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- Derwinger, Kristoffer, 1969, et al.
(författare)
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A study of lymph node ratio in stage IV colorectal cancer.
- 2008
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Ingår i: World journal of surgical oncology. - : Springer Science and Business Media LLC. - 1477-7819. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: The finding of metastasis in colorectal cancer, stage IV disease, has a major impact on prognosis and treatment strategy. Known important factors include the extent of the metastasis and the patients' performance status. The lymph node factors are of known importance in earlier cancer stages but less described in metastatic disease. The aim of the study was to evaluate lymph node status and ratio as prognostic markers in stage IV colorectal cancer. METHOD: The study was retrospective and assessing all patients operated, with bowel resection, for an initial stage IV colorectal cancer during 1999-2003 (n=136). Basic demographic data as well as given treatment was assessed. The Lymph node ratio (LNR), the quota between the number of lymph node metastasis and assessed lymph nodes, was calculated. LNR groups were created by ratio thirds, 3 equally sized groups. The analysis was made by LNR group and by eligibility for chemotherapy with cancer specific survival as outcome parameter. RESULTS: The median survival (CSS) for the entire group was 431 days with great variability. For the patients eligible for chemotherapy it ranged from 791 days in LNR-group 1 to 433 days for the patients in group 3. For patients ineligible for chemotherapy the corresponding figures were 209 and 91 days. The eligibility for chemotherapy was a major prognostic factor which also takes co-morbidity, age and performance status into consideration. The LNR (p<0.01) and the tumour differentiation grade were also significant (p<0.05) factors regarding survival. The LNR group 3 was also associated with a higher frequency of multiple metastasis locations (p<0.05) and of more side effects with chemotherapy and thus of reductions in dosage or pre-emptive treatment ending (p<0.05). CONCLUSION: Stage IV colorectal cancer is a heterogeneous group regarding the survival prognosis. The lymph node ratio was found to be a significant marker for the survival prognosis (p<0.0049). High and low risk groups could be identified with a survival difference of up to one year. It could be of importance when planning a treatment strategy or evaluating clinical data materials. A pathology report should include a node assessment even at presence of synchronous metastasis.
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| 2. |
- Hardell, Lennart, et al.
(författare)
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Tumour risk associated with use of cellular telephones or cordless desktop telephones
- 2006
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Ingår i: World Journal of Surgical Oncology. - : Springer Science and Business Media LLC. - 1477-7819. ; 4:74
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of cellular and cordless telephones has increased dramatically during the last decade. There is concern of health problems such as malignant diseases due to microwave exposure during the use of these devices. The brain is the main target organ. METHODS: Since the second part of the 1990's we have performed six case-control studies on this topic encompassing use of both cellular and cordless phones as well as other exposures. Three of the studies concerned brain tumours, one salivary gland tumours, one non-Hodgkin lymphoma (NHL) and one testicular cancer. Exposure was assessed by self-administered questionnaires. RESULTS: Regarding acoustic neuroma analogue cellular phones yielded odds ratio (OR) = 2.9, 95 % confidence interval (CI) = 2.0-4.3, digital cellular phones OR = 1.5, 95 % CI = 1.1-2.1 and cordless phones OR = 1.5, 95 % CI = 1.04-2.0. The corresponding results were for astrocytoma grade III-IV OR = 1.7, 95 % CI = 1.3-2.3; OR = 1.5, 95 % CI = 1.2-1.9 and OR = 1.5, 95 % CI = 1.1-1.9, respectively. The ORs increased with latency period with highest estimates using > 10 years time period from first use of these phone types. Lower ORs were calculated for astrocytoma grade I-II. No association was found with salivary gland tumours, NHL or testicular cancer although an association with NHL of T-cell type could not be ruled out. CONCLUSION: We found for all studied phone types an increased risk for brain tumours, mainly acoustic neuroma and malignant brain tumours. OR increased with latency period, especially for astrocytoma grade III-IV. No consistent pattern of an increased risk was found for salivary gland tumours, NHL, or testicular cancer.
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| 3. |
- Suzuki, Chikako, et al.
(författare)
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The importance of rectal cancer MRI protocols on interpretation accuracy
- 2008
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Ingår i: World Journal of Surgical Oncology. - : Springer Science and Business Media LLC. - 1477-7819. ; 6, s. 89-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Magnetic resonance imaging (MRI) is used for preoperative local staging in patients with rectal cancer. Our aim was to retrospectively study the effects of the imaging protocol on the staging accuracy. PATIENTS AND METHODS: MR-examinations of 37 patients with locally advanced disease were divided into two groups; compliant and noncompliant, based on the imaging protocol, without knowledge of the histopathological results. A compliant rectal cancer imaging protocol was defined as including T2-weighted imaging in the sagittal and axial planes with supplementary coronal in low rectal tumors, alongside a high-resolution plane perpendicular to the rectum at the level of the primary tumor. Protocols not complying with these criteria were defined as noncompliant. Histopathological results were used as gold standard. RESULTS: Compliant rectal imaging protocols showed significantly better correlation with histopathological results regarding assessment of anterior organ involvement (sensitivity and specificity rates in compliant group were 86% and 94%, respectively vs. 50% and 33% in the noncompliant group). Compliant imaging protocols also used statistically significantly smaller voxel sizes and fewer number of MR sequences than the noncompliant protocols CONCLUSION: Appropriate MR imaging protocols enable more accurate local staging of locally advanced rectal tumors with less number of sequences and without intravenous gadolinium contrast agents.
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| 5. |
- Karlsson, Fredrik, et al.
(författare)
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Measured and predicted energy demand of a low energy building : Important aspects when using building energy simulation
- 2007
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Ingår i: Building Services Engineering Research & Technology. - : SAGE Publications. - 0143-6244 .- 1477-0849. ; 28:3, s. 223-235
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Tidskriftsartikel (refereegranskat)abstract
- Three different simulation tools were used to simulate a low energy terraced house in the south of Sweden. The software tools all use dynamic models to calculate, for example, the energy demand for heating and the indoor temperatures. The aim of this paper is to discuss the relative importance to the annual energy demand of different energy aspects of a Swedish low-energy house. Both measured and simulated values are considered and compared. The focus is on the impact of choice of software, the habits of the tenants, and the relative impact of different design parameters such as ventilation rates. The measured values for total electricity demand range from about 6000 kWh to over 12000kWh, the average demand being 8020kWh. The annual predicted total energy demand using three different simulation software tools deviated by about 2%. The energy use deviation due to airflow control was about 10%, and the deviation due to differences in heat exchanger efficiency was about 20% and the deviation in annual energy use due to differences in internal gains due to differences in tenant habits, assumed in the models, was 7%. Furthermore, when comparing the predicted energy use during the design process of the low-energy building with actual measurements after the tenants have moved in, these differ about 50% in average for this specific case. Practical application: Building energy simulation software is often used to make predictions of how different construction materials, design principles and operation influence the energy balance and indoor thermal comfort. It is therefore important that the output of these software tools is trustworthy and accurate. This paper discusses the importance of accurate input data during the design process in order to achieve a valid prediction of energy use with emphasis on tenants' behaviour. It was shown that the deviations in a parametric study were larger than the deviations in the comparison between the results from the three simulation tools. This indicates a need for more accurate models for modelling tenant behaviour and habits rather than more accurate building component models.
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