The Experts below are selected from a list of 48693 Experts worldwide ranked by ideXlab platform
Anne Korir - One of the best experts on this subject based on the ideXlab platform.
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cervical cancer in sub saharan africa a multinational population based cohort study of care and Guideline adherence
Oncologist, 2021Co-Authors: Mirko Griesel, Tobias Paul Seraphin, Nikolaus C S Mezger, Lucia Hammerl, Jana Feuchtner, Walburga Yvonne Jokofru, Mazvita Sengayimuchengeti, Biying Liu, Samukeliso Vuma, Anne KorirAbstract:BACKGROUND Cervical cancer (CC) is the most common female cancer in many countries of sub-Saharan Africa (SSA). We assessed Treatment Guideline adherence and its association with overall survival (OS). METHODS Our observational study covered nine population-based cancer registries in eight countries: Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44-125 patients diagnosed from 2010 to 2016 were selected in each. Cancer-directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (U.S.) Guidelines. RESULTS Of 632 patients, 15.8% received CDT with curative potential: 5.2% Guideline-adherent, 2.4% with minor deviations, and 8.2% with major deviations. CDT was not documented or was without curative potential in 22%; 15.7% were diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IV disease. Adherence was not assessed in 46.9% (no stage or follow-up documented, 11.9%, or records not traced, 35.1%). The largest share of Guideline-adherent CDT was observed in Nairobi (49%) and the smallest in Maputo (4%). In patients with FIGO stage I-III disease (n = 190), minor and major Guideline deviations were associated with impaired OS (hazard rate ratio [HRR], 1.73; 95% confidence interval [CI], 0.36-8.37; HRR, 1.97; CI, 0.59-6.56, respectively). CDT without curative potential (HRR, 3.88; CI, 1.19-12.71) and no CDT (HRR, 9.43; CI, 3.03-29.33) showed substantially worse survival. CONCLUSION We found that only one in six patients with cervical cancer in SSA received CDT with curative potential. At least one-fifth and possibly up to two-thirds of women never accessed CDT, despite curable disease, resulting in impaired OS. Investments into more radiotherapy, chemotherapy, and surgical training could change the fatal outcomes of many patients. IMPLICATIONS FOR PRACTICE Despite evidence-based interventions including Guideline-adherent Treatment for cervical cancer (CC), there is huge disparity in survival across the globe. This comprehensive multinational population-based registry study aimed to assess the status quo of presentation, Treatment Guideline adherence, and survival in eight countries. Patients across sub-Saharan Africa present in late stages, and Treatment Guideline adherence is remarkably low. Both factors were associated with unfavorable survival. This report warns about the inability of most women with cervical cancer in sub-Saharan Africa to access timely and high-quality diagnostic and Treatment services, serving as guidance to institutions and policy makers. With regard to clinical practice, there might be cancer-directed Treatment options that, although not fully Guideline adherent, have relevant survival benefit. Others should perhaps not be chosen even under resource-constrained circumstances.
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cervical cancer in sub saharan africa a multinational population based cohort study on patterns and Guideline adherence of care
Oncologist, 2021Co-Authors: Mirko Griesel, Tobias Paul Seraphin, Nikolaus C S Mezger, Lucia Hammerl, Jana Feuchtner, Walburga Yvonne Jokofru, Mazvita Sengayimuchengeti, Biying Liu, Samukeliso Vuma, Anne KorirAbstract:Background Cervical cancer (CC) is the most common female cancer in many countries of sub-Saharan Africa (SSA). We assessed Treatment Guideline adherence and its association with overall survival (OS). Methods Our observational study covered nine population-based cancer registries in eight countries: Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44-125 patients diagnosed 2010-2016 were selected in each. Cancer-directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (USA) Guidelines. Results Of 632 patients, 15.8% received CDT with curative potential: 5.2% Guideline-adherent, 2.4% with minor and 8.2% major deviations. CDT was not documented or without curative potential in 22%; 15.7% were diagnosed FIGO IV disease. Adherence was not assessed in 46.9% (no stage or follow-up documented 11.9%) or records not traced (35.1%). The largest share of Guideline-adherent CDT was observed in Nairobi (49%), the smallest in Maputo (4%). In FIGO I-III patients (n=190), minor and major Guideline deviations were associated with impaired OS: hazard rate ratio (HRR) 1.73, 95% confidence interval (CI) 0.36-8.37; and HRR 1.97, CI 0.59-6.56 respectively. CDT without curative potential (HRR 3.88, CI 1.19-12.71) and no CDT (HRR 9.43, CI 3.03-29.33) showed substantially worse survival. Conclusion We found only one in six cervical cancer patients in SSA received CDT with curative potential. At least one-fifth and possibly up to two thirds of women never accessed CDT, despite curable disease, resulting in impaired OS. Investments into more radiotherapy, chemotherapy, and surgical training could change the fatal outcomes of many patients.
Sascha Fauser - One of the best experts on this subject based on the ideXlab platform.
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Central serous chorioretinopathy: Towards an evidence-based Treatment Guideline.
Progress in retinal and eye research, 2019Co-Authors: Thomas J. Van Rijssen, Elon H. C. Van Dijk, Suzanne Yzer, Jan E.e. Keunen, Reinier O. Schlingemann, Sobha Sivaprasad, Giuseppe Querques, Susan M. Downes, Sascha FauserAbstract:Central serous chorioretinopathy (CSC) is a common cause of central vision loss, primarily affecting men 20-60 years of age. To date, no consensus has been reached regarding the classification of CSC, and a wide variety of interventions have been proposed, reflecting the controversy associated with treating this disease. The recent publication of appropriately powered randomised controlled trials such as the PLACE trial, as well as large retrospective, non-randomised Treatment studies regarding the Treatment of CSC suggest the feasibility of a more evidence-based approach when considering Treatment options. The aim of this review is to provide a comprehensive overview of the current rationale and evidence with respect to the variety of interventions available for treating CSC, including pharmacology, laser Treatment, and photodynamic therapy. In addition, we describe the complexity of CSC, the challenges associated with treating CSC, and currently ongoing studies. Many Treatment strategies such as photodynamic therapy using verteporfin, oral mineralocorticoid antagonists, and micropulse laser Treatment have been reported as being effective. Currently, however, the available evidence suggests that half-dose (or half-fluence) photodynamic therapy should be the Treatment of choice in chronic CSC, whereas observation may be the preferred approach in acute CSC. Nevertheless, exceptions can be considered based upon patient-specific characteristics.
Mirko Griesel - One of the best experts on this subject based on the ideXlab platform.
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cervical cancer in sub saharan africa a multinational population based cohort study of care and Guideline adherence
Oncologist, 2021Co-Authors: Mirko Griesel, Tobias Paul Seraphin, Nikolaus C S Mezger, Lucia Hammerl, Jana Feuchtner, Walburga Yvonne Jokofru, Mazvita Sengayimuchengeti, Biying Liu, Samukeliso Vuma, Anne KorirAbstract:BACKGROUND Cervical cancer (CC) is the most common female cancer in many countries of sub-Saharan Africa (SSA). We assessed Treatment Guideline adherence and its association with overall survival (OS). METHODS Our observational study covered nine population-based cancer registries in eight countries: Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44-125 patients diagnosed from 2010 to 2016 were selected in each. Cancer-directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (U.S.) Guidelines. RESULTS Of 632 patients, 15.8% received CDT with curative potential: 5.2% Guideline-adherent, 2.4% with minor deviations, and 8.2% with major deviations. CDT was not documented or was without curative potential in 22%; 15.7% were diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IV disease. Adherence was not assessed in 46.9% (no stage or follow-up documented, 11.9%, or records not traced, 35.1%). The largest share of Guideline-adherent CDT was observed in Nairobi (49%) and the smallest in Maputo (4%). In patients with FIGO stage I-III disease (n = 190), minor and major Guideline deviations were associated with impaired OS (hazard rate ratio [HRR], 1.73; 95% confidence interval [CI], 0.36-8.37; HRR, 1.97; CI, 0.59-6.56, respectively). CDT without curative potential (HRR, 3.88; CI, 1.19-12.71) and no CDT (HRR, 9.43; CI, 3.03-29.33) showed substantially worse survival. CONCLUSION We found that only one in six patients with cervical cancer in SSA received CDT with curative potential. At least one-fifth and possibly up to two-thirds of women never accessed CDT, despite curable disease, resulting in impaired OS. Investments into more radiotherapy, chemotherapy, and surgical training could change the fatal outcomes of many patients. IMPLICATIONS FOR PRACTICE Despite evidence-based interventions including Guideline-adherent Treatment for cervical cancer (CC), there is huge disparity in survival across the globe. This comprehensive multinational population-based registry study aimed to assess the status quo of presentation, Treatment Guideline adherence, and survival in eight countries. Patients across sub-Saharan Africa present in late stages, and Treatment Guideline adherence is remarkably low. Both factors were associated with unfavorable survival. This report warns about the inability of most women with cervical cancer in sub-Saharan Africa to access timely and high-quality diagnostic and Treatment services, serving as guidance to institutions and policy makers. With regard to clinical practice, there might be cancer-directed Treatment options that, although not fully Guideline adherent, have relevant survival benefit. Others should perhaps not be chosen even under resource-constrained circumstances.
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cervical cancer in sub saharan africa a multinational population based cohort study on patterns and Guideline adherence of care
Oncologist, 2021Co-Authors: Mirko Griesel, Tobias Paul Seraphin, Nikolaus C S Mezger, Lucia Hammerl, Jana Feuchtner, Walburga Yvonne Jokofru, Mazvita Sengayimuchengeti, Biying Liu, Samukeliso Vuma, Anne KorirAbstract:Background Cervical cancer (CC) is the most common female cancer in many countries of sub-Saharan Africa (SSA). We assessed Treatment Guideline adherence and its association with overall survival (OS). Methods Our observational study covered nine population-based cancer registries in eight countries: Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44-125 patients diagnosed 2010-2016 were selected in each. Cancer-directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (USA) Guidelines. Results Of 632 patients, 15.8% received CDT with curative potential: 5.2% Guideline-adherent, 2.4% with minor and 8.2% major deviations. CDT was not documented or without curative potential in 22%; 15.7% were diagnosed FIGO IV disease. Adherence was not assessed in 46.9% (no stage or follow-up documented 11.9%) or records not traced (35.1%). The largest share of Guideline-adherent CDT was observed in Nairobi (49%), the smallest in Maputo (4%). In FIGO I-III patients (n=190), minor and major Guideline deviations were associated with impaired OS: hazard rate ratio (HRR) 1.73, 95% confidence interval (CI) 0.36-8.37; and HRR 1.97, CI 0.59-6.56 respectively. CDT without curative potential (HRR 3.88, CI 1.19-12.71) and no CDT (HRR 9.43, CI 3.03-29.33) showed substantially worse survival. Conclusion We found only one in six cervical cancer patients in SSA received CDT with curative potential. At least one-fifth and possibly up to two thirds of women never accessed CDT, despite curable disease, resulting in impaired OS. Investments into more radiotherapy, chemotherapy, and surgical training could change the fatal outcomes of many patients.
Thomas J. Van Rijssen - One of the best experts on this subject based on the ideXlab platform.
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Central serous chorioretinopathy: Towards an evidence-based Treatment Guideline.
Progress in retinal and eye research, 2019Co-Authors: Thomas J. Van Rijssen, Elon H. C. Van Dijk, Suzanne Yzer, Jan E.e. Keunen, Reinier O. Schlingemann, Sobha Sivaprasad, Giuseppe Querques, Susan M. Downes, Sascha FauserAbstract:Central serous chorioretinopathy (CSC) is a common cause of central vision loss, primarily affecting men 20-60 years of age. To date, no consensus has been reached regarding the classification of CSC, and a wide variety of interventions have been proposed, reflecting the controversy associated with treating this disease. The recent publication of appropriately powered randomised controlled trials such as the PLACE trial, as well as large retrospective, non-randomised Treatment studies regarding the Treatment of CSC suggest the feasibility of a more evidence-based approach when considering Treatment options. The aim of this review is to provide a comprehensive overview of the current rationale and evidence with respect to the variety of interventions available for treating CSC, including pharmacology, laser Treatment, and photodynamic therapy. In addition, we describe the complexity of CSC, the challenges associated with treating CSC, and currently ongoing studies. Many Treatment strategies such as photodynamic therapy using verteporfin, oral mineralocorticoid antagonists, and micropulse laser Treatment have been reported as being effective. Currently, however, the available evidence suggests that half-dose (or half-fluence) photodynamic therapy should be the Treatment of choice in chronic CSC, whereas observation may be the preferred approach in acute CSC. Nevertheless, exceptions can be considered based upon patient-specific characteristics.
Nikolaus C S Mezger - One of the best experts on this subject based on the ideXlab platform.
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cervical cancer in sub saharan africa a multinational population based cohort study of care and Guideline adherence
Oncologist, 2021Co-Authors: Mirko Griesel, Tobias Paul Seraphin, Nikolaus C S Mezger, Lucia Hammerl, Jana Feuchtner, Walburga Yvonne Jokofru, Mazvita Sengayimuchengeti, Biying Liu, Samukeliso Vuma, Anne KorirAbstract:BACKGROUND Cervical cancer (CC) is the most common female cancer in many countries of sub-Saharan Africa (SSA). We assessed Treatment Guideline adherence and its association with overall survival (OS). METHODS Our observational study covered nine population-based cancer registries in eight countries: Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44-125 patients diagnosed from 2010 to 2016 were selected in each. Cancer-directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (U.S.) Guidelines. RESULTS Of 632 patients, 15.8% received CDT with curative potential: 5.2% Guideline-adherent, 2.4% with minor deviations, and 8.2% with major deviations. CDT was not documented or was without curative potential in 22%; 15.7% were diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IV disease. Adherence was not assessed in 46.9% (no stage or follow-up documented, 11.9%, or records not traced, 35.1%). The largest share of Guideline-adherent CDT was observed in Nairobi (49%) and the smallest in Maputo (4%). In patients with FIGO stage I-III disease (n = 190), minor and major Guideline deviations were associated with impaired OS (hazard rate ratio [HRR], 1.73; 95% confidence interval [CI], 0.36-8.37; HRR, 1.97; CI, 0.59-6.56, respectively). CDT without curative potential (HRR, 3.88; CI, 1.19-12.71) and no CDT (HRR, 9.43; CI, 3.03-29.33) showed substantially worse survival. CONCLUSION We found that only one in six patients with cervical cancer in SSA received CDT with curative potential. At least one-fifth and possibly up to two-thirds of women never accessed CDT, despite curable disease, resulting in impaired OS. Investments into more radiotherapy, chemotherapy, and surgical training could change the fatal outcomes of many patients. IMPLICATIONS FOR PRACTICE Despite evidence-based interventions including Guideline-adherent Treatment for cervical cancer (CC), there is huge disparity in survival across the globe. This comprehensive multinational population-based registry study aimed to assess the status quo of presentation, Treatment Guideline adherence, and survival in eight countries. Patients across sub-Saharan Africa present in late stages, and Treatment Guideline adherence is remarkably low. Both factors were associated with unfavorable survival. This report warns about the inability of most women with cervical cancer in sub-Saharan Africa to access timely and high-quality diagnostic and Treatment services, serving as guidance to institutions and policy makers. With regard to clinical practice, there might be cancer-directed Treatment options that, although not fully Guideline adherent, have relevant survival benefit. Others should perhaps not be chosen even under resource-constrained circumstances.
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cervical cancer in sub saharan africa a multinational population based cohort study on patterns and Guideline adherence of care
Oncologist, 2021Co-Authors: Mirko Griesel, Tobias Paul Seraphin, Nikolaus C S Mezger, Lucia Hammerl, Jana Feuchtner, Walburga Yvonne Jokofru, Mazvita Sengayimuchengeti, Biying Liu, Samukeliso Vuma, Anne KorirAbstract:Background Cervical cancer (CC) is the most common female cancer in many countries of sub-Saharan Africa (SSA). We assessed Treatment Guideline adherence and its association with overall survival (OS). Methods Our observational study covered nine population-based cancer registries in eight countries: Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44-125 patients diagnosed 2010-2016 were selected in each. Cancer-directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (USA) Guidelines. Results Of 632 patients, 15.8% received CDT with curative potential: 5.2% Guideline-adherent, 2.4% with minor and 8.2% major deviations. CDT was not documented or without curative potential in 22%; 15.7% were diagnosed FIGO IV disease. Adherence was not assessed in 46.9% (no stage or follow-up documented 11.9%) or records not traced (35.1%). The largest share of Guideline-adherent CDT was observed in Nairobi (49%), the smallest in Maputo (4%). In FIGO I-III patients (n=190), minor and major Guideline deviations were associated with impaired OS: hazard rate ratio (HRR) 1.73, 95% confidence interval (CI) 0.36-8.37; and HRR 1.97, CI 0.59-6.56 respectively. CDT without curative potential (HRR 3.88, CI 1.19-12.71) and no CDT (HRR 9.43, CI 3.03-29.33) showed substantially worse survival. Conclusion We found only one in six cervical cancer patients in SSA received CDT with curative potential. At least one-fifth and possibly up to two thirds of women never accessed CDT, despite curable disease, resulting in impaired OS. Investments into more radiotherapy, chemotherapy, and surgical training could change the fatal outcomes of many patients.
