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Sökning: WFRF:(Högmo Anders)

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1.
  • Norling, Rikke, et al. (författare)
  • Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas : a questionnaire survey in the Nordic countries
  • 2012
  • Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 51:3, s. 355-361
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.</p>
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2.
  • Norling, Rikke, et al. (författare)
  • Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries
  • 2012
  • Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 51:3, s. 355-361
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.</p>
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3.
  • Norling, Rikke, et al. (författare)
  • Radiological imaging of the neck for initial decision-making in oral squamous cell carcinomas-A questionnaire survey in the Nordic countries
  • 2012
  • Ingår i: Acta Oncologica. - Informa Healthcare. - 0284-186X .- 1651-226X. ; 51:3, s. 355-361
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background. Fast and accurate work-up is crucial to ensure the best possible treatment and prognosis for patients with head and neck cancer. The presence or absence of neck lymph node metastases is important for the prognosis and the choice of treatment. Clinical lymph node (N)-staging is done by palpation and diagnostic imaging of the neck. We investigated the current practice of the initial radiological work-up of patients with oral squamous cell carcinomas (OSCC) in the Nordic countries. Methods. A questionnaire regarding the availability and use of guidelines and imaging modalities for radiological N-staging in OSCC was distributed to 21 Head and Neck centres in Denmark (n = 4), Finland (n = 5), Iceland (n = 1), Norway (n = 4) and Sweden (n = 7). We also asked for a description of the radiological criteria for determining the lymph nodes as clinical positive (cN+) or negative (cN0). Results. All 21 Head and Neck centres responded to the questionnaire. Denmark and Finland have national guidelines, while Norway and Sweden have local or regional guidelines. Seventeen of the 19 centres with available guidelines recommended computed tomography (CT) of the cN0 neck. The waiting time may influence the imaging modalities used. Lymph node size was the most commonly used criteria for radiological cN+, but the cut-off measures vary from 0.8 to 2.0 cm. Conclusion. Overall, CT is the most commonly recommended and used imaging modality for OSCC. Despite availability of national guidelines the type and number of radiological examinations vary between centres within a country, but the implementation of a fast-track programme may facilitate fast access to imaging. The absence of uniform criteria for determining the lymph nodes of the neck as cN+ complicates the comparison of the accuracy of the imaging modalities. Well-defined radiological strategies and criteria are needed to optimise the radiological work-up in OSCC.</p>
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4.
  • Adnan, Ali, et al. (författare)
  • Health-related quality of life among tonsillar carcinoma patients in Sweden in relation to treatment and comparison with quality of life among the population
  • 2020
  • Ingår i: Head and Neck. - John Wiley & Sons. - 1043-3074 .- 1097-0347. ; 42:5, s. 860-872
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Background: The health-related quality of life (HRQOL) of tonsillar carcinoma survivors was explored to investigate any HRQOL differences associated with tumor stage and treatment. The survivors' HRQOL was also compared to reference scores from the population.</p><p>Methods: In this exploratory cross-sectional study patients were invited 15 months after their diagnosis and asked to answer two quality of life questionnaires (EORTC QLQ- C30, EORTC QLQ- HN35), 405 participated.</p><p>Results: HRQOL was associated with gender, with males scoring better than females on a few scales. Patients' HRQOL was more associated with treatment than tumor stage. Patients' HRQOL was worse than that in an age- and sex-matched reference group from the normal population, the largest differences were found for problems with dry mouth followed by problems with sticky saliva, senses, swallowing and appetite loss.</p><p>Conclusions: The tonsillar carcinoma patients had a worse HRQOL compared to the general population one year after treatment.</p>
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5.
  • Adnan, Ali, et al. (författare)
  • Health-related quality of life among tonsillar carcinoma patients in Sweden in relation to treatment and comparison with quality of life among the population
  • ????
  • Ingår i: Head and Neck. - John Wiley and Sons Inc.. - 1043-3074.
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The health-related quality of life (HRQOL) of tonsillar carcinoma survivors was explored to investigate any HRQOL differences associated with tumor stage and treatment. The survivors' HRQOL was also compared to reference scores from the population. Methods: In this exploratory cross-sectional study patients were invited 15 months after their diagnosis and asked to answer two quality of life questionnaires (EORTC QLQ- C30, EORTC QLQ- HN35), 405 participated. Results: HRQOL was associated with gender, with males scoring better than females on a few scales. Patients' HRQOL was more associated with treatment than tumor stage. Patients' HRQOL was worse than that in an age- and sex-matched reference group from the normal population, the largest differences were found for problems with dry mouth followed by problems with sticky saliva, senses, swallowing and appetite loss. Conclusions: The tonsillar carcinoma patients had a worse HRQOL compared to the general population one year after treatment.
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6.
  • Dahlgren, Liselotte, et al. (författare)
  • Human papillomavirus is more common in base of tongue than in mobile tongue cancer and is a favorable prognostic factor in base of tongue cancer patients.
  • 2004
  • Ingår i: International Journal of Cancer. - 0020-7136 .- 1097-0215. ; 112:6, s. 1015-9
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>The frequency of human papilloma virus (HPV) and its influence on clinical outcome was analyzed retrospectively in pre-treatment paraffin embedded biopsies from 110 patients with tongue cancer. The presence of HPV DNA was examined in 85 mobile tongue tumors and 25 base of tongue tumors by a polymerase chain reaction (PCR) with 2 general primer pairs, GP5+/6+ and CPI/IIG. When HPV-DNA was found, HPV-type specific primers and direct sequencing were used for HPV sub-type verification. Twelve of 110 (10.9%) samples were HPV-positive; 9 for HPV-16, 1 for HPV-33, 1 for HPV-35 and 1 could not be analyzed because of shortage of DNA. HPV was significantly more common in base of tongue tumors (10/25, 40.0%) compared to tumors of the mobile tongue (2/85, 2.3%). The influence of HPV on clinical outcome in mobile tongue cancer could not be studied, due to that HPV was present in too few cases. Of the 19 patients with base of tongue cancer that were included in the survival analysis, however, 7 patients with HPV-positive base of tongue cancer had a significantly favorable 5-year survival rate compared to the 12 HPV-negative patients. In conclusion, HPV is significantly more common in base of tongue cancer than in mobile tongue cancer, and has a positive impact on disease-specific survival in patients with base of tongue cancer.</p>
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7.
  • Högmo, Anders (författare)
  • Squamous cell carcinomas and preneoplastic lesions of the oral cavity : biological factors and prognosis
  • 1999
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • In Sweden, squamous cell carcinoma of the oral cavity comprises only 0.8% of the total cancer incidence. However, this disease often has a poor prognosis and the treatment frequently means some degree of disfiguration of the patient. The TNM classification, defined by UICC (International Union Against Cancer), together with the histopathological evaluation of the tumor, grade of differentiation according to Broders, and the performance status of the patient, serve as the basis for the decisions regarding the treatment of each individual patient. However, this system is a blunt instrument for optimization of treatment and it is well known that a tumor might possess features that are much more aggressive than the evaluation gives the impression of. Some mucosal lesions in the oral cavity are burdened with a risk of cancer development: preneoplastic lesions. Macroscopic appearance and microscopic evaluation of grade of dysplasia, serve as the basis for selection of treatment of these lesions. Again, these decisions are hampered by the subjectivity of the methods and the unpredictable course of the disease. Our general hypothesis is that biological characteristics closer to the genotype of the carcinomas and the preneoplastic lesions could provide information that could be used for optimizing the treatment of the individual patient. Measurement of nuclear DNA content, through Image Cytometry, is a method to estimate genetic instability in tumor cells. The tumor suppressor gene p53 regulates the cell cycle via protein p53, the WAF1 gene and its protein p21. p53 and p21/WAF1 proteins were studied through immunohistochemistry and the p53 gene was screened for mutations, using CDGE (Constant Denaturant Gel Electrophoresis). A tumor cell population depends on neovascularization (angiogenesis) for its survival. This phenomenon, which was studied through immunohistochemistry, is considered to take place as a result of tumor-host interaction. Morphological characteristics of the tumor cell population and tumor-host relationships can be described through microscopic interpretation and measured in a malignancy grading system according to Jakobsson or tumor front grading system according to Bryne. Previous studies on the prognostic value of biological actors hav often shown contradictory results and no marker has emerged as superior to TNM classification. This was also our experience when oral carcinomas of different subsites and of different stages were included. However, when the materials were compiled with an effort to control confounding factors, such as stage, site and treatment, subgroups of patients could be identified through biological factors. In stage I tongue carcinomas, a severe DNA deviation was found to correlate with the risk of local recurrence in the tongue. The DNA deviation of the recurring tumors was comparable to the DNA deviation of advanced tongue carcinomas. Overexpression of the p53 protein correlated with the appearance of cervical metastases (regional recurrence), which also could be predicted through the Jakobsson malignancy grading system. But, when the presence of p53 mutations were investigated through CDGE and sequencing (exons 5-8) no significant prognostic impact could be detected for stage I tongue carcinomas. Preneoplastic lesions with a later development of carcinoma or carcinoma in situ on the same localization, revealed the same nuclear DNA content and frequency of p53 protein overexpression as the subsequent carcinomas, irrespective of the grade of dysplasia. Dysplastic lesions prior to carcinomas on the same localization displayed a more severe DNA deviation than dysplastic lesions without further progression.
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