[ close window ] email this please enter a recipient address and/or check the send me a copy checkbox. cheap viagra india Your email has been sent. Your name:  copy me on this email () recipient's email:  separate multiple email addresses with commas (limit is 10). Subject:  optional message:  visit this blog's front page oncnotes ampullary carcinoma: espac-3 at asco alok khorana, md, oncology, medical, 02:42pm jun 23, 2011 ampullary cancers are difficult to treat, because of a lack of evidence base given the rarity of the diagnosis. viagra 20 yr old For the most part, these patients are treated by extrapolation from similar malignancies such as pancreatic.   prior papers have suggested a benefit for adjuvant treatment, but these are based on single-institution studies with historical cohort comparions.   in the first and only large randomized study of adjuvant therapy in ampullary adenocarcinoma, results presented at asco were encouraging. The authors randomized 304 patients over an 8 yr period to receive either 5-fu (mayo clinic regimen), gemcitabine or observation. Patients were stratified by r0 or r1 resection status prior to randomization (91% were r0). viagra online Median survival was higher for  the 2 chemotherapy arms [57. 1 (41. 7 - 73. 8) months] versus no chemotherapy [43. 0 (27. 6 - ) months] with a hr of 0. 85 (0. 61 - 1. 18), p=0. 323. For r0 patients median survival was also higher for chemotherapy [58. generic viagra price 4 (45. 4 - 84. 0) months] versus no chemotherapy [45. 1 (26. 7 - ) months] with a hr of 0. http://viagrawithoutprescriptiondwl.com 78 (0. 55 - 1. 11), p=0. 173.   in survival analysis, factors prognostic of survival included tumour diameter and grade, lymph node status and r0/r1 status. buy viagra without prescription   in multivariate analysis for r0 patients, chemotherapy trended toward survival benefit (p=0. viagra canada 057) but not for the full population (p=0. is viagra or viagra or viagra best 16). These results suggest there may be  benefit for chemotherapy. The investigators should be applauded for conducting and completing such a study. My bias is to treat good ps patients with adjuvant chemotherapy with gemcitabine and this trial supports that.   in general, as oncologists, our bias is also to treat patients that we are concerned may do poorly. viagra price delhi R1 resection patients would certainly be one category but the subgroup in this population was too small to derive conclusions from. For margin-positive cancers, i also tend to use postop radiation either upfront or after completion of chemotherapy (with cape-based rt) and i will continue to do so. viagra pills in india You need to install Flash Plug-in in order to view Flash content on this website correctly. Click Here to install Flash Plug-in.   Power by A4DeskPro Website Builder