR) and two administrative data sources, the Manitoba Health hospital discharge file and the Manitoba Health medical claims file, for capturing surgical procedures related to the treatment of breast cancer. The study cohort included all women diagnosed in Manitoba with invasive or in situ breast cancer between 1995 and 1999. The surgical procedures of interest were mastectomy, breast conserving surgery and axillary node dissection.

Canadian breast cancer guidelines: have they made a difference?

Background: A principal objective of the Canadian Clinical Practice Guidelines for the Care and Treatment of Breast Cancer was to reduce the variation in the way that breast cancer was being treated. To evaluate whether this goal has been reached, we examined variations among surgeons for 4 measures of surgical care and tested for differences in province-wide rates and in variations among surgeons before and after the guidelines were released.

Methods: We studied a population-based cohort of 7022 women living in Manitoba in whom breast cancer was diagnosed from 1995 to 2003 inclusive.