We conclude that the most important prognostic factors affecting survival of patients with anaplastic astrocytomas and glioblastomas multiforme are tumor grade, age, preoperative performance status, and radiation therapy. Postoperative complications adversely affect survival. Aggressive surgical resection did not impart a significant increase in survival time. Surgical resection may improve survival, but its importance is less than that of other factors and may be demonstrable only by larger studies.

Purpose Urodynamic studies have been proposed as a means of identifying patients at risk for voiding dysfunction following surgery for stress urinary incontinence We determined if preoperative urodynamic findings predict postoperative voiding dysfunction after pubovaginal sling and Burch colposuspension. Materials and Methods Data were analyzed from preoperative, standardized urodynamic studies performed on participants in the Stress Incontinence Treatment Efficacy Trial, in which women with stress urinary incontinence were randomized to undergo pubovaginal sling surgery or Burch colposuspension. Voiding dysfunction was defined as use of any bladder catheter after 6 weeks or reoperation for takedown of a pubovaginal sling or Burch colposuspension. Urodynamic study parameters studied were post void residual urine, maximum flow during non-invasive flowmetry, , maximum flow during pressure flow study (change in vesical pressure at maximum flow during pressure flow study, change in abdominal pressure at maximum flow during pressure flow study and change in detrusor pressure at maximum flow during pressure flow study. The study excluded women with preoperative post-void residual urine volume of more than > 150ml or maximum flow during noninvasive flowmetry of less than 12 ml per second unless advanced pelvic prolapse was also present. Results Of the 655 women in whom data was analyzed voiding dysfunction developed in 57 including 8 in Burch colposuspension and 49 in the pubovaginal sling groups. There were 9 patients who could not be categorized and , thus, were excluded from the remainder of the analyses (646). A total of 38 women used a catheter beyond week 6, 3 had a surgical takedown and 16 had both. All 19 women who had surgery takedown were in the pubovaginal sling group. The statistical analysis of urodynamic predictors is based on subsets of the entire cohort, including 579 with preoperative uroflowmetry, 378 women with change in vesical pressure, and 377 with change in abdominal and detrusor pressure values.. No pre-operative urodynamic study findings were associated with an increased risk of voiding dysfunction in any group. Mean maximum flow during noninvasive flowmetry values were similar among women with voiding dysfunction compared to those without voiding dysfunction in the entire group (23.4 vs. 25.7 ml per second, p=0.16), in the Burch colposuspension group (25.8 vs. 25.7ml per second, p=.98) and in the pubovaginal sling group (23.1 vs. 25.7ml per second, p=0.17). Voiding pressures and degree of abdominal straining were not associated with postoperative voiding dysfunction. Conclusions In this carefully selected group, preoperative urodynamic studies did not predict postoperative voiding dysfunction or the risk for surgical revision in the pubovaginal sling group. Our findings may be limited by our stringent exclusion criteria and studying a group believed to be at greater risk for voiding dysfunction could alter these findings. Additional analysis using subjective measures to define voiding d...

BACKGROUNDThe objective of this study was to determine the clinical response rate of the combination of weekly intravenous (IV) gemcitabine with continuous infusion fluorouracil (5‐FU) and daily oral thalidomide in patients with metastatic renal cell carcinoma (RCC).METHODSBetween June, 2000 and January, 2001, 21 patients with metastatic RCC were enrolled onto this multi‐institutional Phase II study of gemcitabine at 600 mg/m2 per day on Days 1, 8, and 15; 5‐FU at 150 mg/m2 per day by continuous IV infusion through a permanent catheter on Days 1–21; and oral thalidomide on Days 1–28 starting at a dose of 200 mg daily. After the first 2 weeks of therapy, the thalidomide dose was escalated by 100 mg per day every week to a maximum dose of 400 mg per day unless it was precluded by toxicity. Treatment cycles were repeated every 28 days.RESULTSA high rate of venous thromboembolism (VTE) was observed. Five patients developed deep vein thrombosis (DVT), three patients developed pulmonary embolization (PE), and one patient suffered a fatal cardiac arrest preceded by hemoptysis, for an overall VTE rate of 43%. Of the 18 assessable patients, there were no complete responses and 2 partial responses (objective response rate, 10%; 95% confidence interval, 1–30%).CONCLUSIONSThe addition of thalidomide to gemcitabine and 5‐FU did not improve the objective response rate previously observed with gemcitabine and 5‐FU alone and added significant vascular toxicity. The authors recommend against further development or use of this three‐drug regimen. Cancer 2002;95:1629–36. © 2002 American Cancer Society.DOI 10.1002/cncr.10847

The combination of oxaliplatin, leucovorin, and fluorouracil shows significant anti-tumor activity and a favorable toxicity profile in patients with metastatic carcinoma of the esophagus.