| 1. |
- Ewers, Sven-Börje, et al.
(författare)
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Flow cytometry DNA analysis and prediction of loco-regional recurrences after mastectomy in breast cancer
- 1992
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 31:7, s. 733-740
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Tidskriftsartikel (refereegranskat)abstract
- The study concerns whether DNA flow cytometry and estrogen receptor analysis might help predict which breast cancer patients, particularly node-positive ones, were at the greatest risk of developing loco-regional recurrence (LRR). Such patients would best benefit from postoperative radiotherapy following modified radical mastectomy and axillary lymph node dissection. After this type of surgery, 506 patients were followed up for a median time of nearly 5 years. Among the 235 patients given postoperative radiotherapy, the loco-regional control rate was 100% in N0 cases (n = 93), 94% in cases with 1-3 positive nodes (n = 90), 93% in cases with 4-9 positive nodes (n = 43), and 67% in cases with 10 or more positive nodes (n = 9). Among the 271 non-irradiated patients, the corresponding figures for loco-regional control were 91% in N0 cases (n = 141), 71% in cases with 1-3 positive nodes (n = 84), 65% in cases with 4-9 positive nodes (n = 31), and 67% in cases with 10 or more positive nodes (n = 15). Ploidy status, level of S-phase fraction, estrogen receptor content, and primary tumor size did not, in the present material, yield significant additional information with regard to the risk of LRR in the different nodal subgroups, a finding confirmed in multivariate analysis where the only significant predictor of LRR was the number of positive nodes (p = 0.01). Adjuvant tamoxifen treatment could not replace postoperative radiotherapy for achieving loco-regional tumor control, the overall rate of which was 81% among patients treated with tamoxifen only (n = 117), as compared with 98% among those also treated with radiotherapy (n = 54) (p = 0.003).
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| 2. |
- Ewers, Sven-Börje, et al.
(författare)
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Prognostic potential of flow cytometric S-phase and ploidy prospectively determined in primary breast carcinomas
- 1992
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Ingår i: Breast Cancer Research and Treatment. - 1573-7217. ; 20:2, s. 93-108
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective study of a consecutive breast cancer series accumulated in the period 1978-82, the S-phase fraction (SPF) and ploidy status were determined by flow cytometry performed on cell nuclei derived from samples of 580 primary tumors. Sixty percent of the tumors were non-diploid. After correction for debris the median SPF values were 7.3% overall, 12% for non-diploid tumors, and 2.9% for diploid tumors (2.6% when nodal subsets N2 and N3 and cases with metastases at presentation were excluded). The SPF values correlated both to tumor size (p = 0.008) and to the number of positive axillary lymph nodes (p = 0.03). At clinical follow-up in 1986, 467 unilateral breast cancer patients who had undergone radical treatment for cure could be evaluated with respect to the prognostic value of both the SPF value and ploidy status. The median duration of follow-up was then 59 months (range 2-90), and the median time-to-recurrence 24 months (range 2-69, n = 137). At follow-up in 1991, 201/467 of the patients had died, the median duration of follow-up being 50 months (range 2-126) for the decreased, and 119 (range 6-148) for the survivors. In multivariate analysis (Cox's proportional hazards models), the strongest independent predictors of distant recurrence-free survival (DRFS) were the number of positive axillary lymph nodes (p less than 0.0001), the debris-corrected SPF value alone (p = 0.003, versus p = 0.05 for uncorrected value), and ploidy status combined with the corrected SPF value (p = 0.0002). When age was taken into account, both the corrected SPF value and the ploidy-SPF combination were predictors of crude survival (p = 0.006 and p = 0.002, respectively). In univariate life-table analysis, the 5-year DRFS rate was 93% in node-negative (N0) cases with an SPF less than 7.3%, as compared to 80% in those with an SPF greater than or equal to 7.3% (p = 0.005). Among node-positive cases, the prognostic value of the SPF was confined to those with 1-3 positive nodes, the 5-year DRFS rate being 68% in cases with an SPF less than 7.3%, as compared to 40% in cases with an SPF greater than or equal to 7.3% (p = 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)
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| 3. |
- Jakobsson, Kristina, et al.
(författare)
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Gastrointestinal cancer among cement workers. A case-referent study
- 1990
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Ingår i: International Archives of Occupational and Environmental Health. - 1432-1246. ; 62:4, s. 337-340
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Tidskriftsartikel (refereegranskat)abstract
- A matched case-referent study was conducted to investigate the risk of gastrointestinal cancer in cement workers. All male cases of cancer in esophagus, stomach, colon and rectum in the period 1922-1988 from two parishes surrounding a cement plant were identified. For each case, four referents were chosen, matched to age and year of death. Employment in the cement plant was confirmed as from plant records or job title noted in the parish books. Of 25 cases with a definite colorectal tumour, 40% had been blue-collar cement workers for 25 years or more, compared with 20% of their referents [odds ratio (OR) 3.2; 95% confidence limits (CI) 1.1-9.4]. There were indications of a dose (time of employment)-response relationship. For 18 cases with an esophageal or stomach tumour, the OR for those ever employed as cement workers was 3.2 (CI 1.0-11), but short-term employment predominated, thus making a causal relationship less likely.
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| 4. |
- Johansson, L G, et al.
(författare)
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Ferruginous bodies and pulmonary fibrosis in dead low to moderately exposed asbestos cement workers: histological examination
- 1987
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Ingår i: British Journal of Industrial Medicine. - 0007-1072. ; 44:8, s. 550-558
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Tidskriftsartikel (refereegranskat)abstract
- Histological slides from the lungs of 89 dead asbestos cement workers have been examined with respect to ferruginous bodies and fibrosis. The results have been compared with individually matched controls with no known exposure to asbestos, and related to asbestos exposure, expressed as duration of exposure and cumulative asbestos dose, and smoking habits. The asbestos cement workers studied had been employed for on average 15 years, with a mean cumulative dose of 26 fibre-years per ml (f-y/ml). Clear dose-response relations between exposure (duration of exposure and cumulative asbestos dose) and level of ferruginous bodies were found. An association was evident already at a low cumulative dose (1-10 f-y/ml). Fibrosis was more common and more pronounced among the exposed workers than among controls. An association between ferruginous bodies and fibrosis was also found. Among the controls, but not among exposed workers, there was an association between smoking history and fibrosis.
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| 5. |
- Littorin, Margareta, et al.
(författare)
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Mortality and tumour morbidity among Swedish market gardeners and orchardists
- 1993
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Ingår i: International Archives of Occupational and Environmental Health. - 1432-1246. ; 65:3, s. 163-169
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Tidskriftsartikel (refereegranskat)abstract
- In order to investigate possible effects of exposure to pesticides, mainly fungicides and insecticides, we studied a cohort of 2370 subjects, who, during the period 1965-1982, had been members of a horticulturists' trade association (market gardeners and orchardists). Compared to a regional reference population, total mortality ( 542 deaths; standardized mortality morbidity ratio, SMR = 0.8 ; 95 % confidence limits, C Ls = 0.7, 0.9) and mortality due to malignant tumours ( 133 deaths, SMR = 0.9 ; C Ls = 0.7, 1.0), and cardiovascular and respiratory deaths were somewhat decreased Suggestive excesses in mortality were seen for mental disorders and tumours of the stomach, skin and nervous system The tumours of the nervous system were in particular excess in the young and middle-aged horticulturists (below age 60 ; six cases, SMR = 2.9 ; C Ls = 1.1, 6.2) During the period 1965- 1986, the total tumour morbidity was slightly decreased ( 255 cases; SMR = 0.9 ; C Ls = 0.8, 1.0), as were gastrointestinal and respiratory tract tumours The incidence of melanomas was increased ( 15 cases, SMR = 2.1 ; C Ls = 1.2, 3.5), and tumours of the female genital organs, myelomas, and brain tumours ( 12 cases, SMR = 1.5 ; C Ls = 0.8, 2.7) were slightly numerically elevated Brain tumours in the young and middle-aged horticulturists ( 11 cases, SMR = 3.2 ; C Ls = 1.6, 5.7), including meningiomas (four observed, SMR = 6.8 ; C Ls = 1.9, 17.4), were increased, especially in the period 1975-1979 The mortality and tumour morbidity patterns in gardeners and orchardists, analysed separately, were similar to the patterns in all the horticulturists The risk for brain tumours in the young and middle-aged subjects was increased about threefold in the gardeners, and about fivefold in the orchardists; in particular, meningiomas were in excess among the gardeners.
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