| 1. |
- Wikman, Anna, et al.
(författare)
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Presence of symptom clusters in surgically treated patients with esophageal cancer
- 2014
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Ingår i: Cancer. - Stockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery. - 1097-0142 .- 0008-543X.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is not known whether symptoms cluster together after esophageal cancer surgery or whether such symptom clusters are associated with survival in patients with esophageal cancer who are treated surgically. METHODS: Data from a prospective Swedish nationwide cohort study of surgically treated patients with esophageal cancer recruited between 2001 and 2005 were used. General and esophageal cancer-specific symptoms were assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 quality of life questionnaire and the QLQ-OES18 module at 6 months after surgery. Associations between symptom clusters and survival were analyzed using Cox proportional hazards models, providing hazards ratios with 95% confidence intervals, adjusted for other known prognostic factors. RESULTS: Among 402 patients reporting symptoms 6 months after surgery, 3 symptom clusters were identified. The first symptom cluster (“fatigue/pain”) was characterized by symptoms of pain, fatigue, insomnia, and dyspnea and was present in 30% of patients. The second symptom cluster (“reflux/cough”) was characterized by symptoms of dry mouth, problems with taste, coughing, and reflux and was present in 27% of patients. The third symptom cluster (“eating difficulties”) was characterized by appetite loss, dysphagia, eating difficulties, and nausea/vomiting and was present in 28% of patients. The presence of the reflux/cough and eating difficulties symptom clusters was associated with a statistically significantly increased risk of mortality (adjusted hazards ratio, 1.43 [95% confidence interval, 1.08-1.89] and adjusted HR, 1.41 [95% confidence interval, 1.06-1.87], respectively). CONCLUSIONS: Symptoms experienced by surgically treated patients with esophageal cancer appear to cluster together, and the presence of these symptom clusters appears to have strong prognostic value.
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| 2. |
- Gustafson, Pelle, et al.
(författare)
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Soft tissue leiomyosarcoma. A population-based epidemiologic and prognostic study of 48 patients, including cellular DNA content
- 1992
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Ingår i: Cancer. - 1097-0142. ; 70:1, s. 114-119
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. Leiomyosarcoma of soft tissue is a rare tumor. There are different opinions regarding epidemiology and prognosis. METHODS. Epidemiology and prognosis were analyzed in a consecutive, population-based series of 48 patients with subcutaneous and deep-seated leiomyosarcoma in the extremities and trunk wall with a complete follow-up of a minimum of 3 years. Cutaneous tumors were not included. RESULTS. The annual incidence was 0.13/10(5). The ratio of men to women was 1.2, and the median age was 65 years. The thigh was the most common location. Almost half of the tumors were subcutaneous. The median tumor size was 6 cm (range, 1-25 cm). All patients were treated with surgery, and in 19 cases it was combined with adjuvant radiation therapy or chemotherapy. The cumulative 5-year survival rate was 64%. Multivariate analysis indicated that age of 60 years or greater (relative risk [RR] = 8) and intratumoral vascular invasion (RR = 4) were independent risk factors for death resulting from tumor. DNA aneuploidy (RR = 4) and tumor necrosis (RR = 3) were associated with poor prognosis, but did not reach statistic significance. CONCLUSIONS. Advanced age, vascular invasion, and DNA aneuploidy could be used to identify prognostic subgroups.
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| 3. |
- Olsson, Håkan, et al.
(författare)
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Proliferation and DNA ploidy in malignant breast tumors in relation to early oral contraceptive use and early abortions
- 1991
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Ingår i: Cancer. - 1097-0142. ; 67:5, s. 1285-1290
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Tidskriftsartikel (refereegranskat)abstract
- In 175 premenopausal breast cancer patients, a history of oral contraceptive (OC) use before 20 years of age was significantly associated with higher tumor cell proliferative activity, as indicated by a higher S-phase fraction (SPF), and a higher fraction of DNA aneuploid tumors, compared with later or never users (P = 0.05 and p = 0.01, respectively). The higher SPF among early OC users was apparent in patients with aneuploid tumors but not in patients with euploid tumors. Abortions (spontaneous or induced) before the first full-term pregnancy also were associated with a higher SPF compared with other young patients with breast cancer (P = 0.03). Adjusting for parity and abortions or OC use, respectively, an early OC use was associated with a 43% higher SPF and early abortions were associated with 49% higher SPF. Younger patients had a higher SPF and a higher frequency of aneuploid tumors, but this was found to be because the users of OC had a lower median age at diagnosis. Among never users, no significant age relationship was seen for SPF or the frequency of aneuploidy. For the DNA analyses there is a selection of patients with breast cancer with larger tumors, and therefore the conclusions drawn in this article may not be generalizable to patients with smaller primary tumors, e.g., cases diagnosed at breast cancer screening. The higher tumor proliferative activity and frequency of aneuploidy in early OC users are in line with previously reported findings of worse prognostic indicators and a worse survival in early users of OC compared with other young women with breast cancer.
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| 4. |
- Strand, Sven-Erik, et al.
(författare)
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Small animal imaging with pinhole single-photon emission computed tomography
- 1994
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Ingår i: Cancer. - 1097-0142. ; 73:Suppl. 3, s. 981-984
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. High resolution spatial details of the distribution of activity in three dimensions is required to evaluate the localization and dosimetric properties of radiolabelled monoclonal antibodies in tumors and normal tissues. Planar imaging of small animals with a resolution of 5-10 mm is usually the imaging modality of choice. The authors investigated high resolution single-photon emission computed tomographic (SPECT) imaging, based on a rotating pinhole scintillation camera. Although the sensitivity of the pinhole collimator is low, several radionuclides offer suitable decay properties to perform pinhole SPECT, especially in conjunction with high activity levels used in radioimmunotherapy. METHODS. Transverse, sagittal, and coronal sections were reconstructed using a three-dimensional cone-beam algorithm, which is a generalization of the two-dimensional fan-beam filtered backprojection algorithm. Before reconstruction, the pinhole projections were corrected for the decay of the radionuclide, geometric and intrinsic efficiency variations of the camera system, and center of rotation shift. RESULTS. The spatial resolution at 50 mm from the pinhole collimator with 3.3 mm aperture was 3.4 mm, and the sensitivity 7.2 c/s microCi for technetium-99m. With the 2 mm collimator the resolution was 2.2 mm, and the sensitivity was 2.6 c/s/microCi. To show the spatial resolution in vivo, a rat was injected with 185 MBq of technetium-99m-methylene diphosphonate or with 5 mCi technetium-99m-hexamethylpropylene amine oxime. The bone structures were well delineated in the methylene diphosphonate image, and in the hexamethylpropylene amine oxime image, the brain was nicely shown. For comparison a magnetic resonance image for the same section was done. CONCLUSIONS. High resolution SPECT imaging with the pinhole collimator provides mapping of the activity in three-dimensions, needed for more detailed biodistribution data and to perform more accurate dosimetry.
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| 5. |
- Tarkkanen, Maija, et al.
(författare)
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Comparative genomic hybridization of postirradiation sarcomas
- 2001
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Ingår i: Cancer. - 1097-0142. ; 92:7, s. 1992-1998
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. Radiotherapy is a known risk factor for sarcoma development. Postirradiation sarcomas arise within the radiation field after a latency period of several years and usually are highly malignant. Very little is yet known about their genetic changes. METHODS. Twenty-seven postirradiation sarcomas were analyzed by comparative genomic hybridization, which allows genome-wide screening of DNA sequence copy number changes. RESULTS. Copy-number aberrations were detected in 20 (74%) tumors. The mean number of aberrations per tumor was 5.3 with gains outnumbering losses. The most frequent gains affected the minimal common regions of 7q11.2-q21 and 7q22 in 30% and 7p15-pter in 26%. Gain of 8q23-qter was detected in 22%. The most frequent losses affected 11q23-qter and 13q22-q32 in 22%. In osteosarcomas, the most frequent aberration was loss of 1p21-p31, in malignant fibrous histiocytomas (MFH) gain of 7cen-q22, and in fibrosarcomas gain of 7q22. The findings in postirradiation osteosarcomas and MFHs were compared with findings in sporadic osteosarcomas and MFHs, reported previously by the authors. In sporadic osteosarcomas, gains outnumbered losses, but, in postirradiation osteosarcomas, losses were more frequent than gains. Loss at 1p was rare in sporadic osteosarcoma (3%) but frequent (57%) in postirradiation osteosarcomas. Gains at 7q were frequent both in postirradiation and sporadic MFH. CONCLUSIONS. According to previous studies on different types of sporadic sarcomas, gains at 7q or 8q are associated with poor prognosis or large tumor size. Thus, the frequent gains at 7q and 8q might have been responsible in part for the poor prognosis of postirradiation sarcomas. Also, however, some of their clinical features, i.e., high malignancy grade, late diagnosis, and central location, are associated with a poor prognosis.
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| 6. |
- Hertervig, Erik, et al.
(författare)
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Alkaline sphingomyelinase activity is decreased in human colorectal carcinoma
- 1997
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Ingår i: Cancer. - 1097-0142. ; 79:3, s. 448-453
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The metabolism of sphingomyelin generates important signals regulating cell proliferation and apoptosis. Previous studies found that the administration of colon carcinoma carcinogen was associated with an accumulation of membrane sphingomyelin, and that dietary sphingomyelin inhibited promotion of experimental colon carcinoma in mice, indicating that the abnormal metabolism of sphingomyelin is linked to colon carcinoma development. However, the changes in sphingomyelinase (SMase) activity in colon carcinoma have not been directly studied. The authors identified, specifically in the intestine, a distinctive alkaline SMase that differs from the known acidic and neutral SMases. The functions and clinical implications of the enzyme are unknown. This study examined the changes in all three SMase activities in human colorectal carcinoma. METHODS: Tissue samples were taken from colorectal carcinoma and normal mucosa from 18 patients. After homogenization, the activities of acidic, neutral, and alkaline SMase, as well as ceramidase and alkaline phosphatase, were determined. The enzyme activities in cancer tissue were compared with normal tissue from the same patients. RESULTS: In the normal tissue, there is an activity gradient from the ascending colon to the rectum for neutral and alkaline SMases but not for acidic SMase. In colorectal carcinoma, alkaline SMase activity was preferentially decreased by 75%, whereas acidic and neutral SMase activity decreased by 30% and 50%, respectively. No changes could be found for either ceramidase or alkaline phosphatase activity. CONCLUSIONS: Alkaline SMase activity preferentially decreases in human colorectal carcinoma, suggesting a regulatory role of the enzyme in colon mucosa cell proliferation.
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| 7. |
- Loman, Niklas, et al.
(författare)
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Steroid receptors in hereditary breast carcinomas associated with BRCA1 or BRCA2 mutations or unknown susceptibility genes
- 1998
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Ingår i: Cancer. - 1097-0142. ; 83:2, s. 310-319
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The expression of steroid receptors is a common feature of both male and female breast carcinomas and is also one of the most important prognostic factors for patients with this disease. Steroid receptor levels in BRCA1-related breast carcinoma have reportedly been low. Little data on steroid receptor levels have been reported with regard to BRCA2. METHODS: Steroid receptor levels were analyzed in 27 breast carcinomas associated with BRCA1 mutations, 14 associated with BRCA2 mutations, and 32 from individuals who had hereditary breast carcinoma but no detectable mutations of either BRCA1 or BRCA2. Breast carcinomas from 32 consecutive male patients, 6 of whom had mutations of BRCA2, were also examined for steroid receptors. Estrogen receptor (ER) and progesterone receptor (PgR) analyses were performed with radioligand or enzyme immunoassay techniques on tumor cytosol preparations. Germline mutation screening and detection were performed using the protein truncation test, single strand conformation polymorphism, and direct sequencing on DNA from normal tissue. RESULTS: The BRCA1-related tumors expressed significantly lower levels of ER than tumors from the other hereditary groups. The PgR levels were significantly lower in the BRCA1-related cases than in the hereditary cases not related to BRCA1 or BRCA2, but not significantly lower than in the BRCA2-related cases. Fourteen of 32 (44%) of the hereditary tumors not related to BRCA1 or BRCA2 had PgR levels exceeding 100 fmol/mg of protein. The tumors from male patients with BRCA2-related disease did not have receptor levels that differed from those in non-BRCA2-related tumors. CONCLUSIONS: BRCA1- and BRCA2-related breast tumors were distinct in their expression of steroid receptors. Moreover, a subgroup of tumors not related to BRCA1 or BRCA2 manifested a strongly positive PgR phenotype rarely seen in BRCA1- and BRCA2-related tumors. These characteristics may be of relevance to the treatment and follow-up of high risk individuals in these families and may help identify a homogeneous category of hereditary breast carcinomas not related to BRCA1 or BRCA2 in which new susceptibility genes may be sought.
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