Publications for Stephen Lepore
Allen DG, Baak J, Belpomme D, Berek JS, Bertelsen K, Huinink WW, Vanderburg ME, Calvert AH, Conte PE, Dauplat J, Eisenhauer EA, Favalli G, Hacker NF, Hamilton TC, Hansen HH, Hansen M, Vanhouwelingen HC, Kaye SB, Levin L, Lund B, Neijt JP, Ozols RF, Piccart MJ, Rustin GJ, Sessa C, Soutter WP, Thigpen JT, Trope C, Vermorken JB, Devries EG. Advanced Epithelial Ovarian-Cancer - 1993 Consensus Statements. Annals of Oncology. 1993 Jan;4:83-8.
Background: Over the last few days of a 5-day international workshop held in June 1993, a group of specialists in the field of advanced epithelial ovarian cancer tried to reach consensus on a number of issues with implications for standard practice and for research. Methods: Five groups of experts considered several issues which included: biologic factors, prognostic factors, surgery, management recommendations, dose intensity, supportive care, drug resistance, second-line treatment, investigational drugs, and tumour markers. Discussing the management recommendations, the group attempted to arrive at answers to four questions: Is there in fact a cure rate for advanced ovarlan carcinoma? Are there prognostic factors which help to identify patients who will not do well with current therapy? What is the current best therapy for advanced ovarian cancer? What directions should research take in advanced ovarian cancer? In a plenary meeting these issues were discussed. Results: Consensus statements were achieved on all topics mentioned above. This article reports on the statements written by the chairmen and approved by the consensus group.
Trock B, Rimer BK, King E, Balshem A, Cristinzio CS, Engstrom PF. Impact of an Hmo-Based Intervention to Increase Mammography Utilization. Cancer Epidemiology Biomarkers & Prevention. 1993 Mar;2(2):151-6.
A health maintenance organization (HMO)-based program designed to increase breast cancer screening was evaluated, focusing on changes in mammography utilization. The program consisted of a multistage intervention aimed at women members and primary care physicians of the HMO. This report examines the effect of the intervention on mammography utilization. The program was evaluated using a quasiexperimental design in which a random sample of women aged 50-74 from the HMO (intervention) was compared to a similarly aged geographic control group selected through random digit dialing. From 1988 to 1990, 450 intervention women and 450 control women were sampled (without replacement) each year and surveyed about breast cancer screening practices and related knowledge. A clear increase in self-reported mammography utilization was associated with the intervention. The percentage of women who reported a mammogram in the 12 months prior to the survey increased from 41% in 1988 (baseline) to 68% in 1990 among HMO women, compared to a change from 39% to 49% among control women. Comparing postintervention rates of mammography in HMO versus control women yielded a rate ratio (RR) of 1.4. However, this effect was strongly modified by income and race. Women with annual incomes of $31,000 or more showed little (whites, RR = 1.2) or no (blacks, RR = 1.0) effect of the intervention. Among women with incomes less than $31,000, the effect among whites (RR = 1.9) was much stronger than among blacks (RR = 1.2).
Fowler WC, Eisenberg BL, Hoffman JP. Hepatic Resection Following Systemic Chemotherapy for Metastatic Colorectal-Carcinoma. Journal of surgical oncology. 1992 Oct;51(2):122-5.
Increasingly effective systemic chemotherapy has improved responses in patients with previously unresectable colorectal hepatic metastases. In the future, response to chemotherapy may define a new population of patients that may benefit from hepatic resection. A retrospective review to determine the safety and effectiveness of potentially curative hepatic resection of metastatic colorectal carcinoma after systemic chemotherapy identified 11 such patients with resections between July 1987 and October 1991. Five patients had unresectable disease confined to the liver, two had hepatic and limited extrahepatic metastases, two had hepatic recurrences after previous hepatic metastasectomy, and two had initially resectable liver metastases. These patients were resected after a mean of 8 months of systemic chemotherapy. Complications, usually minor, occurred in five patients (45%). There were no deaths. Three patients are disease free at 15, 18, and 31 months (mean 21) after hepatic resection. Eight patients have recurred with a median time to recurrence of 8 months. Five patients have subsequently died of recurrent disease. This study suggests that hepatic resection following systemic chemotherapy can be performed safely and may benefit selected patients.