Survival from testicular cancer in England and Wales up to 2001

www.bjcancer.com For many years testicular cancer has been the prime example of the tumour that is chemocurable, even when metastatic. The disappointment in oncology is that these results have so far not been replicated in the more common solid tumours. Why this should be is not clear but germ-cell tumours retain sensitivity to chemotherapy in vitro and a number of mechanisms including reduced DNA repair capacity and proneness to apoptosis have been proposed (Mayer et al, 2003). Most patients with testicular cancer present after finding a lump in the testicle that may or may not be painful. A small proportion of patients present with symptoms of metastatic disease. With the exception of some patients with metastatic disease, initial treatment after first assessment is to remove the tumour by inguinal orchidectomy. Patients are staged by tumour marke

A multicentre analysis of the detection of clinically significant prostate cancer following transperineal image-fusion targeted and nontargeted systematic prostate biopsy in men at risk

BACKGROUND: Prostate biopsy guided by magnetic resonance imaging (MRI) is increasingly used to obtain tissue from men with suspected prostate cancer (PC). OBJECTIVE: To report a multicentre series of image-fusion transperineal prostate biopsies and compare the diagnostic yield of clinically significant PC (csPC) between targeted and nontargeted biopsies. DESIGN, SETTING, AND PARTICIPANTS: The study included 640 consecutive patients with elevated prostate specific antigen (PSA) presenting for first biopsy or following a previous negative transrectal biopsy under the care of 13 urologists in 11 centres in the UK (April 2014-June 2017). INTERVENTION: Multiparametric MRI was carried out in 61 approved prostate MRI centres with transperineal targeted alone (n=283) or targeted plus nontargeted (n=357) transperineal rigid image-fusion targeted biopsy (MIM-Symphony-DX). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Rates of csPC and insignificant cancer detection in targeted and nontargeted biopsies were measured using a number of thresholds to define clinical significance. The primary definition was Gleason≥4+3 or any grade ≥6mm. RESULTS AND LIMITATIONS: The mean age, median PSA, and median prostate volume for the cohort were 63.8yr (standard deviation [SD] 8.4), 6.3 ng/ml (SD 5.8), and 42.0cm3 (SD 24.7), respectively. Overall, 276/640 men (43.1%) were diagnosed with csPC. csPC was detected from targeted biopsies alone in 263/640 cases (41.1%). Of the 357 men who underwent nontargeted biopsies, three (0.8%) had csPC exclusively in nontargeted cores, with no evidence of cancer in targeted cores. Overall, 32/357 (9.0%) had csPC in nontargeted biopsies regardless of the targeted biopsy findings. Clinically insignificant disease in nontargeted biopsies was detected in 93/357 men (26.1%). Our findings were consistent across all other thresholds of clinical significance. Limitations include the lack of nontargeted biopsies in all men. CONCLUSIONS: In this large multicentre series, nontargeted prostate biopsy cores had a low yield of csPC and a high yield of clinically insignificant PC. An image-fusion targeted-biopsy-only approach maintains high detection for csPC and low detection of clinically insignificant cancers. PATIENT SUMMARY: In this report, we found that following prostate multiparametric magnetic resonance imaging and targeted transperineal biopsies of suspicious areas, the clinical value of performing additional extensive unguided biopsies of nonsuspicious areas is limited and can often find insignificant cancers that do not need treatment

As abordagens market-driven e market-driving de orientação para o mercado e inovação: proposição de um modelo integrado Market-driving strategy for market orientation: a theoretical model and suggestions for research

Direcionamentos recentes da teoria de orientação para o mercado têm apontado para a natureza eminentemente reativa das estratégias relacionadas. Argumenta-se que a abordagem tradicional - market-driven - seja excessivamente determinista e de forte conotação adaptativa perante o ambiente externo. Essa visão passa a ser complementada por uma nova perspectiva - market-driving -, pressupondo a possibilidade de que as estruturas e o comportamento do mercado possam ser modelados pelas organizações. Entretanto, ainda são incipientes os esforços na construção de um modelo de referência que possa nortear futuras pesquisas no âmbito dessa estratégia. É nessa problemática que se insere o objetivo do presente trabalho, em vistas de apresentar um modelo teórico e proposições de pesquisa sobre o tema, baseados em intensiva revisão de literatura. Como conclusão, o modelo construído permite vislumbrar os antecedentes da estratégia market-driving, suas respectivas ações de implementação e variáveis correlatas. Também se verifica a natureza complementar dessa abordagem em relação à postura tradicional de orientação. Ao final, apresentam-se as implicações acadêmicas e gerenciais do presente estudo, bem como a agenda para pesquisas futuras.<br>Recent developments in the market orientation theory have been indicating for the reactive nature of the related strategies. It argues that the traditional approach, market-driven, is excessively determinism and of strong adaptative connotation in front of external atmosphere. That vision becomes complemented by a new perspective, market-driving, presupposing that the market structures and its behavior can be modeled by the organizations. However, this theory is still incipient in the construction of a reference model that can orientate future research using that strategy. This paper looks for fulfill this gap by presenting a theoretical model and some research propositions on the theme, based on intensive literature review. As conclusion, the model allows to analyze the antecedents of the market-driving strategy, review some actions to be implemented and verify correlated variables. The complementally nature of that approach is also verified in relation to the traditional posture of orientation. At the end, some academic and managerial implications as discussed, as well as, the agenda for future research

Results of the first performance tests of the CMS electromagnetic calorimeter

CMS ECALPerformance tests of some aspects of the CMS ECAL were carried out on modules of the "barrel" sub-system in 2002 and 2003. A brief test with high energy electron beams was made in late 2003 to validate prototypes of the new Very Front End electronics. The final versions of the monitoring and cooling systems, and of the high and low voltage regulation were used in these tests. The results are consistent with the performance targets including those for noise and overall energy resolution, required to fulfil the physics programme of CMS at the LHC