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  • 1
    ISSN: 1433-7339
    Keywords: Home-care services ; Cancer center ; Hospital stay ; Place of death
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The clinical data on terminal cancer patients who have died since the establishment of a program of collaboration between community services and the cancer center of Canton of Ticino, southern Switzerland, were retrospectively analyzed to describe the characteristics of patients seen and the effect on them of a home-care program coordinated by the cancer center. The home-care program is based on five geographically grouped community-based domiciliary services, with the addition of one nurse responsible for coordination and one physician from the oncology center. Selection criteria for participation in the home-care program are defined. The main outcome measures were: number of hospitalizations and median hospital stay during the last 3 months of life; reasons for and median length of last hospitalization; place of death of patients who had home care and those who did not. In the group of 993 patients analyzed, the median contact time with the cancer center was 9.5 months (10th percentile: 1 month, 90th percentile: 71 months); the most frequent neoplasm was lung cancer (22%) with the briefest contact time (7.5 months; 10th percentile: 1 month; 90th percentile: 21 months); 13.5% of patients were never hospitalized; half of the patients had a total hospital stay of 24 days or longer and 23% died at home. The sociodemographic and medical characteristics of home-care users were similar to those of the home-care nonusers and to those of the overall group. In the group of home-care users (32% of the total) 22% were never hospitalized, half of the patients had a total hospital stay of 17 days or longer, and 43.5% of them died at home. These values were significantly different (P〈0.001) from those reported in the group of home-care non-users. Palliative care, provided at home through community-based domiciliary services, is associated with less frequent and shorter hospitalizations in the last 3 months of life. Medical oncology and palliative treatments should be mutually complementary to improve patients care. Cancer centers should be involved in the planning and coordination of supportive-care domiciliary services.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-2451
    Keywords: Adenocarcinoma of the colon and rectum ; Adjuvant perioperative liver infusion ; Liver metastases ; Colorectales Carcinom ; Adjuvante, perioperative Chemotherapie ; Lebermetastasen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Untersucht wird beim colorectalen Carcinom die Wirkung einer perioperativen portalen Leberperfusion mit 5-Fluorouracil und Mitomycin C. Zur Zeit sind 409 Patienten auswertbar, 202 im Kontroll- und 207 im Behandlungsarm. Die bisherigen Resultate (März 87), bei einer Beobachtungszeit von 35 Monaten, zeigen im Behandlungsarm eine deutlich geringere Tendenz für Lebermetastasen (10,4% vs 6,3%), besonders auch in den Untergruppen (Colon 11,5% vs 6,8% und Dukes' C: 22,2% vs 6,9%). Entsprechend ist auch der Carcinom-Tod seltener (14,4% vs 12,1%; 15,8% vs 8,5% und 25,4% vs 15,5%). Die Beobachtungszeit ist für eine statistische Analyse noch zu kurz.
    Notes: Summary The efficacy of adjuvant, perioperative portal liver infusion with 5-fluorouracil and mitomycin C was investigated (409 patients, 202 control subjects, 207 treated). Liver metastases were detected in 10.4% of the untreated vs 6.3% of the treated patients. The median follow-up was 35 months. For the colon subgroups (excluding the rectum) and Dukes' C tumors alone, the corresponding results were as follows: 11.5% vs 6.8% and 22.2% vs 6.9%, respectively. Death from progressive cancer disease occurred in 14.4% vs 12.1% of all patients: 15.8% vs 8.5% (colon) and 25.4% vs 15.5% (Dukes' C), respectively. The follow-up time is too short for statistical analysis, however.
    Type of Medium: Electronic Resource
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