ABSTRACT
BACKGROUND: Bevacizumab is an angiogenesis inhibitor and a new therapy for the treatment of colorectal cancer. It is a humanized monoclonal antibody that targets vascular endothelial growth factor. METHODS: This review is based on a literature search of Medline, Pubmed, ISI web of knowledge and other published work for original articles, reviews and abstracts relevant to the surgical management of colorectal cancer with bevacizumab. RESULTS AND CONCLUSION: Combined with current chemotherapy regimens, bevacizumab offers a significant survival advantage, making it likely to see widespread use. Despite being generally well tolerated, serious toxicities, including wound complications and gastrointestinal perforation, have been reported that affect surgical management. Consideration should be given to the timing of surgical and adjuvant intervention when using this drug.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents/therapeutic use , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/surgery , Angiogenesis Inhibitors/adverse effects , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Antineoplastic Agents/adverse effects , Bevacizumab , Combined Modality Therapy , Humans , Neovascularization, Pathologic/drug therapy , Postoperative Complications/chemically induced , Treatment Outcome , Up-Regulation , Vascular Endothelial Growth Factor A/metabolism , Wound Healing/drug effectsABSTRACT
In this paper we have shown that the statements made in our original paper and disputed by Sloane and Lee are not ". . . . .at least partially in error." Concerning the first two areas of disagreement, Sloane and Lee's analysis did not address the conclusions that we reached and, therefore, could not refute them. In the first instance the observations of Sloane and Lee are useful in understanding how one of the effects we observed occurred, but in the second area the usefulness of their analysis is not at all clear. The third area of disagreement resulted because Sloane and Lee paid insufficient attention to the observed sample relationships and used a statistical test that is inefficient for the type of data used. Of course, our disagreement is not with log-linear methodology, but with its inappropriate application and interpretation by Sloane and Lee. In two instances they used results from the log-linear procedures to address issues that could not be addressed by those particular results, and in another instance they used a log-linear test of statistical significance when a more efficient alternative provides a different picture. The problems associated with the Sloane and Lee analysis illustrate the importance of precise specification of the substantive issues being investigated and the careful interpretation of the substantive implications of the original data and statistical results.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Family Planning Services , Fertility , Parity , Adult , Child , Demography , Educational Status , Family Characteristics , Female , Humans , Male , Marriage , MichiganABSTRACT
Changing fertility expectations and preferences from 1962 to 1977 are compared with final parity in a longitudinal study. Results are strongly affected by initial parity in 1962. Final parity, 27 percent below expectations for those initially childless, illustrates the effect for couples free to change expectations downward of declining fertility preferences. Changes in expectations early in marriage had a significant long-term effect on final parity, as did early differences between wife's expectations and husband's preferences. unplanned births increased final parity significantly. Religion, education, and income had no systematic relation to the discrepancy between initial expectations and final parity.
