Identifying the Causes of Cancer Readmissions: A Patient Centered Approach

While there are large efforts to decrease readmission rates in the United States, cancer patients represent a population that has been overlooked. Cancer patients are a vulnerable population who make up a large portion of hospital readmissions. Most of the current research on the causes of readmissions in cancer patients focuses on medical chart reviews and insurance claims. Many of these studies fail to incorporate patient input which could further the understanding of the complete burden associated with cancer readmissions. The goal of this study is to understand the personal reasons behind the decision of cancer patients to return to the hospital, resulting in a readmission. This qualitative study will use a semi-structured interview guide to interview readmitted patients that are under the care of the Sidney Kimmel Cancer Center Medical Oncology Service at Thomas Jefferson University Hospital. All interviews will be conducted by trained interviewers, and then transcribed verbatim. NVivo 12, a qualitative software program will be used to analyze themes and trends between interviews. Data displays (table, graphic, etc) will be used to look for interrelationships between interviews and to draw conclusions. Results from this project could highlight potential areas of improvement for cancer patient care. This inductive research project intends to generate a hypothesis from the results to be used for further deductive research on the topic of cancer patient readmissions

Influence of bevacizumab on vaginal cuff evisceration eight months after ovarian cancer cytoreduction surgery: A case report.

•44 year old woman treated with bevacizumab for metastatic epithelial ovarian cancer•The patient experienced vaginal cuff dehiscence and evisceration at 8 months post-operatively.•Metastasis at the surgical site and chronic inflammation implicated

Adjuvant vaginal cuff brachytherapy for high-risk, early stage endometrial cancer.

PURPOSE: To report outcomes following adjuvant high-dose-rate vaginal brachytherapy (VBT) with or without chemotherapy for high-intermediate risk (HIR) and high-risk, early stage endometrial cancer as defined in Gynecologic Oncology Group trial 0249. MATERIAL AND METHODS: From May 2000 to January 2014, 68 women with HIR and high-risk endometrial cancer underwent surgical staging followed by VBT. Median VBT dose was 21 Gy delivered in three fractions prescribed to 0.5 cm depth. Paclitaxel 175 mg/m(2) and carboplatin area under the curve 6 was administered every 21 days in sequence with VBT. Actuarial survival estimates were calculated using the Kaplan-Meier method. RESULTS: Patient demographics included a median age of 66 years (range: 36-91) and stages IA (49%), IB (38%), and II (13%), respectively. Thirty-one (46%) patients had HIR disease with endometrioid histology, and 33 (48%) patients had serous or clear cell histology. Thirty-seven (54%) patients received a median 3 cycles (range: 3-6) of chemotherapy in addition to VBT, and 65 patients (96%) completed all prescribed therapy. During a median follow up of 33.1 months (range: 4.0-161.7), four patients have recurred, including one vaginal recurrence. The 3-year estimates of vaginal, pelvic, and distant recurrences were 1.9%, 2.4%, and 9.1%, respectively. The 3-year rates of disease-free and overall survival were 87.7% and 93.9%, respectively. CONCLUSIONS: Early outcomes with adjuvant VBT with or without chemotherapy demonstrate high rates of vaginal and pelvic control for women with HIR disease. Early vaginal and pelvic relapses in high-risk patients suggest that pelvic external beam radiotherapy is warranted in this subgroup, but additional data from large phase III trials is warranted