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655 results on '"Grimer, Robert"'

2. The Surveillance After Extremity Tumor Surgery (SAFETY) trial: protocol for a pilot study to determine the feasibility of a multi-centre randomised controlled trial

Author

Ghert, Michelle, Bhandari, Mohit, Bozzo, Anthony, Dijkstra, PD Sander, Griffin, Anthony, Grimer, Robert, Manherz, Arlene, Masrouha, Karim, Hayden, James, McKay, Paula, Miller, Benjamin, Parasu, Naveen, Puri, Ajay, Randall, R Lor, Schneider, Patricia, Sprague, Sheila, Szpakowski, Nina, Thabane, Lehana, Turcotte, Robert, Velez, Roberto, Wilson, David, Zbuk, Kevin, and Guyatt, Gordon

Subjects
Cancer, Clinical Research, Clinical Trials and Supportive Activities, Patient Safety, Management of diseases and conditions, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, 7.3 Management and decision making, Good Health and Well Being, Aftercare, Disease-Free Survival, Extremities, Feasibility Studies, Health Care Costs, Humans, Lung Neoplasms, Neoplasm Recurrence, Local, Pilot Projects, Radiography, Thoracic, Sarcoma, Tomography, X-Ray Computed, surveillance, soft tissue sarcoma, study protocol, randomised controlled trial, pilot study, SAFETY Investigators, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

IntroductionFollowing the treatment of patients with soft tissue sarcomas (STS) that are not metastatic at presentation, the high risk for local and systemic disease recurrence necessitates post-treatment surveillance. Systemic recurrence is most often detected in the lungs. The most appropriate surveillance frequency and modality remain unknown and, as such, clinical practice is highly varied. We plan to assess the feasibility of conducting a multi-centre randomised controlled trial (RCT) that will evaluate the effect on overall 5-year survival of two different surveillance frequencies and imaging modalities in patients with STS who undergo surgical excision with curative intent.Methods and analysisThe Surveillance After Extremity Tumor Surgery trial will be a multi-centre 2×2 factorial RCT. Patients with non-metastatic primary Grade II or III STS treated with excision will be allocated to one of four treatment arms1: chest radiograph (CXR) every 3 months for 2 years2; CXR every 6 months for 2 years3; chest CT every 3 months for 2 years or4 chest CT every 6 months for 2 years. The primary outcome of the pilot study is the feasibility of a definitive RCT based on a combination of feasibility endpoints. Secondary outcomes for the pilot study include the primary outcome of the definitive trial (overall survival), patient-reported outcomes on anxiety, satisfaction and quality of life, local recurrence-free survival, metastasis-free survival, treatment-related complications and net healthcare costs related to surveillance.Ethics and disseminationThis trial received provisional ethics approval from the McMaster/Hamilton Health Sciences Research Ethics Board on 7 August 2019 (Project number 7562). Final ethics approval will be obtained prior to commencing patient recruitment. Once feasibility has been established and the definitive protocol is finalised, the study will transition to the definitive study.Trial registrationNCT03944798; Pre-results.

Published
2019

5. Surgical Downstaging in an Open-Label Phase II Trial of Denosumab in Patients with Giant Cell Tumor of Bone

Author

Rutkowski, Piotr, Ferrari, Stefano, Grimer, Robert J, Stalley, Paul D, Dijkstra, Sander PD, Pienkowski, Andrzej, Vaz, Gualter, Wunder, Jay S, Seeger, Leanne L, Feng, Amy, Roberts, Zachary J, and Bach, Bruce A

Subjects
Patient Safety, Clinical Research, Cancer, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, Adult, Bone Density Conservation Agents, Bone Neoplasms, Combined Modality Therapy, Denosumab, Female, Follow-Up Studies, Giant Cell Tumor of Bone, Humans, Male, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Prospective Studies, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundSurgical resection with curative intent for giant cell tumor of bone (GCTB) may be associated with severe morbidity. This interim analysis evaluated reduction in surgical invasiveness after denosumab treatment in patients with resectable GCTB.MethodsPatients with primary or recurrent GCTB, for whom the initially planned surgery was associated with functional compromise or morbidity, received denosumab 120 mg subcutaneously every 4 weeks (additional doses on days 8 and 15 of the first cycle). Planned and actual GCTB-related surgical procedures before and after denosumab treatment were reported. Patients were followed for surgical outcome, adverse events, and recurrence following resection.ResultsOverall, 222 patients were evaluable for surgical downstaging (54 % were women; median age 34 years). Lesions (67 % primary and 33 % recurrent) were located in the axial (15 %) and appendicular skeleton (85 %). At the data cutoff date, most patients had not yet undergone surgery (n = 106; 48 %) or had a less morbid procedure (n = 84; 38 %) than originally planned. Median (interquartile range) time on denosumab was 19.5 (12.4-28.6) months for the 106 patients who had not undergone surgery and were continuing on monthly denosumab. Native joint preservation was 96 % (n = 24/25) for patients with planned joint/prosthesis replacement and 86 % (n = 30/35) for patients with planned joint resection/fusion. Of the 116 patients who had surgery (median postsurgical follow-up 13.0 [8.5-17.9] months), local recurrence occurred in 17 (15 %) patients.ConclusionFor patients with resectable GCTB, neoadjuvant denosumab therapy resulted in beneficial surgical downstaging, including either no surgery or a less morbid surgical procedure.

Published
2015

7. Survival and prognosis with osteosarcoma: outcomes in more than 2000 patients in the EURAMOS-1 (European and American Osteosarcoma Study) cohort

Author

Smeland, Sigbjørn, Bielack, Stefan S., Whelan, Jeremy, Bernstein, Mark, Hogendoorn, Pancras, Krailo, Mark D., Gorlick, Richard, Janeway, Katherine A., Ingleby, Fiona C., Anninga, Jakob, Antal, Imre, Arndt, Carola, Brown, Ken L.B., Butterfass-Bahloul, Trude, Calaminus, Gabriele, Capra, Michael, Dhooge, Catharina, Eriksson, Mikael, Flanagan, Adrienne M., Friedel, Godehard, Gebhardt, Mark C., Gelderblom, Hans, Goldsby, Robert, Grier, Holcombe E., Grimer, Robert, Hawkins, Douglas S., Hecker-Nolting, Stefanie, Sundby Hall, Kirsten, Isakoff, Michael S., Jovic, Gordana, Kühne, Thomas, Kager, Leo, von Kalle, Thekla, Kabickova, Edita, Lang, Susanna, Lau, Ching C., Leavey, Patrick J., Lessnick, Stephen L., Mascarenhas, Leo, Mayer-Steinacker, Regine, Meyers, Paul A., Nagarajan, Raj, Randall, R.Lor, Reichardt, Peter, Renard, Marleen, Rechnitzer, Catherine, Schwartz, Cindy L., Strauss, Sandra, Teot, Lisa, Timmermann, Beate, Sydes, Matthew R., and Marina, Neyssa

Published
2019
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9. Improving outcomes for patients with musculoskeletal tumours

Author

Grimer, Robert John

Subjects
616.994, RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Abstract

This thesis summarises the author’s lifelong work to improve outcomes for patients with musculoskeletal tumours. It starts with analysing diagnostic features and steps that could be taken to improve the time to diagnosis of these rare tumours. It continues with a number of basic science projects which the author has either carried out or collaborated with. Benign bone tumours are common in children and are discussed. The author has probably one of the largest personal experiences of treating primary malignant bone and soft tissue tumours and this is evidenced by the papers on osteosarcoma, chondrosarcoma, Ewing’s sarcoma and soft tissue sarcoma. The indications for and outcomes of major ablative amputations are outlined followed by an extensive review of the outcomes of limb salvage surgery with endoprostheses and other techniques. The role of this type of surgery in metastatic disease is put in context. Finally the importance of follow up and guidelines is considered. The thesis represents an analysis of the huge improvements that have taken place in the past 25 years in musculoskeletal oncology but also reveals the many still unanswered questions in this evolving field.

Published
2011

14. Supplementary Tables 2 and 3 from A Gene Expression Signature Associated with Metastatic Outcome in Human Leiomyosarcomas

Author

Lee, Yin-Fai, primary, John, Megan, primary, Falconer, Alison, primary, Edwards, Sandra, primary, Clark, Jeremy, primary, Flohr, Penny, primary, Roe, Toby, primary, Wang, Rubin, primary, Shipley, Janet, primary, Grimer, Robert J., primary, Mangham, D. Chas, primary, Thomas, J. Meirion, primary, Fisher, Cyril, primary, Judson, Ian, primary, and Cooper, Colin S., primary

Published
2023
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15. Supplementary Figure 1 from A Gene Expression Signature Associated with Metastatic Outcome in Human Leiomyosarcomas

Author

Lee, Yin-Fai, primary, John, Megan, primary, Falconer, Alison, primary, Edwards, Sandra, primary, Clark, Jeremy, primary, Flohr, Penny, primary, Roe, Toby, primary, Wang, Rubin, primary, Shipley, Janet, primary, Grimer, Robert J., primary, Mangham, D. Chas, primary, Thomas, J. Meirion, primary, Fisher, Cyril, primary, Judson, Ian, primary, and Cooper, Colin S., primary

Published
2023
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16. Supplementary Table 1 from A Gene Expression Signature Associated with Metastatic Outcome in Human Leiomyosarcomas

Author

Lee, Yin-Fai, primary, John, Megan, primary, Falconer, Alison, primary, Edwards, Sandra, primary, Clark, Jeremy, primary, Flohr, Penny, primary, Roe, Toby, primary, Wang, Rubin, primary, Shipley, Janet, primary, Grimer, Robert J., primary, Mangham, D. Chas, primary, Thomas, J. Meirion, primary, Fisher, Cyril, primary, Judson, Ian, primary, and Cooper, Colin S., primary

Published
2023
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17. Mesenchymal chondrosarcoma: Prognostic factors and outcome in 113 patients. A European Musculoskeletal Oncology Society study

Author

Frezza, Anna Maria, Cesari, Marilena, Baumhoer, Daniel, Biau, David, Bielack, Stephen, Campanacci, Domenico Andrea, Casanova, José, Esler, Claire, Ferrari, Stefano, Funovics, Philipp T., Gerrand, Craig, Grimer, Robert, Gronchi, Alessandro, Haffner, Nicolas, Hecker-Nolting, Stefanie, Höller, Sylvia, Jeys, Lee, Jutte, Paul, Leithner, Andreas, San-Julian, Mikel, Thorkildsen, Joachim, Vincenzi, Bruno, Windhager, Reinhard, and Whelan, Jeremy

Published
2015
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37. Impact of the national sarcoma guidelines on the prevalence and outcome of inadvertent excisions of soft tissue sarcomas: An observational study from a UK tertiary referral centre

Author

Fujiwara, Tomohiro, Evans, Scott, Stevenson, Jonathan, Tsuda, Yusuke, Gregory, Jonathan, Grimer, Robert, Abudu, Adesegun, Fujiwara, Tomohiro, Evans, Scott, Stevenson, Jonathan, Tsuda, Yusuke, Gregory, Jonathan, Grimer, Robert, and Abudu, Adesegun

Abstract

Objectives: This study aims to investigate the impact of the national guideline on the prevalence and outcome in patients with soft-tissue sarcoma (STS) who had undergone inadvertent excisions. Methods: A total of 2336 patients were referred to a tertiary sarcoma centre from six regions (North East, North West, East Midlands, West Midlands, Wales, and South West) in the United Kingdom with a diagnosis of STS between 1996 and 2016, of whom 561 patients (24.0%) had undergone inadvertent excisions. Patients were categorised into two groups of 10-year periods pre and post the National Institute for Health and Clinical Excellence (NICE) guideline implementation in 2006. Results: The proportion of inadvertent excisions decreased after the NICE guideline implementation: 27.2% (pre-NICE) versus 19.8% (post-NICE) (p = 0.001). A substantial regional variation (17.4%–34.5%) in the proportion of inadvertent excisions in the pre-NICE era was reduced in the post-NICE era (14.3%–22.4%). The 5-year disease-specific survival was 77.7% (pre-NICE) versus 75.6% (post-NICE) (p = 0.961) and there was a trend toward lower incidence of local recurrence in the post-NICE era; 13.5% (pre-NICE) versus 10.5% (post-NICE) (p = 0.522). Multivariate analyses revealed that residual tumours in re-resection specimens were independently associated with an increased risk of disease-specific mortality (HR, 3.35; p < 0.001) and local recurrence (HR, 1.99; p = 0.017), which was significantly reduced after the NICE guideline implementation (53.2% versus 42.0%; p = 0.022). Conclusions: The NICE guideline implementation reduced the proportion of patients with STS who had undergone inadvertent excisions and residual tumour in re-resection specimens, indicating an improved pre-referral management of STSs.

Published
2022

38. Development and comparison of 1-year survival models in patients with primary bone sarcomas:External validation of a Bayesian belief network model and creation and external validation of a new gradient boosting machine model

Author

Holm, Christina E., Grazal, Clare F., Raedkjaer, Mathias, Baad-Hansen, Thomas, Nandra, Rajpal, Grimer, Robert, Forsberg, Jonathan A., Petersen, Michael Moerk, Soerensen, Michala Skovlund, Holm, Christina E., Grazal, Clare F., Raedkjaer, Mathias, Baad-Hansen, Thomas, Nandra, Rajpal, Grimer, Robert, Forsberg, Jonathan A., Petersen, Michael Moerk, and Soerensen, Michala Skovlund

Abstract

Background: Bone sarcomas often present late with advanced stage at diagnosis and an according, varying short-term survival. In 2016, Nandra et al. generated a Bayesian belief network model for 1-year survival in patients with bone sarcomas. The purpose of this study is: (1) to externally validate the prior 1-year Bayesian belief network prediction model for survival in patients with bone sarcomas and (2) to develop a gradient boosting machine model using Nandra et al.'s cohort and evaluate whether the gradient boosting machine model outperforms the Bayesian belief network model when externally validated in an independent Danish population cohort.Material and Methods: The training cohort comprised 3493 patients newly diagnosed with bone sarcoma from the institutional prospectively maintained database at the Royal Orthopaedic Hospital, Birmingham, UK. The validation cohort comprised 771 patients with newly diagnosed bone sarcoma included from the Danish Sarcoma Registry during January 1, 2000-June 22, 2016. We performed area under receiver operator characteristic curve analysis, Brier score and decision curve analysis to evaluate the predictive performance of the models.Results: External validation of the Bayesian belief network 1-year prediction model demonstrated an area under receiver operator characteristic curve of 68% (95% confidence interval, 62%-73%). Area under receiver operator characteristic curve of the gradient boosting machine model demonstrated: 75% (95% confidence interval: 70%-80%), overall model performance by the Brier score was 0.09 (95% confidence interval: 0.077-0.11) and decision curve analysis demonstrated a positive net benefit for threshold probabilities above 0.5. External validation of the developed gradient boosting machine model demonstrated an area under receiver operator characteristic curve of 63% (95% confidence interval: 57%-68%), and the Brier score was 0.14 (95% confidence interval: 0.12-0.16).Conclusion: E

Published
2022

46. Development and comparison of 1-year survival models in patients with primary bone sarcomas: External validation of a Bayesian belief network model and creation and external validation of a new gradient boosting machine model

Author

Holm, Christina E, primary, Grazal, Clare F, additional, Raedkjaer, Mathias, additional, Baad-Hansen, Thomas, additional, Nandra, Rajpal, additional, Grimer, Robert, additional, Forsberg, Jonathan A, additional, Petersen, Michael Moerk, additional, and Skovlund Soerensen, Michala, additional

Published
2022
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47. Prognostic factors and outcomes for osteosarcoma: An international collaboration

Author

Pakos, Emilios E., Nearchou, Andreas D., Grimer, Robert J., Koumoullis, Haris D., Abudu, Adesegun, Bramer, Jos A.M., Jeys, Lee M., Franchi, Alessandro, Scoccianti, Guido, Campanacci, Domenico, Capanna, Rodolfo, Aparicio, Jorge, Tabone, Marie-Dominique, Holzer, Gerold, Abdolvahab, Fashid, Funovics, Philipp, Dominkus, Martin, Ilhan, Inci, Berrak, Su G., Patino-Garcia, Ana, Sierrasesumaga, Luis, San-Julian, Mikel, Garraus, Moira, Petrilli, Antonio Sergio, Filho, Reynaldo Jesus Garcia, Macedo, Carla Renata Pacheco Donato, Alves, Maria Teresa de Seixas, Seiwerth, Sven, Nagarajan, Rajaram, Cripe, Timothy P., and Ioannidis, John P.A.

Published
2009
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