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- Bexe-Lindskog, Elinor, et al.
(författare)
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A population-based cohort study on adherence to practice guidelines for adjuvant chemotherapy in colorectal cancer
- 2014
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 14, s. 948-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The value of adjuvant chemotherapy in colorectal cancer is well studied, and guidelines have been established. Little is known about how treatment guidelines are implemented in the everyday clinical setting. Methods: This national population-based study on nearly 34,000 patients with colorectal cancer evaluates the adherence to present clinical guidelines for adjuvant chemotherapy. Virtually all patients with colorectal cancer in Sweden during the years 2007-2012 and data from the Swedish Colorectal Cancer Registry were included. Results: In colon cancer stage III, adherence to national guidelines was associated with lower age, presence of multidisciplinary team (MDT) conference, low co-morbidity, and worse N stage. The MDT forum also affected whether or not high-risk stage II colon cancer patients were considered for adjuvant chemotherapy. Rectal cancer patients both in stage II and III were considered for adjuvant chemotherapy less often than colon cancer patients, but the same factors influenced the decision. Adjuvant chemotherapy was started later than eight weeks after surgery in 30% of colon cancer patients and in 38% of rectal cancer patients. Conclusions: In Sweden, the adherence to national guidelines for adjuvant chemotherapy in colon cancer stage III is acceptable in younger and healthier patients. MDT conferences are of major importance and affect whether patients are recommended for adjuvant chemotherapy. Special consideration needs to be given to certain subgroups of patients, particularly older patients and patients with poorly differentiated tumors. There is a need to shorten the waiting time until start of chemotherapy.
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| 3. |
- Bexe-Lindskog, Elinor, et al.
(författare)
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Thymidine phosphorylase expression is associated with time to progression in patients with metastatic colorectal cancer.
- 2014
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Ingår i: BMC clinical pathology. - : Springer Science and Business Media LLC. - 1472-6890. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- 5-Fluorouracil (5-FU) is the cornerstone of chemotherapeutic treatment for patients with colorectal cancer. The enzyme thymidine phosphorylase (TP) catalyzes the conversion of 5-FU to its active metabolite, 5-fluoro-2'-deoxyuridine. TP is expressed in tumour epithelial cells and stromal cells, particularly in tumour-associated macrophages. These macrophages may affect sensitivity to chemotherapy. Previously, we identified TP as a predictive factor in microdissected tumour samples of patients with advanced colorectal cancer. In the present study, we analysed TP expression in tissues and associated stromal cells from patients with advanced colorectal cancer and associated TP levels to tumour response and time-to-event variables during first-line chemotherapy treatment. We also investigated the association between serum TP levels at the time of surgery and gene expression in primary tumour tissues.
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| 4. |
- Bexe-Lindskog, Elinor, et al.
(författare)
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Thymidine Phosphorylase Gene Expression in Stage III Colorectal Cancer.
- 2012
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Ingår i: Clinical Medicine Insights. Oncology. - 1179-5549. ; 6, s. 347-53
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Tidskriftsartikel (refereegranskat)abstract
- The thymidine phosphorylase (TP) enzyme has several tumor-promoting functions. The aim of this study was to explore TP gene expression in relation to clinical and histopathological data obtained from patients with stage III colorectal cancer.
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| 7. |
- Derwinger, Kristoffer, 1969, et al.
(författare)
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Tumour differentiation grade is associated with TNM staging and the risk of node metastasis in colorectal cancer.
- 2010
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Ingår i: Acta oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 49:1, s. 57-62
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The tumour differentiation grade has been shown by numerous multivariate analyses to be a stage-independent prognostic factor in colorectal cancer. The aim of this study was to explore the importance of differentiation grading for the staging of colorectal cancer and how it relates to the components of the TNM system. MATERIAL AND METHODS: The study was a retrospective single-centre analysis of all patients undergoing surgical resection for colorectal cancer during the period 2002-2007 (n = 1239). The clinical parameters and pathology data of overall stage, differentiation grade, local tumour (T)-stage and metastasis status (M-stage) were included as well as the lymph node count of both assessed and metastatic nodes. The differentiation grade was correlated with demography, overall stage and each component of the TNM staging system. The correlation between differentiation grade and N-stage was also explored for the separate T-stages. RESULTS: The tumour differentiation grade correlated significantly with the overall TNM stage (p < 0.0001). The grade significantly correlated with the T-stage and the risk of having lymph node metastasis (p < 0.0001). A high grade was associated with a higher positive lymph node count in stage III disease (p < 0.0002). For the T-stages, the risk of node metastasis was significantly linked to the tumour grade. A low grade (G1) T2 had a 17% risk of lymph node metastasis compared to a 44% risk for a high grade (G4) T2. CONCLUSION: Tumour differentiation is an important prognostic factor. It correlates significantly with the overall stage of the TNM system and also to each of its components. The risk of having lymph node metastasis for each T-stage also correlates with the tumour grade. The findings can be of importance in postoperative risk assessment or when considering local resection procedures like TEM.
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| 8. |
- Engsner, Hampus, et al.
(författare)
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The value of a liability cash flow in discrete time subject to capital requirements
- 2020
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Ingår i: Finance and Stochastics. - : Springer Science and Business Media LLC. - 0949-2984 .- 1432-1122. ; 24:1, s. 125-167
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this paper is to define the market-consistent multi-period value of an insurance liability cash flow in discrete time subject to repeated capital requirements, and explore its properties. In line with current regulatory frameworks, the presented approach is based on a hypothetical transfer of the original liability and a replicating portfolio to an empty corporate entity, whose owner must comply with repeated one-period capital requirements but has the option to terminate the ownership at any time. The value of the liability is defined as the no-arbitrage price of the cash flow to the policyholders, optimally stopped from the owner’s perspective, taking capital requirements into account. The value is computed as the solution to a sequence of coupled optimal stopping problems or, equivalently, as the solution to a backward recursion.
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| 9. |
- Lindensjö, Kristoffer, et al.
(författare)
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Optimal dividends and capital injection under dividend restrictions
- 2020
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Ingår i: Mathematical Methods of Operations Research. - : Springer Science and Business Media LLC. - 1432-2994 .- 1432-5217. ; 92, s. 461-487
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Tidskriftsartikel (refereegranskat)abstract
- We study a singular stochastic control problem faced by the owner of an insurance company that dynamically pays dividends and raises capital in the presence of the restriction that the surplus process must be above a givendividend payout barrierin order for dividend payments to be allowed. Bankruptcy occurs if the surplus process becomes negative and there are proportional costs for capital injection. We show that one of the following strategies is optimal: (i) Pay dividends and inject capital in order to reflect the surplus process at an upper barrier and at 0, implying bankruptcy never occurs. (ii) Pay dividends in order to reflect the surplus process at an upper barrier and never inject capital-corresponding to absorption at 0-implying bankruptcy occurs the first time the surplus reaches zero. We show that if the costs of capital injection arelow, then a sufficiently high dividend payout barrier will change the optimal strategy from type (i) (without bankruptcy) to type (ii) (with bankruptcy). Moreover, if the costs arehigh, then the optimal strategy is of type (ii) regardless of the dividend payout barrier. We also consider the possibility for the owner to choose a stopping time at which the insurance company is liquidated and the owner obtains a liquidation value. The uncontrolled surplus process is a Wiener process with drift.
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| 10. |
- Lindskog, Anders, 1967, et al.
(författare)
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Early SF6 gas leakage detection through a novel comparison algorithm based on pressure only
- 2023
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Ingår i: IEEE Transactions on Power Delivery. - 0885-8977 .- 1937-4208. ; 39:2, s. 922-930
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Tidskriftsartikel (refereegranskat)abstract
- SF6 gas is widely used in high voltage switchgear thanks to its excellent electrical properties. Unfortunately it is also the most potent greenhouse gas known today, where 1 kg of SF6 is equivalent to approximately 25 tons of CO2. Therefore it is important to monitor equipment containing SF6 to find and repair any leakage as early as possible. This paper discusses both practical challenges and provides a novel algorithm, that can be used for automatic and early SF6 gas leakage detection for circuit breakers. The work is based on laboratory and field tests in three substations in the south of Sweden. The tests has been carried out with two different types of digital SF6 gas sensors: a density sensor and a pressure sensor. The core of the early SF6 gas leakage detection algorithm is that it detects very small changes in gas content by comparing the varying pressures between circuit breakers. The algorithm detects leaks in the order of 0.1%/year within 2–3 weeks based on absolute pressure reading only. The total installation cost is approximately 750 EUR per sensor.
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