1: J Pediatr Surg



Leia o título e o resumo (até métodos) e identifique os estudos:

A. Tratamento

B. Etiologia/risco

C. Prognóstico

D. Diagnóstico

1. Prospectivo

2. Retrospectivo

3. Transversal

4. Não se aplica

a. Revisão narrativa

b. Editorial

c. Relato de caso

d. Série de casos

e. Caso-controle

f. Coorte individual

g. Coortes aleatorizadas (randomizadas)

h. Estudo de acurácia (padrão-ouro)

i. Revisão Sistemática com metanálise

j. Fase I

k. Fase II

l. Fase III

m. Fase IV

(exemplo). Sobrero A, et al. Phase IV study of bevacizumab in combination with infusional fluorouracil, leucovorin and irinotecan (FOLFIRI) in first-line metastatic colorectal cancer. Oncology. 2009;77(2):113-9.

BACKGROUND: Bevacizumab (Avastin) significantly improves overall survival (OS) and progression-free survival (PFS) when combined with first-line irinotecan (IFL) plus bolus 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic colorectal cancer (CRC). This open-label, phase IV trial evaluated the efficacy and safety of first-line bevacizumab in combination with IFL and infusional 5-FU/LV (FOLFIRI). METHODS: Two-hundred and nine treatment-naïve metastatic CRC patients were enrolled and received bevacizumab and FOLFIRI every 2 weeks. Treatment was continued until disease progression. The primary objective was PFS, with additional determinations of OS, response and toxicity.

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1. Karacetin D, et al. Capecitabine and oxaliplatin (XELOX) as first-line treatment for patients with metastatic colorectal cancer. J BUON. 2009 Oct-Dec;14(4):605-8.

PURPOSE: For almost 40 years, 5-fluorouracil (5-FU) had been the only drug with demonstrated activity against (CRC), commonly used in combination with leucovorin (LV). Oxaliplatin and capecitabine are two relatively novel drugs used in the treatment of CRC. These drugs have been found to act synergistically, both in vivo and in vitro and their combination (XELOX) is highly active in metastatic colorectal cancer (mCRC). The aim of this study was to determine the safety and efficacy of XELOX in patients with mCRC. METHODS: The study endpoints were response rates, toxicity, progression free (PFS) and overall survival (OS). XELOX was administered as first line treatment to patients with mCRC. Patient selection criteria included histological confirmation of mCRC, ECOG performance status (PS) /=65 years with a discharge diagnosis of pneumonia in fiscal years 2002-2007, and at least 1 year of Department of Veterans Affairs outpatient care before the index admission.

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7. Wu C, Lee AY. Malignancy and venous thrombosis in the critical care patient. Crit Care Med. 2010 Feb;38(2 Suppl):S64-70.

Venous thromboembolic disease has significant clinical consequences. There are few data available to guide its management in the critically ill cancer patient, perhaps the most complex and challenging patient population encountered. Multiple interacting and often unique factors contribute to both the thrombotic and bleeding risk in such patients. Anticoagulants are effective for prophylaxis and treatment; heparins are the best-studied agents in this setting. Whether unfractionated or low-molecular-weight heparin is the most appropriate agent depends on the exact clinical situation. Prevention of venous thrombosis is a well-recognized health priority, but thromboprophylaxis remains underused, especially in some high-risk populations such as cancer patients. Enhanced recognition of the thrombotic risk factors and a better understanding of the risks and benefits of anticoagulant therapy are necessary to improve utilization, and much research is needed to address how to implement effective thromboprophylaxis strategies. Careful consideration of the patient's overall prognosis is necessary to develop safe, effective, and individualized approaches to treating thrombosis.

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8. Jenab M, et al. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ. 2010 Jan 21;340:b5500.

OBJECTIVE: To examine the association between pre-diagnostic circulating vitamin D concentration, dietary intake of vitamin D and calcium, and the risk of colorectal cancer in European populations. DESIGN: Nested case-control study. Setting The study was conducted within the EPIC study, a cohort of more than 520 000 participants from 10 western European countries. PARTICIPANTS: 1248 cases of incident colorectal cancer, which developed after enrolment into the cohort, were matched to 1248 controls MAIN OUTCOME MEASURES: Circulating vitamin D concentration (25-hydroxy-vitamin-D, 25-(OH)D) was measured by enzyme immunoassay. Dietary and lifestyle data were obtained from questionnaires. Incidence rate ratios and 95% confidence intervals for the risk of colorectal cancer by 25-(OH)D concentration and levels of dietary calcium and vitamin D intake were estimated from multivariate conditional logistic regression models, with adjustment for potential dietary and other confounders.

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9. Wilke LG, et al. Breast self-examination: defining a cohort still in need. Am J Surg. 2009 Oct;198(4):575-9.

BACKGROUND: The value of breast self-examination (BSE) to detect early breast cancer is controversial. METHODS: Within an institutional review board-approved prospective study, 147 high-risk women were enrolled from 2004 to 2007. Yearly clinical examination, BSE teaching, and mammography were performed simultaneously followed by interval breast magnetic resonance imaging (MRI). Women underwent additional BSE teaching at 6 months. Women reporting a mass on BSE underwent clinical evaluation.

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10. Boman KK, et al. Long-term outcomes of childhood cancer survivors in Sweden: a population-based study of education, employment, and income. Cancer. 2010 Mar 1;116(5):1385-91.

BACKGROUND: Studies of different national populations were indispensable for estimating the impact of illness-related disability on social outcomes in adult childhood cancer survivors. The effects of childhood cancer on educational attainment, employment, and income in adulthood in a Swedish setting were studied. METHODS: The study population was a national cohort of 1.46 million Swedish residents, including 1716 survivors of childhood cancer diagnosed before their 16th birthday, followed up in 2002 in registries at >25 years of age. Main outcomes were educational attainment, employment, and net income. Markers of persistent disability were considered, and outcomes were analyzed with multivariate linear and logistic regression models adjusted for age, sex, and socioeconomic indicators of the childhood households.

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11. Iyer VR, Lee SI. MRI, CT, and PET/CT for ovarian cancer detection and adnexal lesion characterization. AJR Am J Roentgenol. 2010 Feb;194(2):311-21.

OBJECTIVE: The purpose of this article is to describe the role of MR, CT, and PET/CT in the detection of ovarian cancer and the evaluation of adnexal lesions. CONCLUSION: The goal of imaging in ovarian cancer detection is to expeditiously distinguish benign adnexal lesions from those requiring further pathologic evaluation for malignancy. For lesions indeterminate on ultrasound, MRI increases the specificity of imaging evaluation, thus decreasing benign resections. CT is useful in diagnosis and treatment planning of advanced cancer. Although (18)F-FDG-avid ovarian lesions in postmenopausal women are considered suspicious for malignancy, PET/CT is not recommended for primary cancer detection because of high false-positive rates.

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12. Anand SM, et al. The role of sentinel lymph node biopsy in differentiated thyroid carcinoma. Arch Otolaryngol Head Neck Surg. 2009 Dec;135(12):1199-204.

OBJECTIVE: To determine whether sentinel lymph node (SLN) biopsy can accurately predict central compartment metastasis in patients with differentiated thyroid carcinoma. DESIGN: Prospective clinical study. SETTING: Academic tertiary care center. PATIENTS: Ninety-eight patients (82 women and 16 men; mean age, 48.3 years) underwent a total thyroidectomy and central compartment dissection. INTERVENTION: Peritumoral injection of methylene blue dye, 1%, followed by SLN biopsy. MAIN OUTCOME MEASURES: The final pathology report established the presence of metastasis among SLNs and lymph nodes that did not stain blue (non-SLNs [NSLNs]).

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13. Malone JP, et al. Early prediction of response to chemoradiotherapy for head and neck cancer: reliability of restaging with combined positron emission tomography and computed tomography. Arch Otolaryngol Head Neck Surg. 2009 Nov;135(11):1119-25.

OBJECTIVE: To assess the role of combined positron emission tomography and computed tomography (PET-CT) in predicting early treatment response at the primary site and in the neck after chemoradiotherapy (CRT) for advanced squamous cell carcinoma of the head and neck (SCCHN). DESIGN: Retrospective analysis with a median follow-up of 24 months. SETTING: Academic, tertiary referral center. PATIENTS AND INTERVENTIONS: Thirty-one patients who were treated with concomitant intra-arterial CRT underwent PET-CT 6 to 8 weeks after the completion of treatment. Patients with findings on the physical examination, CT, or PET-CT indicative of persistent disease underwent appropriate surgical intervention for pathological assessment. Patients with a complete clinical response were observed with routine follow-up physical examination for disease recurrence. No evidence of disease at least 6 months after the completion of PET-CT was considered confirmation of complete clinical response. MAIN OUTCOME MEASURES: Presence or absence of residual or recurrent disease during the follow-up period was used to calculate the sensitivity, specificity, and positive and negative predictive values of PET-CT for the primary site and the neck.

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14. Holmström B, et al. Prostate specific antigen for early detection of prostate cancer: longitudinal study. BMJ. 2009 Sep 24;339:b3537.

OBJECTIVE: To evaluate if prostate specific antigen test attains validity standards required for screening in view of recent prostate cancer screening trial results. DESIGN: Case-control study nested in longitudinal cohort. SETTING: Västerbotten Intervention Project cohort, Umeå, Sweden. PARTICIPANTS: 540 cases and 1034 controls matched for age and date of blood draw. MAIN OUTCOME MEASURE: Validity of prostate specific antigen for prediction of subsequent prostate cancer diagnosis by record linkage to cancer registry.

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15. Wang ZG, et al. Randomized clinical trial to compare the effects of preoperative oral carbohydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg. 2010 Mar;97(3):317-27.

BACKGROUND: Preoperative oral carbohydrate (OCH) reduces postoperative insulin resistance (PIR). This randomized trial investigated whether this effect is related to insulin-induced activation of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (PKB) signalling pathway. METHODS: Patients with colorectal cancer scheduled for elective open resection were randomly assigned to preoperative OCH, fasting or placebo.

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16. Kao J, et al. Phase 1 study of concurrent sunitinib and image-guided radiotherapy followed by maintenance sunitinib for patients with oligometastases: acute toxicity and preliminary response. Cancer. 2009 Aug 1;115(15):3571-80.

BACKGROUND: To determine the safety and maximum-tolerated dose of concurrent sunitinib and image-guided radiotherapy (IGRT) followed by maintenance sunitinib in oligometastastic patients. METHODS: Eligible patients had 1 to 5 sites of metastatic cancer measuring ................
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