Oncology Research Today is a free monthly online journal that collates and summarizes the latest research about Oncology, including details on cancer, surgery, chemotherapy, radiotherapy.

Development of Communities of Practice to Facilitate Quality Improvement Initiatives in Surgical Oncology.

Fung-Kee-Fung M, Goubanova E, Sequeira K, Abdulla A, Cook R, Crossley C, Langer B, Smith AJ, Stern H

Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada (Messrs Fung-Kee-Fung and Stern); and Cancer Care Ontario, Toronto, Ontario, Canada (Messrs Fung-Kee-Fung, Crossley, Langer, Smith, and Stern, and Mss Goubanova, Sequeira, Abdulla, and Cook).

BACKGROUND: The process of developing clinical guidelines and standards for cancer treatment and screening is well established in the Ontario health care system; however, the dissemination and implementation of such guidelines and standards are more recent undertakings. Traditional implementation strategies to improve surgical practice and the delivery of cancer care have not been consistently effective. There is a recognized need to develop integrated models that offer direct support for implementation strategies. Such a model should be feasible, adaptable, and open to evaluation across diverse surgical settings. DISCUSSION: Research suggests that successful implementation should consider tools and expertise from other disciplines. This article considers a community of practice (COP) model to provide a supportive infrastructure for quality improvements in cancer surgery. The COP model was adapted for cancer surgeons. It is supported by 5 enablers referred to as tools: communication system, project development support, access to data, access to evidence review, and accreditation with continued medical education and continued professional development. These tools need to be part of an infrastructure that is both provided and supported by a team of administrators and health care professionals, who have active roles and responsibilities. Therefore, the primary objective of this article is to describe our COP model in cancer surgery including the key success factors necessary for providing the infrastructure and tools. The secondary objective is to offer the integrated COP model as a basis for future research and the evaluation of various collaborative improvement projects. SUMMARY: Building on knowledge management concepts, we identified the 4 essential processes that should be targeted by implementation strategies. A common COP evaluation framework uses the outcomes of 4 knowledge conversion modes-organizational memory, social capital, innovation, and knowledge transfer-as proxies for actual provider and organizational behavior. Insights from different collaborative improvement projects described in a consistent way could inform future research and assist in the collation of systematic reviews on this topic.

Published 25 April 2008 in Qual Manag Health Care, 17(2): 174-185.
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Articles on Oncology published 23 April 2008:

The principle of respect for autonomy - concordant with the experience of oncology physicians and molecular biologists in their daily work?   BMC Med Ethics, 9: 5.

BACKGROUND: This article presents results from a qualitative empirical investigation of how Danish oncology physicians and Danish molecular biologists experience the principle of respect for autonomy in their daily work. METHODS: This study is based on 12 semi-structured interviews with three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university ... [Abstract] [Full-text]

Survival of children with cancer in Italy, 1989-98. A report from the hospital based registry of the Italian Association of Paediatric Haematology and Oncology (AIEOP).   Eur J Cancer.

We describe the survival patterns of 10,791 Italian children (age 0-14) diagnosed with cancer during 1989-1998 and who were included in the hospital-based registry of the Italian Association of Paediatric Haematology and Oncology. Five-year cumulative survival percentages were 76% for lymphoproliferative disorders and 68% for solid tumours. Survival rates in 1994-1998 significantly improved for acute lymphocytic leukaemia (ALL), acute non-lymphocytic leukaemia, Hodgkin's lymphoma and Wilms' ... [Abstract] [Full-text]

Validation of FACT/GOG-AD subscale for ovarian cancer-related abdominal discomfort: A Gynecologic Oncology Group study.   Gynecol Oncol.

OBJECTIVE: To evaluate the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Abdominal Discomfort (FACT/GOG-AD) subscale for assessing abdominal discomfort in patients undergoing treatment for ovarian cancer. METHODS: A four-item questionnaire was developed for use in Gynecologic Oncology Group (GOG) protocol 172. It was administered to patients with advanced ovarian cancer treated on this protocol with intravenous (IV) cisplatin/paclitaxel or a combination of intravenous and ... [Abstract] [Full-text]

Articles on Oncology published 22 April 2008:

Surgical versus radiographic determination of para-aortic lymph node metastases before chemoradiation for locally advanced cervical carcinoma : a Gynecologic Oncology Group study.   Cancer, 112(9): 1954-1963.

BACKGROUND: Patients with cervical cancer who had negative para-aortic lymph nodes (PALNs) identified by pretreatment surgical staging were compared with patients who had only radiographic exclusion of PALN metastases before they received treatment with pelvic radiation and brachytherapy (RT) plus cisplatin (C)-based chemotherapy. METHODS: Patients who participated in 1 of 3 Phase III Gynecologic Oncology Group (GOG) trials (GOG 85, GOG 120, and GOG 165) and who were assigned randomly to ... [Abstract] [Full-text]

Surgical strategies in the management of ecthyma gangrenosum in paediatric oncology patients.   Pediatr Surg Int.

Clinical presentation and microbiology profiles of neutropenic paediatric oncology patients presenting with ecthyma gangrenosum (EG) were studied. Surgical strategies deployed for these critically ill children are reported. Between 1994 and 2005, all children with EG were identified. Case notes were reviewed. Hospital course and long-term outcome were documented. Ten patients were identified. Eight had acute lymphoblastic leukaemia, one child had acute myeloid leukaemia and another had ... [Abstract] [Full-text]

Articles on Oncology published 21 April 2008:

Mistletoe therapy in oncology.   Cochrane Database Syst Rev.

BACKGROUND: Mistletoe extracts are commonly used in cancer patients. It is claimed that they improve survival and quality of life (QOL) in cancer patients. OBJECTIVES: To determine the effectiveness, tolerability and safety of mistletoe extracts given either as monotherapy or adjunct therapy for patients with cancer. SEARCH STRATEGY: Search sources included the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2007) Cochrane Complementary Medicine Field Registry of randomized ... [Abstract] [Full-text]

Cyclin-dependent kinase 9: a key transcriptional regulator and potential drug target in oncology, virology and cardiology.   Trends Pharmacol Sci.

Unlike other CDKs, CDK9 does not regulate the cell cycle but promotes RNA synthesis in genetic programmes for cell growth, differentiation and viral pathogenesis. It is becoming clear that CDK9 inhibition contributes to the anticancer activity of most CDK inhibitors under clinic investigation. CDK9 was discovered in the context of HIV research because retroviruses hijack host transcription and CDK9 inhibitors might become specific antiretroviral agents, particularly as they might prevent drug ... [Abstract] [Full-text]

Symptoms and signs of port-related infections in oncology patients related to the offending pathogens.   Int J Clin Pract.

Aim: There is limited information about symptoms and signs of port-related infections linking to their offending pathogens. Methods: Oncology patients proven to have port-related infections were retrospectively analysed. We divided them into two subgroups according to their symptoms and signs. Onset of fever and chills with or without hypotension following the port flush was classified as 'port flush form infection'. Presence of local inflammatory signs, including erythema, warmth, tenderness ... [Abstract] [Full-text]

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