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Adherence and persistence with oral adjuvant chemotherapy in older women with early-stage breast cancer in CALGB 49907: adherence companion study 60104.

https://arctichealth.org/en/permalink/ahliterature144428
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Publication Type
Article
Date
May-10-2010
Author
Ann H Partridge
Laura Archer
Alice B Kornblith
Julie Gralow
Debjani Grenier
Edith Perez
Antonio C Wolff
Xiaofei Wang
Helen Kastrissios
Donald Berry
Clifford Hudis
Eric Winer
Hyman Muss
Author Affiliation
Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA. ahpartridge@partners.org
Source
J Clin Oncol. 2010 May 10;28(14):2418-22
Date
May-10-2010
Language
English
Publication Type
Article
Keywords
Administration, Oral
Age Factors
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic - administration & dosage - adverse effects
Breast Neoplasms - drug therapy - mortality - pathology - surgery
Canada
Chemotherapy, Adjuvant
Deoxycytidine - administration & dosage - adverse effects - analogs & derivatives
Drug Administration Schedule
Drug Monitoring - instrumentation
Female
Fluorouracil - administration & dosage - adverse effects - analogs & derivatives
Humans
Kaplan-Meier Estimate
Linear Models
Logistic Models
Mastectomy
Medication Adherence
Micro-Electrical-Mechanical Systems - instrumentation
Neoplasm Staging
Risk assessment
Risk factors
Time Factors
Treatment Outcome
United States
Abstract
Patient adherence is critical in evaluating the effectiveness of an oral therapy. We sought to measure adherence among women randomly assigned to capecitabine in a preplanned substudy of a multicenter clinical trial.
Cancer and Leukemia Group B study CALGB 49907 was a randomly assigned trial comparing standard chemotherapy versus oral chemotherapy with capecitabine in patients age 65 years or older with early-stage breast cancer. We used microelectronic monitoring system (MEMS) caps on participants' capecitabine bottles to record pill bottle openings. Capecitabine was given in two divided daily doses for 14 consecutive days of a 21-day cycle for six cycles. Adherence was calculated as the number of doses taken divided by doses expected, taking into account toxicity-related dosing changes. A participant was defined as adherent if 80% or more of expected doses were recorded by MEMS.
Overall, 161 patients were enrolled. Median age was 71 years (range, 65 to 89 years); 124 patients (83%) persisted with capecitabine to completion of planned protocol therapy. Adherence was 78% across all cycles, and adherence did not vary by cycle (P = .32). Twenty-five percent of participants took fewer than 80% of expected doses and were nonadherent. In a logistic regression model, participants with node-negative disease (P = .01) and mastectomy (P = .01) were more likely to be nonadherent. Adherence was not related to age, tumor stage, or hormone receptor status. Adherence was not significantly associated with relapse-free survival or grade 3 or 4 toxicity.
Most older women with early-stage breast cancer were adherent to short-term oral chemotherapy in a randomized clinical trial. Age was not associated with adherence.
Notes
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PubMed ID
20368559 View in PubMed
Less detail

Advanced phase chronic myeloid leukaemia (CML) in the tyrosine kinase inhibitor era - a report from the Swedish CML register.

https://arctichealth.org/en/permalink/ahliterature279977
Source
Eur J Haematol. 2017 Jan;98(1):57-66
Publication Type
Article
Date
Jan-2017
Author
Stina Söderlund
Torsten Dahlén
Fredrik Sandin
Ulla Olsson-Strömberg
Maria Creignou
Arta Dreimane
Anna Lübking
Berit Markevärn
Anders Själander
Hans Wadenvik
Leif Stenke
Johan Richter
Martin Höglund
Source
Eur J Haematol. 2017 Jan;98(1):57-66
Date
Jan-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antineoplastic Agents - therapeutic use
Blast Crisis
Combined Modality Therapy
Disease Progression
Female
Humans
Kaplan-Meier Estimate
Leukemia, Myeloid, Chronic-Phase - diagnosis - drug therapy - epidemiology - mortality
Male
Middle Aged
Neoplasm Staging
Population Surveillance
Protein Kinase Inhibitors - therapeutic use
Registries
Sweden - epidemiology
Treatment Outcome
Young Adult
Abstract
The primary goal in management of chronic phase (CP) chronic myeloid leukaemia (CML) is to prevent disease progression to accelerated phase (AP) or blast crisis (BC). We have evaluated progression rates in a decentralised healthcare setting and characterised patients progressing to AP/BC on TKI treatment.
Using data from the Swedish CML register, we identified CP-CML patients diagnosed 2007-2011 who progressed to AP/BC within 2 yrs from diagnosis (n = 18) as well as patients diagnosed in advanced phase during 2007-2012 (n = 36) from a total of 544 newly diagnosed CML cases. We evaluated baseline characteristics, progression rates, outcome and adherence to guidelines for monitoring and treatment.
The cumulative progression rate at 2 yrs was 4.3%. All 18 progression cases had been treated with imatinib, and six progressed within 6 months. High-risk EUTOS score was associated to a higher risk of progression. Insufficient cytogenetic and/or molecular monitoring was found in 33%. Median survival after transformation during TKI treatment was 1.4 yrs. In those presenting with BC and AP, median survival was 1.6 yrs and not reached, respectively.
In this population-based setting, progression rates appear comparable to that reported from clinical trials, with similar dismal patient outcome. Improved adherence to CML guidelines may minimise the risk of disease progression.
PubMed ID
27428357 View in PubMed
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Among women who experience a recurrence after postmastectomy radiation therapy irradiation is not associated with more aggressive local recurrence or reduced survival.

https://arctichealth.org/en/permalink/ahliterature144754
Source
Breast Cancer Res Treat. 2010 Sep;123(2):597-605
Publication Type
Article
Date
Sep-2010
Author
Wendy A Woodward
Pauline T Truong
Tse-Kuan Yu
Welela Tereffe
Julia Oh
George Perkins
Eric Strom
Funda Meric-Bernstam
Ana-Maria Gonzalez-Angulo
Caroline Speers
Joseph Ragaz
Thomas A Buchholz
Author Affiliation
Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA. wwoodward@mdanderson.org
Source
Breast Cancer Res Treat. 2010 Sep;123(2):597-605
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Adult
Breast Neoplasms - mortality - secondary - therapy
British Columbia
Chemotherapy, Adjuvant
Chi-Square Distribution
Clinical Trials as Topic
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Mastectomy
Middle Aged
Neoplasm Recurrence, Local - etiology - mortality - pathology
Neoplasm Staging
Radiotherapy, Adjuvant - adverse effects - mortality
Retrospective Studies
Risk assessment
Risk factors
Survival Rate
Texas
Time Factors
Treatment Outcome
Abstract
Recent pre-clinical models suggest that radiation can promote tumor aggressiveness. We hypothesized that if this were occurring clinically, locoregional recurrences (LRRs) after postmastectomy radiation therapy (PMRT) would lead to lower survival than LRR after mastectomy alone. This study used two independent datasets to compare survival after LRR in women treated with versus without PMRT. Data from 229 LRR cases among 1,500 patients enrolled on prospective trials at the MD Anderson Cancer Center (MDA), and 66 LRR cases among 318 patients enrolled in the British Columbia Cancer Agency (BCCA) PMRT randomized trial were analyzed. In the MDA non-randomized dataset, 189/1031 had LRR after mastectomy alone and 40/469 had LRR after PMRT. In the randomized BC trial dataset, 52/158 had LRR after mastectomy alone and 14/160 had LRR after PMRT. In both datasets, survival was calculated from the time of LRR to death. Analysis of MDA data shows that in all LRR cases regardless of distant metastasis (DM), 5/10-year OS were 50/34% without PMRT and 27/19% after PMRT (P = 0.006). However, PMRT-treated patients had increased risk factors for DM (advanced T and N stages) and more PMRT-treated patients developed DM prior to LRR (63 vs. 34%, P = 0.005). Analyzing only patients will an isolated LRR (without previous or simultaneous, DMV), there was no OS difference between groups (P = 0.33). Analysis of BCCA data shows that distributions of T and N stages were similar in patients with LRR after mastectomy alone versus after PMRT. DM free survival after any LRR and after isolated LRR were similar in mastectomy alone versus PMRT-treated patients (P = 0.75, P = 0.26, respectively). Overall survival after any LRR and after isolated LRR were also similar in the two groups (P = 0.93, P = 0.28, respectively). Patients who develop LRR after mastectomy alone have high rates of DM and poor OS but these rates are not affected by the use of PMRT at the time of primary treatment. These data do not support the hypothesis that irradiation promotes biologically aggressive local recurrences.
PubMed ID
20306128 View in PubMed
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Analysis of survival predictors in a prospective cohort of patients undergoing transarterial chemoembolization for hepatocellular carcinoma in a single Canadian centre.

https://arctichealth.org/en/permalink/ahliterature127146
Source
HPB (Oxford). 2012 Mar;14(3):162-70
Publication Type
Article
Date
Mar-2012
Author
Karim M Eltawil
Robert Berry
Mohamed Abdolell
Michele Molinari
Author Affiliation
Department of Surgery, Queen Elizabeth II Health Sciences Center, Dalhousie University, Halifax, NS, Canada.
Source
HPB (Oxford). 2012 Mar;14(3):162-70
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - blood - mortality - pathology - therapy
Chemoembolization, Therapeutic - adverse effects - mortality
Female
Humans
Kaplan-Meier Estimate
Liver Neoplasms - blood - mortality - pathology - therapy
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Nova Scotia
Palliative Care
Proportional Hazards Models
Prospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Tumor Burden
alpha-Fetoproteins - metabolism
Abstract
Despite advances in the treatment of hepatocellular carcinoma (HCC), a great proportion of patients are eligible only for palliative therapy for reasons of advanced-stage disease or poor hepatic reserve. The use of transarterial chemoembolization (TACE) in the palliation of non-resectable HCC has shown a survival benefit in European and Asian populations. The aim of this study was to assess the efficacy of TACE by analysing overall 5-year survival, interval changes of tumour size and serum alpha-fetoprotein (AFP) levels in a prospective North American cohort.
From September 2005 to December 2010, 46 candidates for TACE were enrolled in the study. Collectively, they underwent 102 TACE treatments. Data on tumour response, serum AFP and survival were prospectively collected.
In compensated cirrhotic patients, serial treatment with TACE had a stabilizing effect on tumour size and reduced serum AFP levels during the first 12 months. Overall survival rates at 1, 2 and 3 years were 69%, 58% and 20%, respectively. Younger individuals and patients with a lower body mass index, affected by early-stage HCC with involvement of a single lobe, had better survival in univariate analysis. After adjustment for risk factors, early tumour stage (T1 and T2 vs. T3 and T4) at diagnosis was the only statistically significant predictor for survival.
In compensated cirrhotic patients, TACE is an effective palliative intervention and HCC stage at diagnosis seems to be the most important predictor of longterm outcomes.
Notes
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PubMed ID
22321034 View in PubMed
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Associations between comorbidity, and overall survival and bladder cancer specific survival after radical cystectomy: results from the Alberta Urology Institute Radical Cystectomy database.

https://arctichealth.org/en/permalink/ahliterature150930
Source
J Urol. 2009 Jul;182(1):85-92; discussion 93
Publication Type
Article
Date
Jul-2009
Author
Adrian S Fairey
Niels-Erik B Jacobsen
Michael P Chetner
David R Mador
James B Metcalfe
Ronald B Moore
Keith F Rourke
Gerald T Todd
Peter M Venner
Don C Voaklander
Eric P Estey
Author Affiliation
Division of Urology, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. afairey@ualberta.ca
Source
J Urol. 2009 Jul;182(1):85-92; discussion 93
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Alberta
Analysis of Variance
Cause of Death
Cohort Studies
Comorbidity
Confidence Intervals
Cystectomy - methods - mortality
Databases, Factual
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Invasiveness - pathology
Neoplasm Staging
Probability
Proportional Hazards Models
Retrospective Studies
Risk assessment
Sex Factors
Societies, Medical
Statistics, nonparametric
Survival Analysis
Time Factors
Treatment Outcome
Urinary Bladder Neoplasms - mortality - pathology - surgery
Abstract
We determined the associations between comorbidity, and overall survival and bladder cancer specific survival after radical cystectomy.
The Alberta Urology Institute Radical Cystectomy database is an ongoing multi-institutional computerized database containing data on all adult patients with a diagnosis of primary bladder cancer treated with radical cystectomy in Edmonton, Canada from April 1994 forward. The current study is an analysis of consecutive database patients treated between April 1994 and September 2007. Comorbidity information was obtained through a medical record review using the Adult Comorbidity Evaluation 27 instrument. The outcome measures were overall survival and bladder cancer specific survival. Cox proportional regression analysis was used to determine the associations between comorbidity, and overall survival and bladder cancer specific survival.
Of the database patients 160 (34%), 225 (48%) and 83 (18%) had no/mild comorbidity, moderate comorbidity and severe comorbidity, respectively. Compared to patients with no or mild comorbidity, multivariate Cox proportional regression analyses that included age, adjuvant chemotherapy, surgeon procedure volume, pathological T stage, pathological lymph node status, total number of lymph nodes removed, surgical margin status and lymphovascular invasion showed that increased comorbidity was independently associated with overall survival (moderate HR 1.59, 95% CI 1.16-2.18, p = 0.004; severe HR 1.83, 95% CI 1.22-2.72, p = 0.003) and bladder cancer specific survival (moderate HR 1.50, 95% CI 1.04-2.15, p = 0.028; severe HR 1.65, 95% CI 1.04-2.62, p = 0.034).
Increased comorbidity was independently associated with an increased risk of overall mortality and bladder cancer specific mortality after radical cystectomy.
Notes
Comment In: J Urol. 2009 Jul;182(1):10-119450857
PubMed ID
19447413 View in PubMed
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Associations of beta-catenin alterations and MSI screening status with expression of key cell cycle regulating proteins and survival from colorectal cancer.

https://arctichealth.org/en/permalink/ahliterature117072
Source
Diagn Pathol. 2013;8:10
Publication Type
Article
Date
2013
Author
Sakarias Wangefjord
Jenny Brändstedt
Kajsa Ericson Lindquist
Björn Nodin
Karin Jirström
Jakob Eberhard
Author Affiliation
Department of Clinical Sciences, Division of Pathology, Lund University, Skåne University Hospital, Lund, Sweden. sakarias.wangefjord@med.lu.se
Source
Diagn Pathol. 2013;8:10
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cell Cycle Proteins - analysis
Chemotherapy, Adjuvant
Chi-Square Distribution
Colectomy
Colorectal Neoplasms - chemistry - genetics - mortality - pathology - therapy
Cyclin D1 - analysis
Cyclin-Dependent Kinase Inhibitor p21 - analysis
Cyclin-Dependent Kinase Inhibitor p27 - analysis
Female
Humans
Immunohistochemistry
Incidence
Kaplan-Meier Estimate
Male
Microsatellite Instability
Middle Aged
Multivariate Analysis
Neoplasm Staging
Proportional Hazards Models
Prospective Studies
Registries
Risk factors
Sweden - epidemiology
Time Factors
Tissue Array Analysis
Treatment Outcome
Tumor Markers, Biological - analysis
Tumor Suppressor Protein p53 - analysis
Up-Regulation
beta Catenin - analysis
Abstract
Despite their pivotal roles in colorectal carcinogenesis, the interrelationship and prognostic significance of beta-catenin alterations and microsatellite instability (MSI) in colorectal cancer (CRC) needs to be further clarified. In this paper, we studied the associations between beta-catenin overexpression and MSI status with survival from CRC, and with expression of p21, p27, cyclin D1 and p53, in a large, prospective cohort study.
Immunohistochemical MSI-screening status and expression of p21, p27 and p53 was assessed in tissue microarrays with tumours from 557 cases of incident CRC in the Malmö Diet and Cancer Study. Chi Square and Spearman's correlation tests were used to explore the associations between beta-catenin expression, MSI status, clinicopathological characteristics and investigative parameters. Kaplan-Meier analysis and Cox proportional hazards modelling were used to assess the relationship between beta-catenin overexpression, MSI status and cancer specific survival (CSS).
Positive MSI screening status was significantly associated with older age, female sex, proximal tumour location, non-metastatic disease, and poor differentiation, and inversely associated with beta-catenin overexpression. Beta-catenin overexpression was significantly associated with distal tumour location, low T-stage and well-differentiated tumours. Patients with MSI tumours had a significantly prolonged CSS in the whole cohort, and in stage III-IV disease, also in multivariable analysis, but not in stage I-II disease. Beta-catenin overexpression was associated with a favourable prognosis in the full cohort and in patients with stage III-IV disease. Neither MSI nor beta-catenin status were predictive for response to adjuvant chemotherapy in curatively treated stage III patients. P53 and p27 expression was positively associated with beta-catenin overexpression and inversely associated with MSI. Cyclin D1 expression was positively associated with MSI and beta-catenin overexpression, and p21 expression was positively associated with MSI but not beta-catenin overexpression.
Findings from this large, prospective cohort study demonstrate that MSI screening status in colorectal cancer is an independent prognostic factor, but not in localized disease, and does not predict response to adjuvant chemotherapy. Beta-catenin overexpression was also associated with favourable outcome but not a treatment predictive factor. Associations of MSI and beta-catenin alterations with other investigative and clinicopathological factors were in line with the expected.
The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8778585058652609.
Notes
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PubMed ID
23337059 View in PubMed
Less detail

Basal Ki67 expression measured by digital image analysis is optimal for prognostication in oral squamous cell carcinoma.

https://arctichealth.org/en/permalink/ahliterature121620
Source
Eur J Cancer. 2012 Sep;48(14):2166-74
Publication Type
Article
Date
Sep-2012
Author
Alexander C Klimowicz
Pinaki Bose
Steven C Nakoneshny
Michelle Dean
Longlong Huang
Shamir Chandarana
Anthony M Magliocco
T. Wayne Matthews
Nigel T Brockton
Joseph C Dort
Author Affiliation
Department of Oncology, University of Calgary, Calgary, Canada.
Source
Eur J Cancer. 2012 Sep;48(14):2166-74
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Aged
Alberta
Carcinoma, Squamous Cell - chemistry - mortality - pathology - therapy
Disease-Free Survival
Female
Fluorescent Antibody Technique
Humans
Image Interpretation, Computer-Assisted
Kaplan-Meier Estimate
Ki-67 Antigen - analysis
Male
Microscopy, Fluorescence
Middle Aged
Mouth Neoplasms - chemistry - mortality - pathology - therapy
Neoplasm Staging
Predictive value of tests
Proportional Hazards Models
Registries
Risk assessment
Risk factors
Time Factors
Tissue Array Analysis - methods
Treatment Outcome
Abstract
The prognostic significance of Ki67 expression in cancers, including oral squamous cell carcinoma (OSCC), is unclear. This may be partly attributed to the lack of consensus surrounding the optimal approach for measuring tumour Ki67 expression. The aim of this study was to evaluate the association between different measures of Ki67 expression and disease-specific survival (DSS) in OSCC.
Tissue microarrays (TMAs) were assembled from triplicate cores of formalin-fixed paraffin embedded (FFPE) pre-treatment tumour tissue obtained from 121 OSCC patients diagnosed between 1998 and 2006. Ki67 expression was quantified using fluorescence immunohistochemistry (IHC) and AQUAnalysis® in normal oral cavity squamous epithelium (OCSE) and OSCC tumour samples. Intensity and percentage-based approaches for Ki67 scoring were tested for their association with survival.
Ki67 scores obtained from intensity and percentage-based approaches had similar associations with prognosis. We also found that high basal (lowest observed in triplicate cores) Ki67 expression was more strongly associated with improved 5-year disease-specific survival than hot-spot and average Ki67 measurements. The association of high basal Ki67 expression with improved prognosis was most pronounced in patients who received postoperative radiation. Cox proportional hazards analysis showed that the basal Ki67 expression is an independent prognostic marker in our OSCC cohort when adjusted for pathological T-stage, nodal status and treatment.
Our study provides a framework for reaching a consensus on the optimal approach for measuring Ki67 expression in cancers. Our results suggest that rigorous comparisons of measurement approaches should be applied in a tumour-type and treatment-specific manner to enhance the clinical application of Ki67 assessment.
PubMed ID
22892062 View in PubMed
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Biochemical recurrence after robot-assisted radical prostatectomy in a European single-centre cohort with a minimum follow-up time of 5 years.

https://arctichealth.org/en/permalink/ahliterature124035
Source
Eur Urol. 2012 Nov;62(5):768-74
Publication Type
Article
Date
Nov-2012
Author
Prasanna Sooriakumaran
Leif Haendler
Tommy Nyberg
Henrik Gronberg
Andreas Nilsson
Stefan Carlsson
Abolfazl Hosseini
Christofer Adding
Martin Jonsson
Achilles Ploumidis
Lars Egevad
Gunnar Steineck
Peter Wiklund
Author Affiliation
Department of Urology, Karolinska University Hospital, Stockholm, Sweden.
Source
Eur Urol. 2012 Nov;62(5):768-74
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Aged
Confounding Factors (Epidemiology)
Disease-Free Survival
Follow-Up Studies
Hospitals, University
Humans
Kallikreins - blood
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Neoplasm Grading
Neoplasm Staging
Proportional Hazards Models
Prostate-Specific Antigen - blood
Prostatectomy - adverse effects - methods - mortality
Prostatic Neoplasms - blood - mortality - pathology - surgery
Recurrence
Risk assessment
Risk factors
Robotics
Surgery, Computer-Assisted - adverse effects - mortality
Sweden
Time Factors
Treatment Outcome
Abstract
Robot-assisted radical prostatectomy (RARP) is an increasingly commonly used surgical treatment option for prostate cancer (PCa); however, its longer-term oncologic results remain uncertain.
To report biochemical recurrence-free survival (BRFS) outcomes for men who underwent RARP =5 yr ago at a single European centre.
A total of 944 patients underwent RARP as monotherapy for PCa from January 2002 to December 2006 at Karolinska University Hospital, Stockholm, Sweden. Standard clinicopathologic variables were recorded and entered into a secure, ethics-approved database made up of those men with registered domiciles in Stockholm. The median follow-up time was 6.3 yr (interquartile range: 5.6-7.2).
The outcome of this study was biochemical recurrence (BCR), defined as a confirmed prostate-specific antigen (PSA) of =0.2 ng/ml. Kaplan-Meier survival plots with log-rank tests, as well as Cox univariable and multivariable regression analyses, were used to determine BRFS estimates and determine predictors of PSA relapse, respectively.
The BRFS for the entire cohort at median follow-up was 84.8% (95% confidence interval [CI], 82.2-87.1); estimates at 5, 7, and 9 yr were 87.1% (95% CI, 84.8-89.2), 84.5% (95% CI, 81.8-86.8), and 82.6% (95% CI, 79.0-85.6), respectively. Nine and 19 patients died of PCa and other causes, respectively, giving end-of-follow-up Kaplan-Meier survival estimates of 98.0% (95% CI, 95.5-99.1) and 94.1% (95% CI, 90.4-96.4), respectively. Preoperative PSA >10, postoperative Gleason sum =4 + 3, pathologic T3 disease, positive surgical margin status, and lower surgeon volume were associated with increased risk of BCR on multivariable analysis. This study is limited by a lack of nodal status and tumour volume, which may have confounded our findings.
This case series from a single, high-volume, European centre demonstrates that RARP has satisfactory medium-term BRFS. Further follow-up is necessary to determine how this finding will translate into cancer-specific and overall survival outcomes.
Notes
Comment In: Eur Urol. 2012 Nov;62(5):775-6; discussion 777-822790290
PubMed ID
22633365 View in PubMed
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Breast cancer prognosis and isolated tumor cell findings in axillary lymph nodes after core needle biopsy and fine needle aspiration cytology: Biopsy method and breast cancer outcome.

https://arctichealth.org/en/permalink/ahliterature272917
Source
Eur J Surg Oncol. 2016 Jan;42(1):64-70
Publication Type
Article
Date
Jan-2016
Author
J. Liikanen
M. Leidenius
H. Joensuu
J. Vironen
P. Heikkilä
T. Meretoja
Source
Eur J Surg Oncol. 2016 Jan;42(1):64-70
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Axilla
Biopsy, Fine-Needle - methods
Biopsy, Large-Core Needle - methods
Breast Neoplasms - mortality - pathology - surgery
Cohort Studies
Female
Finland
Humans
Immunohistochemistry
Kaplan-Meier Estimate
Lymph Nodes - pathology
Neoplasm Invasiveness - pathology
Neoplasm Recurrence, Local - epidemiology - pathology
Neoplasm Staging
Neoplastic Cells, Circulating - pathology
Prognosis
Proportional Hazards Models
Prospective Studies
Risk assessment
Survival Analysis
Abstract
It is unknown whether performing a core needle biopsy (CNB) to diagnose breast cancer increases the incidence of isolated tumor cells (ITC) in the axillary sentinel lymph nodes.
Patients diagnosed with unilateral invasive pT1 breast cancer (=2 cm in diameter, n = 1525) at a single center between February 2001 and August 2005 were included in this prospective observational cohort study. The patients were categorized into two groups according to the type of the preoperative breast needle biopsy performed, the CNB and the fine needle aspiration cytology (FNAC) groups, and followed up for a median of 9.5 years after breast surgery.
868 (56.9%) patients had FNAC and 657 (43.2%) CNB. In the subset of patients with no axillary metastases (pN0, n = 1005) 70 patients had ITC, 37 (4.3%) out of the 546 patients in FNAC group and 33 (5.0%) out of the 459 patients in the CNB group (p = 0.798). The type of tumor biopsy did not influence breast cancer-specific survival (p = 0.461) or local recurrence-free survival (p = 0.814) in univariable survival analyses. Overall, survival favored the CNB group in a univariable analysis, but no difference in survival emerged in a multivariable analysis (p = 0.718).
CNB was not associated with a greater incidence of ITC in axillary lymph nodes as compared with FNAC, and did not have an adverse effect on survival outcomes in a patient population treated with modern adjuvant therapies.
PubMed ID
26427542 View in PubMed
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Breast cancer-specific survival by clinical subtype after 7 years follow-up of young and elderly women in a nationwide cohort.

https://arctichealth.org/en/permalink/ahliterature300477
Source
Int J Cancer. 2019 03 15; 144(6):1251-1261
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
03-15-2019
Author
Anna L V Johansson
Cassia B Trewin
Kirsti Vik Hjerkind
Merete Ellingjord-Dale
Tom Børge Johannesen
Giske Ursin
Author Affiliation
Cancer Registry of Norway, Oslo, Norway.
Source
Int J Cancer. 2019 03 15; 144(6):1251-1261
Date
03-15-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Biomarkers, Tumor - metabolism
Breast - pathology
Breast Neoplasms - mortality - pathology
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Middle Aged
Neoplasm Grading
Neoplasm Staging
Norway - epidemiology
Prognosis
Prospective Studies
Receptor, erbB-2 - metabolism
Receptors, Estrogen - metabolism
Receptors, Progesterone - metabolism
Survival Rate
Young Adult
Abstract
Age and tumor subtype are prognostic factors for breast cancer survival, but it is unclear which matters the most. We used population-based data to address this question. We identified 21,384 women diagnosed with breast cancer at ages 20-89 between 2005 and 2015 in the Cancer Registry of Norway. Subtype was defined using estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (HER2) status as luminal A-like (ER+PR+HER2-), luminal B-like HER2-negative (ER+PR-HER2-), luminal B-like HER2-positive (ER+PR+/-HER2+), HER2-positive (ER-PR-HER2+) and triple-negative (TNBC) (ER-PR-HER2-). Cox regression estimated hazard ratios (HR) for breast cancer-specific 7-year survival by age and subtype, while adjusting for year, grade, TNM stage and treatment. Young women more often had HER2-positive and TNBC tumors, while elderly women (70-89) more often had luminal A-like tumors. Compared to age 50-59, young women had doubled breast cancer-specific mortality rate (HR = 2.26, 95% CI 1.81-2.82), while elderly had two to five times higher mortality rate (70-79: HR = 2.25, 1.87-2.71; 80-89: HR = 5.19, 4.21-6.41). After adjustments, the association was non-significant among young women but remained high among elderly. Young age was associated with increased breast cancer-specific mortality among luminal A-like subtype, while old age was associated with increased mortality in all subtypes. Age and subtype were strong independent prognostic factors. The elderly always did worse, also after adjustment for subtype. Tumor-associated factors (subtype, grade and stage) largely explained the higher breast cancer-specific mortality among young. Future studies should address why luminal A-like subtype is associated with a higher mortality rate in young women.
PubMed ID
30367449 View in PubMed
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