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Cancer-specific survival of patients with multiple cancers: an application to patients with multiple breast cancers.

https://arctichealth.org/en/permalink/ahliterature188224
Source
Stat Med. 2002 Nov 15;21(21):3183-95
Publication Type
Article
Date
Nov-15-2002
Author
S. Heinävaara
L. Teppo
T. Hakulinen
Author Affiliation
Finnish Cancer Registry, Liisankatu 21 B, 00170 Helsinki, Finland. sirpa.heinavaara@cancer.fi
Source
Stat Med. 2002 Nov 15;21(21):3183-95
Date
Nov-15-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - mortality
Cause of Death
Female
Finland - epidemiology
Humans
Middle Aged
Neoplasms, Multiple Primary - mortality
Prognosis
Proportional Hazards Models
Registries
Survival Analysis
Abstract
In the analysis of cause-specific survival, the causes of death must be known. For single-cancer patients with a known cause of death, the estimation of the cause-specific survival rate is straightforward. For multiple-cancer patients with two primary cancers, however, the analysis of cause-specific survival rates is more complex, particularly if the cancers are of the same primary site. In these situations, a concept of cancer-specific survival may also be distinguished from cause-specific survival. Cancer-specific survival rates are studied here by introducing two models, the primary one where the death from cancer is attributed to one of the cancers, and an alternative where such an attribution is not necessary. The models are illustrated using data on patients with multiple breast cancers. The model-based survival rates are compared with each other and with the corresponding relative survival rates based on analogous modelling of relative survival. The results show that for the subsequent breast cancer, the cancer-specific survival rates based on the alternative, where the distinction between the cancers as a cause of death was not necessary, tended to be higher than those based on that distinction. It is thus possible that the subsequent cancer was too often coded as a cause of death, particularly when being localized at diagnosis.
PubMed ID
12375298 View in PubMed
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Causes of death among female patients with cancer of the breast and intestines.

https://arctichealth.org/en/permalink/ahliterature250163
Source
Ann Clin Res. 1977 Feb;9(1):15-24
Publication Type
Article
Date
Feb-1977
Author
T. Hakulinen
L. Teppo
Source
Ann Clin Res. 1977 Feb;9(1):15-24
Date
Feb-1977
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - mortality
Cardiovascular Diseases - mortality
Colonic Neoplasms - mortality
Female
Finland
Follow-Up Studies
Humans
Intestinal Neoplasms - mortality
Middle Aged
Neoplasms, Multiple Primary - mortality
Abstract
The cause-specific mortality of women with cancer of the breast or of the intestines (= small intestine and colon) diagnosed in 1953-70 in Finland was analyzed with respect to the extent of the disease, the age of the patient at the time of diagnosis, and the follow-up time. The total mortality in breast-cancer patients was higher than had been expected during the entire follow-up period (maximum of 18 years), whereas in patients with intestinal cancer no more than slight excess mortality existed after 5 years of follow-up. The mortality from cardiovascular diseases was less than had been expected among patients with intestinal cancer. Patients with non-localized cancer of the breast had a risk of dying from accidents and other violent causes of death during the first 5 years of follow-up which was slightly higher than expected. From information compiled from various sources, the Finnish Cancer Registry records not only the official cause of death mentioned on the death certificate, but also a "corrected" cause of death. With this correction, the mortality from forms of malignancy other than the primary cancer was lower than had been expected during the first 5 years of follow-up, and subsequently reached the level expected. In regard to specific sites, mortality lower than that expected was observed for cancer of the stomach (both breast- and intestinal-cancer patients), and cancer of the cervix uteri (breast-cancer patients). In patients with localized breast cancer, the mortality from leukaemia was higher than that expected after 5 years of follow-up. No mutual excess risk was demonstrable with breast and intestinal cancers.
PubMed ID
883752 View in PubMed
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[Clinical course of cutaneous melanoma of the head and neck, and the factors affecting patient survival].

https://arctichealth.org/en/permalink/ahliterature112595
Source
Vopr Onkol. 2013;59(1):114-7
Publication Type
Article
Date
2013
Author
S A Tarkov
A E Mikhnin
K V Shelekhova
O S Frolova
A O Nefedov
Source
Vopr Onkol. 2013;59(1):114-7
Date
2013
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Disease-Free Survival
Ear Neoplasms - mortality - pathology
Extremities
Facial Neoplasms - mortality - pathology
Female
Head and Neck Neoplasms - mortality - pathology
Humans
Male
Melanoma - mortality - pathology - secondary
Middle Aged
Multivariate Analysis
Neoplasms, Multiple Primary - mortality - pathology
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk assessment
Risk factors
Russia - epidemiology
Scalp
Skin Neoplasms - mortality - pathology
Survival Analysis
Survival Rate
Torso
Abstract
It was found that melanomas of the skin of the head and neck, compared to the trunk and limbs, were characterized by a greater proportion of men, an older average age of the patients, high frequency spindle cell tumors, more frequent synchronous distant metastasis and worse survival. Melanomas, which are localized on the skin of the neck and scalp, have similar aggressive clinical course and are characterized by worse overall and disease-free survival than skin melanomas on the trunk and limbs. However, melanomas of the skin on the ear and face proceed more favorably as compared to skin melanomas of the scalp and neck. Multivariate regression analysis using Cox models showed that the melanoma of the head and neck Breslow tumor thickness was the strongest predictor of overall survival. For skin melanomas of the neck and scalp Breslow tumor thickness was the only significant independent factor for overall survival. In melanoma, skin and ear predictors of survival are: sex, age and tumor thickness. In skin melanomas of the face and ear predictors of survival were sex, age and tumor thickness.
PubMed ID
23814837 View in PubMed
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Contralateral cancerous breast lesions in women with clinical invasive breast carcinoma.

https://arctichealth.org/en/permalink/ahliterature26401
Source
Cancer. 1986 Mar 1;57(5):897-903
Publication Type
Article
Date
Mar-1-1986
Author
M. Nielsen
L. Christensen
J. Andersen
Source
Cancer. 1986 Mar 1;57(5):897-903
Date
Mar-1-1986
Language
English
Publication Type
Article
Keywords
Adult
Aged
Autopsy
Axilla
Breast Neoplasms - mortality - pathology - secondary
Carcinoma in Situ - mortality - pathology - secondary
Carcinoma, Intraductal, Noninfiltrating - mortality - pathology - secondary
Combined Modality Therapy
Denmark
Female
Humans
Hysterectomy
Lymphatic Metastasis
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Neoplasms, Multiple Primary - mortality - pathology
Research Support, Non-U.S. Gov't
Tamoxifen - therapeutic use
Abstract
Eighty-four consecutive autopsies of women with a clinical diagnosis of invasive breast carcinoma (BC) were examined by extensive histopathologic methods for malignant changes of the contralateral breast. Sixty-eight percent of the women were found to have primary contralateral BC, of which 33% were invasive and 35% in situ lesions. Another 16% had metastases to the breast. Only two women had had treatment for their contralateral BC. In eight cases a malignant lesion was diagnosed or suspected clinically, but in the remaining cases, the malignancies were identified only by histopathologic examination. No clinical data or histologic characteristics of the first BC had any predictive value for the risk of contralateral BC. In the contralateral breast, a significant coincidence was found between fibrocystic disease and the occurrence of primary malignant BC. The majority of the BC on both sides were of ductal type. Seventy-nine percent of the invasive contralateral BC were tumefacient, and 71% had axillary lymph node metastases. The mean survival time was comparable for women with and without contralateral primaries, but a significantly higher proportion of women with contralateral invasive BC died of disseminated BC. The frequency of contralateral malignancies is thus much higher than previously reported. The consequence of these findings may implicate a reevaluation of the treatment and control schedule regarding the contralateral breast in women with invasive BC.
PubMed ID
3002593 View in PubMed
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Multiple tumours in survival estimates.

https://arctichealth.org/en/permalink/ahliterature90564
Source
Eur J Cancer. 2009 Apr;45(6):1080-94
Publication Type
Article
Date
Apr-2009
Author
Rosso Stefano
De Angelis Roberta
Ciccolallo Laura
Carrani Eugenio
Soerjomataram Isabelle
Grande Enrico
Zigon Giulia
Brenner Hermann
Author Affiliation
CPO-Piedmont Cancer Registry, via San Francesco da Paola 31, 10123 Torino, Italy. Stefano.rosso@cpo.it
Source
Eur J Cancer. 2009 Apr;45(6):1080-94
Date
Apr-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Europe - epidemiology
Female
Humans
Male
Middle Aged
Neoplasms, Multiple Primary - mortality
Sex Distribution
Survival Analysis
Young Adult
Abstract
In international comparisons of cancer registry based survival it is common practice to restrict the analysis to first primary tumours and exclude multiple cancers. The probability of correctly detecting subsequent cancers depends on the registry's running time, which results in different proportions of excluded patients and may lead to biased comparisons. We evaluated the impact on the age-standardised relative survival estimates of also including multiple primary tumours. Data from 2,919,023 malignant cancers from 69 European cancer registries participating in the EUROCARE-4 collaborative study were used. A total of 183,683 multiple primary tumours were found, with an overall proportion of 6.3% over all the considered cancers, ranging from 0.4% (Naples, Italy) to 12.9% (Iceland). The proportion of multiple tumours varied greatly by type of tumour, being higher for those with high incidence and long survival (breast, prostate and colon-rectum). Five-year relative survival was lower when including patients with multiple cancers. For all cancers combined the average difference was -0.4 percentage points in women and -0.7 percentage points in men, and was greater for older registries. Inclusion of multiple tumours led to lower survival in 44 out of 45 cancer sites analysed, with the greatest differences found for larynx (-1.9%), oropharynx (-1.5%), and penis (-1.3%). Including multiple primary tumours in survival estimates for international comparison is advisable because it reduces the bias due to different observation periods, age, registration quality and completeness of registration. The general effect of inclusion is to reduce survival estimates by a variable amount depending on the proportion of multiple primaries and cancer site.
PubMed ID
19121933 View in PubMed
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Parametric mixture model for analysing relative survival of patients with multiple cancers.

https://arctichealth.org/en/permalink/ahliterature186088
Source
J Cancer Epidemiol Prev. 2002;7(3):147-53
Publication Type
Article
Date
2002
Author
S. Heinävaara
T. Hakulinen
Author Affiliation
Finnish Cancer Registry, Liisankatu, Helsinki.
Source
J Cancer Epidemiol Prev. 2002;7(3):147-53
Date
2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Colorectal Neoplasms - mortality
Finland - epidemiology
Humans
Lung Neoplasms - mortality
Middle Aged
Models, Statistical
Neoplasms, Multiple Primary - mortality
Neoplasms, Second Primary - mortality
Risk
Survival Analysis
Abstract
This study aimed to provide a parametric mixture model for analysing relative survival and cure rates of patients with multiple cancers.
A new model was introduced by extending a parametric mixture model on relative survival of patients with a single cancer. The model was applied to empirical data on lung cancer as a first and second tumour after a first localised colorectal cancer.
Survival and cure from subsequent cancer are estimatable with the parametric mixture model on relative survival of patients with multiple cancers. Survival from lung cancer does not differ between the first and second tumour, but there is suggestive evidence that survival from second lung cancer is higher than that from the first lung cancer.
Relative survival analysis of patients with multiple cancers can be extended to incorporate cure rates and excess hazards related to the individual cancers. Prognostic factors can be included in the model.
PubMed ID
12665214 View in PubMed
Less detail

Relative survival of patients with subsequent cancer.

https://arctichealth.org/en/permalink/ahliterature184614
Source
J Cancer Epidemiol Prev. 2002;7(4):173-9
Publication Type
Article
Date
2002
Author
S. Heinävaara
T. Hakulinen
Author Affiliation
Finnish Cancer Registry, Liisankatu 21 B, 00170 Helsinki, Finland. sirpa.heinavaara@cancer.fi
Source
J Cancer Epidemiol Prev. 2002;7(4):173-9
Date
2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - mortality
Female
Finland - epidemiology
Humans
Middle Aged
Models, Statistical
Neoplasms, Multiple Primary - mortality
Neoplasms, Second Primary - mortality
Proportional Hazards Models
Risk
Survival Analysis
Abstract
With the increasing numbers of patients with multiple primary cancers, survival from subsequent cancers is of growing interest. The majority of the analyses on the subject so far have, however, suffered from methodological difficulties.
A new model is now proposed for estimating relative survival of patients with subsequent primary cancer. The model is an extension to that proposed earlier by Estève et al. for estimating relative survival using individual patient data. The model is illustrated with real data on patients with one or two primary breast cancers and used in comparing the excess hazards between first and subsequent breast cancer.
For patients with multiple cancers, the traditional analysis of relative survival can be made cancer-specific. The excess hazards are different between the first and subsequent breast cancer: The excess hazard of the subsequent breast cancer tends to decrease with increasing age when compared to the corresponding hazard of the first breast cancer.
Relative survival of patients with subsequent cancer can be modelled facilitating studies on different hypothesis on the excess hazards of a first and subsequent cancer.
PubMed ID
12846488 View in PubMed
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Risk of malignancy and death in neurofibromatosis.

https://arctichealth.org/en/permalink/ahliterature22200
Source
Arch Pathol Lab Med. 1997 Feb;121(2):139-43
Publication Type
Article
Date
Feb-1997
Author
M. Poyhonen
S. Niemela
R. Herva
Author Affiliation
Department of Clinical Genetics, University Hospital of Oulu, Finland.
Source
Arch Pathol Lab Med. 1997 Feb;121(2):139-43
Date
Feb-1997
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Child, Preschool
Female
Finland
Humans
Infant
Male
Middle Aged
Neoplasms, Multiple Primary - mortality - pathology
Nerve Sheath Neoplasms
Neurofibromatoses - mortality - pathology
Peripheral Nervous System Neoplasms
Research Support, Non-U.S. Gov't
Survival Analysis
Abstract
OBJECTIVE AND METHODS: Neurofibromatoses are cancer-prone hamartomatoses that involve a variety of tissue and cell types. As part of a population-based clinical and genetic study of neurofibromatosis in northern Finland, all surgical and autopsy specimens of neurofibromatosis patients were retrieved and histologic slides were reviewed. RESULTS: Specimens were available for 69 of the 197 neurofibromatosis type 1 patients identified. Six malignant peripheral nerve sheath tumors and nine other malignant tumors were detected. In this study, the risk for neurofibromatosis-related malignancy was 8%. Nine neurofibromatosis type 1 patients died, at a mean age of 37 years. The cause of death was related to neurofibromatosis in eight. CONCLUSIONS: The risk of developing malignant tumors and early death is increased in patients with neurofibromatosis, the most common malignancy being malignant peripheral nerve sheath tumors. These risks need to be recognized, and the families should be advised to seek genetic counseling and proper follow-up.
PubMed ID
9126041 View in PubMed
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11 records – page 1 of 2.