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The advent of prophylactic mastectomy and the new surgical techniques that are available has encouraged the use of nipple-sparing mastectomy. This Perspectives article examines this technique in terms of aesthetics, contraindications, side effects and recurrence, and outlines why, in the authors' opinion, nipple-sparing mastectomy should be offered to patients with breast cancer and those at high risk.
Since the issue of the seventh edition of the TNM classification guidelines for colorectal cancer there has been discussion about some of the associated changes in classification and stage. This Perspectives article examines the impact a new staging system can have on patient care, and makes suggestions for how the constant re-evaluation of classification guidelines could be improved going forward.
Many trials report progression-free survival rather than overall survival outcomes but few trials have good quality-of-life data collected via patient-reported outcome measures. The authors describe what is understood by progression-free survival, and discuss what this means for patients with advanced-stage cancer and what factors should be taken into account when clinicians try to help patients considering treatment options.
The use of therapy that is truly targeted to the needs and biological requirements of an individual patient is an aim for many in the oncology field. Jackson and Sood discuss the implications of targeted therapies on patients and the health-care system and discuss methods that might be used to maximize efficiency, cost effectiveness and patient survival.
The optimal treatment for patients with advanced-stage Hodgkin lymphoma is an ongoing controversy. A recent trial seemed to answer some of the important open questions in the field; however, closer examination of the data indicates that the answers are not as clear as they might initially seem.
From 1989 to 2003, 709 phase III trials evaluating systemic cancer treatment were presented at ASCO meetings. Tam and collaborators have now reported that 9% of these trials were never published, and 13% were published after a 5-year delay. More than half of these studies would have had clinical impact if published promptly.
Elderly patients have often been excluded from, or under represented in, clinical trials. Now, a phase III trial has demonstrated that a platinum-based doublet regimen provides superior outcomes in elderly patients with advanced-stage non-small-cell lung cancer, and should be considered for palliative chemotherapy in this group of patients.
The ability to follow the distribution and migration of biologically active cells in living organisms is crucial for the development of cell-based therapies. In this Review, Kircher et al. describe the imaging principles underlying currently available cell-tracking methods and highlight recent examples of their application in animal models and patients.
