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- Jahnson, S., et al.
(författare)
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Thromboembolism in Muscle-Invasive Bladder Cancer. A Population-based Nationwide Study
- 2021
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Ingår i: Bladder Cancer. - : IOS Press. - 2352-3727 .- 2352-3735. ; 7:2, s. 161-171
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Routine VTE prophylaxis within 30 days of radical cystectomy (RC) for urinary bladder cancer (UBC) is used to protect from venous thromboembolism (VTE). However, randomized studies and nationwide population-based studies are lacking. OBJECTIVE: To study VTE and risk factors for VTE in muscle-invasive UBC in a nationwide population-based series, with a focus on the association with RC with and without chemotherapy. MATERIALS AND METHODS: We studied all patients with clinical stage T2-T4 UBC diagnosed 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe). Previous VTE events and risk factors for VTE were registered from 1987. Cox regression analyses and Kaplan-Meier curves were performed to study risk factors for VTE and cumulative incidence of VTE. RESULTS: In 9720 patients (71% males) with a median age of 74 years 546 (5.6%) had VTE after diagnosis. In Cox analyses controlling for patient's and tumour characteristics, and risk factors for VTE, VTE after diagnosis and first treatment date were associated with chemotherapy with or without RC. Cumulative incidence of VTE increased during 24 months after diagnosis and first treatment date. VTE were less common in patients with previous cardiovascular disease. CONCLUSION: VTE was commonly observed after 30 days from diagnosis and from first treatment date in patients with T2-T4 UBC, particularly after chemotherapy. The findings suggest that long-term intervention studies of benefit and possible harms of VTE prophylaxis after UBC should be undertaken.
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- Malmstrom, A., et al.
(författare)
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INTERNATIONAL SURVEY REGARDING USE OF MGMT ANALYSES FOR GLIOMA
- 2018
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Ingår i: Neuro-Oncology. - : OXFORD UNIV PRESS INC. - 1522-8517 .- 1523-5866. ; 20, s. 215-215
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: MGMT promotor methylation status is part of glioma diagnostics, supporting clinical decision making. Internationally different methods and cut-off levels are used to determine whether a tumor is methylated or unmethylated. Treatment decisions can be inadequate, when methylation status of the tumor can change due to the analysis and cutoff used. MATERIAL AND METHODS: We conducted an international survey, consisting of 27 questions, to clarify which methods are regularly used in different clinico-pathological settings and why a specific method is selected. We also asked about opinions regarding an international consensus on methods and cut-off levels. RESULTS: The survey was answered by 146 respondents - mainly neuropathologists - from 24 countries. The responses show that MGMT methylation status is determined for all gliomas in 37% of laboratories, while 8% do not perform the analysis. The most commonly used methods are msPCR (37%) and pyrosequencing (34%). The main reasons for choosing a specific method are simplicity (56%), cost-effectiveness (49%) and reproducibility of results (49%). For those using pyrosequencing, the most common number of CpG sites analyzed is four, but varies between 1–3 and more than 16. For 50% of laboratories, the company producing the kit determines which CpG sites should be examined, while 33% select the sites themselves. Selection of cut-off is equally distributed between a cut-off a) published in the literature, b) defined by the lab or c) defined by the company performing the analysis. This cut-off varies between different pathology departments. In one lab tumor is determined as methylated in case of 1 methylated CpG site of 17 analyzed. For others cut-off for methylated varies from 1% to 30%. Some report tumor as unmethylated or weakly versus highly methylated. An international consensus on MGMT methylation method is believed to be of advantage by 66%, while only 20% do not find this necessary. A consensus on a cut-off is warranted by 76%. Most suggest that the consensus method should be msPCR (45%) or pyrosequencing (42%), while 17% suggest next generation sequencing. CONCLUSION: While analysis and use of MGMT methylation status has become routine in the clinico-pathological setting, there is still controversy regarding the best laboratory method and the clinically relevant cut-off level. Most respondents suggest that an international consensus on both method and cut-off should be established.
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