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British Journal of Cancer logoLink to British Journal of Cancer
. 1994 Aug;70(2):352–362. doi: 10.1038/bjc.1994.306

Centralised treatment, entry to trials and survival.

C A Stiller 1
PMCID: PMC2033490  PMID: 8054285

Abstract

A review was carried out of the published literature on survival rates for cancer in relation to patterns of organisation of medical care, specifically treatment at specialist centres or at hospitals treating larger numbers of patients and treatment by protocol, usually within the context of a clinical trial. Centralised referral or entry to trials was frequently associated with a higher survival rate, particularly for the less common cancers, and was never found to be associated with a lower survival rate. Few studies were identified for any one cancer site and some antedated current methods of treatment. At a time when the health service in the United Kingdom is undergoing far-reaching organisational change, further research is needed to establish the most beneficial patterns of care for people with cancer. Population-based cancer registries are an invaluable source of data for such studies.

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Selected References

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  1. Aass N., Klepp O., Cavallin-Stahl E., Dahl O., Wicklund H., Unsgaard B., Baldetorp L., Ahlström S., Fosså S. D. Prognostic factors in unselected patients with nonseminomatous metastatic testicular cancer: a multicenter experience. J Clin Oncol. 1991 May;9(5):818–826. doi: 10.1200/JCO.1991.9.5.818. [DOI] [PubMed] [Google Scholar]
  2. Allum W. H., Powell D. J., McConkey C. C., Fielding J. W. Gastric cancer: a 25-year review. Br J Surg. 1989 Jun;76(6):535–540. doi: 10.1002/bjs.1800760604. [DOI] [PubMed] [Google Scholar]
  3. Bagshawe K. D., Begent R. H., Newlands E. S., Rustin G. J. What sort of oncology team should treat testicular teratoma? Lancet. 1985 Apr 20;1(8434):930–930. doi: 10.1016/s0140-6736(85)91704-0. [DOI] [PubMed] [Google Scholar]
  4. Basnett I., Gill M., Tobias J. S. Variations in breast cancer management between a teaching and a non-teaching district. Eur J Cancer. 1992;28A(12):1945–1950. doi: 10.1016/0959-8049(92)90233-r. [DOI] [PubMed] [Google Scholar]
  5. Begg C. B., Carbone P. P., Elson P. J., Zelen M. Participation of community hospitals in clinical trials: analysis of five years of experience in the Eastern Cooperative Oncology Group. N Engl J Med. 1982 May 6;306(18):1076–1080. doi: 10.1056/NEJM198205063061803. [DOI] [PubMed] [Google Scholar]
  6. Bertelsen K. Protocol allocation and exclusion in two Danish randomised trials in ovarian cancer. Br J Cancer. 1991 Dec;64(6):1172–1176. doi: 10.1038/bjc.1991.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Boffetta P., Merletti F., Winkelmann R., Magnani C., Cappa A. P., Terracini B. Survival of breast cancer patients from Piedmont, Italy. Cancer Causes Control. 1993 May;4(3):209–215. doi: 10.1007/BF00051315. [DOI] [PubMed] [Google Scholar]
  8. Bonett A., Roder D., Esterman A. Case-survival rates for infiltrating ductal carcinomas by category of hospital at diagnosis in South Australia. Med J Aust. 1991 May 20;154(10):695–697. doi: 10.5694/j.1326-5377.1991.tb121265.x. [DOI] [PubMed] [Google Scholar]
  9. Brewer J. I., Eckman T. R., Dolkart R. E., Torok E. E., Webster A. Gestational trophoblastic disease. A comparative study of the results of therapy in patients with invasive mole and with choriocarcinoma. Am J Obstet Gynecol. 1971 Jan 15;109(2):335–340. [PubMed] [Google Scholar]
  10. Chouillet A. M., Bell C. M., Hiscox J. G. Management of breast cancer in southeast England. BMJ. 1994 Jan 15;308(6922):168–171. doi: 10.1136/bmj.308.6922.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Christman K., Muss H. B., Case L. D., Stanley V. Chemotherapy of metastatic breast cancer in the elderly. The Piedmont Oncology Association experience [see comment]. JAMA. 1992 Jul 1;268(1):57–62. [PubMed] [Google Scholar]
  12. Chu J., Polissar L., Tamimi H. K. Quality of care in women with stage I cervical cancer. West J Med. 1982 Jul;137(1):13–17. [PMC free article] [PubMed] [Google Scholar]
  13. Davis S., Dahlberg S., Myers M. H., Chen A., Steinhorn S. C. Hodgkin's disease in the United States: a comparison of patient characteristics and survival in the Centralized Cancer Patient Data System and the Surveillance, Epidemiology, and End Results Program. J Natl Cancer Inst. 1987 Mar;78(3):471–478. [PubMed] [Google Scholar]
  14. Davis S., Wright P. W., Schulman S. F., Hill L. D., Pinkham R. D., Johnson L. P., Jones T. W., Kellogg H. B., Jr, Radke H. M., Sikkema W. W. Participants in prospective, randomized clinical trials for resected non-small cell lung cancer have improved survival compared with nonparticipants in such trials. Cancer. 1985 Oct 1;56(7):1710–1718. doi: 10.1002/1097-0142(19851001)56:7<1710::aid-cncr2820560741>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  15. Diamond J. J., Steinfeld A. D., Hanks G. E. The relationship between facility structure and outcome in cancer of the prostate and uterine cervix. Int J Radiat Oncol Biol Phys. 1991 Sep;21(4):1085–1087. doi: 10.1016/0360-3016(91)90753-q. [DOI] [PubMed] [Google Scholar]
  16. Duffner P. K., Cohen M. E., Flannery J. T. Referral patterns of childhood brain tumors in the state of Connecticut. Cancer. 1982 Oct 15;50(8):1636–1640. doi: 10.1002/1097-0142(19821015)50:8<1636::aid-cncr2820500829>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  17. Ebeling K., Tanneberger S., Nischan P., Jarofke D., Kluge E. Bösartige Neubildungen der weiblichen Brustdrüse in der Hauptstadt der DDR, Berlin, in der Periode 1975 bis 1979. Arch Geschwulstforsch. 1982;52(4):307–321. [PubMed] [Google Scholar]
  18. Eden O. B., Stiller C. A., Gerrard M. P. Improved survival for childhood acute lymphoblastic leukemia: possible effect of protocol compliance. Pediatr Hematol Oncol. 1988;5(2):83–91. doi: 10.3109/08880018809031258. [DOI] [PubMed] [Google Scholar]
  19. Edge S. B., Schmieg R. E., Jr, Rosenlof L. K., Wilhelm M. C. Pancreas cancer resection outcome in American University centers in 1989-1990. Cancer. 1993 Jun 1;71(11):3502–3508. doi: 10.1002/1097-0142(19930601)71:11<3502::aid-cncr2820711107>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  20. Eisenkop S. M., Spirtos N. M., Montag T. W., Nalick R. H., Wang H. J. The impact of subspecialty training on the management of advanced ovarian cancer. Gynecol Oncol. 1992 Nov;47(2):203–209. doi: 10.1016/0090-8258(92)90107-t. [DOI] [PubMed] [Google Scholar]
  21. Fallowfield L. J., Hall A., Maguire G. P., Baum M. Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. BMJ. 1990 Sep 22;301(6752):575–580. doi: 10.1136/bmj.301.6752.575. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Fentiman I. S. Treatment of cancer in the elderly. Br J Cancer. 1991 Dec;64(6):993–995. doi: 10.1038/bjc.1991.453. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Gill M., McCarthy M., Murrells T., Silcocks P. Chemotherapy for the primary treatment of osteosarcoma: population effectiveness over 20 years. Lancet. 1988 Mar 26;1(8587):689–692. doi: 10.1016/s0140-6736(88)91485-7. [DOI] [PubMed] [Google Scholar]
  24. Gillespie B. W., Diamond J. J., Davis L. W., Rominger C. J. An outcome study of the RTOG Cancer Control program. Int J Radiat Oncol Biol Phys. 1986 Dec;12(12):2157–2163. doi: 10.1016/0360-3016(86)90015-5. [DOI] [PubMed] [Google Scholar]
  25. Gillis C. R., Hole D. J., Still R. M., Davis J., Kaye S. B. Medical audit, cancer registration, and survival in ovarian cancer. Lancet. 1991 Mar 9;337(8741):611–612. doi: 10.1016/0140-6736(91)91673-i. [DOI] [PubMed] [Google Scholar]
  26. Goodwin J. S., Hunt W. C., Samet J. M. Determinants of cancer therapy in elderly patients. Cancer. 1993 Jul 15;72(2):594–601. doi: 10.1002/1097-0142(19930715)72:2<594::aid-cncr2820720243>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  27. Greenberg E. R., Baron J. A., Dain B. J., Freeman D. H., Jr, Yates J. W., Korson R. Cancer staging may have different meanings in academic and community hospitals. J Clin Epidemiol. 1991;44(6):505–512. doi: 10.1016/0895-4356(91)90213-s. [DOI] [PubMed] [Google Scholar]
  28. Griffel M. Wilms' tumor in New York State: epidemiology and survivorship. Cancer. 1977 Dec;40(6):3140–3145. doi: 10.1002/1097-0142(197712)40:6<3140::aid-cncr2820400658>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  29. Gulliford M. C., Petruckevitch A., Burney P. G. Survival with bladder cancer, evaluation of delay in treatment, type of surgeon, and modality of treatment. BMJ. 1991 Aug 24;303(6800):437–440. doi: 10.1136/bmj.303.6800.437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Hakama M., Karjalainen S., Hakulinen T. Outcome-based equity in the treatment of colon cancer patients in Finland. Int J Technol Assess Health Care. 1989;5(4):619–630. doi: 10.1017/s0266462300008497. [DOI] [PubMed] [Google Scholar]
  31. Hanks G. E., Diamond J. J., Kramer S. The need for complex technology in radiation oncology. Correlations of facility characteristics and structure with outcome. Cancer. 1985 May 1;55(9 Suppl):2198–2201. doi: 10.1002/1097-0142(19850501)55:9+<2198::aid-cncr2820551423>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  32. Hanks G. E., Herring D. F., Kramer S. Patterns of care outcome studies. Results of the national practice in cancer of the cervix. Cancer. 1983 Mar 1;51(5):959–967. doi: 10.1002/1097-0142(19830301)51:5<959::aid-cncr2820510533>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  33. Harding M. J., Paul J., Gillis C. R., Kaye S. B. Management of malignant teratoma: does referral to a specialist unit matter? Lancet. 1993 Apr 17;341(8851):999–1002. doi: 10.1016/0140-6736(93)91082-w. [DOI] [PubMed] [Google Scholar]
  34. Howard J., Hankey B. F., Greenberg R. S., Austin D. F., Correa P., Chen V. W., Durako S. A collaborative study of differences in the survival rates of black patients and white patients with cancer. Cancer. 1992 May 1;69(9):2349–2360. doi: 10.1002/1097-0142(19920501)69:9<2349::aid-cncr2820690925>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  35. Högberg T., Carstensen J., Simonsen E. Treatment results and prognostic factors in a population-based study of epithelial ovarian cancer. Gynecol Oncol. 1993 Jan;48(1):38–49. doi: 10.1006/gyno.1993.1007. [DOI] [PubMed] [Google Scholar]
  36. Junor E. J., Hole D. J., Gillis C. R. Management of ovarian cancer: referral to a multidisciplinary team matters. Br J Cancer. 1994 Aug;70(2):363–370. doi: 10.1038/bjc.1994.307. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Karjalainen S. Geographical variation in cancer patient survival in Finland: chance, confounding, or effect of treatment? J Epidemiol Community Health. 1990 Sep;44(3):210–214. doi: 10.1136/jech.44.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Karjalainen S., Palva I. Do treatment protocols improve end results? A study of survival of patients with multiple myeloma in Finland. BMJ. 1989 Oct 28;299(6707):1069–1072. doi: 10.1136/bmj.299.6707.1069. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Karjalainen S., Pukkala E. Social class as a prognostic factor in breast cancer survival. Cancer. 1990 Aug 15;66(4):819–826. doi: 10.1002/1097-0142(19900815)66:4<819::aid-cncr2820660437>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  40. Kingston R. D., Walsh S., Jeacock J. Colorectal surgeons in district general hospitals produce similar survival outcomes to their teaching hospital colleagues: review of 5-year survivals in Manchester. J R Coll Surg Edinb. 1992 Aug;37(4):235–237. [PubMed] [Google Scholar]
  41. Kogevinas M., Marmot M. G., Fox A. J., Goldblatt P. O. Socioeconomic differences in cancer survival. J Epidemiol Community Health. 1991 Sep;45(3):216–219. doi: 10.1136/jech.45.3.216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Kramer S. An overview of process and outcome data in the patterns of care study. Int J Radiat Oncol Biol Phys. 1981 Jun;7(6):795–800. doi: 10.1016/0360-3016(81)90476-4. [DOI] [PubMed] [Google Scholar]
  43. Kramer S., Meadows A. T., Pastore G., Jarrett P., Bruce D. Influence of place of treatment on diagnosis, treatment, and survival in three pediatric solid tumors. J Clin Oncol. 1984 Aug;2(8):917–923. doi: 10.1200/JCO.1984.2.8.917. [DOI] [PubMed] [Google Scholar]
  44. Lanciano R. M., Won M., Coia L. R., Hanks G. E. Pretreatment and treatment factors associated with improved outcome in squamous cell carcinoma of the uterine cervix: a final report of the 1973 and 1978 patterns of care studies. Int J Radiat Oncol Biol Phys. 1991 Apr;20(4):667–676. doi: 10.1016/0360-3016(91)90007-q. [DOI] [PubMed] [Google Scholar]
  45. Launoy G., Le Coutour X., Gignoux M., Pottier D., Dugleux G. Influence of rural environment on diagnosis, treatment, and prognosis of colorectal cancer. J Epidemiol Community Health. 1992 Aug;46(4):365–367. doi: 10.1136/jech.46.4.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Lazovich D. A., White E., Thomas D. B., Moe R. E. Underutilization of breast-conserving surgery and radiation therapy among women with stage I or II breast cancer. JAMA. 1991 Dec 25;266(24):3433–3438. [PubMed] [Google Scholar]
  47. Leibel S. A., Hanks G. E., Kramer S. Patterns of care outcome studies: results of the national practice in adenocarcinoma of the prostate. Int J Radiat Oncol Biol Phys. 1984 Mar;10(3):401–409. doi: 10.1016/0360-3016(84)90061-0. [DOI] [PubMed] [Google Scholar]
  48. Lennox E. L., Draper G. J., Sanders B. M. Retinoblastoma: a study of natural history and prognosis of 268 cases. Br Med J. 1975 Sep 27;3(5986):731–734. doi: 10.1136/bmj.3.5986.731. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Lennox E. L., Stiller C. A., Jones P. H., Wilson L. M. Nephroblastoma: treatment during 1970-3 and the effect on survival of inclusion in the first MRC trial. Br Med J. 1979 Sep 8;2(6190):567–569. doi: 10.1136/bmj.2.6190.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Liberati A., Confalonieri C., Andreani A., Colombo F., Franceschi S., La Vecchia C., Talamini R., Tognoni G. Lung cancer care in general hospitals. Tumori. 1983 Dec 31;69(6):567–573. doi: 10.1177/030089168306900614. [DOI] [PubMed] [Google Scholar]
  51. Liberati A., Mangioni C., Bratina L., Carinelli G., Marsoni S., Parazzini F., Regallo M., Talamini R., Tognoni G. Process and outcome of care for patients with ovarian cancer. Br Med J (Clin Res Ed) 1985 Oct 12;291(6501):1007–1012. doi: 10.1136/bmj.291.6501.1007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Lustig R. A., Krall J. M., Curran W. J., Hanks G. E. Improvements observed in care and outcome in carcinoma of the larynx. Int J Radiat Oncol Biol Phys. 1991 Jan;20(1):101–104. doi: 10.1016/0360-3016(91)90144-s. [DOI] [PubMed] [Google Scholar]
  53. Lustig R. A., MacLean C. J., Hanks G. E., Kramer S. The Patterns of Care Outcome Studies: results of the National practice in carcinoma of the larynx. Int J Radiat Oncol Biol Phys. 1984 Dec;10(12):2357–2362. doi: 10.1016/0360-3016(84)90245-1. [DOI] [PubMed] [Google Scholar]
  54. Marshall J. R., Funch D. P. Social environment and breast cancer. A cohort analysis of patient survival. Cancer. 1983 Oct 15;52(8):1546–1550. doi: 10.1002/1097-0142(19831015)52:8<1546::aid-cncr2820520835>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  55. Matthews H. R., Powell D. J., McConkey C. C. Effect of surgical experience on the results of resection for oesophageal carcinoma. Br J Surg. 1986 Aug;73(8):621–623. doi: 10.1002/bjs.1800730811. [DOI] [PubMed] [Google Scholar]
  56. McArdle C. S., Hole D. Impact of variability among surgeons on postoperative morbidity and mortality and ultimate survival. BMJ. 1991 Jun 22;302(6791):1501–1505. doi: 10.1136/bmj.302.6791.1501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Meadows A. T., Kramer S., Hopson R., Lustbader E., Jarrett P., Evans A. E. Survival in childhood acute lymphocytic leukemia: effect of protocol and place of treatment. Cancer Invest. 1983;1(1):49–55. doi: 10.3109/07357908309040932. [DOI] [PubMed] [Google Scholar]
  58. Möhner M., Slisów W. Untersuchung zum Einfluss der regional zentralisierten Behandlung auf die Uberlebenschancen beim Rektumkarzinom in der DDR. Zentralbl Chir. 1990;115(13):801–812. [PubMed] [Google Scholar]
  59. Neugut A. I., Timony D., Murray T. Colorectal cancer: differences between community and geographically distant patients seen at an urban medical center. Dis Colon Rectum. 1991 Jan;34(1):64–68. doi: 10.1007/BF02050210. [DOI] [PubMed] [Google Scholar]
  60. Nguyen H. N., Averette H. E., Hoskins W., Penalver M., Sevin B. U., Steren A. National survey of ovarian carcinoma. Part V. The impact of physician's specialty on patients' survival. Cancer. 1993 Dec 15;72(12):3663–3670. doi: 10.1002/1097-0142(19931215)72:12<3663::aid-cncr2820721218>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  61. Parry J., Wilson S., Cummins C., Redman V., Woodman C. A review of parotid pleomorphic adenomas in the West Midlands region 1977-1986. Clin Oncol (R Coll Radiol) 1993;5(3):147–149. doi: 10.1016/s0936-6555(05)80311-5. [DOI] [PubMed] [Google Scholar]
  62. Phillips R. K., Hittinger R., Blesovsky L., Fry J. S., Fielding L. P. Local recurrence following 'curative' surgery for large bowel cancer: I. The overall picture. Br J Surg. 1984 Jan;71(1):12–16. doi: 10.1002/bjs.1800710104. [DOI] [PubMed] [Google Scholar]
  63. Pickering R. M., Chadwell I. R., Mountney L. Importance of district of residence and known primary site for bowel cancer survival: analysis of data from Wessex Cancer Registry. J Epidemiol Community Health. 1992 Jun;46(3):266–270. doi: 10.1136/jech.46.3.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
  64. Pollock A. M. The future of health care in the United Kingdom. BMJ. 1993 Jun 26;306(6894):1703–1704. doi: 10.1136/bmj.306.6894.1703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  65. Pritchard J., Stiller C. A., Lennox E. L. Overtreatment of children with Wilms' tumour outside paediatric oncology centres. BMJ. 1989 Sep 30;299(6703):835–836. doi: 10.1136/bmj.299.6703.835. [DOI] [PMC free article] [PubMed] [Google Scholar]
  66. Robertson C. M., Stiller C. A., Kingston J. E. Causes of death in children diagnosed with non-Hodgkin's lymphoma between 1974 and 1985. Arch Dis Child. 1992 Nov;67(11):1378–1383. doi: 10.1136/adc.67.11.1378. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. Romano P. S., Mark D. H. Patient and hospital characteristics related to in-hospital mortality after lung cancer resection. Chest. 1992 May;101(5):1332–1337. doi: 10.1378/chest.101.5.1332. [DOI] [PubMed] [Google Scholar]
  68. Sanders B. M., Draper G. J., Kingston J. E. Retinoblastoma in Great Britain 1969-80: incidence, treatment, and survival. Br J Ophthalmol. 1988 Aug;72(8):576–583. doi: 10.1136/bjo.72.8.576. [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Silagy C. Developing a register of randomised controlled trials in primary care. BMJ. 1993 Apr 3;306(6882):897–900. doi: 10.1136/bmj.306.6882.897. [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Slisów W., Marx G., Seifart W., Staneczek W. Argumentation für eine regionale zentralisierte Behandlung beim Magenkarzinom. Eine statistische Untersuchung von nationalen Resultaten. Zentralbl Chir. 1987;112(1):27–33. [PubMed] [Google Scholar]
  71. Stiller C. A. Centralisation of treatment and survival rates for cancer. Arch Dis Child. 1988 Jan;63(1):23–30. doi: 10.1136/adc.63.1.23. [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. Stiller C. A., Draper G. J. Treatment centre size, entry to trials, and survival in acute lymphoblastic leukaemia. Arch Dis Child. 1989 May;64(5):657–661. doi: 10.1136/adc.64.5.657. [DOI] [PMC free article] [PubMed] [Google Scholar]
  73. Stiller C. A., Eatock E. M. Survival from acute non-lymphocytic leukaemia, 1971-88: a population based study. Arch Dis Child. 1994 Mar;70(3):219–223. doi: 10.1136/adc.70.3.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  74. Stiller C. A., Lennox E. L. Childhood medulloblastoma in Britain 1971-77: analysis of treatment and survival. Br J Cancer. 1983 Dec;48(6):835–841. doi: 10.1038/bjc.1983.274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. Thornhill J. A., Walsh A., Conroy R. M., Fennelly J. J., Kelly D. G., Fitzpatrick J. M. Physician-dependent prognostic variables in the management of testicular cancer. Br J Urol. 1988 Mar;61(3):244–249. [PubMed] [Google Scholar]
  76. Thornhill J. A., Walsh A., Kelly D., Fennelly J. J., Fitzpatrick J. M. Non-seminomatous germ cell testis cancer in Ireland (1980-1985). Management, results and prognostic variables with relevance to national management protocols. Eur Urol. 1988;15(1-2):84–88. doi: 10.1159/000473402. [DOI] [PubMed] [Google Scholar]
  77. Ward L. C., Fielding J. W., Dunn J. A., Kelly K. A. The selection of cases for randomised trials: a registry survey of concurrent trial and non-trial patients. The British Stomach Cancer Group. Br J Cancer. 1992 Nov;66(5):943–950. doi: 10.1038/bjc.1992.390. [DOI] [PMC free article] [PubMed] [Google Scholar]

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