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Sökning: WFRF:(Alvegård Thor)

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  • Lindqvist, Rikard, et al. (författare)
  • Hospital stay related to TNM-stage and the surgical procedure in primary breast cancer.
  • 2004
  • Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 43:6, s. 545-50
  • Tidskriftsartikel (refereegranskat)abstract
    • In Sweden from 1980 to 1995 there was an overall decrease of 56% in mean length of stay (MLOS) for surgical curative breast cancer treatment. The objective of this study was to separate the possible impact of tumour size and lymph node dissemination and changes in surgical procedures. All women diagnosed (n=13 290) with breast cancer between 1982 and 1995 were selected from the Southern Swedish Tumour Register. Data on LOS, diagnoses, and surgical procedures were obtained from the Swedish Hospital Discharge Register. A multi-factorial model was fitted to the data. Discharges where patients were treated with breast conserving surgery had more than two days shorter MLOS (-2.49, 95% CI -1.66) compared with mastectomy. Although TNM data imply a shift from T2 to smaller T1 among operated women the effect on MLOS is negligible when controlled for age, type of operation etc. Changes in clinical practice such as changes in operation technique can explain approximately 13% of the total decrease in MLOS.
  • Alvegård, Thor, et al. (författare)
  • Cellular DNA content and prognosis of high-grade soft tissue sarcoma: the Scandinavian Sarcoma Group experience
  • 1990
  • Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology. - 1527-7755. ; 8:3, s. 538-547
  • Tidskriftsartikel (refereegranskat)abstract
    • The nuclear DNA content of 148 high-grade soft tissue sarcomas of the extremities and trunk was determined by flow cytometry, using tumor material from paraffin-embedded tissue. The patients were part of a prospective randomized clinical trial on the efficacy of adjuvant single-agent chemotherapy with doxorubicin. Chemotherapy did not improve the metastasis-free survival (MFS). After a median follow-up time of 48 months (range, 2 to 97), a multivariate analysis of prognostic factors for developing metastatic disease was performed. DNA aneuploidy was found to be an independent prognostic risk factor in addition to histologic malignancy grade IV, intratumoral vascular invasion, tumor size over 10 cm, and male sex. Patients with none or one risk factor had a 5-year MFS of 79%, with two risk factors 65%, with three risk factors 43%, and with four and five risk factors 0%. About one half (78 of 148) of the patients with three factors or less belonged to a group with a MFS over 60%. The combination of different risk factors, including DNA aneuploidy, seems to be a useful prognostic model for soft tissue sarcomas, which could be of value to select high-risk patients for further trials with adjunctive therapy.
  • Bauer, Henrik C. F, et al. (författare)
  • Monitoring referral and treatment in soft tissue sarcoma: study based on 1,851 patients from the Scandinavian Sarcoma Group Register
  • 2001
  • Ingår i: Acta Orthopaedica Scandinavica. - : Taylor & Francis. - 0001-6470. ; 72:2, s. 150-159
  • Tidskriftsartikel (refereegranskat)abstract
    • This report is based on 1.851 adult patients with soft tissue sarcoma (STS) of the extremities or trunk wall diagnosed between 1986 and 1997 and reported from all tertiary referral centers in Norway and Sweden. The median age at diagnosis was 65 years and the male-to-female ratio was 1.1:1. One third of the tumors were subcutaneous, one third deep, intramuscular and one third deep, extramuscular. The median size was 7 (1-35) cm and 75% were high grade (III-IV). Metastases at presentation were diagnosed in 8% of the patients. Two thirds of STS patients were referred before surgery and the referral practices have improved during the study. The preoperative morphologic diagnosis was made with fine-needle aspiration cytology in 81%, core-needle biopsy in 9% and incisional biopsy in 10%. The frequency of amputations has decreased from 15% in 198688 to 9% in 1995-1997. A wide surgical margin was achieved in 77% of subcutaneous and 60% of deep-seated lesions. Overall, 24% of operated STS patients had adjuvant radiotherapy. The use of such therapy at sarcoma centers increased from 20% 1986-88 to 30% in 1995-97. Follow-up has been reported in 96% of the patients. The cumulative local recurrence rate was 0.20 at 5 years and 0.24 at 10 years. The 5-year metastasis-free survival rate was 0.70.
  • CHOONG, PETER F.M., et al. (författare)
  • Expression of proliferating cell nuclear antigen (PCNA) and Ki‐67 in soft tissue sarcoma. Is prognostic significance histotype‐specific?
  • Ingår i: APMIS. - : John Wiley and Sons Inc.. - 0903-4641. ; 103:7-8, s. 797-805
  • Forskningsöversikt (refereegranskat)abstract
    • Abnormal patterns of proliferation characterize the behavior of many tumors. Proliferating cell nuclear antigen (PCNA) and Ki‐67 are two cell cycle antigens which are expressed in proliferative states. Our study examines the prognostic value of these cell‐cycle antigens in soft tissue sarcoma (STS). Paraffin‐embedded primary tumor tissues from 185 patients (1980–92) were stained with the anti‐PCNA antibody PC‐10; 182 of these were stained with the antibody MIB‐1 for Ki‐67. Using PCNA (≤50; >50%) and Ki‐67 (≤10; >10%) indices, we examined and compared metastasis‐free survival (MFS) in a mixed‐histotype group, as well as after subdivision into MFH and non‐MFH groups. Fifty‐seven patients developed metastases. The median follow‐up for survivors was 6 (2–13) years. In the mixed series, the 2‐year MFS for a PCNA index ≤50 was 76%, and for an index >50 56%. Survival predicted by Ki‐67 index was comparable. PCNA index (but not Ki‐67) strongly correlated with the incidence of metastasis in MFH tumors and predicted 2‐year MFS of 81 vs 48%. In contrast, Ki‐67 index (but not PCNA) strongly correlated with metastasis in non‐MFH tumors and predicted 2‐year MFS survival of 90 vs 45%. No correlation existed between PCNA and Ki‐67 indices in the mixed histotype, MFH or non‐MFH groups. In combination, a high PCNA and Ki‐67 index correlated with poor survival, a high PCNA and lower Ki‐67 index (or vice versa) with an intermediate survival, and low PCNA and Ki‐67 indices with the best survival. The pattern of PCNA and Ki‐67 expression raises the possibility of histotype specificity.
  • Choong, Peter F.M., et al. (författare)
  • Urokinase-plasminogen-activator levels and prognosis in 69 soft-tissue sarcomas
  • Ingår i: International Journal of Cancer. - : John Wiley and Sons Inc.. - 0020-7136. ; 69:4, s. 268-272
  • Tidskriftsartikel (refereegranskat)abstract
    • The local and systemic invasiveness of soft-tissue sarcomas may depend upon an interaction between the primary tumour and the extracellular matrix in which the proteolytic enzyme, urokinase plasminogen activator (uPA), may have an important role. We analyzed the expression of uPA in soft-tissue sarcoma using a luminescent immunoassay technique; and examined the relationships between different uPA levels and tumour characteristics and behaviour. We evaluated 69 adult patients with surgically treated soft-tissue sarcomas (MFH 43, leiomyosarcoma 8, liposarcoma 5, synovial sarcoma 4, others 9) of the extremities and trunk wall. Sixteen developed local recurrences, 26 developed metastases, and 5 had both. The median follow-up for survivors was 55 (30-80) months. The median uPA level was 1.4 (0.04-10.6) ng/mg protein. Increasing uPA levels correlated with increasing grade, malignant fibrous histiocytomas, leiomyosarcomas, DNA non-diploidy, tumour necrosis, local recurrence, and metastasis. Storiform-pleomorphic MFH had higher uPA levels than the myxoid variant. A cut-off value of 0.25 ng/mg protein was identified, above which local recurrence and metastasis occurred more frequently. High uPA levels appear to reflect the malignant phenotype in soft-tissue sarcoma, thus supporting the role of uPA as a prognostic indicator.
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