| 1. |
- Bodén, Robert, et al.
(author)
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Antidopaminergic drugs and acute pancreatitis : a population-based study
- 2012
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In: BMJ Open. - : BMJ. - 2044-6055. ; 2:3, s. e000914-
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To evaluate the suggested association between antidopaminergic drugs and acute pancreatitis.DESIGN: A large population-based nested case-control study.SETTING: Swedish nationwide study from 2006 to 2008.PARTICIPANTS: The Patient Register was used to identify 6161 cases of acute pancreatitis. The 61 637 control subjects were randomly selected from the Register of the Total Population by frequency-based density sampling, matched for age, sex and calendar year.EXPOSURE: Exposure data were extracted from the Prescribed Drug Register. Antidopaminergic drugs were grouped into antiemetic/anxiolytic and other antipsychotics. Current use of antidopaminergic drugs was defined as filling a prescription 1-114 days before index date, while previous use was 115 days to 3.5 years before index date.MAIN OUTCOME MEASURES: Cases were defined as being diagnosed as having acute pancreatitis. ORs and 95% CIs were calculated using unconditional logistic regression.RESULTS: The unadjusted OR indicated an increased risk of acute pancreatitis among current users of antiemetic/anxiolytics (OR 1.9, 95% CI 1.4 to 2.6), but not in the multivariable model adjusting for alcohol-related comorbidity, chronic obstructive lung disease, ischaemic heart disease, obesity, diabetes, opioid use, gallstone disease, educational level, marital status and number of concomitant medications (OR 0.9, 95% CI 0.6 to 1.2). Similarly, among current users of other antipsychotics, the unadjusted OR was 1.4 (95% CI 1.1 to 1.6), while the adjusted OR was 0.8 (95% CI 0.6 to 0.9). Results regarding previous use of antidopaminergic drugs followed a similar risk pattern as for current use.CONCLUSIONS: The lack of association between antidopaminergic drugs and acute pancreatitis after adjustment for confounding factors in this study suggests that the previously reported positive associations might be explained by confounding.
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| 2. |
- Chandanos, Evangelos, et al.
(author)
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Endogenous estrogen exposure in relation to distribution of histological type and estrogen receptors in gastric adenocarcinoma
- 2008
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In: Gastric Cancer. - : Springer Science and Business Media LLC. - 1436-3291 .- 1436-3305. ; 11:3, s. 168-174
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Journal article (peer-reviewed)abstract
- BACKGROUND: Estrogen might protect women against gastric adenocarcinoma of the intestinal histological type. We addressed this hypothesis and proposed that gastric estrogen receptors (ERs) are involved. METHODS: A population-based cohort of patients with gastric adenocarcinoma diagnosed in 1958-2004 in the county of Stockholm was identified through the Swedish Cancer Register. The patients were categorized regarding their endogenous estrogen exposure at diagnosis into: women aged less than 50 years, labelled "exposed women" (n=364), men aged less than 50 years, labelled "unexposed men" (n=396), and women aged more than 70 years, labelled "unexposed women" (n=3008). Tumor specimens were reviewed, and 289 cases were classified into intestinal (n=101) or diffuse type (n=188). Cases of intestinal adenocarcinomas (n=45) were tested for presence of ERalpha, ERbeta, and ERbeta cx by immunohistochemistry. RESULTS: Compared to "exposed women", the intestinal type of gastric adenocarcinoma was more than four times more common among "unexposed men" (odds ratio [OR], 4.7; 95% confidence interval [CI], 2.2-10.3) and nine times more common among "unexposed women" (OR, 9.1; 95% CI, 4.3-19.6). No differences in ER expression were found. A comparison of ERs in tissues taken from the tumors and adjacent gastric mucosa revealed a loss of ERbeta and a gain of ERalpha in the tumor cells. The presence of ERbeta cx was identified for the first time in gastric tumors. CONCLUSION: Gastric adenocarcinoma of the intestinal type is less common in women with high endogenous estrogen exposure, indicating a preventive effect of estrogen. No differences in the distribution of ERs was found between the three estrogen exposure groups. The presence of ERbeta cx in gastric cancer warrants further investigation.
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| 4. |
- Hayami, Masaru, et al.
(author)
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Population-Based Cohort Study from a Prospective National Registry : Better Long-Term Survival in Esophageal Cancer After Minimally Invasive Compared with Open Transthoracic Esophagectomy
- 2022
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In: Annals of Surgical Oncology. - : Springer Nature. - 1068-9265 .- 1534-4681. ; 29:9, s. 5609-5621
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Journal article (peer-reviewed)abstract
- Background Recent research indicates long-term survival benefits of minimally invasive esophagectomy (MIE) compared with open esophagectomy (OE) for patients with esophageal and gastroesophageal junction (GEJ) cancers, but there is a need for more population-based studies. Methods We conducted a prospective population-based nationwide cohort study including all patients in Sweden diagnosed with esophageal or junctional cancer who underwent a transthoracic esophagectomy with intrathoracic anastomosis. Data were collected from the Swedish National Register for Esophageal and Gastric Cancer in 2006-2019. Patients were grouped into OE and MIE including hybrid MIE (HMIE) and totally MIE (TMIE). Overall survival and short-term postoperative outcomes were compared using Cox regression and logistic regression models, respectively. All models were adjusted for age, sex, American Society of Anesthesiologists (ASA) score, clinical T and N stage, neoadjuvant therapy, year of surgery, and hospital volume. Results Among 1404 patients, 998 (71.1%) underwent OE and 406 (28.9%) underwent MIE. Compared with OE, overall survival was better following MIE (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.55-0.94), TMIE (HR 0.67, 95% CI 0.47-0.94), and possibly also after HMIE (HR 0.76, 95% CI 0.56-1.02). MIE was associated with shorter operation time, less intraoperative bleeding, higher number of resected lymph nodes, and shorter hospital stay compared with OE. MIE was also associated with fewer overall complications (odds ratio [OR] 0.70, 95% CI 0.47-1.03) as well as non-surgical complications (OR 0.64, 95% CI 0.40-1.00). Conclusions MIE seems to offer better survival and similar or improved short-term postoperative outcomes in esophageal and GEJ cancers compared with OE in this unselected population-based cohort.
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| 5. |
- Holmberg, Dag, et al.
(author)
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Aspirin or statin use in relation to survival after surgery for esophageal cancer : a population-based cohort study
- 2023
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In: BMC Cancer. - : BioMed Central (BMC). - 1471-2407. ; 23:1
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Journal article (peer-reviewed)abstract
- Background: Adjuvant postoperative treatment with aspirin and statins may improve survival in several solid tumors. This study aimed to assess whether these medications improve the survival after curatively intended treatment (including esophagectomy) for esophageal cancer in an unselected setting.Methods: This nationwide cohort study included nearly all patients who underwent esophagectomy for esophageal cancer in Sweden from 2006 to 2015, with complete follow-up throughout 2019. Risk of 5-year disease-specific mortality in users compared to non-users of aspirin and statins was analyzed using Cox regression, providing hazard ratios (HR) with 95% confidence intervals (CI). The HRs were adjusted for age, sex, education, calendar year, comorbidity, aspirin/statin use (mutual adjustment), tumor histology, pathological tumor stage, and neoadjuvant chemo(radio)therapy.Results: The cohort included 838 patients who survived at least 1 year after esophagectomy for esophageal cancer. Of these, 165 (19.7%) used aspirin and 187 (22.3%) used statins during the first postoperative year. Neither aspirin use (HR 0.92, 95% CI 0.67-1.28) nor statin use (HR 0.88, 95% CI 0.64-1.23) were associated with any statistically significant decreased 5-year disease-specific mortality. Analyses stratified by subgroups of age, sex, tumor stage, and tumor histology did not reveal any associations between aspirin or statin use and 5-year disease-specific mortality. Three years of preoperative use of aspirin (HR 1.26, 95% CI 0.98-1.65) or statins (HR 0.99, 95% CI 0.67-1.45) did not decrease the 5-year disease-specific mortality.Conclusions: Use of aspirin or statins might not improve the 5-year survival in surgically treated esophageal cancer patients.
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| 6. |
- Shore, Richard, et al.
(author)
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Risk of esophageal and gastric adenocarcinoma in men receiving androgen deprivation therapy for prostate cancer
- 2021
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In: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 11:1
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore the male predominance in esophageal and gastric adenocarcinoma by evaluating the preventive potential of androgen deprivation therapy (ADT). This matched cohort study was based on a national Swedish database of prostate cancer patients in 2006-2013. Prostate cancer patients receiving ADT were the exposed group. Prostate cancer-free men from the general population were randomly selected and matched to the index case by birth year and county of residence, forming the unexposed control group. The participants were followed until a diagnosis of esophageal or gastric cancer, death, emigration, or end of the study period. The risk of esophageal adenocarcinoma, cardia gastric adenocarcinoma, non-cardia gastric adenocarcinoma, and esophageal squamous-cell carcinoma among ADT-exposed compared to unexposed was calculated by multivariable Cox proportional hazard regression. The hazard ratios (HRs) and 95% confidence intervals (CIs) were adjusted for confounders. There was a risk reduction of non-cardia gastric adenocarcinoma among ADT-users compared to non-users (HR 0.49 [95% CI 0.24-0.98]). No such decreased risk was found for esophageal adenocarcinoma (HR 1.17 [95% CI 0.60-2.32]), cardia gastric adenocarcinoma (HR 0.99 [95% CI 0.40-2.46]), or esophageal squamous cell carcinoma (HR 0.99 [95% CI 0.31-3.13]). This study indicates that androgen deprivation therapy decreases the risk of non-cardia gastric adenocarcinoma, while no decreased risk was found for esophageal adenocarcinoma, cardia gastric adenocarcinoma, or esophageal squamous-cell carcinoma.
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| 7. |
- Viklund, Pernilla, et al.
(author)
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Quality of life and persisting symptoms after oesophageal cancer surgery
- 2006
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In: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 42:10, s. 1407-1414
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Journal article (peer-reviewed)abstract
- To assess quality of life (QoL) and symptoms after oesophageal cancer surgery, a prospective nationwide population-based study was conducted in 2001-2005, including most surgically treated oesophageal cancer patients in Sweden. Six months postoperatively patients responded to an EORTC quality of life core questionnaire (QLQ C-30) with an oesophageal-specific module (OES-18). Mean scores were calculated. Mann-Whitney test was used for group comparisons. Among 282 patients, QoL was considerably reduced compared to a reference general population (P < 0.001), and functioning scales were similarly negatively affected; particularly role (P < 0.001) and social (P < 0.001) functions. Younger patients scored worse than older. No gender differences were found. Dominating general symptoms included fatigue, appetite loss, diarrhoea, and dyspnoea, each significantly more pronounced than the general population (P < 0.001). Eating problems, cough, reflux, and oesophageal pain were common oesophageal-specific symptoms. Thus, patients who undergo oesophageal cancer resection suffer greatly from reduced QoL and several general and oesophageal-specific symptoms six months postoperatively. (c) 2006 Elsevier Ltd. All rights reserved.
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