scholarly journals Long-term follow-up of the Medical Research Council CLASICC trial of conventionalversuslaparoscopically assisted resection in colorectal cancer

2012 ◽  
Vol 100 (1) ◽  
pp. 75-82 ◽  
Author(s):  
B. L. Green ◽  
H. C. Marshall ◽  
F. Collinson ◽  
P. Quirke ◽  
P. Guillou ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Medical Research ◽  
Research Council ◽  
Medical Research Council ◽  
Long Term Follow Up

Long-Term Survival in Patients Receiving Conventional Therapy for Newly Diagnosed Multiple Myeloma; Results from United Kingdom Medical Research Council Trials 1980–1997.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4921-4921
Author(s):  
Bradley M. Augustson ◽  
Gulnaz Begum ◽  
Gareth J. Morgan ◽  
J. Anthony Child ◽  
Nicola J. Barth ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Medical Research ◽  
Conventional Therapy ◽  
Research Council ◽  
Medical Research Council ◽  
Performance Status ◽  
Serological Response ◽  
Long Term Survivors

Abstract Introduction: With conventional therapy, the median survival for patients following diagnosis of multiple myeloma (MM) is 31 months. Prior to 1985 2–4% of patients survived up to 10 years, subsequently this figure has improved to around 10%. We have analysed the United Kingdom Medical Research Council (MRC) trial records to identify the proportion, presentation features and outcome of patients who have survived greater than 7.5 years. Methods: Patients selected were those randomised to conventional (melphalan and ABCM based) therapy who survived greater than 7.5 years; all of these patients had achieved a plateau phase. Their presenting clinical and laboratory features were compared to a group of patients (matched by trial and treatment) who also reached plateau but were the first of the cohort to die directly from MM. Time to response and absolute response was calculated. Clinical course and performance status were assessed from 3 month follow-up clinical data forms and central laboratory paraprotein analysis. Results: 239/2781 (8.5%) of eligible patients survived greater than 7.5 years. 170 patients had died (median and interquartile range (IQR) 9.5 years and 8.3–11.7 years) and 69 patients were still alive at the time of the analysis, median follow-up of 11.4 years (IQR 9.2–14.1 years). Compared to the matched short-lived control group, these long term survivors had lower β2-microglobulin, preserved albumin, lower marrow plasmacytosis, less renal impairment, better performance status, fewer fractures, less bone pain and fewer lytic lesions at presentation. There were no differences in age, lymphocytes, or depth of serological response, however, median time to reach plateau was delayed for the long term survivors {0.77 years (IQR 0.41–1.05) versus 0.42 years (0.26–0.73 for controls)}. 35 patients remain in first plateau with no progression, 28 patients died in first plateau most commonly of vascular disease (25%) or cancer (21%). 176 patients relapsed and 11 (6%) died of myeloma in first relapse, however the majority (140/176, 80%) achieved a second plateau and having relapsed a second time 53/114 (46%) achieved a third plateau. 43 of these 140 patients died in second plateau or beyond of a cause other than myeloma - (vascular 7/43 (16%), cancer 5/43 (12%), renal 5/43 (12%), infection 6/43 (14%), other 4/43 (9%). 30/239 patients (13%) died with no information on disease status or cause of death. Following second relapse 73/114 (64%) patients died directly as a result of myeloma. Time spent in performance status 1 and 2 was 96% for plateau 1, 83% for relapse 1 and 63% beyond relapse 2. Conclusions: 8.5% of MRC trial patients receiving conventional non-intensive therapy survive greater than 7.5 years. Factors associated with long survival include low disease burden, better performance status and less end organ damage. Absolute serological response had no bearing on overall outcome; however rapid response is associated with poorer survival. The existence of second and subsequent plateau phases of MM, have rarely been documented in the literature. A large proportion of time following relapse is spent with good performance status, suggesting that patients experience a good quality of life during much of this period.

Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer

2010 ◽  
Vol 97 (11) ◽  
pp. 1638-1645 ◽  
Author(s):  
D. G. Jayne ◽  
H. C. Thorpe ◽  
J. Copeland ◽  
P. Quirke ◽  
J. M. Brown ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Medical Research ◽  
Open Surgery ◽  
Research Council ◽  
Medical Research Council

scholarly journals Colorectal cancer screening:potential pitfalls

2001 ◽  
Vol 24 (1) ◽  
pp. 148 ◽  
Author(s):  
John Duggan
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Medical Research ◽  
Colorectal Cancer Screening ◽  
National Health ◽  
Research Council ◽  
Medical Research Council

The National Health and Medical Research Council has recently issued guidelines on colo-rectal cancer, and givensignificant support to Colorectal Cancer Screening. However, the evidence of cost-effectiveness is inconclusiveaccording to the Cochrane Centre.I argue that it would be wise to undertake trials that are appropriately funded. Otherwise, there is a risk that muchmoney will be spent that cannot subsequently be justified.

Medical Research Council Clinical Psychiatry Unit

1971 ◽  
Vol 1 (5) ◽  
pp. 429-436 ◽  
Keyword(s):  
Clinical Research ◽  
Medical Research ◽  
Research Council ◽  
Medical Research Council ◽  
County Council ◽  
Regional Hospital ◽  
Sussex County ◽  
Hospital Boards ◽  
Further Development

The Clinical Research Department was started at Graylingwell Hospital, Chichester, Sussex, by Dr. J. Carse in 1947, when the hospital was administered by Sussex County Council. The first director was Dr. (now Professor) E. Stengel, and he undertook the first systematic follow-up of leucotomized patients. From 1950 to 1955 the director was Dr. Martin Roth; his studies on the psychoses of old age, and especially those delineating depressive psychoses, are now a landmark in clinical research. At about this time, the means by which clinical research in the National Health Service hospitals should be administered was reviewed and a policy evolved whereby departments in which clinical research was prospering and whose further development would make financial demands beyond those available to the regional hospital boards would be considered for support by the Medical Research Council.

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