Clinical Versus Pathologic Laryngeal Cancer Staging and the Impact of Stage Change on Outcomes

2020 ◽  
Author(s):  
Kevin J. Contrera ◽  
Bryan B. Hair ◽  
Brandon Prendes ◽  
Chandana A. Reddy ◽  
David I. Zimmer ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Cancer Staging ◽  
Stage Change ◽  
The Impact

scholarly journals Well-Being of Caregivers of Patients with Laryngeal Cancer Treated by Radiotherapy

2020 ◽  
Vol 24 (02) ◽  
pp. e170-e174
Author(s):  
Therese Karlsson ◽  
Mia Johansson ◽  
Caterina Finizia
Keyword(s):  
Laryngeal Cancer ◽  
Negative Impact ◽  
Early Stage ◽  
Depression Scale ◽  
Well Being ◽  
Hospital Treatment ◽  
Curative Intent ◽  
Treatment Pathway ◽  
Male Caregivers ◽  
The Impact

Abstract Introduction Laryngeal cancer is the second most common head and neck cancer, but no study to date reports exclusively on the well-being of the caregivers of patients with laryngeal cancer treated by radiotherapy. Objective The present prospective pilot study aims to describe the impact of the work on the well-being of the caregivers of patients with laryngeal cancer. Methods The caregivers of patients undergoing radiotherapy with curative intent for laryngeal cancer were included in the present study, and they were asked to fill out a specific questionnaire, while the patients filled out the Hospital Anxiety and Depression Scale (HADS) following diagnosis but prior to treatment. Results A total of 50 caregivers were included, 20% of which were male, and 80%, female. In total, 62% (n = 31) of the caregivers were spouses, while the remaining were daughters/sons (n = 11; 22%), siblings (n = 6; 12%), or they were classified as “other” (n = 2; 4%). The female caregivers scored lower (worse) on the depression/worry domain, and this was statistically significant (p = 0.047); they also reported a statistically significant higher negative impact on employment (p = 0.011) compared with the male caregivers. In general, the caregivers of patients with late-stage tumors tended to report lower (worse) scores on all domains (except hospital contact) compared with the caregivers of patients with early-stage tumors. No other differences were observed regarding the patients' age, gender, tumor site or their HADS score. Conclusion The diagnosis and treatment of laryngeal cancer impacts the caregiver's psychological well-being, particularly that of female caregivers. This should be taken into consideration when the patients begin the hospital treatment pathway. However, larger studies are needed to target resources more appropriately.

Systematic review of the impact of endoscopic ultrasound on the management of patients with esophageal cancer

2008 ◽  
Vol 24 (01) ◽  
pp. 25-35 ◽  
Author(s):  
Suzanne M. Dyer ◽  
Dane B. Levison ◽  
Robert Y. Chen ◽  
Sarah J. Lord ◽  
Stephen Blamey
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Endoscopic Ultrasound ◽  
Patient Management ◽  
Patient Survival ◽  
Cancer Staging ◽  
Therapeutic Impact ◽  
Impact Studies ◽  
The Impact

Objectives:Although endoscopic ultrasound (EUS) staging of esophageal cancer is established in clinical practice, high-quality evidence about its impact on patient outcomes is not available. This study aims to determine the impact of EUS for esophageal cancer staging on patient management and survival.Methods:A systematic review was conducted using Medline, PreMedline, Embase, and The Cochrane Library. Included studies were (i) comparative studies reporting survival following EUS esophageal cancer staging, (ii) therapeutic impact studies reporting change in patient management following EUS. The quality of included studies was critically appraised.Results:One systematic review, five studies reporting therapeutic impact, and two studies reporting patient survival were identified. The design and quality of the therapeutic impact studies varied widely. Management changed in 24–29 percent of patients following EUS staging of esophageal cancer (two studies). No studies provided data on the avoidance of surgery for this indication. One retrospective cohort study with historical control found EUS staging of esophageal cancer improved patient survival; a second study with similar design limitations did not find a survival benefit for EUS staging in patients undergoing resection. These studies had a high potential for bias, limiting the value of these findings.Conclusions:Two studies provided evidence of a change in patient management following EUS for staging esophageal cancer, a higher level of evidence for a clinical benefit than can be obtained from accuracy studies alone. This evidence contributed to a recommendation for public funding of EUS in staging esophageal cancer in Australia.

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