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Canadian healthcare system's management of patients with cancer.

https://arctichealth.org/en/permalink/ahliterature198647
Source
Cancer Invest. 2000;18(4):403-5
Publication Type
Article
Date
2000
Author
C. Giacomantonio
W J Temple
Author Affiliation
Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Alberta, Canada.
Source
Cancer Invest. 2000;18(4):403-5
Date
2000
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care - economics - organization & administration
Financing, Government
Health Services Accessibility
Humans
Neoplasms - therapy
Patient Advocacy
Prognosis
Referral and Consultation
Social Class
State Medicine
PubMed ID
10808377 View in PubMed
Less detail

Combination regional therapy for extremity sarcoma. A tricenter study.

https://arctichealth.org/en/permalink/ahliterature229479
Source
Arch Surg. 1990 Mar;125(3):355-9
Publication Type
Article
Date
Mar-1990
Author
H J Wanebo
W J Temple
M B Popp
C E Douvill
M. Yablonski
Author Affiliation
Brown University, Providence, RI.
Source
Arch Surg. 1990 Mar;125(3):355-9
Date
Mar-1990
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alberta
Arm
Bone Neoplasms - complications - mortality - pathology - therapy
Chemotherapy, Cancer, Regional Perfusion - methods
Combined Modality Therapy - methods
Doxorubicin - administration & dosage
Female
Heparin - administration & dosage
Humans
Leg
Male
Middle Aged
Multicenter Studies as Topic
Neoplasm Staging
Ohio
Postoperative Care - methods
Radiotherapy Dosage
Sarcoma - complications - mortality - pathology - therapy
Soft Tissue Neoplasms - complications - mortality - pathology - therapy
Survival Analysis
Virginia
Abstract
Patients with extremity sarcomas were treated with a neoadjuvant therapy protocol that had originated within the Southeastern Cancer Study Group. Major objectives were to determine tolerance of therapy and its effects on tumor control and survival. After undergoing biopsy, patients received intra-arterial infusion with doxorubicin hydrochloride (Adriamycin) (30 mg every 24 hours) for 3 days and were allocated by institution to receive irradiation of 30 or 35 Gy in 10 fractions or 46 Gy in 23 to 25 fractions. Surgery was done within 7 to 10 days or 30 days pending irradiation dose. Postoperative chemotherapy was given to 31 patients. There were 60 patients, 29 women and 31 men with a median age of 48 years, with 53 soft-tissue tumors and 7 malignant bone tumors. Stages (American Joint Committee on Cancer) included stage IB, 2 patients; stages IIA and IIB, 9 patients; stage IIIA, IIIB, or IIIC, 39 patients; and stages IVA or IVB, 10 patients. Limb salvage surgery was done in 57 patients, including radical resection in 23 with large extensive tumors, wide local excision in 30, excision with narrow margins in 7, primary amputation in 3, and delayed amputation in 2 because of wound complications. There was one local recurrence in the 57 patients who had limb salvage surgery. Disease-free and overall survival at 48 months were 47% and 56%, respectively. We conclude that combined therapy for extremity sarcomas in a multicenter setting resulted in excellent local control, good function, and reasonable long-term survival in patients having limb salvage surgery.
PubMed ID
2407227 View in PubMed
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Education is the key to quality of surgery for rectal cancer.

https://arctichealth.org/en/permalink/ahliterature173795
Source
Eur J Surg Oncol. 2005 Aug;31(6):636-44
Publication Type
Article
Date
Aug-2005
Author
L A Mack
W J Temple
Author Affiliation
Department of Surgery/Oncology, University of Calgary, Calgary, Alta., Canada.
Source
Eur J Surg Oncol. 2005 Aug;31(6):636-44
Date
Aug-2005
Language
English
Publication Type
Article
Keywords
Canada
Colorectal Surgery - education - standards - statistics & numerical data
Education, Medical, Continuing
Humans
Quality Assurance, Health Care - methods
Quality of Health Care
Rectal Neoplasms - surgery
Treatment Outcome
Abstract
Surgical quality assurance is a central issue in the treatment of rectal cancer and has led to substantial improvements in sphincter preservation, local control, and overall survival. Education or training as well as volume of practice are often cited as the major predictors of quality outcomes. While volume is a simple measure to analyze, it is likely a superficial or surrogate measure of quality surgery. It has been conclusively demonstrated that education, from total mesorectum excision workshops to nation-wide educational initiatives are effective methods of improving quality of care for the rectal cancer patient. New methods of quality assurance and improvement are being developed including prospective quality registers, the synoptic operative report, and pathology audits. It is imperative that improved measures of quality, other than volume, be implemented to audit our own practices, hospitals and regions with the goal of identifying issues that will improve outcomes for rectal cancer patients.
PubMed ID
16023945 View in PubMed
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Guidelines for the surgical management of soft-tissue sarcoma. Report of the Canadian Sarcoma Group.

https://arctichealth.org/en/permalink/ahliterature232257
Source
Can J Surg. 1988 Nov;31(6):410-2
Publication Type
Article
Date
Nov-1988
Author
W J Temple
V. Bramwell
E. Eisenhauer
R D Jenkin
F. Langer
A J Worth
Author Affiliation
Canadian Sarcoma Group (CSG), National Cancer Institute of Canada.
Source
Can J Surg. 1988 Nov;31(6):410-2
Date
Nov-1988
Language
English
Publication Type
Article
Keywords
Biopsy - methods
Canada
Clinical Protocols
Fascia - pathology - surgery
Humans
Methods
Sarcoma - pathology - surgery
Soft Tissue Neoplasms - pathology - surgery
Abstract
The Canadian Sarcoma Group was formed in 1985 by interested surgeons, oncologists and pathologists. In the evaluation of new protocols, standard surgical guidelines have been developed which incorporate the concepts of multimodality therapy, particularly radiotherapy and chemotherapy. Also defined are the procedures performed: biopsy, marginal resection, wide local excision, radical resection and the principles to be considered when doing a diagnostic biopsy and a curative resection, particularly with limb salvage in mind. To optimize local control of the disease, centres treating sarcomas should have access to computed tomography, radionuclide scanning, to radiation and medical oncologists, and members of other surgical specialties. This team approach increases survival by 10% and also provides the best circumstances in which to study adjuvant therapy. Surgical guidelines are also essential in order to compare the results of different clinical trials.
PubMed ID
3179850 View in PubMed
Less detail

Introduction: management of cancer in the Canadian Healthcare System.

https://arctichealth.org/en/permalink/ahliterature198648
Source
Cancer Invest. 2000;18(4):395-6
Publication Type
Article
Date
2000
Author
F L Moffat
C. Giacomantonio
W J Temple
Author Affiliation
Department of Surgery, University of Miami School of Medicine, Sylvester Comprehensive Cancer Center, Florida, USA.
Source
Cancer Invest. 2000;18(4):395-6
Date
2000
Language
English
Publication Type
Article
Keywords
Canada
Delivery of Health Care - organization & administration
Humans
Medical Oncology - organization & administration
Neoplasms - therapy
State Medicine
PubMed ID
10808375 View in PubMed
Less detail

Ocular melanoma in Alberta: a 38 year review pointing to the importance of tumor size and tumor histology as predictors of survival.

https://arctichealth.org/en/permalink/ahliterature229736
Source
J Surg Oncol. 1989 Dec;42(4):215-8
Publication Type
Article
Date
Dec-1989
Author
S. Hayton
R. Lafreniere
L M Jerry
W J Temple
P. Ashley
Author Affiliation
Department of Surgery, University of Calgary, Alberta, Canada.
Source
J Surg Oncol. 1989 Dec;42(4):215-8
Date
Dec-1989
Language
English
Publication Type
Article
Keywords
Alberta - epidemiology
Choroid Neoplasms - mortality - pathology
Eye Neoplasms - mortality - pathology
Female
Humans
Male
Melanoma - mortality - pathology
Middle Aged
Registries
Retrospective Studies
Survival Rate
Time Factors
Abstract
A large number of cases of ocular melanoma have been entered in The Provincial Cancer Registry of Alberta over the past 40 years. This study was undertaken in order to describe further the natural history of this disease and derive management recommendations for use at the provincial level. A retrospective chart review was carried out on all cases of ocular melanoma registered through The Alberta Provincial Cancer Registry between 1949 and 1987. Two hundred fifty-one cases were identified: 143 were males and 108 were females. The mean age of the patients at diagnosis was 60. The majority of the melanomas arose from the choroid of the eye (82%) with the remainder arising from the iris, conjunctiva and ciliary body, respectively. According to the Callender classification for ocular melanomas, the majority of the melanomas were of the spindle cell type (53%), the others being either mixed cell (23%), epithelioid (8%), or fascicular (1%). Survival rates differed depending on the cell type. Spindle cell tumors demonstrated a mean survival time of 5.2 years; epithelioid tumors 4.8 years and the mixed cell tumors appeared to be the most aggressive with a mean survival time of 2.7 years after diagnosis. The majority of deaths from ocular melanoma occurred within 5 years of diagnosis, although 14% of patients in this review presented with metastases more than 10 years after diagnosis. Some of the cases of ocular melanoma could be classified pathologically as small, medium, or large. Patients with large ocular melanomas had a 5 year survival rate of 33% compared to 70% and 66% for patients with small and medium sized tumors. Of note, 43% of patients with large ocular melanomas who were dead from their disease within 5 years of diagnosis were also found to have mixed cell tumors. These findings call for a longer follow-up period for ocular melanomas and point to the importance of cell type and tumor size as predictors of survival and as guides in planning prophylactic therapeutic interventions.
PubMed ID
2593663 View in PubMed
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Opening the black box of cancer surgery quality: WebSMR and the Alberta experience.

https://arctichealth.org/en/permalink/ahliterature151747
Source
J Surg Oncol. 2009 Jun 15;99(8):525-30
Publication Type
Article
Date
Jun-15-2009
Author
L A Mack
O F Bathe
M A Hebert
E. Tamano
W D Buie
T. Fields
W J Temple
Author Affiliation
Department of Surgery and Oncology, University of Calgary, Alberta, Canada.
Source
J Surg Oncol. 2009 Jun 15;99(8):525-30
Date
Jun-15-2009
Language
English
Publication Type
Article
Keywords
Alberta
Forms and Records Control
Humans
Medical Records Systems, Computerized - standards
Neoplasms - surgery
Outcome Assessment (Health Care) - methods - statistics & numerical data
Reference Standards
User-Computer Interface
Vocabulary, Controlled
Abstract
A web-based synoptic operative report, the WebSMR (Surgical Medical Record), was developed to define and improve the quality of cancer surgery. Surgeons accurately record the essential steps of an operation including important decision-making in an analyzable format. Outcomes can be reviewed with provincial aggregates for quality improvement and maintenance of certification. Future synoptic pathology and follow-up templates will open the "black box" of surgical processes to define quality indicators for the improvement of cancer outcomes.
PubMed ID
19338026 View in PubMed
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Synoptic operative record for point of care outcomes: a leap forward in knowledge translation.

https://arctichealth.org/en/permalink/ahliterature142320
Source
Eur J Surg Oncol. 2010 Sep;36 Suppl 1:S44-9
Publication Type
Article
Date
Sep-2010
Author
L A Mack
K. Dabbs
W J Temple
Author Affiliation
Department of Surgery and Oncology, University of Calgary, 1331-29th Street NW, Calgary, Alberta, Canada.
Source
Eur J Surg Oncol. 2010 Sep;36 Suppl 1:S44-9
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Alberta
Breast Neoplasms - surgery
Decision Making
Electronic Health Records - standards
Female
Humans
Information Management
International Cooperation
Knowledge
Mastectomy
Point-of-Care Systems
Software
Abstract
Modern information technology coupled with synoptic methodology allows point of care, real time outcomes generation. Our objective was to review province-wide breast cancer surgery outcomes from a prospective synoptic operative record to demonstrate its value in knowledge translation.
All synoptic reports for breast cancer procedures from 2006 until March 2010 were reviewed and descriptively analyzed. Key outcomes included frequency of breast cancer procedures captured over time, methods of breast cancer detection, clinical staging, method of axillary staging, breast conservation and reconstruction rates. Further analysis involved important decision-making for mastectomy and resource allocation for surgery.
Four thousand nine hundred fifty-five breast cancer procedures were recorded synoptically; greater than 80% of cases provincially. Method of breast cancer detection was 49%, 45% and 4% by screening radiology, patient or family, and physician, respectively. Pathologic diagnoses were via core or mammotome biopsy in 94%; nearly half of all patients were clinical Stage I at time of operation. Overall rate of breast conservation was 48%. Of the 65% who had no contra-indication to breast conservation surgery, 76% had breast conservation and 4% had primary reconstruction. Of those having mastectomy, one third were due to patient choice. Seventy-nine percent had sentinel node staging, 18% had full axillary dissection and 3% had no axillary staging.
A new paradigm of creating medical records using synoptic electronic templates allows prospective outcomes generation at point of care by the surgeon which is unparalleled in its depth of surgical detail capturing surgical decision-making.
PubMed ID
20609548 View in PubMed
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9 records – page 1 of 1.