A randomized controlled trial to improve lymph node assessment in stage II colon cancer.

Hypothesis: Physicians seem to learn best from their peers, yet the impact of opinion leaders on physician behavior is unclear. Because colon cancer staging has been identified as being suboptimal in Ontario, Canada, we sought to evaluate the influence of expert and local opinion leaders for colon cancer on optimizing colon cancer lymph node assessment.

Design, Setting, Participants: A cluster-randomized trial including all hospitals in Ontario that identified a local opinion leader with intervention between January 5 and June 17, 2004.

Compliance, attitudes and barriers to post-operative colorectal cancer follow-up.

Rationale: Meta-analyses demonstrate that surveillance following curative-intent colorectal cancer (CRC) surgery can improve survival. Our multidisciplinary team adopted a stringent CRC follow-up (FU) guideline in 2000. The purpose of this study was to assess adherence and barriers to FU for CRC.

Outcomes of salvage surgery for squamous cell carcinoma of the anal canal.

Background: For patients with anal canal cancer who fail combined modality treatment (CMT), salvage surgery (SS) offers the potential for long term survival. The literature regarding SS is limited by small patient numbers and/or heterogeneous treatment protocols. We report on a large series of patients initially treated with chemoradiation at a major referral center.

Surgery as a bridge to palliative chemotherapy in patients with malignant bowel obstruction from colorectal cancer.

Background: Malignant bowel obstruction (MBO) is a feature of the clinical course of 10-28% of colorectal cancer (CRC) patients and is associated with a poor prognosis. Recent advancements in palliative chemotherapy regimens have prolonged survival in patients with stage IV CRC. Few reports exist that describe outcomes in patients who have had surgery for MBO and subsequent chemotherapy as part of their treatment.

Results of an aggressive approach to resection of locally recurrent rectal cancer.

Background: The value of resection for locally recurrent rectal cancer (LRRC) remains controversial. We analyzed outcomes of an aggressive approach to resection of LRRC.

Methods: We conducted a retrospective chart review of 52 consecutive patients who underwent resection of LRRC from September 1997 through August 2005.

A blended knowledge translation initiative to improve colorectal cancer staging [ISRCTN56824239].

Background: A significant gap has been documented between best practice and the actual practice of surgery. Our group identified that colorectal cancer staging in Ontario was suboptimal and subsequently developed a knowledge translation strategy using the principles of social marketing and the influence of expert and local opinion leaders for colorectal cancer.

Methods/design: Opinion leaders were identified using the Hiss methodology.

Identifying educationally influential specialists: issues arising from the use of "classic" criteria.

Introduction: Educationally influential physicians (EIPs) are identified by their colleagues as people who (1) encourage learning and enjoy sharing their knowledge, (2) are clinical experts and always seem up to date, and (3) treat others as equals. We aimed to identify surgical and pathologist EIPs for colorectal cancer (CRC) in Ontario as part of a blended knowledge transfer program.

Methods: A population-based cohort of surgeons (n = 794) and pathologists (n = 449) were sent surveys modeled on the Hiss method for identifying EIPs.

Barriers to optimal assessment of lymph nodes in colorectal cancer specimens.

Lymph node (LN) retrieval and assessment is critically important for accurate staging and treatment planning in colorectal cancer (CRC). Practicing pathologists in Ontario were identified and surveyed by phone to identify barriers to optimal retrieval and assessment. Of the pathologists surveyed, 57.

Interest and participation in support group programs among patients with colorectal cancer.

Previous studies have demonstrated that support intervention improved quality of life and survival for patients with breast, melanoma, prostate, and gastrointestinal cancer. A standardized approach to encourage participation in support group programs among patients with colorectal cancer (CRC) had been initiated at this study site. The purpose of this study was to examine the characteristics of patients with CRC interested in this type of intervention and to identify barriers to attendance at an established patient support program.