Abstract:
:A regional cancer network has been set up in the Rhône-Alpes region in France. The aim of the project is to improve the quality of care and to rationalize prescriptions in the network. In this network, we assessed the impact of the implementation of a clinical practice guidelines project by assessing the conformity of practice with the guidelines and comparing this with the conformity in an external matched control group from another French region without a regional cancer network. Four hospitals (private and public) accepted to assess the impact of the clinical practice guidelines on the management of breast and colon cancer in the experimental group and three hospitals (private and public) in the control group. In 1994 and 1996, women with non-metastatic breast cancer (282 and 346 patients in the experimental group, 194 and 172 patients in the control group, respectively) and all new patients with colon cancer (95 and 94 patients in the experimental group, and 89 and 118 patients in the control group, respectively) were selected. A controlled "before-after" study, using institutional medical records of patients with breast and colon cancer. The medical decisions concerning the patients were analyzed to assess their compliance with the clinical practice guidelines. When medical decisions were judged to be non-compliant, we verified if they were based on scientific evidence in a published article, if they were not, the medical decision was classified as having "no convincing supporting scientific evidence". The compliance rates were significantly higher in 1996 than in 1994 in the experimental group; 36% (126 out of 346) vs 12% (34 out of 282) and 46% (56 out of 123) vs 14% (14 out of 103) (P<0.001) for breast and colon cancer, respectively. Whereas, in the control group the compliance rates were the same for the two periods; 7% (12 out of 173) vs 6% (12 out of 194) (P=0.46) and 39% (49 out of 126) vs 32% (31 out of 96), P=0.19. In the experimental group, in 1994, 101 of the 282 medical decisions (36%) and 27 of the 103 (26%) for breast and colon cancer, respectively, were classified as having "no convincing supporting scientific evidence" compare with 72 out of 346 in 1996 (21%) for breast cancer, and 21 of the 123 (17%) for colon cancer P<0.05. Whereas in the control group these results were 106 out of 194 in 1994 (55%) and 90 out of 172 in 1996 (52%), P=0.65 for breast cancer and 28 out of 96 in 1994 (29%) and 30 out of 126 in 1996 (24%), P=0.36 for colon cancer. The development and implementation strategy of the clinical practice guidelines programme for cancer management results in significant changes in medical practice in our cancer network. These results would suggest that introducing guidelines with specific implementation strategy might also increase the compliance rate with the guideline and "evidence-based medicine".
journal_name
Br J Cancerjournal_title
British journal of cancerauthors
Ray-Coquard I,Philip T,de Laroche G,Froger X,Suchaud JP,Voloch A,Mathieu-Daudé H,Fervers B,Farsi F,Browman GP,Chauvin Fdoi
10.1038/sj.bjc.6600057subject
Has Abstractpub_date
2002-02-01 00:00:00pages
313-21issue
3eissn
0007-0920issn
1532-1827journal_volume
86pub_type
杂志文章abstract::An analysis of the occurrence of breast cancer in this long-term prospective cohort study shows a significant relative risk (RR) in women who have ever used oral contraceptives (OC) of 3.33 in women age 30 to 34 years at diagnosis and an RR of 5.88 (P = 0.0011) in women who were parity 1 at the time of diagnosis. In w...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1988.285
更新日期:1988-11-01 00:00:00
abstract::Delta-aminolevulinic acid (ALA) is the precursor in the biosynthesis of porphyrins. The knowledge of both the regulation of ALA entrance and efflux from the cells and the control of porphyrin biosynthesis is essential to improve ALA-mediated photodynamic therapy. In this work, we studied the regulation of ALA uptake a...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6601066
更新日期:2003-07-07 00:00:00
abstract::Throughout the world there are problems recruiting ethnic minority patients into cancer clinical trials. A major barrier to trial entry may be distrust of research and the medical system. This may be compounded by the regulatory framework governing research with an emphasis on written consent, closed questions and con...
journal_title:British journal of cancer
pub_type: 杂志文章,评审
doi:10.1038/bjc.2012.240
更新日期:2012-09-25 00:00:00
abstract:BACKGROUND:The mitogen-activated protein kinase (MAPK) pathway has been implicated in the molecular pathogenesis of human cancers, including metastatic colorectal cancer (mCRC). This provides a rationale for the development of MAPK-targeted agents such as pimasertib. METHODS:Patients with KRAS mutant mCRC were treated...
journal_title:British journal of cancer
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1038/bjc.2015.144
更新日期:2015-06-09 00:00:00
abstract::Selection of cytostatic agents for intrathecal administration is the subject of this paper.Both the toxic side effects-destruction of blood-brain barrier and change of body weight-and the cytostatic effects on intracranially transplanted Yoshida ascites sarcoma were investigated of intrathecal administration of variou...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1970.59
更新日期:1970-09-01 00:00:00
abstract::In haemagglutination tests we have found that the monoclonal antibody B5 discriminates between erythrocytes from patients with malignant cancer (total 386; greater than 80% B5 positive) and individuals with no known tumour (total 247; less than 20% B5 positive). The B5 antigen detected on intact erythrocytes is a tigh...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1984.53
更新日期:1984-03-01 00:00:00
abstract:BACKGROUND:Pancreaticoduodenectomy remains a major undertaking. A preoperative blood test, which could confidently predict the benefits of surgery would improve the selection of pancreatic cancer patients for surgery. This study aimed to identify protein biomarkers prognostic for long-term survival and to validate them...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2012.458
更新日期:2012-11-20 00:00:00
abstract::We screened 145 HIV-infected non-pregnant women at a tertiary care centre in Lusaka, Zambia. Liquid-based cytology and human papillomavirus (HPV) genotyping with PGMY09/11 biotinylated primers (Roche Linear Array HPV genotyping test) maximised sensitivity of cytology and HPV assessments. Among high-risk (HR) types, HP...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6603737
更新日期:2007-05-07 00:00:00
abstract::We have evaluated the relation between cancer of the lower urinary tract ("bladder cancer") and the use of artificial sweeteners, by means of case-control studies in Manchester, U.K., and Nagoya, Japan, areas where extensive use occurred 30-40 years ago. In each area, a broadly based series of cases (555 in Manchester...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1982.59
更新日期:1982-03-01 00:00:00
abstract:BACKGROUND:Multiple myeloma is a plasma cell disorder that is characterised by clonal proliferation of malignant plasma cells in the bone marrow, monoclonal paraprotein in the blood or urine and associated organ dysfunction. It accounts for approximately 1% of cancers and 13% of haematological cancers. Myeloma arises f...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2012.525
更新日期:2012-12-04 00:00:00
abstract::In the UK, 10% of patients diagnosed with rectal cancer have inoperable disease at presentation. This study ascertained whether the resectability rate of inoperable locally advanced rectal cancer was improved by administration of intravenous irinotecan, 5-fluorouracil (5-FU) and pelvic radiotherapy. During phase I of ...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6604292
更新日期:2008-04-08 00:00:00
abstract::Screen-detected (SD) breast cancers are smaller and biologically more indolent than clinically presenting cancers. An often debated question is: if left undiagnosed during their preclinical phase, would they become more aggressive or would they only increase in size? This study considered a registry-based series (1988...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6602289
更新日期:2005-01-17 00:00:00
abstract::Wnt genes are transforming to mouse breast epithelium and are hormonally regulated in vivo. To assess their role in another endocrine-responsive human cancer, the expression of seven Wnt genes (Wnt 2, 3, 4, 5a, 7a, 7b and 10b) in normal human endometrium and endometrial cells, and endometrial carcinoma tissues and cel...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1997.195
更新日期:1997-01-01 00:00:00
abstract::Dendritic cells (DC) are professional antigen-presenting cells that play a pivotal role in the induction of immunity. Ex vivo-generated, tumour antigen-loaded mature DC are currently exploited as cancer vaccines in clinical studies. However, antigen loading and maturation of DC directly in vivo would greatly facilitat...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6603341
更新日期:2006-10-09 00:00:00
abstract:BACKGROUND:Antihypertensives may inhibit pancreatic carcinogenesis. We examined the association between use of these drugs and pancreatic cancer in patients with chronic pancreatitis. METHODS:We conducted a nationwide population-based cohort study of all chronic pancreatitis patients diagnosed in Denmark during 1996-2...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/s41416-019-0562-y
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:This first-in-human, phase I clinical trial of p28 (NSC745104), a 28-amino-acid fragment of the cupredoxin azurin, investigated the safety, tolerability, pharmacokinetics and preliminary activity of p28 in patients with p53(+) metastatic solid tumours. METHODS:A total of 15 patients were administered p28 i....
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2013.74
更新日期:2013-03-19 00:00:00
abstract::No numerical aberration of chromosomes that might be specific for prostate cancer has so far been established. We used fluorescence in situ hybridisation (FISH) with centromere-specific probes for chromosomes 7, 8, 17, X and Y to establish the distribution of centromere copy numbers in frozen-stored or freshly prepare...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1996.617
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Immunoscore have shown a promising prognostic value in many cancers. We aimed to establish and validate an immune classifier to predict survival after curative resection of hepatocellular carcinoma (HCC) patients who have undergone curative resection. METHODS:The immunohistochemistry (IHC) classifier assay ...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/s41416-020-0864-0
更新日期:2020-07-01 00:00:00
abstract::We conducted a case-control study to investigate the role of early infections in the aetiology of childhood acute leukaemias. The study included 280 incident cases (240 acute lymphoblastic leukaemia and 40 acute non-lymphoblastic leukaemia) and 288 hospital controls, frequency matched by age, gender, hospital, catchme...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6600091
更新日期:2002-04-08 00:00:00
abstract:BACKGROUND:The association between gall bladder removal (cholecystectomy) and hepatocellular carcinoma warrants investigation. An increased intrahepatic bile duct pressure following cholecystectomy might cause chronic inflammation in the surrounding liver tissue, which might induce cancer development. METHODS:A nation...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2011.181
更新日期:2011-06-28 00:00:00
abstract:BACKGROUND:This phase 1 study evaluated the maximum tolerated dose (MTD), safety, and efficacy of bosutinib (competitive Src/Abl tyrosine kinase inhibitor) plus capecitabine. METHODS:Patients with locally advanced/metastatic breast, pancreatic, or colorectal cancers; cholangiocarcinoma; or glioblastoma received bosuti...
journal_title:British journal of cancer
pub_type: 杂志文章,多中心研究
doi:10.1038/bjc.2014.508
更新日期:2014-11-25 00:00:00
abstract::Methotrexate (MTX)-based chemotherapy extends survival in patients with primary brain lymphomas, but it is not clear whether multiagent chemotherapy is superior to MTX alone. Treatment options for patients with recurrent primary brain lymphoma are limited; there is no standard second-line chemotherapy. New chemotherap...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6603660
更新日期:2007-03-26 00:00:00
abstract::Various procedures for immunoprotection in the A-SW mouse SEWA tumour system were compared. Four types of protector agents were used: polyoma virus, allogeneic S724 cells, A9/SEWA hybrid cells and xenogeneic ST(py) cells. Several injection schedules were also employed. On the whole, reasonable immunoprotection was obt...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1974.70
更新日期:1974-04-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated that senescent cancer-associated fibroblasts (CAFs) derived from genetically unstable oral squamous cell carcinomas (GU-OSCC), unlike non-senescent CAFs from genetically stable carcinomas (GS-OSCC), promoted keratinocyte invasion in vitro in a paracrine manner. The mechanis...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2014.438
更新日期:2014-09-09 00:00:00
abstract::HMGI and HMGY are splicing variants of the HMGI(Y) gene and together with HMGI-C, belong to a family of DNA binding proteins involved in maintaining active chromatin conformation and in the regulation of gene transcription. The expression of the HMGI(Y) gene is maximal during embryonic development, declines in adult d...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1054/bjoc.2000.1494
更新日期:2000-12-01 00:00:00
abstract::Imatinib mesilate (Glivec), Novartis Pharmaceuticals) is a novel therapy for the treatment of chronic myeloid leukaemia (CML). We evaluated the cost-effectiveness of imatinib (600 mg daily) when used for the treatment of patients in advanced stages of CML (accelerated phase and blast crisis) against conventional thera...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6601151
更新日期:2003-08-18 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) frequently complicates cancer. Data on tumour-specific VTE predictors are limited, but may inform strategies to prevent thrombosis. METHODS:We computed incidence rates (IRs) with 95% confidence intervals (CIs) for VTE hospitalisation in a cohort of cancer patients (n=57,591) and...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/sj.bjc.6605883
更新日期:2010-09-28 00:00:00
abstract::The continuous cell line UCRU BL 17CL was derived from a human invasive bladder cancer and expresses elements of transitional, squamous and glandular differentiation. Nine clones of this line were established by limit dilution and have been extensively characterised. Only six of these clones grew subcutaneously in nud...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.1990.81
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Biomarkers for metastatic castration-resistant prostatic cancer (mCRPC) are an unmet medical need. METHODS:The prognostic and predictive value for survival and response to salvage hormonal therapy (SHT) of baseline testosterone level (TL) was analysed in a cohort of 101 mCRPC patients participating in 9 non...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2014.189
更新日期:2014-04-29 00:00:00
abstract:BACKGROUND:Although mortality rates are elevated in psychiatric patients relative to their healthy counterparts, little is known about the impact of mental health on survival in people with cancer. METHODS AND RESULTS:Among 16 498 Swedish men with cancer, survival was worse in those with a history of psychiatric hospi...
journal_title:British journal of cancer
pub_type: 杂志文章
doi:10.1038/bjc.2012.150
更新日期:2012-05-22 00:00:00