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Clinically significant prognostic factors for differentiated thyroid carcinoma: a population-based, nested case-control study.

https://arctichealth.org/en/permalink/ahliterature16571
Source
Cancer. 2006 Feb 1;106(3):524-31
Publication Type
Article
Date
Feb-1-2006
Author
Catharina Ihre Lundgren
Per Hall
Paul W Dickman
Jan Zedenius
Author Affiliation
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. cia.ihre-lundgren@ki.se
Source
Cancer. 2006 Feb 1;106(3):524-31
Date
Feb-1-2006
Language
English
Publication Type
Article
Keywords
Adenocarcinoma, Follicular - mortality - pathology - surgery
Adult
Aged
Aged, 80 and over
Carcinoma, Papillary - mortality - pathology - surgery
Case-Control Studies
Diagnosis, Differential
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging - standards
Prognosis
Registries - statistics & numerical data
Research Support, Non-U.S. Gov't
Risk assessment
Thyroid Neoplasms - mortality - pathology - surgery
Abstract
BACKGROUND: Different scoring systems currently are being used to stratify patients with differentiated thyroid carcinoma (DTC) into risk groups. DTC is usually subdivided into papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). The objective of the current study was to identify those factors that predict long-term unfavorable prognosis and to evaluate the predictive accuracy of the TNM staging system. METHODS: The authors conducted a nested case-control study within the cohort of all patients (n=5123) diagnosed with DTC in Sweden between 1958-1987 who survived at least 1 year after diagnosis. One control, matched by age at diagnosis, gender, and calendar period, was randomly selected for each case (patients who died of DTC). All patients were classified at the time of diagnosis according to the TNM staging system. The effect of prognostic factors on DTC mortality was evaluated using conditional logistic regression. RESULTS: Patients with widely invasive FTC experienced a significantly higher mortality compared with PTC patients. The grade of differentiation was found to influence mortality significantly. Patients with TNM Stage IV disease had a higher mortality rate compared with patients with Stage II disease (odds ratio [OR]=9.1; 95% confidence interval [95% CI], 5.7-14.6). Patients with lymph node metastases experienced a higher mortality (OR=2.5; 95% CI, 1.6-4.1) and patients with distant metastasis at the time of diagnosis were found to have a nearly 7-fold higher mortality rate (OR=6.6; 95% CI, 4.1-10.5). Incomplete surgical excision was associated with higher mortality, particularly in patients with Stage I disease. CONCLUSIONS: In the current study, the following were found to be clinically significant prognostic factors for patients with DTC: histopathologic subgroup, TNM staging including lymph node metastases and distant metastases, and completeness of the surgical excision.
PubMed ID
16369995 View in PubMed
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Hodgkin's disease in Denmark. A national clinical study by the Danish Hodgkin Study Group, LYGRA.

https://arctichealth.org/en/permalink/ahliterature27316
Source
Scand J Haematol. 1980 Apr;24(4):321-34
Publication Type
Article
Date
Apr-1980
Source
Scand J Haematol. 1980 Apr;24(4):321-34
Date
Apr-1980
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Denmark
Female
Hodgkin Disease - epidemiology - mortality - therapy
Humans
Infant
Leukemia, Myelocytic, Acute - epidemiology
Lymph Nodes - pathology
Lymphography
Male
Middle Aged
Neoplasm Staging - standards
Pneumococcal Infections - epidemiology - etiology
Postoperative Complications
Prognosis
Splenectomy - adverse effects
Abstract
During the last 8 years (1971-1979) all newly diagnosed previously untreated patients with Hodgkin's disease in Denmark have been centralized to uniform staging procedures and treatment. A total of 802 patients were registered, or 2 patients/100 000. Lymphangiography was performed in 708 patients (88%), and 437 patients (55%) underwent laparotomy with splenectomy. Treatment included radiotherapy, combination chemotherapy (MOPP or similar programmes), and combined modality treatment. The overall 8-year actuarial survival for all stages combined was 66%, and relapse-free survival was 55%. 144 patients died of Hodgkin's disease, 23 from complications to therapy and examination procedures, and 54 died of unrelated causes. Survival was significantly better for patients without B-symptoms, and decreased gradually with advancing age. There was a strong correlation between unfavourable prognosis and advancing stage and/or histology, but mediastinal involvement had no influence upon the prognosis. Staging laparotomy was associated with 4 deaths due to infection, and splenectomy with 10 cases of severe pneumococcal infections, 4 of which were fatal. Fatal complications due to subsequent treatment included 2 cases of cardiac arrest following mantle-field irradiation and 3 cases of haemorrhage or sepsis following chemotherapy. 5 cases of acute myeloid leukaemia were observed.
PubMed ID
6932097 View in PubMed
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Pretreatment staging of colon cancer in the Swedish population.

https://arctichealth.org/en/permalink/ahliterature258049
Source
Colorectal Dis. 2013 Nov;15(11):1361-6
Publication Type
Article
Date
Nov-2013
Author
A. Sjövall
L. Blomqvist
A. Martling
Author Affiliation
Center of Surgical Gastroenterology, Karolinska University Hospital, Stockholm, Sweden.
Source
Colorectal Dis. 2013 Nov;15(11):1361-6
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - radiography - secondary - surgery
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Colonic Neoplasms - pathology - radiography - surgery
Emergencies
Female
Guideline Adherence - statistics & numerical data
Humans
Liver Neoplasms - diagnosis - secondary
Lung Neoplasms - diagnosis - secondary
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Staging - standards - statistics & numerical data
Practice Guidelines as Topic
Preoperative Period
Surgical Procedures, Elective - statistics & numerical data
Sweden
Tomography, X-Ray Computed
Young Adult
Abstract
Preoperative staging of colon cancer according to Swedish national guidelines implies imaging evaluation of the primary tumour, liver and lungs. Failure to adhere to these guidelines results in negative scorings in the national registration system. In the present study we report the extent of compliance with these guidelines.
Since 2007 clinical data on all patients diagnosed with colon cancer in Sweden have been collected in a national database. This includes information on pretherapeutic diagnostic imaging performed, pretherapeutic TNM stage and data on treatment and follow-up. All patients diagnosed with colon cancer in Sweden between 2007 and 2010 were included.
Nine thousand and eight-three patients (i.e. 60.5% of all patients) had a complete pretherapeutic radiological evaluation; 65.2% had a CT or MRI of the primary tumour, whereas over 80% had examinations of the liver and lungs. There were no difference related to sex, but more patients under 75 years had a complete evaluation. There were large differences between different regions; one region performed a complete evaluation of 78.3% of all patients. The proportion of patients examined increased from 53.9 to 65.0% during the study period. Elective cases were more frequently evaluated before treatment than those with an emergency presentation.
Most patients in Sweden had a complete pretreatment imaging evaluation of the colon cancer with geographical and time-dependent variations. Knowledge of the importance of these variations and correlation of pre- and postoperative TNM stage is warranted, and such studies are ongoing.
PubMed ID
23773574 View in PubMed
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Surgeons' knowledge of quality indicators for gastric cancer surgery.

https://arctichealth.org/en/permalink/ahliterature159715
Source
Gastric Cancer. 2007;10(4):205-14
Publication Type
Article
Date
2007
Author
Lucy K Helyer
Catherine O'Brien
Natalie G Coburn
Carol J Swallow
Author Affiliation
Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada.
Source
Gastric Cancer. 2007;10(4):205-14
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Clinical Competence
Combined Modality Therapy
Female
Gastrectomy - standards
General Surgery - standards
Humans
Lymph Node Excision - standards
Male
Middle Aged
Neoplasm Staging - standards
Ontario
Palliative Care
Physicians - standards
Quality Indicators, Health Care
Questionnaires
Stomach Neoplasms - surgery - therapy
Abstract
Gastric cancer survival in the West is inferior to that achieved in Asian centers. While differences in tumor biology may play a role, poor quality surgery likely contributes to understaging. We hypothesize that the majority of surgeons performing gastric cancer surgery in North America are unaware of the recommended standards.
Using the Ontario College of Physicians and Surgeons registry, surgeons who potentially included gastric cancer surgery in their scope of practice were identified. A questionnaire was mailed to 559; of those, 206 surgeons reported managing gastric cancer. Results were evaluated by chi(2) and logistic regression; P
PubMed ID
18095075 View in PubMed
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Surgical staging, treatment, and follow-up of borderline tumors in different hospital categories: a prospective nationwide survey in Finland.

https://arctichealth.org/en/permalink/ahliterature163896
Source
Acta Obstet Gynecol Scand. 2007;86(5):610-4
Publication Type
Article
Date
2007
Author
Salla Kumpulainen
Tapio Kuoppala
Arto Leminen
Marja Komulainen
Ulla Puistola
Risto Sankila
Juha Mäkinen
Seija Grénman
Author Affiliation
Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, PL 52, 20521, Finland.
Source
Acta Obstet Gynecol Scand. 2007;86(5):610-4
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cystadenocarcinoma, Serous - epidemiology - etiology - pathology - surgery
Female
Finland - epidemiology
Gynecologic Surgical Procedures - utilization
Hospitals, District
Hospitals, University
Hospitals, Urban
Humans
Hysterectomy - utilization
Lymph Node Excision - utilization
Middle Aged
Neoplasm Staging - standards
Outcome Assessment (Health Care)
Ovarian Neoplasms - epidemiology - etiology - pathology - surgery
Ovariectomy - utilization
Prospective Studies
Questionnaires
Registries
Abstract
Surgical treatment and staging of ovarian borderline tumors have been reported to be often suboptimal and differ considerably. We evaluated the extent of surgical treatment of these tumors in different hospital categories.
A prospective survey performed in 1999 included 65 patients operated on for borderline ovarian tumors and covered 78% of such patients reported to the Finnish Cancer Registry. Detailed information of demographic data and surgical treatment was reported by the responsible physicians using a special questionnaire after confirmation of histopathology.
Fifty-eight patients (89%) had stage I tumor, only two patients (3%) had stage II disease and five patients (8%) had stage III disease with peritoneal implants. The majority of the patients underwent bilateral salpingo-oophorectomy (66%) and hysterectomy (58%). Unilateral salpingo-oophorectomy was performed for 21 (32%) and omentectomy for 22 (34%) patients. Ten out of the 16 women under 40 years of age had fertility-sparing surgery. Peritoneal biopsies were taken in 16 (25%) women and lymphadenectomy was performed for 9 (14%) patients with clinical suspicion of invasive ovarian carcinoma. Frozen section was taken in half of the patients and the histology remained the same in 72% of the final pathology reports. No clear differences of the extent of surgical treatment were detected between different hospital categories. Overall cumulative 5-year relative survival rate was 96%.
Bilateral salpingo-oophorectomy and hysterectomy was performed for the majority of patients with borderline ovarian tumor. More attention should be paid to adequate staging of borderline tumors in all hospital categories.
PubMed ID
17464592 View in PubMed
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