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Locum Tenens Oncology Job in Medical Oncology Hematology California with CompHealth Inc
Job 0078512-0055 Practice looking for two extra physician to help out while one doctor is out sick and while they recruit for and additional doctor. 10-12 patients per day 2-3 new consults BC in Medical
Locum Tenens Oncology Job in Virginia needs Medical Oncology Coverage Virginia with CompHealth Inc
Job 0929444-0147 16-20 Patients/Day 1:4 Call night and weekends, 2nd call only Great Virginia Location We offer competitive pay that may include incentives and bonuses We coordinate and pay for your
Locum Tenens Oncology Job in Maine is needing Medical Oncolog Coverage Maine with CompHealth Inc
Job 1064412-0136 14-20 Patients/Day 1 long weekend/month (Friday 8 am - Monday 5 pm) Great Maine Location We offer competitive pay that may include incentives and bonuses We coordinate and pay for your

Annals of Oncology - current issue

in this issue
Fri, 24 Oct 2008 00:00:00 -0000

The effects of surgery on tumor growth: a century of investigations
Demicheli, R., Retsky, M. W., Hrushesky, W. J. M., Baum, M., Gukas, I. D. Fri, 24 Oct 2008 00:00:00 -0000
A few clinical investigations suggest that while primary breast cancer surgical removal favorably modifies the natural history for some patients, it may also hasten the metastatic development for others. The concepts underlying this disease paradigm, i.e. tumor homeostasis, tumor dormancy and surgery-driven enhancement of metastasis development, have a long history that is reviewed. The review reveals the context in which these concepts were conceived and structured to explain experimental data and shows that they are not so new and far fetched. The idea that surgical cancer resection has both beneficial and adverse effects upon cancer spread and growth that result from the modulation of tumor dormancy by the resection should be considered a potentially fruitful working hypothesis.
Management of patients with asymptomatic colorectal cancer and synchronous irresectable metastases
Scheer, M. G. W., Sloots, C. E. J., van der Wilt, G. J., Ruers, T. J. M. Fri, 24 Oct 2008 00:00:00 -0000
Background: In patients with asymptomatic colorectal cancer with irresectable metastatic disease, the optimal treatment strategy remains controversial. Resection of the primary tumor followed by chemotherapy when possible versus systemic chemotherapy followed by resection of the primary tumor when necessary are compared in this systematic review. Patients and methods: Seven studies reported series of patients with asymptomatic stage IV colorectal cancer and compared first-line chemotherapy with surgery for the primary tumor (n = 850 patients). Primary outcome measure was the complication rate related to the primary tumor in situ in patients receiving first-line systemic chemotherapy. Results: When leaving the primary tumor in situ, the mean complications were intestinal obstruction in 13.9% [95% confidence interval (CI) 9.6% to 18.8%] and hemorrhage in only 3.0% (95% CI 0.95% to 6.0%) of the patients. After resection, the overall postoperative morbidity ranged from 18.8% to 47.0%. Conclusions: For patients with stage IV colorectal cancer, resection of the asymptomatic primary tumor provides only minimal palliative benefit, can give rise to major morbidity and mortality and therefore potentially delays beneficial systemic chemotherapy. When presenting with asymptomatic disease, initial chemotherapy should be started and resection of the primary tumor should be reserved for the small portion of patients who develop major complications from the primary tumor.

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