scholarly journals Surgical Strategy for Rectovaginal Fistula After Colorectal Anastomosis at a High-volume Cancer Center According to Image Type and Colonoscopy Findings

2019 ◽  
Vol 39 (9) ◽  
pp. 5097-5103 ◽  
Author(s):  
KOJI KOMORI ◽  
TAKASHI KINOSHITA ◽  
TAIHEI OSHIRO ◽  
AKIRA OUCHI ◽  
SEIJI ITO ◽  
...  
Keyword(s):  
Rectovaginal Fistula ◽  
Colorectal Anastomosis ◽  
High Volume ◽  
Surgical Strategy ◽  
Cancer Center ◽  
Image Type

Educational system for acquiring appropriate laparoscopic colorectal surgical skills: analysis in a Japanese high-volume cancer center

2020 ◽  
Author(s):  
Ryota Nakanishi ◽  
Yosuke Fukunaga ◽  
Toshiki Mukai ◽  
Toshiya Nagasaki ◽  
Tomohiro Yamaguchi ◽  
...  
Keyword(s):  
Educational System ◽  
High Volume ◽  
Surgical Skills ◽  
Cancer Center

scholarly journals High volume pancreaticoduodenectomy performed at a community cancer center

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S38-S39
Author(s):  
A. Sabesan ◽  
B. Gough ◽  
C. Anderson ◽  
R. Abdel-Misih ◽  
N.J. Petrelli ◽  
...  
Keyword(s):  
High Volume ◽  
Cancer Center

scholarly journals Prior Authorization for Medications in a Breast Oncology Practice: Navigation of a Complex Process

2017 ◽  
Vol 13 (4) ◽  
pp. e273-e282 ◽  
Author(s):  
Ankit Agarwal ◽  
Rachel A. Freedman ◽  
Felicia Goicuria ◽  
Catherine Rhinehart ◽  
Kathleen Murphy ◽  
...  
Keyword(s):  
Care Delivery ◽  
High Volume ◽  
Cancer Center ◽  
Prior Authorization ◽  
Patient Demographics ◽  
Approval Rate ◽  
Decision Points ◽  
Oncology Practice ◽  
The Cost ◽  
The Impact

Introduction: The cost and burden associated with prior authorization (PA) for specialty medications are concerns for oncologists, but the impact of the PA process on care delivery has not been well described. We examined PA processes and approval patterns within a high-volume breast oncology clinic at a major academic cancer center. Methods: We met with institutional staff to create a PA workflow and process map. We then abstracted pharmacy and medical records for all patients with breast cancer (N = 279) treated at our institution who required a PA between May and November 2015 (324 prescriptions). We examined PA approval rates, time to approval, and associations of these outcomes with the type of medication being prescribed, patient demographics, and method of PA. Results: Seventeen possible process steps and 10 decision points were required for patients to obtain medications requiring a PA. Of the 324 PAs tracked, 316 (97.5%) were approved on the first PA request after an average time of 0.82 days (range, 0 to 14 days). Approximately half of PAs were for either palbociclib (26.5%) or pegfilgrastim (22.2%), and 13.6% of PAs were for generic hormonal therapy. Requirements to fax PA requests were associated with greater delay in approval time (1.31 v 0.17 days for online requests; P < .001). The use of specialty pharmacies increased staff burden and delays in medication receipt. Conclusion: The PA process is complicated and labor intensive. Given the high PA approval rate, it is unlikely that PA requirements reduce medication utilization in practice, and these requirements may impose unnecessary burdens on patient care. The goals and requirements for PAs should be readdressed.

scholarly journals An analysis of 37 patients with uterine leiomyosarcoma at a high-volume cancer center

2015 ◽  
Vol 12 (3) ◽  
pp. 158-163 ◽  
Author(s):  
Ulaş Solmaz ◽  
Levent Dereli ◽  
Gülşah Selvi Demirtaş ◽  
Atalay Ekin ◽  
Emre Mat ◽  
...  
Keyword(s):  
High Volume ◽  
Cancer Center ◽  
Uterine Leiomyosarcoma

Factors influencing treatment of inflammatory breast cancer in the United States.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 118-118
Author(s):  
Heather Y. Lin ◽  
Gildy Babiera ◽  
Isabelle Bedrosian ◽  
Simona Flora Shaitelman ◽  
Henry Mark Kuerer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Inflammatory Breast Cancer ◽  
Standard Of Care ◽  
High Volume ◽  
The United States ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Data ◽  
Number Of Patients ◽  
Facility Level

118 Background: Guidelines for treating inflammatory breast cancer (IBC) using trimodality (chemotherapy, surgery and radiation) therapy (TT) remain largely unchanged since 2000. However, many such patients did not receive TT. It is unknown how patient-level (PL) and facility-level (FL) factors contribute to TT utilization. Methods: Using the National Cancer Data Base (NCDB), patients who underwent surgical treatment of locoregional IBC from 2003-2011 were identified. We correlated patient, tumor, and treatment data with TT. An observed to expected (O/E) ratio of number of patients treated with TT was calculated for each hospital by adjusting for PL factors. Hierarchical mixed effects models were used to assess the proportion of variation in the use of TT attributable to PL and FL factors, respectively. Results: Among 5,537 patients who met the study criteria, the use of TT fluctuated annually (67.3%-75.7%) and was less likely for patients who were over 70, had a lower income or had an N0 tumor (all p < 0.05). By insurance type, TT use was lowest among Medicare patients. Of the 542 hospitals examined, 55 (10.1%) and 24 (4.4%) were identified as significantly low and high outliers for the use of TT (p < 0.05), respectively. While comprehensive cancer centers represented the majority of high outliers, the TT use by facility type overall was not significantly different demonstrating variability within comprehensive cancer center practice. The percentage of the total variance in the use of TT attributable to facility (11%) was almost triple the variance attributable to the measured PL factors (3.4%). Conclusions: The use of standard of care TT varied widely across facilities with some high volume centers clearly underutilizing TT. To improve clinical outcomes for this rare and aggressive malignancy, it is critical to identify facility level factors impacting the use of TT to ensure the guideline adherence of IBC treatment.

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