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61.
  • 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. ; 112:6, s. 1015-9
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
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62.
  • Dahlstrand, Hanna, et al. (författare)
  • Presence of human papillomavirus in tonsillar cancer is a favourable prognostic factor for clinical outcome.
  • 2004
  • Ingår i: Anticancer Research. - 0250-7005. ; 24:3b, s. 1829-35
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this article is to review the current knowledge on the status and significance of human papillomavirus (HPV) in tonsillar cancer. Current data in scientific reports and data from the Karolinska Hospital and Karolinska Institute, Sweden, demonstrate that approximately half of all tonsillar cancer is HPV-positive. Moreover, patients with HPV-positive cancer have a lower risk of relapse and longer survival compared to patients with HPV-negative tonsillar cancer. The favourable outcome for patients harbouring HPV-positive tonsillar cancer cannot be attributed to increased radiosensitivity, since there is no significant difference in sensitivity to radiotherapy between HPV-positive and -negative tonsillar cancer. However, HPV-positive cancer exhibits less genetic instability i.e. shows a lower degree of aneuploidy and a tendency to have fewer chromosomal aberrations, when compared to HPV-negative tonsillar cancer.
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63.
  • Dickman, P. W., et al. (författare)
  • Hip fractures in men with prostate cancer treated with orchiectomy
  • 2004
  • Ingår i: J Urol. - 0022-5347 (Print). ; 172:6 Pt 1, s. 2208-12
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Androgen deprivation therapy increases the risk of osteoporosis related fractures. This issue is of increasing importance in men with prostate cancer as increasingly more undergo androgen deprivation therapy and therapy is administered sooner following diagnosis. Data directly addressing the long-term fracture risk in men diagnosed with prostate cancer are limited. MATERIALS AND METHODS: Using population based registries in Sweden we studied the incidence of hip fractures in 17,731 men diagnosed with prostate cancer from 1964 to 1996 who were treated with bilateral orchiectomy within 6 months of diagnosis. The fracture incidence was compared to the incidence in 43,230 men diagnosed with prostate cancer but not treated with orchiectomy and in 362,354 of similar age who were randomly selected from the general population. RESULTS: Men treated with orchiectomy were at increased risk for hip fracture. The estimated relative risk comparing men who underwent orchiectomy to population controls was 2.11 (95% CI 1.94 to 2.29) for femoral neck fractures and 2.16 (95% CI 1.97 to 2.36) for intertrochanter fractures. An increased risk of hip fracture was observed as early as 6 months after orchiectomy and the relative risk remained fairly constant up to 15 years following orchiectomy. CONCLUSIONS: Hip fracture risk increases almost immediately following orchiectomy and the excess risk persists for at least 15 years. This side effect should be considered when assessing the merits of androgen deprivation therapy, particularly in symptom-free men diagnosed with localized prostate cancer. Measures to prevent osteoporosis should be considered in men undergoing androgen deprivation therapy.
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64.
  • Diep, Chieu B, et al. (författare)
  • Genome characteristics of primary carcinomas, local recurrences, carcinomatoses, and liver metastases from colorectal cancer patients
  • 2004
  • Ingår i: Molecular Cancer. - BioMed Central. - 1476-4598. ; 3
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Colorectal cancer (CRC) is one of the most common causes of cancer-related deaths in the Western world, and despite the fact that metastases are usually the ultimate cause of deaths, the knowledge of the genetics of advanced stages of this disease is limited. In order to identify potential genetic abnormalities underlying the development of local and distant metastases in CRC patients, we have, by comparative genomic hybridization, compared the DNA copy number profiles of 10 primary carcinomas, 14 local recurrences, 7 peritoneal carcinomatoses, and 42 liver metastases from 61 CRC patients. RESULTS: The median number of aberrations among the primary carcinomas, local recurrences, carcinomatoses, and liver metastases was 10, 6, 13, and 14, respectively. Several genetic imbalances, such as gains of 7, 8q, 13q, and 20, and losses of 4q, 8p, 17p, and 18, were common in all groups. In contrast, gains of 5p and 12p were more common in the carcinomatoses than in other stages of the disease. With hierarchical cluster analysis, liver metastases could be divided into two main subgroups according to clusters of chromosome changes. CONCLUSIONS: Each stage of CRC progression is characterized by a particular genetic profile, and both carcinomatoses and liver metastases are more genetically complex than local recurrences and primary carcinomas. This is the first genome profiling of local recurrences and carcinomatoses, and gains of 5p and 12p seem to be particularly important for the spread of the CRC cells within the peritoneal cavity.
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69.
  • Ekman, Inger, 1952-, et al. (författare)
  • Maintaining normality and support are central issues when receiving chemotherapy for ovarian cancer.
  • 2004
  • Ingår i: Cancer nursing. - 0162-220X. ; 27:3, s. 177-82
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to enrich the understanding of patients' perspective of being diagnosed and treated for ovarian cancer. A qualitative approach was used to obtain knowledge and insight into patients' experiences and thoughts. Ten Swedish women, diagnosed with ovarian cancer, participated in a total of 23 interviews on 3 occasions: at the time of diagnosis, during chemotherapy, and after completion of chemotherapy. The results of the interpretation of the interviews were formulated in the form of 3 themes: (1) feeling the same despite radical castrating surgery, (2) accepting chemotherapy, and (3) maintaining normality and support. Suggestions of caring implications from our interpretation of the interview data underscore the need to support these women in learning to cope with their feelings of weakness and anxiety. The findings further indicate the potential in narrative methods to identify important issues in comprehensive cancer care.
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70.
  • Elmberger, Eva (författare)
  • Att som förälder få en cancersjukdom erfarenheter av föräldraansvar
  • 2004
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Parents with cancer - the experiences of family responsibility Then main aim of this study was to gain an understanding of how women and men with cancer illnesses, looking after children at home, experience and manage their life situation, with focus on the responsibility as parent. An additional aim was to identify the parents' need for support, in order to develop support activities for them from a family nursing perspective. The perspective of symbolic interactionism influenced the qualitative studies in the thesis. Concepts used in the thesis were transition, identified as a core concept in nursing, and mothering and ethics of care as sensitizing concepts. The emphasis was on a conceptual framework in nursing, encompassing the main components of the theory of transition. The analysis methods used were grounded theory (study I and III), interpretive description (study II) and secondary analysis (study IV). Data was collected from open interviews with women and men with cancer who had children living at home. The participants in study I were nine women with breast cancer, in study II, eight men with cancer in the circulatory system and in study III, ten women with cancer in blood systems and a focus group interview. Study IV involved the same participants as study I and III. The results of study I illustrate the main theme of how the lives of these women had changed: transforming the exhausting-toenergising process of being a good parent in the face of cancer. All of the women expressed the desire to be a good mother. In study II, a central theme was generated - change in self-image as a man and as a parent. The men's self-image changed as well as their function as parents. In study III the core concept identified was the experience of dealing with the moral responsibility of being a mother with cancer. The findings were presented as a life story where the women's experiences were weaved together. In Study IV, the three phases in the transition process were used and a main theme was constructed that integrated these phases: "the desire to manage one's responsibility as a parent" within the context of mothering. All of the women included in this study expressed the need for professional support to help them to endure treatment procedures as well as to sustain their moral responsibility as good mothers. A model for professional moral support is suggested, based on these findings. The research implications are that the concept of moral support has been identified and can be incorporated into a theoretical model in order to further generate a hypothesis with the aim of creating a useful clinical intervention model. The clinical implications of this are to use and evaluate the tentative model for moral support in clinical practice in patient encounters with the family and in training health care staff.
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