| 41. |
- Waldenström, Ann-Charlotte, 1950, et al.
(författare)
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Survival of patients with adenocarcinoma of the uterine cervix in western Sweden.
- 1999
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Ingår i: Int J Gynecol Cancer. - 1048-891X. ; 9:1, s. 18-23
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Tidskriftsartikel (refereegranskat)abstract
- Survival in adenocarcinoma of the uterine cervix varies between different reports. In our study the patients have been treated in a similar way as those with squamous cell carcinoma. One hundred twenty-one adenocarcinomas were diagnosed between 1987 and 1994 in the West Sweden Health Care Region. One hundred of the patients with adenocarcinoma were treated at Sahlgrenska University Hospital and studied retrospectively. The median age was 54 years (range 27-91). Histopathologic differentiation was relatively evenly distributed between well (34%), intermediately (38%), and poorly differentiated (28%). All FIGO stages were represented, but stage I predominated (65%). Depending mainly on tumor stage and age, the patients had either surgery, surgery + radiotherapy, or radiotherapy only. In our study, the five-year survival for adenocarcinoma was 64% and for squamous/adenosquamous carcinoma was 66% (NS). The five-year survival for different stages of adenocarcinomas was for stage I 86%, stage II 38%, stage III 23%, and stage IV 0%, the difference between stage I and stage II being highly significant. Treated in a similar way, the five-year survival for adenocarcinoma is equal to that for squamous/adenosquamous carcinoma in our study.
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| 42. |
- Åkeson, Margaretha, 1944, et al.
(författare)
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A population-based 5-year cohort study including all cases of epithelial ovarian cancer in western Sweden: 10-year survival and prognostic factors.
- 2009
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Ingår i: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. - 1525-1438. ; 19:1, s. 116-23
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Tidskriftsartikel (refereegranskat)abstract
- Epithelial ovarian cancer (EOC) is the major gynecologic cancer mortality cause in Sweden. The aim of the present study was to investigate the long-term survival and prognostic factors of a complete population-based 5-year cohort of 682 patients with invasive EOC in western Sweden (population around 1.6 million). Data relating to residual tumor after surgery, FIGO stage, grade, histopathologic subtype, ploidy status, adjuvant chemotherapy (the prepaclitaxel period), and disease state (recurrence and death) were reported to a quality register in a prospectively kept database and were controlled against the Swedish National Cancer Registry for completeness. The median follow-up durations for the prospectively collected data in the Cox analysis and for the survival analysis that was made for all patients were 81 months (range, 52-109 months) and 11.7 years (range, 8.7-14.1 years), respectively. No patient was lost to follow-up. The relative 10-year survival rate was 38.4% (95% confidence interval, 34.5%-42.8%). The median relative survival time was 4.3 years (95% confidence interval, 3.6%-5.2%). In the univariate Cox regression analysis, prognostic significances for age, stage, residual tumor, histopathologic subtype of serous cystadenocarcinoma, grade, CA-125, and ploidy status were seen. In the multivariate analysis, age, stage, residual tumor after surgery, and postoperative CA-125 were of prognostic significance. In conclusion, 4 major prognostic factors were found for EOC in this population-based cohort study that also presents nearly accurate long-term survival owing to the nonselective nature and completeness regarding patients and follow-up of the study.
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| 43. |
- Åkeson, Margaretha, 1944, et al.
(författare)
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Effect of adjuvant paclitaxel and carboplatin for advanced stage epithelial ovarian cancer: a population-based cohort study of all patients in western Sweden with long-term follow-up
- 2008
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 87:12, s. 1343-52
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate long-term survival and prognostic factors for all epithelial ovarian cancer (EOC) patients after adjuvant treatment with paclitaxel and carboplatin. DESIGN: Prospectively collected data from a population-based cohort. SETTING: Western Sweden Health Care Region. POPULATION: All women diagnosed with EOC between 1998 and 2005. METHODS: Data related to age, stage, surgery, histopathology, grade, ploidy status, CA-125, follow-up, recurrence and death of EOC patients (n=976) were prospectively collected in a quality register. No patient was lost to follow-up and the median follow-up was 68 months (range: 27-110). MAIN OUTCOME MEASURES: Relative survival at 5 and 8 years for all and for those treated with chemotherapy; median progression-free survival (PFS) for stage IIB-IV patients treated with paclitaxel and carboplatin. RESULTS: Relative 5- and 8-year survival rates in the subgroup of patients treated with chemotherapy after surgery (n=853) were 50.4% (95% CI: 46.4-54.3) and 40.5% (95% CI: 35.4-45.6), respectively. The median relative survival time of the entire group of patients was 60 months (95% CI: 52-73). The median PFS for the patients in stage IIB-IV treated with paclitaxel and carboplatin was 18 months (95% CI: 17-20). Well-established prognostic factors of age, stage, residual tumor and post-operative CA-125 were of prognostic significance. CONCLUSION: Post-surgical adjuvant chemotherapy of paclitaxel and carboplatin for advanced stages of EOC does not seem to increase the relative 5-year survival rate or the median PFS compared to results of earlier studies of a similar patient cohort from the same geographical area.
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| 44. |
- Åkeson, Margaretha, 1944, et al.
(författare)
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Improved survival with clinical guidelines? Evaluation of a guality register linked to clinical guidelines for ovarian cancer in the western health care region in Sweden between 1 September 1993 and 1 June 1998.
- 2005
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. ; 84, s. 1113-1118
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. New clinical guidelines (CGs) for ovarian cancer in the western health care region in Sweden were established, beginning in September 1993 and still in effect. METHODS. A retrospective evaluation of 5 years of quality registration linked to CGs for ovarian cancer in this region was undertaken. The study material comprised 718 patients. Relative survival rates for the studied patients were compared with National Cancer Register data for the western health care region during the same period. The National Cancer Register data were also used to compare survival rate during the studied period and the preceding 5-year period. RESULTS. Relative 5-year survival rate in our material was 46.1%. Relative survival in western Sweden during the studied period was found to be improved compared with that during the preceding period (P<0.02). CONCLUSIONS. The CGs have led to an improved, tighter organization, with fewer clinicians in special 'tumor teams' performing more aggressive tumor reduction surgery. Chemotherapy prescription is centralized, while the actual administration is decentralized. This has probably been important for the good 5-year survival results.
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| 45. |
- Åkeson, Margaretha, 1944, et al.
(författare)
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Population-based cohort follow-up study of all patients operated for borderline ovarian tumor in western Sweden during an 11-year period
- 2008
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Ingår i: International Journal of Gynecological Cancer. - : BMJ. - 1525-1438 .- 1048-891X. ; 18:3, s. 453-9
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Tidskriftsartikel (refereegranskat)abstract
- Borderline ovarian tumors (BOTs) make up around 10-20% of all epithelial ovarian tumors. The aim of the present study was to investigate the outcome of a complete large population-based cohort of patients treated for BOT. All patients (n= 399) treated for BOT in the western part of Sweden (population around 1.6 million) between 1993 and 2004 were followed. The treatment consisted of primary staging surgery with addition of platinum-based adjuvant chemotherapy for the majority of aneuploid tumors. Data relating to the surgical procedure, FIGO stage, histopathology, ploidy status, adjuvant chemotherapy, and disease state (recurrence or death) at follow-up visits were continuously entered into a cancer quality registry. Data concerning cases and deaths were also controlled against the Swedish National Cancer Registry. The median age of the BOT patients was 55 years (range 16-90). The relative 5- and 10-year survivals were 99.9% (95% CI 96.3-102.4) and 103.5% (95% CI 97.2-108.2), respectively. Aneuploidy was found in 63 (17%) patients, with significantly more aneuploid tumors found among patients of older (>60 years) age. Out of the 399 patients, 8 had recurrence of the disease. Three of the eight patients died from the disease. Five patients with recurrence are alive, three of these patients with no signs of disease after additional treatment. This complete long-term follow-up of a large population-based cohort of BOT patients shows that there is a good overall survival in this patient group.
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| 46. |
- Österberg, Lovisa, 1978, et al.
(författare)
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Cytogenetic analysis of carboplatin resistance in early-stage epithelial ovarian carcinoma.
- 2005
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Ingår i: Cancer genetics and cytogenetics. - : Elsevier BV. - 0165-4608. ; 163:2, s. 144-50
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Tidskriftsartikel (refereegranskat)abstract
- Ovarian carcinoma is the leading cause of death among women with gynecological malignancies in western Europe. The high mortality rate is largely due to drug resistance. It is thus essential to increase knowledge and understanding of the underlying mechanisms of chemotherapy resistance, which might be caused by changes in the tumor genome. After surgery, carboplatin is the standard treatment for patients with early-stage ovarian cancer. Using comparative genomic hybridization (CGH), we explored cytogenetic alterations in 63 early-stage epithelial ovarian tumors, comparing the aberration patterns in the carboplatin-resistant and carboplatin-sensitive tumors. Several chromosomal regions were more frequently altered in the resistant tumors; some of these differences were statistically significant. We also found differences in tumor histology. Gains of 1q, 5q14 approximately q23, and 13q21 approximately q32, and losses of 8p and 9q were associated with clinical carboplatin resistance. Also, differences were found between the primary resistant and the secondary resistant tumors. Our findings demonstrate biologic observations of clinical drug resistance and specifically reveal chromosomal regions of interest for platinum resistance.
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| 47. |
- Österberg, Lovisa, 1978, et al.
(författare)
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Genetic alterations of serous borderline tumors of the ovary compared to stage I serous ovarian carcinomas.
- 2006
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Ingår i: Cancer genetics and cytogenetics. - : Elsevier BV. - 0165-4608. ; 167:2, s. 103-8
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Tidskriftsartikel (refereegranskat)abstract
- Borderline tumors of the ovary comprise 10-20% of all epithelial ovarian tumors, and are placed between clearly benign and obviously malignant ovarian tumors. The issue of whether borderline tumors are precursors of invasive carcinoma or distinct clinical entities, however, is still the subject of discussion. To increase our understanding in relation to this issue, the aim of our study was to analyze both serous borderline and invasive ovarian tumors, and to investigate early carcinogenesis in serous ovarian tumors. Using comparative genomic hybridization, we compared cytogenetic changes in borderline ovarian tumors and stage I invasive tumors. The average number of genetic alterations differed significantly between the borderline and the invasive tumors (1.9 and 9.2, respectively). The most common genetic alterations among the borderline tumors were loss of chromosome 17, 20q, and 18p, and gain of 12p13 approximately q23. These changes were also found among the invasive tumors in a similar percentage. In conclusion, we found four distinct cytogenetic alterations that might be early events in serous ovarian tumors, and that might also characterize a subgroup of borderline ovarian tumors that may have the potential to progress and develop malignancy.
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| 48. |
- Österberg, Lovisa, 1978, et al.
(författare)
-
High-resolution genomic profiling of carboplatin resistance in early-stage epithelial ovarian carcinoma.
- 2009
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Ingår i: Cytogenetic and genome research. - : S. Karger AG. - 1424-859X .- 1424-8581. ; 125:1, s. 8-18
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Tidskriftsartikel (refereegranskat)abstract
- Chemotherapy resistance remains a major obstacle to successful treatment of ovarian cancer patients. Therefore, increased knowledge of underlying mechanisms and identification of predictive factors are of great importance. Standard treatment for ovarian carcinoma is surgery followed by platinum-based chemotherapy. In this study, we aimed to search for genes or genomic regions involved in platinum resistance in ovarian carcinoma. Array-based comparative genomic hybridization (CGH) was used to identify genetic alterations in 32 early-stage epithelial ovarian carcinomas homogeneously treated with single-agent carboplatin. The arrays contain 33,370 bacterial artificial chromosome (BAC) clones and form a contiguous and tiling coverage of the human genome with an average resolution of approximately 100 kb. We found certain genetic changes associated with carboplatin response. Gains in 1q25.1-q41 were significantly more frequent in carboplatin-resistant tumours. In this region, we further detected two smallest regions of overlap (SRO) at 1q25.2 and 1q32.2 (approximately 690 and approximately 830 kb in size, respectively). Interestingly, we found some regions that were lost exclusively in the sensitive tumours 17q24.1, Xq21.33-q22.1, and 6 regions in 15q. We also detected genetic differences with regard to histologic subtype. Gain in 8q was found highly associated with serous and clear cell subtypes, and an SRO was identified at 8q24.22-q24.23. The genomic regions found altered in this study confirm some of our previous metaphase CGH results. The alteration found in chromosome arm 1q was verified and specified, and is therefore of great interest as a candidate for predictive markers. Identifying predictive markers of chemosensitive and chemoresistant disease would greatly help in the choice of chemotherapy in the clinic, and thus improve treatment of women with ovarian cancer.
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| 49. |
- Österberg, Lovisa, 1978, et al.
(författare)
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Potential predictive markers of chemotherapy resistance in stage III ovarian serous carcinomas.
- 2009
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Ingår i: BMC cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Chemotherapy resistance remains a major obstacle in the treatment of women with ovarian cancer. Establishing predictive markers of chemoresponse would help to individualize therapy and improve survival of ovarian cancer patients. Chemotherapy resistance in ovarian cancer has been studied thoroughly and several non-overlapping single genes, gene profiles and copy number alterations have been suggested as potential markers. The objective of this study was to explore genetic alterations behind chemotherapy resistance in ovarian cancer with the ultimate aim to find potential predictive markers.
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| 50. |
- Österberg, Lovisa, 1978, et al.
(författare)
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Specific Copy Number Alterations Associated with Docetaxel/Carboplatin Response in Ovarian Carcinomas
- 2010
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Ingår i: Anticancer Research. - : Highwire Press. - 0250-7005 .- 1791-7530. ; 30:11, s. 4451-4458
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Tidskriftsartikel (refereegranskat)abstract
- Background: The continued high recurrence and mortality rate in ovarian cancer is a significant problem and the major obstacle in the treatment of ovarian cancer patients is chemotherapy resistance. Thus, finding predictive markers of chemoresistance and elucidating resistance mechanisms is crucial for individualising treatment and improving survival of ovarian cancer patients. Materials and Methods: Using array comparative genomic hybridisation (CGH), this pilot study analysed the tumour genomes of patients treated with docetaxel/carboplatin as first-line chemotherapy (6 resistant versus 24 sensitive cases). This is the first array CGH study of such material. Results: The study identified genetic alterations specific to chemoresistant (gains in 9p13.2-13.1, 9q21.2-21.32, 9q21.33, 9q22.2-22.31, 9q22.32-22.33 and 9q33.1-34.11) and chemosensitive (losses in 8p23.3-23.1 and 8p22) disease. Additionally, when comparing the results to previously analysed tumour material from patients treated with paclitaxel/carboplatin, the two datasets identified different genetic alteration profiles. Conclusion: Specific genetic alterations were identified and associated with chemotherapy response in ovarian cancer. It will be interesting to investigate these exciting data further in larger independent series of ovarian tumours, and hopefully will contribute to the establishment of predictive markers.
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