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Sun City Center, Nebraska, United States

Are C.,Fred and Pamela Buffett Cancer Center
JNCCN Journal of the National Comprehensive Cancer Network | Year: 2014

Gallbladder cancer is a rare and lethal malignancy. Most patients are best served at high-volume centers of excellence, where they are likely to receive evidence-based care derived from a multidisciplinary approach. Surgical resection is recommended for early-stage disease, whereas if the disease is unresectable, the treatment options include biliary drainage, gemcitabine-based combination chemotherapy, fluoropyrimidine chemoradiation, clinical trial enrollment, or best supportive care. While treatment by T-stage is straightforward in many cases, the debate regarding simple versus radical cholecystectomy is still active for patients with T1b disease. Other controversies exist over the necessity of resecting the bile duct and port sites, the extent of lymph node dissection and hepatic resections, and the value of resection for patients with jaundice. © JNCCN - Journal of the National Comprehensive Cancer Network. Source


O'Brien S.,University of Texas | Radich J.P.,Fred Hutchinson Cancer Research Center | Abboud C.N.,University of Washington | Akhtari M.,Fred and Pamela Buffett Cancer Center | And 17 more authors.
JNCCN Journal of the National Comprehensive Cancer Network | Year: 2013

The 2014 NCCN Clinical Practice Guidelines in Oncology for Chronic Myelogenous Leukemia recommend quantitative reverse-transcription polymerase chain reaction (QPCR) standardized to International Scale (IS) as the preferred method for monitoring molecular response to tyrosine kinase inhibitor (TKI) therapy. A BCR-ABL1 transcript level of 10% or less (IS) is now included as the response milestone at 3 and 6 months. Change of therapy to an alternate TKI is recommended for patients with BCR-ABL1 transcript levels greater than 10% (IS) at 3 months after primary treatment with imatinib. Continuing the same dose of TKI or switching to an alternate TKI are options for patients with BCR-ABL1 transcript levels greater than 10% (IS) at 3 months after primary treatment with dasatinib or nilotinib. The guidelines recommend 6-month evaluation with QPCR (IS) for patients with BCR-ABL1 transcript levels greater than 10% at 3 months. Monitoring with QPCR (IS) every 3 months is recommended for all patients, including those who meet response milestones at 3, 6, 12, and 18 months (BCR-ABL1 transcript level ≤10% [IS] at 3 and 6 months, complete cytogenetic response at 12 and 18 months). © JNCCN-Journal of the National Comprehensive Cancer Network. Source


Morgan Jr. R.J.,City of Hope Comprehensive Cancer Center | Alvarez R.D.,University of Alabama at Birmingham | Armstrong D.K.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Burger R.A.,Fox Chase Cancer Center | And 20 more authors.
JNCCN Journal of the National Comprehensive Cancer Network | Year: 2013

These NCCN Guidelines Insights focus on the major updates to the 2013 NCCN Guidelines for Ovarian Cancer. Four updates were selected based on recent important updates in the guidelines and on debate among panel members about recent clinical trials. The topics include 1) intraperitoneal chemotherapy, 2) CA-125 monitoring for ovarian cancer recurrence, 3) surveillance recommendations for less common ovarian histopathologies, and 4) recent changes in therapy for recurrent epithelial ovarian cancer. These NCCN Guidelines Insights also discuss why some recommendations were not made. © JNCCN-Journal of the National Comprehensive Cancer Network. Source


Coccia P.F.,Fred and Pamela Buffett Cancer Center | Pappo A.S.,University of Tennessee Health Science Center | Altman J.,Northwestern University | Bhatia S.,City of Hope Comprehensive Cancer Center | And 19 more authors.
JNCCN Journal of the National Comprehensive Cancer Network | Year: 2014

The NCCN Guidelines Insights on Adolescent and Young Adult (AYA) Oncology discuss the fertility and endocrine issues that are relevant to the management of AYA patients with cancer. Fertility preservation should be an essential part in the treatment of AYA patients with cancer. The NCCN Guidelines recommend discussion of fertility preservation and contraception before the start of treatment. Oophoropexy and embryo cryopreservation are the 2 established options for fertility preservation in women. Semen cryopreservation before the start of treatment is the most reliable and well-established method of preserving fertility in men. AYA women with cancer also have unique contraception needs, depending on the type of cancer, its treatment, and treatment-related complications. Management of cancer during pregnancy poses significant diagnostic and therapeutic challenges for both the patient and the physician. AYA women diagnosed with cancer during pregnancy require individualized treatment from a multidisciplinary team involving medical, surgical, radiation, and gynecologic oncologists; obstetricians; and perinatologists. Copyright © 2014 by the National Comprehensive Cancer Network. Source


Carroll P.R.,University of California at San Francisco | Parsons J.K.,University of California at San Diego | Andriole G.,University of Washington | Bahnson R.R.,Ohio State University | And 21 more authors.
JNCCN Journal of the National Comprehensive Cancer Network | Year: 2014

The NCCN Guidelines for Prostate Cancer Early Detection provide recommendations for men choosing to participate in an early detection program for prostate cancer. These NCCN Guidelines Insights highlight notable recent updates. Overall, the 2014 update represents a more streamlined and concise set of recommendations. The panel stratified the age ranges at which initiating testing for prostate cancer should be considered. Indications for biopsy include both a cutpoint and the use of multiple risk variables in combination. In addition to other biomarkers of specificity, the Prostate Health Index has been included to aid biopsy decisions in certain men, given recent FDA approvals. Copyright © 2014 by the National Comprehensive Cancer Network. All rights reserved. Source

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