PubMed · 15587366
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
Lise Aagaard. 2004-11-15. [Drug interactions].. https://pubmed.ncbi.nlm.nih.gov/15587366/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND: The objectives of the current study were to examine how the estimated stage-specific survival is altered in the 2002 American Joint Committee on Cancer (AJCC) melanoma staging system compared with the 1997 AJCC staging system and to contrast the predictive accuracy of the 2 staging systems. METHODS: There were 5847 consecutive melanoma patients who presented to Memorial Sloan-Kettering Cancer Center from 1996 to 2004 and who were entered prospectively into a data base. These patients were staged according to both the 1997 and 2002 AJCC staging criteria. Overall survival estimates were determined using the Kaplan-Meier method. The overall predictive accuracy of the two staging systems was compared using concordance estimation. RESULTS: In total, 1035 patients were shifted to a lower stage in the 2002 staging system, whereas only 15 patients were upstaged. The number of patients with Stage I melanoma increased by 697 under the 2002 system (n = 2166 patients) compared with the 1997 system (n = 1463 patients). Because of the changes in 2002, the estimated 5-year overall survival for patients with Stage II melanoma decreased considerably, from 79% (1997) to 64% (2002). With the initiation of subgroups in 2002, it became apparent that patients with Stage III melanoma were very heterogeneous in terms of their survival probabilities (5-yr overall survival ranged from 70% in patients with Stage IIIA disease to 24% in patients with Stage IIIC disease). Furthermore, in the 2002 system, there was substantial prognostic overlap between Stage II and Stage III. Despite the increased complexity of the 2002 system, the 2 staging systems had similar concordance estimates: 58% for the 1997 staging system compared with 58% (ignoring the subgroups) and 59% (with subgroups) for the 2002 system. CONCLUSIONS: Estimates of stage-specific survival were altered substantially by the changes made in the 2002 AJCC staging system for melanoma, particularly for Stage II. Stage subgroups that were added in the 2002 system resulted in a large diversity of risk within Stage III. This must be taken into account to stratify patients properly for clinical trials. The increased complexity of the 2002 system did not improve its predictive ability over the simpler 1997 system, highlighting the importance of developing individualized risk-prediction models.
Only recently fast-paced developments in computer technology allowed for the digitization of complete histologic slides. The resulting virtual slides may be viewed via webbrowser by any number of pathologists or students independent of time and location. Usage of a virtual microscope simply requires a computer workstation with a fast internet connection, which opens this technology to a broad public. A virtual microscopy system consists of three components: acquisition, server and client. Such systems are under development by different commercial and academic bodies worldwide. We have developed a virtual microscope system called vMic (http://www.vmic.unibas.ch) which provides virtual slides of very high image quality. Several successfully held online slide seminars and a histology course for students in dentistry are freely accessible in the internet. With the commercial availability of ultra rapid and easy-to-use slide scanners and the fast improvements of technology virtual microscopy will offer many applications in teaching, research and diagnostics. Thanks to additional functionalities, real microscopes will most likely be replaced by computer workstations in a couple of years.
Explore the source record for details and available documents.