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143 results on '"Birgisson H."'

1. A Validation of the Swedish Colorectal Cancer Register – With Focus on Histopathology, Complications and Recurrences

Author

Arnarson Ö, Moberger P, Sköldberg F, Smedh K, Birgisson H, and Syk I

Subjects
quality registry, national registry, validation, colorectal cancer, swedish registry, Infectious and parasitic diseases, RC109-216
Abstract

Örvar Arnarson,1,* Peter Moberger,2,3,* Filip Sköldberg,4,5 Kenneth Smedh,2,3 Helgi Birgisson,4,5 Ingvar Syk1 1Department of Surgery, Skåne University Hospital, Lund University, Malmö, Sweden; 2Centre for Clinical research Västerås, Uppsala University, Uppsala, Sweden; 3Department of Surgery Västmanlands Hospital Västerås, Västerås, Sweden; 4Gastrointestinal Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; 5Department of Surgery, Uppsala University Hospital, Uppsala, Sweden*These authors contributed equally to this workCorrespondence: Ingvar Syk, Department of Surgery, Skåne University Hospital, Malmö, SE-214 28, Email ingvar.syk@telia.comBackground: There is an urgent need to evaluate the quality of healthcare systems to improve and deliver high-quality care. Clinical registries have become important platforms for performance measurements, improvements, and clinical research. Hence, the quality of data in registries is crucial. This study aimed to assess the validity of data in the Swedish Colorectal Cancer Register (SCRCR).Methods: Seven hundred patients from 12 hospitals were randomly selected and proportionally distributed among three different hospital categories in Sweden using two-stage cluster sampling. Validity was assessed by re-abstracting data from the medical files of patients reported to the SCRCR in 2015. Data on histopathology, postoperative complications, and a 3-year follow-up were selected for validation. Re-abstracted data were defined as source data, and validity was defined as the proportion of cases in the SRCRC dataset that agreed with the source data. Validity was expressed as the percentage of exact agreement of non-missing data in both data sets, and Cohen´s kappa coefficient (κ) was used to measure the strength of the agreement.Results: The median agreement of the categorical histopathology variables was 93.4% (κ = 0.83). The general postoperative complication variable showed substantial agreement (84.3%, κ = 0.61). Likewise, the variable for overall cancer recurrence showed an almost perfect agreement (95.7%, κ = 0.86), whereas specific variables for local recurrence and distant recurrence displayed only moderate and fair agreement (85.9% and 89.1%, κ = 0.58 and 0.34, respectively).Conclusion: Validation of the SCRCR data showed high validity of pathology data and recurrence rates, whereas detailed data on recurrence were not as good. Data on postoperative complications were less reliable, although the incidence and Clavien–Dindo grading of severe complications (grade 3b or higher) were reliable.Keywords: quality registry, national registry, validation, colorectal cancer, Swedish registry

Published
2024

2. Stage-specific survival among men with prostate cancer in the Nordic countries 2004-2016 - the NORDCAN survival studies

Author

Larsen, S.B., primary, Lundberg, F.E., additional, Friis, S., additional, Birgisson, H., additional, Andersson, T.M.L., additional, Engholm, G., additional, Lambert, P.C., additional, Lambe, M., additional, Pettersson, D., additional, Ólafsdóttir, E., additional, Johannesen, T.B., additional, Kønig, S.M., additional, Johansson, A.L.V., additional, and Mørch, L.S., additional

Published
2024
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3. International incidence of childhood cancer, 2001–10: a population-based registry study

Author

Bouzbid, S, Hamdi-Cherif, M, Hablas, A, Chirpaz, E, Buziba, N, Chesumbai, GC, Manraj, SS, Reynders, D, Wabinga, HR, Chokunonga, E, Moreno, F, Lima, CA, Asturian Laporte, C, de Oliveira, JC, de Aquino, JA Pontes, Gallagher, SM Vargas, Uribe, CJ, Bravo, LE, Yepez Chamorro, MC, Torres Alvarado, G, Galán Alvarez, YH, Martinez Reyes, FC, Castillo Calvas, JC, Mendoza Alava, M, Cueva Ayala, P, Hanchard, B, Fajardo-Gutiérrez, A, Zavala Zegarra, DE, Barrios, E, Nikiforuk, C, Woods, R, Turner, D, MacIntyre, M, Corriveau, A, Navaneelan, T, Bertrand, C, Stuart-Panko, H, Wilson, RJ, Kosary, C, Shen, X, Brockhouse, J, Yee, GA, Mitchell, TC, Snipes, K, West, D, Rao, C, Bolick, S, Rycroft, RK, Mueller, L, Zheng, Y, Dosch, K, Brown, H, Vargas, A, Levin, GM, Bayakly, R, Johnson, C, Shen, T, Ruppert, L, Lynch, CF, Lai, SM, Tucker, TC, Wu, XC, Schwenn, M, Stern, K, Gershman, S, Copeland, G, Bushhouse, S, Rogers, DB, Jackson Thompson, J, Lemons, D, Frederick, S, Harris, JA, Riddle, B, Stroup, A, Wiggins, C, Schymura, MJ, Giljahn, LK, Sheikh, A, Schubert, S, Aldinger, W, Fulton, JP, Whiteside, M, Nogueira, L, Sweeney, C, Johnson, A, Martin, J, Farley, S, Harrelson, D, Malicki, R, Espinoza, JR, Hernandez, BY, Abulfateh, N, Wang, N, Ngan, RKC, Lingegowda, KB, Swaminathan, R, Koyande, SS, Silverman, B, Ozasa, K, Kanemura, S, Soda, M, Miyashiro, I, Shibata, A, Nimri, O, Won, YJ, Kim, CH, Hong, NS, Nam, HS, Kweon, S, Kim, WC, Huh, JS, Jung, KW, Yoo, CI, Elbasmy, A, Laudico, AV, Lumague, MR, AlMutlag, H, Buasom, R, Srisukho, S, Tanabodee, J, Wiangnon, S, Pongnikorn, D, Sriplung, H, Dirican, O, Eser, S, Le Hoang, M, Hackl, M, Zborovskaya, A, Dimitrova, N, Valerianova, Z, Sekerija, M, Pavlou, P, Dušek, M, Mägi, M, Clavel, J, Lacour, B, Guizard, AV, Bouvier, V, Troussard, X, Woronoff, AS, Tretarre, B, Colonna, M, Molinié, F, Bara, S, Velten, M, Marrer, E, Ganry, O, Grosclaude, P, Kaatsch, P, Zeissig, SR, Holleczek, B, Katalinic, A, Jakab, Z, Birgisson, H, Walsh, PM, Mangone, L, Merletti, F, Magoni, M, Ferretti, S, Serraino, D, Spagnoli, G, Fusco, M, Michiara, M, Tumino, R, Falcini, F, Sensi, F, Tisano, F, Piffer, S, Stracci, F, Tagliabue, G, Smailyte, G, Agius, D, Visser, O, Ursin, G, Didkowska, J, Trojanowski, M, Wojciechowska, U, Forjaz de Lacerda, G, Silva, MA, Laranja Pontes, J, da Costa Miranda, A, Kaiserova, E, Primic Žakelj, M, Peris-Bonet, R, Vicente Raneda, ML, Almar Marqués, E, Quirós Garcia, JR, Ramos Monserrat, M, Errezola Saizar, M, Alemán Herrera, A, Díaz García, JM, Marcos-Gragera, R, Sanchez-Perez, MJ, Ardanaz Aicua, E, Galceran, J, Klint, A, Kuehni, CE, Bouchardy, C, Levi, F, Bordoni, A, Konzelmann, I, Rohrmann, S, Stiller, CA, Gavin, AT, Brewster, DH, Phung, H, Rushton, S, Guthridge, S, Aitken, J, D'Onise, K, Venn, A, Farrugian, H, Threlfall, TJ, Laumond, S, Yen Kai Sun, L, Hendrix, J, Ballantine, K, Colombet, M, Dolya, A, Masuyer, E, Steliarova-Foucher, E, Steliarova-Foucher, Eva, Colombet, Murielle, Ries, Lynn A G, Moreno, Florencia, Dolya, Anastasia, Bray, Freddie, Hesseling, Peter, Shin, Hee Young, and Stiller, Charles A

Published
2017
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4. Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study

Author

Botta, L, Gatta, G, Capocaccia, R, Stiller, C, Canete, A, Dal Maso, L, Innos, K, Mihor, A, Erdmann, F, Spix, C, Lacour, B, Marcos-Gragera, R, Murray, D, Rossi, S, Hackl, M, Van Eycken, E, Van Damme, N, Valerianova, Z, Sekerija, M, Scoutellas, V, Demetriou, A, Dusek, L, Krejci, D, Storm, H, Magi, M, Paapsi, K, Malila, N, Pitkaniemi, J, Jooste, V, Clavel, J, Poulalhon, C, Desandes, E, Monnereau, A, Katalinic, A, Petridou, E, Markozannes, G, Garami, M, Birgisson, H, Walsh, P, Mazzoleni, G, Vittadello, F, Cuccaro, F, Galasso, R, Sampietro, G, Rosso, S, Gasparotto, C, Maifredi, G, Ferrante, M, Torrisi, A, Sutera Sardo, A, Gambino, M, Lanzoni, M, Ballotari, P, Giacomazzi, E, Ferretti, S, Caldarella, A, Manneschi, G, Sant, M, Baili, P, Berrino, F, Trama, A, Lillini, R, Bernasconi, A, Bonfarnuzzo, S, Vener, C, Didone, F, Lasalvia, P, Del Monego, G, Buratti, L, Serraino, D, Taborelli, M, De Angelis, R, Demuru, E, Di Benedetto, C, Santaquilani, M, Venanzi, S, Tallon, M, Boni, L, Iacovacci, S, Russo, A, Gervasi, F, Spagnoli, G, Cavalieri d'Oro, L, Fusco, M, Vitale, M, Usala, M, Vitale, F, Michiara, M, Chiranda, G, Sacerdote, C, Maule, M, Cascone, G, Spata, E, Mangone, L, Falcini, F, Cavallo, R, Piras, D, Dinaro, Y, Castaing, M, Fanetti, A, Minerba, S, Candela, G, Scuderi, T, Rizzello, R, Stracci, F, Tagliabue, G, Rugge, M, Brustolin, A, Pildava, S, Smailyte, G, Azzopardi, M, Johannesen, T, Didkowska, J, Wojciechowska, U, Bielska-Lasota, M, Pais, A, Ferreira, A, Bento, M, Miranda, A, Safaei Diba, C, Zadnik, V, Zagar, T, Sanchez-Contador Escudero, C, Franch Sureda, P, Lopez de Munain, A, De-La-Cruz, M, Rojas, M, Aleman, A, Vizcaino, A, Almela, F, Sanvisens, A, Sanchez, M, Chirlaque, M, Sanchez-Gil, A, Guevara, M, Ardanaz, E, Canete-Nieto, A, Peris-Bonet, R, Galceran, J, Carulla, M, Kuehni, C, Redmond, S, Visser, O, Karim-Kos, H, Stevens, S, Gavin, A, Morrison, D, Huws, D, Botta L., Gatta G., Capocaccia R., Stiller C., Canete A., Dal Maso L., Innos K., Mihor A., Erdmann F., Spix C., Lacour B., Marcos-Gragera R., Murray D., Rossi S., Hackl M., Van Eycken E., Van Damme N., Valerianova Z., Sekerija M., Scoutellas V., Demetriou A., Dusek L., Krejci D., Storm H., Magi M., Paapsi K., Malila N., Pitkaniemi J., Jooste V., Clavel J., Poulalhon C., Desandes E., Monnereau A., Katalinic A., Petridou E., Markozannes G., Garami M., Birgisson H., Walsh P. M., Mazzoleni G., Vittadello F., Cuccaro F., Galasso R., Sampietro G., Rosso S., Gasparotto C., Maifredi G., Ferrante M., Torrisi A., Sutera Sardo A., Gambino M. L., Lanzoni M., Ballotari P., Giacomazzi E., Ferretti S., Caldarella A., Manneschi G., Sant M., Baili P., Berrino F., Trama A., Lillini R., Bernasconi A., Bonfarnuzzo S., Vener C., Didone F., Lasalvia P., Del Monego G., Buratti L., Serraino D., Taborelli M., De Angelis R., Demuru E., Di Benedetto C., Santaquilani M., Venanzi S., Tallon M., Boni L., Iacovacci S., Russo A. G., Gervasi F., Spagnoli G., Cavalieri d'Oro L., Fusco M., Vitale M. F., Usala M., Vitale F., Michiara M., Chiranda G., Sacerdote C., Maule M., Cascone G., Spata E., Mangone L., Falcini F., Cavallo R., Piras D., Dinaro Y., Castaing M., Fanetti A. C., Minerba S., Candela G., Scuderi T., Rizzello R. V., Stracci F., Tagliabue G., Rugge M., Brustolin A., Pildava S., Smailyte G., Azzopardi M., Johannesen T. B., Didkowska J., Wojciechowska U., Bielska-Lasota M., Pais A., Ferreira A. M., Bento M. J., Miranda A., Safaei Diba C., Zadnik V., Zagar T., Sanchez-Contador Escudero C., Franch Sureda P., Lopez de Munain A., De-La-Cruz M., Rojas M. D., Aleman A., Vizcaino A., Almela F., Sanvisens A., Sanchez M. J., Chirlaque M. D., Sanchez-Gil A., Guevara M., Ardanaz E., Canete-Nieto A., Peris-Bonet R., Galceran J., Carulla M., Kuehni C., Redmond S., Visser O., Karim-Kos H., Stevens S., Gavin A., Morrison D., Huws D. W., Botta, L, Gatta, G, Capocaccia, R, Stiller, C, Canete, A, Dal Maso, L, Innos, K, Mihor, A, Erdmann, F, Spix, C, Lacour, B, Marcos-Gragera, R, Murray, D, Rossi, S, Hackl, M, Van Eycken, E, Van Damme, N, Valerianova, Z, Sekerija, M, Scoutellas, V, Demetriou, A, Dusek, L, Krejci, D, Storm, H, Magi, M, Paapsi, K, Malila, N, Pitkaniemi, J, Jooste, V, Clavel, J, Poulalhon, C, Desandes, E, Monnereau, A, Katalinic, A, Petridou, E, Markozannes, G, Garami, M, Birgisson, H, Walsh, P, Mazzoleni, G, Vittadello, F, Cuccaro, F, Galasso, R, Sampietro, G, Rosso, S, Gasparotto, C, Maifredi, G, Ferrante, M, Torrisi, A, Sutera Sardo, A, Gambino, M, Lanzoni, M, Ballotari, P, Giacomazzi, E, Ferretti, S, Caldarella, A, Manneschi, G, Sant, M, Baili, P, Berrino, F, Trama, A, Lillini, R, Bernasconi, A, Bonfarnuzzo, S, Vener, C, Didone, F, Lasalvia, P, Del Monego, G, Buratti, L, Serraino, D, Taborelli, M, De Angelis, R, Demuru, E, Di Benedetto, C, Santaquilani, M, Venanzi, S, Tallon, M, Boni, L, Iacovacci, S, Russo, A, Gervasi, F, Spagnoli, G, Cavalieri d'Oro, L, Fusco, M, Vitale, M, Usala, M, Vitale, F, Michiara, M, Chiranda, G, Sacerdote, C, Maule, M, Cascone, G, Spata, E, Mangone, L, Falcini, F, Cavallo, R, Piras, D, Dinaro, Y, Castaing, M, Fanetti, A, Minerba, S, Candela, G, Scuderi, T, Rizzello, R, Stracci, F, Tagliabue, G, Rugge, M, Brustolin, A, Pildava, S, Smailyte, G, Azzopardi, M, Johannesen, T, Didkowska, J, Wojciechowska, U, Bielska-Lasota, M, Pais, A, Ferreira, A, Bento, M, Miranda, A, Safaei Diba, C, Zadnik, V, Zagar, T, Sanchez-Contador Escudero, C, Franch Sureda, P, Lopez de Munain, A, De-La-Cruz, M, Rojas, M, Aleman, A, Vizcaino, A, Almela, F, Sanvisens, A, Sanchez, M, Chirlaque, M, Sanchez-Gil, A, Guevara, M, Ardanaz, E, Canete-Nieto, A, Peris-Bonet, R, Galceran, J, Carulla, M, Kuehni, C, Redmond, S, Visser, O, Karim-Kos, H, Stevens, S, Gavin, A, Morrison, D, Huws, D, Botta L., Gatta G., Capocaccia R., Stiller C., Canete A., Dal Maso L., Innos K., Mihor A., Erdmann F., Spix C., Lacour B., Marcos-Gragera R., Murray D., Rossi S., Hackl M., Van Eycken E., Van Damme N., Valerianova Z., Sekerija M., Scoutellas V., Demetriou A., Dusek L., Krejci D., Storm H., Magi M., Paapsi K., Malila N., Pitkaniemi J., Jooste V., Clavel J., Poulalhon C., Desandes E., Monnereau A., Katalinic A., Petridou E., Markozannes G., Garami M., Birgisson H., Walsh P. M., Mazzoleni G., Vittadello F., Cuccaro F., Galasso R., Sampietro G., Rosso S., Gasparotto C., Maifredi G., Ferrante M., Torrisi A., Sutera Sardo A., Gambino M. L., Lanzoni M., Ballotari P., Giacomazzi E., Ferretti S., Caldarella A., Manneschi G., Sant M., Baili P., Berrino F., Trama A., Lillini R., Bernasconi A., Bonfarnuzzo S., Vener C., Didone F., Lasalvia P., Del Monego G., Buratti L., Serraino D., Taborelli M., De Angelis R., Demuru E., Di Benedetto C., Santaquilani M., Venanzi S., Tallon M., Boni L., Iacovacci S., Russo A. G., Gervasi F., Spagnoli G., Cavalieri d'Oro L., Fusco M., Vitale M. F., Usala M., Vitale F., Michiara M., Chiranda G., Sacerdote C., Maule M., Cascone G., Spata E., Mangone L., Falcini F., Cavallo R., Piras D., Dinaro Y., Castaing M., Fanetti A. C., Minerba S., Candela G., Scuderi T., Rizzello R. V., Stracci F., Tagliabue G., Rugge M., Brustolin A., Pildava S., Smailyte G., Azzopardi M., Johannesen T. B., Didkowska J., Wojciechowska U., Bielska-Lasota M., Pais A., Ferreira A. M., Bento M. J., Miranda A., Safaei Diba C., Zadnik V., Zagar T., Sanchez-Contador Escudero C., Franch Sureda P., Lopez de Munain A., De-La-Cruz M., Rojas M. D., Aleman A., Vizcaino A., Almela F., Sanvisens A., Sanchez M. J., Chirlaque M. D., Sanchez-Gil A., Guevara M., Ardanaz E., Canete-Nieto A., Peris-Bonet R., Galceran J., Carulla M., Kuehni C., Redmond S., Visser O., Karim-Kos H., Stevens S., Gavin A., Morrison D., and Huws D. W.

Abstract

Background: The EUROCARE-5 study revealed disparities in childhood cancer survival among European countries, giving rise to important initiatives across Europe to reduce the gap. Extending its representativeness through increased coverage of eastern European countries, the EUROCARE-6 study aimed to update survival progress across countries and years of diagnosis and provide new analytical perspectives on estimates of long-term survival and the cured fraction of patients with childhood cancer. Methods: In this population-based study, we analysed 135 847 children (aged 0–14 years) diagnosed during 2000–13 and followed up to the end of 2014, recruited from 80 population-based cancer registries in 31 European countries. We calculated age-adjusted 5-year survival differences by country and over time using period analysis, for all cancers combined and for major cancer types. We applied a variant of standard mixture cure models for survival data to estimate the cure fraction of patients by childhood cancer and to estimate projected 15-year survival. Findings: 5-year survival for all childhood cancer combined in Europe in 2010–14 was 81% (95% CI 81–82), showing an increase of three percentage points compared with 2004–06. Significant progress over time was observed for almost all cancers. Survival remained stable for osteosarcomas, Ewing sarcoma, Burkitt lymphoma, non-Hodgkin lymphomas, and rhabdomyoscarcomas. For all cancers combined, inequalities still persisted among European countries (with age-adjusted 5-year survival ranging from 71% [95% CI 60–79] to 87% [77–93]). The 15-year survival projection for all patients with childhood cancer diagnosed in 2010–13 was 78%. We estimated the yearly long-term mortality rate due to causes other than the diagnosed cancer to be around 2 per 1000 patients for all childhood cancer combined, but to approach zero for retinoblastoma. The cure fraction for patients with childhood cancer increased over time from 74% (95% CI 73–75) in 1998–

Published
2022

5. Clear Improvement in Real-World Chronic Myeloid Leukemia Survival: A Comparison With Randomized Controlled Trials

Author

Vener, C., Rossi, S., Minicozzi, P., Marcos-Gragera, R., Poirel, H. A., Maynadie, M., Troussard, X., Pravettoni, G., De Angelis, R., Sant, M., Hackl, M., Van Eycken, E., Valerianova, Z., Sekerija, M., Pavlou, P., Dusek, L., Storm, H., Magi, M., Innos, K., Malila, N., Pitkaniemi, J., Velten, M., Bouvier, A. M., Jooste, V., Guizard, A. V., Launoy, G., Yonli, S. D., Woronoff, A. S., Nousbaum, J. B., Coureau, G., Monnereau, A., Baldi, I., Hammas, K., Tretarre, B., Colonna, M., Plouvier, S., D'Almeida, T., Molinie, F., Cowppli-Bony, A., Bara, S., Schvartz, C., Defossez, G., Lapotre-Ledoux, B., Grosclaude, P., Luttmann, S., Stabenow, R., Nennecke, A., Kieschke, J., Zeissig, S., Holleczek, B., Katalinic, A., Birgisson, H., Murray, D., Walsh, P. M., Mazzoleni, G., Vittadello, F., Cuccaro, F., Galasso, R., Sampietro, G., Rosso, S., Magoni, M., Ferrante, M., Sardo, A. S., Gambino, M. L., Ballotari, P., Giacomazzi, E., Ferretti, S., Caldarella, A., Manneschi, G., Gatta, G., Baili, P., Berrino, F., Botta, L., Trama, A., Lillini, R., Bernasconi, A., Bonfarnuzzo, S., Didone, F., Lasalvia, P., Del Monego, G., Magri, M. C., Buratti, L., Serraino, D., Dal Maso, L., Capocaccia, R., Demuru, E., Di Benedetto, C., Santaquilani, M., Venanzi, S., Filiberti, R. A., Iacovacci, S., Gennaro, V., Russo, A. G., Spagnoli, G., D'Oro, L. C., Fusco, M., Vitale, M. F., Usala, M., Vitale, F., Michiara, M., Chiranda, G., Cascone, G., Spata, E., Mangone, L., Falcini, F., Cavallo, R., Piras, D., Madeddu, A., Bella, F., Fanetti, A. C., Minerba, S., Candela, G., Scuderi, T., Rizzello, R. V., Stracci, F., Tagliabue, G., Rugge, M., Brustolin, A., Pildava, S., Smailyte, G., Azzopardi, M., Johannesen, T. B., Didkowska, J., Wojciechowska, U., Bielska-Lasota, M., Pais, A., Pontes, J. L., Miranda, A., Diba, C. S., Zadnik, V., Zagar, T., Escudero, C. S. -C., Sureda, P. F., de Munain, A. L., De-La-cruz, M., Rojas, M. D., Aleman, A., Vizcaino, A., Sanchez, M. J., Chirlaque, M. D., Eslava, M. G., Ardanaz, E., Galceran, J., Carulla, M., Bergeron, Y., Bouchardy, C., Mousavi, S. M., Bordoni, A., Visser, O., Rashbass, J., Gavin, A., Morrison, D., and Huws, D. W.

Subjects
Cancer Research, Survival, real-world data, randomized controlled trials (RCTs), tyrosine kinase inhibitor (TKI), population-based studies, Tyrosine kinase inhibitor (TKI), Randomized controlled trials (RCTs), survival, Real-world data, Europe, Oncology, cancer registries, chronic myeloid leukemia (CML), Chronic myeloid leukemia (CML), Cancer registries, Population-based studies
Abstract

This study was funded by the Compagnia di San Paolo, the Cariplo Foundation and the European Commission (grant number 801520 HP-JA-2017, Innovative Partnership for Action Against Cancer, iPAAC Joint Action). The sources of the funding played no role in designing the study, collecting, analyzing, or interpreting the data, writing the report, or deciding whether or not to submit the article for publication. This research was (partially) funded by Italian Ministry of Health "Ricerca Corrente" funds. Tyrosine kinase inhibitors (TKIs) have been improving the prognosis of patients with chronic myeloid leukemia (CML), but there are still large differences in survival among European countries. This raises questions on the added value of results from population-based studies, which use real-world data, compared to results of randomized controlled trials (RCTs) involving patients with CML. There are also questions about the extent of the findings on RCTs effectiveness for patients in the general population. We compare survival data extracted from our previous systematic review and meta-analysis of CML RCTs with the latest updated population-based survival data of EUROCARE-6, the widest collaborative study on cancer survival in Europe. The EUROCARE-6 CML survival estimated in patients (15-64 years) diagnosed in 2000-2006 vs. 2007-2013 revealed that the prognostic improvement highlighted by RCTs was confirmed in real-world settings, too. The study shows, evaluating for the first time all European regions, that the optimal outcome figures obtained in controlled settings for CML are also achievable (and indeed achieved) in real-world settings with prompt introduction of TKIs in daily clinical practice. However, some differences still persist, particularly in Eastern European countries, where overall survival values are lower than elsewhere, probably due to a delayed introduction of TKIs. Our results suggest an insufficient adoption of adequate protocols in daily clinical practice in those countries where CML survival values remain lower in real life than the values obtained in RCTs. New high-resolution population-based studies may help to identify failures in the clinical pathways followed there.

Published
2022
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7. Cohort profile:Nordic Helicobacter Pylori eradication project (NordHePEP)

Author

Pettersson, A.-K. (Anna-Klara), Santoni, G. (Giola), Yan, J. (Jacinth), Radkiewicz, C. (Cecilia), Xie, S. (Shaohua), Birgisson, H. (Helgi), Ness-Jensen, E. (Eivind), von Euler-Chelpin, M. (My), Kauppila, J. H. (Joonas H.), Lagergren, J. (Jesper), Pettersson, A.-K. (Anna-Klara), Santoni, G. (Giola), Yan, J. (Jacinth), Radkiewicz, C. (Cecilia), Xie, S. (Shaohua), Birgisson, H. (Helgi), Ness-Jensen, E. (Eivind), von Euler-Chelpin, M. (My), Kauppila, J. H. (Joonas H.), and Lagergren, J. (Jesper)

Abstract

Purpose: This cohort description presents the Nordic Helicobacter Pylori Eradication Project (NordHePEP), a population-based cohort of patients having received eradication treatment for Helicobacter pylori (HP). The cohort is created with the main purpose of examining whether and to what extent HP eradication treatment influences the risk of gastrointestinal cancer. Participants: NordHePEP includes all adults (aged ≥18 years) having been prescribed and dispensed HP eradication treatment according to the nationwide complete drug registries in any of the five Nordic countries (Denmark, Finland, Iceland, Norway, or Sweden) between 1994 and 2020 (start and end year varies between countries). We have retrieved and merged individual-level data from multiple national registries, including drug, patient, cancer, population, and death registries. Findings: The cohort includes 674,771 patients having received HP eradication treatment. During up to 23 years of follow-up, 59,292 (8.8%) participants were diagnosed with cancer (non-melanoma skin cancer excluded), whereof 15,496 (2.3%) in the gastrointestinal tract. Future plans: We will analyse HP eradication treatment in relation to gastrointestinal cancer risk. Standardised incidence ratios will be calculated as the observed cancer incidence in the cohort divided by the expected cancer incidence, derived from the background population of the corresponding age, sex, and calendar year.

Published
2022

12. Reasons for low cervical cancer survival in new accession European Union countries: a EUROCARE-5 study

Author

Bielska-Lasota, M., Rossi, S., Krzyzak, M., Haelens, A., Domenic, A., De Angelis, R., Maciejczyk, A., Rodriguez-Barranco, M., Zadnik, V., Minicozzi, P., Hackl, M., Ihle, P., Vaneycken, E., Henau, K., Valerianova, Z., Dimitrova, N., Sekerija, M., Cukelj, P., Dusek, L., Zvolsky, M., Magi, M., Aareleid, T., Malila, N., Seppa, K., Velten, M., Guizard, A. V., Faivre, J., Woronoff, A. S., Tretarre, B., Bossard, N., Uhry, Z., Colonna, M., Molinie, F., Cowppli-Bony, A., Bara, S., Lapotre-Ledoux, B., Grosclaude, P., Stabenow, R., Luttmann, S., Eberle, A., Brenner, H., Nennecke, A., Engel, J., Schubert-Fritschle, G., Heidrich, J., Holleczek, B., Katalinic, A., Birgisson, H., Tryggvadottir, L., Clough-Gorr, K., Mazzoleni, G., Bulatko, A., Buzzoni, C., Suterasardo, A., Mancuso, P., Ferretti, S., Barchielli, A., Caldarella, A., Gatta, G., Sant, M., Amati, C., Baili, P., Berrino, F., Bonfarnuzzo, S., Botta, L., Capocaccia, R., Foschi, R., Margutti, C., Meneghini, E., Trama, A., Serraino, D., Dalmaso, L., Deangelis, R., Dibenedetto, C., Caldora, M., Francisci, S., Galati, F., Mallone, S., Pierannunzio, D., Tallon, M., Santaquilani, M., Tavilla, A., Pannozzo, F., Busco, S., Filiberti, R. A., Marani, E., Ricci, P., Spagnoli, G., Cirilli, C., Fusco, M., Vitale, M. F., Usala, M., Vitale, F., Mazzucco, W., Michiara, M., Zanetti, R., Rosso, S., Tumino, R., Mangone, L., Difelice, E., Russo, A. G., Andreano, A., Falcini, F., Caiazzo, A. L., Cesaraccio, R., Piffer, S., Madeddu, A., Tisano, F., Fanetti, A. C., Cometti, I., Candela, P., Scuderi, T., Stracci, F., Bianconi, F., Tagliabue, G., Contiero, P., Rugge, M., Zorzi, M., Pildava, S., Smailyte, G., Azzopardi, M., Calleja, N., Johannesen, T. B., Rachtan, J., Gozdz, S., Macek, P., Blaszczyk, J., Bebenek, M., Forjaz deLacerda, G., Bento, M. J., Antunes, L., Miranda, A., Mayer-da-Silva, A., Safaeidiba, C., Primic-Zakelj, M., Lopez deMunain, A., Gil, L., Diazgarcia, J. M., Marcos-Navarro, A. I., Marcos-Gragera, R., Puigdemont, M., Sanchez, M. J., Chang, D. Y. L., Chirlaque, M. D., Ardanaz, E., Guevara, M., Galceran, J., Carulla, M., Lambe, M., Khan, S., Staehelin, K., Bouchardy, C., Fournier, E., Mousavi, S. M., Ess, S. M., Lorez, M., Mousavi, M., Herrmann, C., Bordoni, A., Spitale, A., Konzelmann, I., Visser, O., Aarts, M., Otter, R., Coleman, M., Allemani, C., Rachet, B., Rashbass, J., Broggio, J., Verne, J., Gavin, A., Donnelly, D., Morrison, D., Black, R., Huws, D. W., Thomas, R., Bielska‑Lasota, M, Rossi, S, Krzyżak, M, Haelens, A, Domenic, A, De Angelis, R, Maciejczyk, A, Rodríguez‑Barranco, M, Zadnik, V, Minicozzi, P, Vitale, F, and Mazzucco, W

Subjects
Morphology, Adult, Male, Stage at diagnosi, Survival, Adolescent, Socio-culturale, Uterine Cervical Neoplasms, Disease, Settore MED/42 - Igiene Generale E Applicata, 03 medical and health sciences, 0302 clinical medicine, Medicine, media_common.cataloged_instance, Humans, European Union, European union, Survival rate, Population-based study, media_common, Aged, Retrospective Studies, Cervical cancer, Aged, 80 and over, Cervical cancer, Europe, Morphology, Population-based study, Stage at diagnosis, Survival, 030219 obstetrics & reproductive medicine, Relative survival, business.industry, Absolute risk reduction, Obstetrics and Gynecology, Retrospective cohort study, Stage at diagnosis, General Medicine, Middle Aged, medicine.disease, Europe, Eastern european, Survival Rate, 030220 oncology & carcinogenesis, Female, business, Demography
Abstract

Purpose: With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis (local, regional and metastatic), morphology (mainly squamous versus glandular tumours) and patients’ age. Methods: We analysed 101,714 CC women diagnosed in 2000–2007 and followed-up to December 2008. Age-standardised 5-year relative survival (RS) and the excess risks of cancer death in the 5years after diagnosis were computed. Results: EE women were older and less commonly diagnosed with glandular tumours. Proportions of local stage cancers were similar across Europe, while morphology- and stage-specific RS (especially for non-metastatic disease) were lower in Eastern Europe. Adjusting for age and morphology, excess risk of local stage CC death for EE patients remained higher than that for other European women. Conclusion: Stage, age and morphology alone do not explain worse survival in Eastern Europe: less effective care may play a role, probably partly due to fewer or inadequate resources being allocated to health care in this area, compared to the rest of Europe.

Published
2019

13. International incidence of childhood cancer, 2001-10 a population-based registry study

Author

Steliarova Foucher Eva, Colombet, Murielle, Ries Lynn, A. G., Moreno, Florencia, Dolya, Anastasia, Bray, Freddie, Hesseling, Peter, Shin, Hee Young Stiller, Iicc, 3 contributors, Bouzbid, S, Hamdi Cherif, M, Hablas, A, Chirpaz, E, Buziba, N, Chesumbai, Gc, Manraj, Ss, Reynders, D, Wabinga, Hr, Chokunonga, E, Moreno, F, Lima, Ca, Asturian Laporte, C, de Oliveira JC, de Aquino JP, Gallagher, Sv, Uribe, Cj, Bravo, Le, Yepez Chamorro MC, Torres Alvarado, G, Galán Alvarez YH, Martinez Reyes FC, Castillo Calvas JC, Mendoza Alava, M, Cueva Ayala, P, Hanchard, B, Fajardo Gutiérrez, A, Zavala Zegarra DE, Barrios, E, Nikiforuk, C, Woods, R, Turner, D, Macintyre, M, Corriveau, A, Navaneelan, T, Bertrand, C, Stuart Panko, H, Wilson, Rj, Kosary, C, Shen, X, Brockhouse, J, Yee, Ga, Mitchell, Tc, Snipes, K, West, D, Rao, C, Bolick, S, Rycroft, Rk, Mueller, L, Zheng, Y, Dosch, K, Brown, H, Vargas, A, Levin, Gm, Bayakly, R, Johnson, C, Shen, T, Ruppert, L, Lynch, Cf, Lai, Sm, Tucker, Tc, Wu, Xc, Schwenn, M, Stern, K, Gershman, S, Copeland, G, Bushhouse, S, Rogers, Db, Jackson Thompson, J, Lemons, D, Frederick, S, Harris, Ja, Riddle, B, Stroup, A, Wiggins, C, Schymura, Mj, Giljahn, Lk, Sheikh, A, Schubert, S, Aldinger, W, Fulton, Jp, Whiteside, M, Nogueira, L, Sweeney, C, Johnson, A, Martin, J, Farley, S, Harrelson, D, Malicki, R, Espinoza, Jr, Hernandez, By, Abulfateh, N, Wang, N, Ngan, R, Lingegowda, Kb, Swaminathan, R, Koyande, Ss, Silverman, B, Ozasa, K, Kanemura, S, Soda, M, Miyashiro, I, Shibata, A, Nimri, O, Won, Yj, Kim, Ch, Hong, Ns, Nam, Hs, Kweon, S, Kim, Wc, Huh, Js, Jung, Kw, Yoo, Ci, Elbasmy, A, Laudico, Av, Lumague, Mr, Almutlag, H, Buasom, R, Srisukho, S, Tanabodee, J, Wiangnon, S, Pongnikorn, D, Sriplung, H, Dirican, O, Eser, S, Le Hoang, M, Hackl, M, Zborovskaya, A, Dimitrova, N, Valerianova, Z, Sekerija, M, Pavlou, P, Dušek, M, Mägi, M, Clavel, J, Lacour, B, Guizard, Av, Bouvier, V, Troussard, X, Woronoff, As, Tretarre, B, Colonna, M, Molinié, F, Bara, S, Velten, M, Marrer, E, Ganry, O, Grosclaude, P, Kaatsch, P, Zeissig, Sr, Holleczek, B, Katalinic, A, Jakab, Z, Birgisson, H, Walsh, Pm, Mangone, L, Merletti, Franco, Magoni, M, Ferretti, S, Serraino, D, Spagnoli, G, Fusco, M, Michiara, M, Tumino, R, Falcini, F, Sensi, F, Tisano, F, Piffer, S, Stracci, F, Tagliabue, G, Smailyte, G, Agius, D, Visser, O, Ursin, G, Didkowska, J, Trojanowski, M, Wojciechowska, U, Forjaz de Lacerda, G, Silva, Ma, Laranja Pontes, J, da Costa Miranda, A, Kaiserova, E, Primic Žakelj, M, Peris Bonet, R, Vicente Raneda ML, Almar Marqués, E, Quirós Garcia JR, Ramos Monserrat, M, Errezola Saizar, M, Alemán Herrera, A, Díaz García JM, Marcos Gragera, R, Sanchez Perez MJ, Ardanaz Aicua, E, Galceran, J, Klint, A, Kuehni, Ce, Bouchardy, C, Levi, F, Bordoni, A, Konzelmann, I, Rohrmann, S, Stiller, Ca, Gavin, At, Brewster, Dh, Phung, H, Rushton, S, Guthridge, S, Aitken, J, D'Onise, K, Venn, A, Farrugian, H, Threlfall, Tj, Laumond, S, Yen Kai Sun, L, Hendrix, J, Ballantine, K, Colombet, M, Dolya, A, Masuyer, E, Steliarova Foucher, E., IICC-3 contributors, Bouzbid, S., Hamdi-Cherif, M., Hablas, A., Chirpaz, E., Buziba, N., Chesumbai, G.C., Manraj, S.S., Reynders, D., Wabinga, H.R., Chokunonga, E., Moreno, F., Lima, C.A., Asturian Laporte, C., de Oliveira, J.C., de Aquino, J.P., Gallagher, S.V., Uribe, C.J., Bravo, L.E., Yepez Chamorro, M.C., Torres Alvarado, G., Galán Alvarez, Y.H., Martinez Reyes, F.C., Castillo Calvas, J.C., Mendoza Alava, M., Cueva Ayala, P., Hanchard, B., Fajardo-Gutiérrez, A., Zavala Zegarra, D.E., Barrios, E., Nikiforuk, C., Woods, R., Turner, D., MacIntyre, M., Corriveau, A., Navaneelan, T., Bertrand, C., Stuart-Panko, H., Wilson, R.J., Kosary, C., Shen, X., Brockhouse, J., Yee, G.A., Mitchell, T.C., Snipes, K., West, D., Rao, C., Bolick, S., Rycroft, R.K., Mueller, L., Zheng, Y., Dosch, K., Brown, H., Vargas, A., Levin, G.M., Bayakly, R., Johnson, C., Shen, T., Ruppert, L., Lynch, C.F., Lai, S.M., Tucker, T.C., Wu, X.C., Schwenn, M., Stern, K., Gershman, S., Copeland, G., Bushhouse, S., Rogers, D.B., Jackson Thompson, J., Lemons, D., Frederick, S., Harris, J.A., Riddle, B., Stroup, A., Wiggins, C., Schymura, M.J., Giljahn, L.K., Sheikh, A., Schubert, S., Aldinger, W., Fulton, J.P., Whiteside, M., Nogueira, L., Sweeney, C., Johnson, A., Martin, J., Farley, S., Harrelson, D., Malicki, R., Espinoza, J.R., Hernandez, B.Y., Abulfateh, N., Wang, N., Ngan, R., Lingegowda, K.B., Swaminathan, R., Koyande, S.S., Silverman, B., Ozasa, K., Kanemura, S., Soda, M., Miyashiro, I., Shibata, A., Nimri, O., Won, Y.J., Kim, C.H., Hong, N.S., Nam, H.S., Kweon, S., Kim, W.C., Huh, J.S., Jung, K.W., Yoo, C.I., Elbasmy, A., Laudico, A.V., Lumague, M.R., AlMutlag, H., Buasom, R., Srisukho, S., Tanabodee, J., Wiangnon, S., Pongnikorn, D., Sriplung, H., Dirican, O., Eser, S., Le Hoang, M., Hackl, M., Zborovskaya, A., Dimitrova, N., Valerianova, Z., Sekerija, M., Pavlou, P., Dušek, M., Mägi, M., Clavel, J., Lacour, B., Guizard, A.V., Bouvier, V., Troussard, X., Woronoff, A.S., Tretarre, B., Colonna, M., Molinié, F., Bara, S., Velten, M., Marrer, E., Ganry, O., Grosclaude, P., Kaatsch, P., Zeissig, S.R., Holleczek, B., Katalinic, A., Jakab, Z., Birgisson, H., Walsh, P.M., Mangone, L., Merletti, F., Magoni, M., Ferretti, S., Serraino, D., Spagnoli, G., Fusco, M., Michiara, M., Tumino, R., Falcini, F., Sensi, F., Tisano, F., Piffer, S., Stracci, F., Tagliabue, G., Smailyte, G., Agius, D., Visser, O., Ursin, G., Didkowska, J., Trojanowski, M., Wojciechowska, U., Forjaz de Lacerda, G., Silva, M.A., Laranja Pontes, J., da Costa Miranda, A., Kaiserova, E., Primic Žakelj, M., Peris-Bonet, R., Vicente Raneda, M.L., Almar Marqués, E., Quirós Garcia, J.R., Ramos Monserrat, M., Errezola Saizar, M., Alemán Herrera, A., Díaz García, J.M., Marcos-Gragera, R., Sanchez-Perez, M.J., Ardanaz Aicua, E., Galceran, J., Klint, A., Kuehni, C.E., Bouchardy, C., Levi, F., Bordoni, A., Konzelmann, I., Rohrmann, S., Stiller, C.A., Gavin, A.T., Brewster, D.H., Phung, H., Rushton, S., Guthridge, S., Aitken, J., D'Onise, K., Venn, A., Farrugian, H., Threlfall, T.J., Laumond, S., Yen Kai Sun, L., Hendrix, J., Ballantine, K., Colombet, M., Dolya, A., Masuyer, E., Steliarova-Foucher, E., University of Zurich, and Steliarova-Foucher, Eva

Subjects
0301 basic medicine, Male, Pediatrics, cancer incidence, sistema de registros, humanos, Ethnic group, adolescente, population-based registry study, North America/epidemiology, 0302 clinical medicine, Neoplasms, Medicine, Registries, Young adult, Child, Cancer in children -- Mortality, Cause of death, neoplasias, education.field_of_study, Incidence (epidemiology), Incidence, South America/epidemiology, Articles, Càncer en els infants -- Mortalitat, incidence, cancer registry, childhood cancer, 3. Good health, adulto joven, Caribbean Region/epidemiology, Oncology, Oceania/epidemiology, 030220 oncology & carcinogenesis, Child, Preschool, Oncology, childhood, cancer, population-based registry study, cancer incidence, 2730 Oncology, Female, medicine.medical_specialty, Oceanía, Adolescent, Oceania, Population, Socio-culturale, 610 Medicine & health, incidencia, Europe/epidemiology, 03 medical and health sciences, Young Adult, Age Distribution, distribución por edades, SDG 3 - Good Health and Well-being, cancer, Humans, education, childhood, lactante, Asia/epidemiology, business.industry, Cancer, Infant, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), medicine.disease, Cancer registry, 030104 developmental biology, Africa/epidemiology, business, Neoplasms/epidemiology, International Classification of Diseases for Oncology, Demography
Abstract

Background Cancer is a major cause of death in children worldwide, and the recorded incidence tends to increase with time. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. This study aimed to provide internationally comparable local data on the incidence of childhood cancer to promote research of causes and implementation of childhood cancer control. Methods This population-based registry study, devised by the International Agency for Research on Cancer in collaboration with the International Association of Cancer Registries, collected data on all malignancies and nonmalignant neoplasms of the CNS diagnosed before age 20 years in populations covered by high-quality cancer registries with complete data for 2001-10. Incidence rates per million person-years for the 0-14 years and 0-19 years age groups were age-adjusted using the world standard population to provide age-standardised incidence rates (WSRs), using the age-specific incidence rates (ASR) for individual age groups (0-4 years, 5-9 years, 10-14 years, and 15-19 years). All rates were reported for 19 geographical areas or ethnicities by sex, age group, and cancer type. The regional WSRs for children aged 0-14 years were compared with comparable data obtained in the 1980s. Findings Of 532 invited cancer registries, 153 registries from 62 countries, departments, and territories met quality standards, and contributed data for the entire decade of 2001-10. 385 509 incident cases in children aged 0-19 years occurring in 2.64 billion person-years were included. The overall WSR was 140.6 per million person-years in children aged 0-14 years (based on 284 649 cases), and the most common cancers were leukaemia (WSR 46.4), followed by CNS tumours (WSR 28.2), and lymphomas (WSR 15.2). In children aged 15-19 years (based on 100 860 cases), the ASR was 185.3 per million person-years, the most common being lymphomas (ASR 41.8) and the group of epithelial tumours and melanoma (ASR 39.5). Incidence varied considerably between and within the described regions, and by cancer type, sex, age, and racial and ethnic group. Since the 1980s, the global WSR of registered cancers in children aged 0-14 years has increased from 124.0 (95% CI 123.3-124.7) to 140.6 (140.1-141.1) per million person-years. Interpretation This unique global source of childhood cancer incidence will be used for aetiological research and to inform public health policy, potentially contributing towards attaining several targets of the Sustainable Development Goals. The observed geographical, racial and ethnic, age, sex, and temporal variations require constant monitoring and research., International Agency for Research on Cancer and the Union for International Cancer Control.

Published
2017
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14. Plasma Protein Profiling Reveal Osteoprotegerin as a Marker of Prognostic Impact for Colorectal Cancer

Author

Birgisson, H, Tsimogiannis, Kostas, Freyhult, Eva, and Kamali-Moghaddam, Masood

Subjects
Original article, Cancer och onkologi, Cancer and Oncology, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282
Abstract

BACKGROUND: Due to difficulties in predicting recurrences in colorectal cancer stages II and III, reliable prognostic biomarkers could be a breakthrough for individualized treatment and follow-up. OBJECTIVE: To find potential prognostic protein biomarkers in colorectal cancer, using the proximity extension assays. METHODS: A panel of 92 oncology-related proteins was analyzed with proximity extension assays, in plasma from a cohort of 261 colorectal cancer patients with stage II-IV. The survival analyses were corrected for disease stage and age, and the recurrence analyses were corrected for disease stage. The significance threshold was adjusted for multiple comparisons. RESULTS: The plasma proteins expression levels had a greater prognostic relevance in disease stage III colorectal cancer than in disease stage II, and for overall survival than for time to recurrence. Osteoprotegerin was the only biomarker candidate in the protein panel that had a statistical significant association with overall survival (P = .00029). None of the proteins were statistically significantly associated with time to recurrence. CONCLUSIONS: Of the 92 analyzed plasma proteins, osteoprotegerin showed the strongest prognostic impact in patients with colorectal cancer, and therefore osteoprotegerin is a potential predictive marker, and it also could be a target for treatments.

Published
2018

15. International incidence of childhood cancer, 2001–10: a population-based registry study

Author

Steliarova-Foucher, Eva, primary, Colombet, Murielle, additional, Ries, Lynn A G, additional, Moreno, Florencia, additional, Dolya, Anastasia, additional, Bray, Freddie, additional, Hesseling, Peter, additional, Shin, Hee Young, additional, Stiller, Charles A, additional, Bouzbid, S, additional, Hamdi-Cherif, M, additional, Hablas, A, additional, Chirpaz, E, additional, Buziba, N, additional, Chesumbai, GC, additional, Manraj, SS, additional, Reynders, D, additional, Wabinga, HR, additional, Chokunonga, E, additional, Moreno, F, additional, Lima, CA, additional, Asturian Laporte, C, additional, de Oliveira, JC, additional, de Aquino, JA Pontes, additional, Gallagher, SM Vargas, additional, Uribe, CJ, additional, Bravo, LE, additional, Yepez Chamorro, MC, additional, Torres Alvarado, G, additional, Galán Alvarez, YH, additional, Martinez Reyes, FC, additional, Castillo Calvas, JC, additional, Mendoza Alava, M, additional, Cueva Ayala, P, additional, Hanchard, B, additional, Fajardo-Gutiérrez, A, additional, Zavala Zegarra, DE, additional, Barrios, E, additional, Nikiforuk, C, additional, Woods, R, additional, Turner, D, additional, MacIntyre, M, additional, Corriveau, A, additional, Navaneelan, T, additional, Bertrand, C, additional, Stuart-Panko, H, additional, Wilson, RJ, additional, Kosary, C, additional, Shen, X, additional, Brockhouse, J, additional, Yee, GA, additional, Mitchell, TC, additional, Snipes, K, additional, West, D, additional, Rao, C, additional, Bolick, S, additional, Rycroft, RK, additional, Mueller, L, additional, Zheng, Y, additional, Dosch, K, additional, Brown, H, additional, Vargas, A, additional, Levin, GM, additional, Bayakly, R, additional, Johnson, C, additional, Shen, T, additional, Ruppert, L, additional, Lynch, CF, additional, Lai, SM, additional, Tucker, TC, additional, Wu, XC, additional, Schwenn, M, additional, Stern, K, additional, Gershman, S, additional, Copeland, G, additional, Bushhouse, S, additional, Rogers, DB, additional, Jackson Thompson, J, additional, Lemons, D, additional, Frederick, S, additional, Harris, JA, additional, Riddle, B, additional, Stroup, A, additional, Wiggins, C, additional, Schymura, MJ, additional, Giljahn, LK, additional, Sheikh, A, additional, Schubert, S, additional, Aldinger, W, additional, Fulton, JP, additional, Whiteside, M, additional, Nogueira, L, additional, Sweeney, C, additional, Johnson, A, additional, Martin, J, additional, Farley, S, additional, Harrelson, D, additional, Malicki, R, additional, Espinoza, JR, additional, Hernandez, BY, additional, Abulfateh, N, additional, Wang, N, additional, Ngan, RKC, additional, Lingegowda, KB, additional, Swaminathan, R, additional, Koyande, SS, additional, Silverman, B, additional, Ozasa, K, additional, Kanemura, S, additional, Soda, M, additional, Miyashiro, I, additional, Shibata, A, additional, Nimri, O, additional, Won, YJ, additional, Kim, CH, additional, Hong, NS, additional, Nam, HS, additional, Kweon, S, additional, Kim, WC, additional, Huh, JS, additional, Jung, KW, additional, Yoo, CI, additional, Elbasmy, A, additional, Laudico, AV, additional, Lumague, MR, additional, AlMutlag, H, additional, Buasom, R, additional, Srisukho, S, additional, Tanabodee, J, additional, Wiangnon, S, additional, Pongnikorn, D, additional, Sriplung, H, additional, Dirican, O, additional, Eser, S, additional, Le Hoang, M, additional, Hackl, M, additional, Zborovskaya, A, additional, Dimitrova, N, additional, Valerianova, Z, additional, Sekerija, M, additional, Pavlou, P, additional, Dušek, M, additional, Mägi, M, additional, Clavel, J, additional, Lacour, B, additional, Guizard, AV, additional, Bouvier, V, additional, Troussard, X, additional, Woronoff, AS, additional, Tretarre, B, additional, Colonna, M, additional, Molinié, F, additional, Bara, S, additional, Velten, M, additional, Marrer, E, additional, Ganry, O, additional, Grosclaude, P, additional, Kaatsch, P, additional, Zeissig, SR, additional, Holleczek, B, additional, Katalinic, A, additional, Jakab, Z, additional, Birgisson, H, additional, Walsh, PM, additional, Mangone, L, additional, Merletti, F, additional, Magoni, M, additional, Ferretti, S, additional, Serraino, D, additional, Spagnoli, G, additional, Fusco, M, additional, Michiara, M, additional, Tumino, R, additional, Falcini, F, additional, Sensi, F, additional, Tisano, F, additional, Piffer, S, additional, Stracci, F, additional, Tagliabue, G, additional, Smailyte, G, additional, Agius, D, additional, Visser, O, additional, Ursin, G, additional, Didkowska, J, additional, Trojanowski, M, additional, Wojciechowska, U, additional, Forjaz de Lacerda, G, additional, Silva, MA, additional, Laranja Pontes, J, additional, da Costa Miranda, A, additional, Kaiserova, E, additional, Primic Žakelj, M, additional, Peris-Bonet, R, additional, Vicente Raneda, ML, additional, Almar Marqués, E, additional, Quirós Garcia, JR, additional, Ramos Monserrat, M, additional, Errezola Saizar, M, additional, Alemán Herrera, A, additional, Díaz García, JM, additional, Marcos-Gragera, R, additional, Sanchez-Perez, MJ, additional, Ardanaz Aicua, E, additional, Galceran, J, additional, Klint, A, additional, Kuehni, CE, additional, Bouchardy, C, additional, Levi, F, additional, Bordoni, A, additional, Konzelmann, I, additional, Rohrmann, S, additional, Stiller, CA, additional, Gavin, AT, additional, Brewster, DH, additional, Phung, H, additional, Rushton, S, additional, Guthridge, S, additional, Aitken, J, additional, D'Onise, K, additional, Venn, A, additional, Farrugian, H, additional, Threlfall, TJ, additional, Laumond, S, additional, Yen Kai Sun, L, additional, Hendrix, J, additional, Ballantine, K, additional, Colombet, M, additional, Dolya, A, additional, Masuyer, E, additional, and Steliarova-Foucher, E, additional

Published
2017
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17. Increased incidence of bowel cancer after non-surgical treatment of appendicitis

Author

Enblad, Malin, Birgisson, H, Ekbom, Anders, Sandin, Fredrik, Graf, Wilhelm, Enblad, Malin, Birgisson, H, Ekbom, Anders, Sandin, Fredrik, and Graf, Wilhelm

Abstract

BACKGROUND: There is an ongoing debate on the use of antibiotics instead of appendectomy for treating appendicitis but diagnostic difficulties and longstanding inflammation might lead to increased incidence of bowel cancer in these patients. The aim of this population-based study was to investigate the incidence of bowel cancer after non-surgical treatment of appendicitis. PATIENTS AND METHODS: Patients diagnosed with appendicitis but lacking the surgical procedure code for appendix removal were retrieved from the Swedish National Inpatient Register 1987-2013. The cohort was matched with the Swedish Cancer Registry and the standardised incidence ratios (SIR) with 95% confidence interval (95% CI) for appendiceal, colorectal and small bowel cancers were calculated. RESULTS: Of 13 595 patients with non-surgical treatment of appendicitis, 352 (2.6%) were diagnosed with appendiceal, colorectal or small bowel cancer (SIR 4.1, 95% CI 3.7-4.6). The largest incidence increase was found for appendiceal (SIR 35, 95% CI 26-46) and right-sided colon cancer (SIR 7.5, 95% CI 6.6-8.6). SIR was still elevated when excluding patients with less than 12 months since appendicitis and the incidence of right-sided colon cancer was elevated five years after appendicitis (SIR 3.5, 95% CI 2.1-5.4). An increased incidence of bowel cancer was found after appendicitis with abscess (SIR 4.6, 95% CI 4.0-5.2), and without abscess (SIR 3.5, 95% CI 2.9-4.1). CONCLUSION: Patients with non-surgical treatment of appendicitis have an increased short and long-term incidence of bowel cancer. This should be considered in the discussion about optimal management of patients with appendicitis.

Published
2017
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18. International incidence of childhood cancer, 2001-10: a population-based registry study.

Author

IICC-3 contributors, Bouzbid, S., Hamdi-Cherif, M., Hablas, A., Chirpaz, E., Buziba, N., Chesumbai, G.C., Manraj, S.S., Reynders, D., Wabinga, H.R., Chokunonga, E., Moreno, F., Lima, C.A., Asturian Laporte, C., de Oliveira, J.C., de Aquino, J.P., Gallagher, S.V., Uribe, C.J., Bravo, L.E., Yepez Chamorro, M.C., Torres Alvarado, G., Galán Alvarez, Y.H., Martinez Reyes, F.C., Castillo Calvas, J.C., Mendoza Alava, M., Cueva Ayala, P., Hanchard, B., Fajardo-Gutiérrez, A., Zavala Zegarra, D.E., Barrios, E., Nikiforuk, C., Woods, R., Turner, D., MacIntyre, M., Corriveau, A., Navaneelan, T., Bertrand, C., Stuart-Panko, H., Wilson, R.J., Kosary, C., Shen, X., Brockhouse, J., Yee, G.A., Mitchell, T.C., Snipes, K., West, D., Rao, C., Bolick, S., Rycroft, R.K., Mueller, L., Zheng, Y., Dosch, K., Brown, H., Vargas, A., Levin, G.M., Bayakly, R., Johnson, C., Shen, T., Ruppert, L., Lynch, C.F., Lai, S.M., Tucker, T.C., Wu, X.C., Schwenn, M., Stern, K., Gershman, S., Copeland, G., Bushhouse, S., Rogers, D.B., Jackson Thompson, J., Lemons, D., Frederick, S., Harris, J.A., Riddle, B., Stroup, A., Wiggins, C., Schymura, M.J., Giljahn, L.K., Sheikh, A., Schubert, S., Aldinger, W., Fulton, J.P., Whiteside, M., Nogueira, L., Sweeney, C., Johnson, A., Martin, J., Farley, S., Harrelson, D., Malicki, R., Espinoza, J.R., Hernandez, B.Y., Abulfateh, N., Wang, N., Ngan, R., Lingegowda, K.B., Swaminathan, R., Koyande, S.S., Silverman, B., Ozasa, K., Kanemura, S., Soda, M., Miyashiro, I., Shibata, A., Nimri, O., Won, Y.J., Kim, C.H., Hong, N.S., Nam, H.S., Kweon, S., Kim, W.C., Huh, J.S., Jung, K.W., Yoo, C.I., Elbasmy, A., Laudico, A.V., Lumague, M.R., AlMutlag, H., Buasom, R., Srisukho, S., Tanabodee, J., Wiangnon, S., Pongnikorn, D., Sriplung, H., Dirican, O., Eser, S., Le Hoang, M., Hackl, M., Zborovskaya, A., Dimitrova, N., Valerianova, Z., Sekerija, M., Pavlou, P., Dušek, M., Mägi, M., Clavel, J., Lacour, B., Guizard, A.V., Bouvier, V., Troussard, X., Woronoff, A.S., Tretarre, B., Colonna, M., Molinié, F., Bara, S., Velten, M., Marrer, E., Ganry, O., Grosclaude, P., Kaatsch, P., Zeissig, S.R., Holleczek, B., Katalinic, A., Jakab, Z., Birgisson, H., Walsh, P.M., Mangone, L., Merletti, F., Magoni, M., Ferretti, S., Serraino, D., Spagnoli, G., Fusco, M., Michiara, M., Tumino, R., Falcini, F., Sensi, F., Tisano, F., Piffer, S., Stracci, F., Tagliabue, G., Smailyte, G., Agius, D., Visser, O., Ursin, G., Didkowska, J., Trojanowski, M., Wojciechowska, U., Forjaz de Lacerda, G., Silva, M.A., Laranja Pontes, J., da Costa Miranda, A., Kaiserova, E., Primic Žakelj, M., Peris-Bonet, R., Vicente Raneda, M.L., Almar Marqués, E., Quirós Garcia, J.R., Ramos Monserrat, M., Errezola Saizar, M., Alemán Herrera, A., Díaz García, J.M., Marcos-Gragera, R., Sanchez-Perez, M.J., Ardanaz Aicua, E., Galceran, J., Klint, A., Kuehni, C.E., Bouchardy, C., Levi, F., Bordoni, A., Konzelmann, I., Rohrmann, S., Stiller, C.A., Gavin, A.T., Brewster, D.H., Phung, H., Rushton, S., Guthridge, S., Aitken, J., D'Onise, K., Venn, A., Farrugian, H., Threlfall, T.J., Laumond, S., Yen Kai Sun, L., Hendrix, J., Ballantine, K., Colombet, M., Dolya, A., Masuyer, E., Steliarova-Foucher, E., Ries, LAG, Bray, F., Hesseling, P., Shin, H.Y., IICC-3 contributors, Bouzbid, S., Hamdi-Cherif, M., Hablas, A., Chirpaz, E., Buziba, N., Chesumbai, G.C., Manraj, S.S., Reynders, D., Wabinga, H.R., Chokunonga, E., Moreno, F., Lima, C.A., Asturian Laporte, C., de Oliveira, J.C., de Aquino, J.P., Gallagher, S.V., Uribe, C.J., Bravo, L.E., Yepez Chamorro, M.C., Torres Alvarado, G., Galán Alvarez, Y.H., Martinez Reyes, F.C., Castillo Calvas, J.C., Mendoza Alava, M., Cueva Ayala, P., Hanchard, B., Fajardo-Gutiérrez, A., Zavala Zegarra, D.E., Barrios, E., Nikiforuk, C., Woods, R., Turner, D., MacIntyre, M., Corriveau, A., Navaneelan, T., Bertrand, C., Stuart-Panko, H., Wilson, R.J., Kosary, C., Shen, X., Brockhouse, J., Yee, G.A., Mitchell, T.C., Snipes, K., West, D., Rao, C., Bolick, S., Rycroft, R.K., Mueller, L., Zheng, Y., Dosch, K., Brown, H., Vargas, A., Levin, G.M., Bayakly, R., Johnson, C., Shen, T., Ruppert, L., Lynch, C.F., Lai, S.M., Tucker, T.C., Wu, X.C., Schwenn, M., Stern, K., Gershman, S., Copeland, G., Bushhouse, S., Rogers, D.B., Jackson Thompson, J., Lemons, D., Frederick, S., Harris, J.A., Riddle, B., Stroup, A., Wiggins, C., Schymura, M.J., Giljahn, L.K., Sheikh, A., Schubert, S., Aldinger, W., Fulton, J.P., Whiteside, M., Nogueira, L., Sweeney, C., Johnson, A., Martin, J., Farley, S., Harrelson, D., Malicki, R., Espinoza, J.R., Hernandez, B.Y., Abulfateh, N., Wang, N., Ngan, R., Lingegowda, K.B., Swaminathan, R., Koyande, S.S., Silverman, B., Ozasa, K., Kanemura, S., Soda, M., Miyashiro, I., Shibata, A., Nimri, O., Won, Y.J., Kim, C.H., Hong, N.S., Nam, H.S., Kweon, S., Kim, W.C., Huh, J.S., Jung, K.W., Yoo, C.I., Elbasmy, A., Laudico, A.V., Lumague, M.R., AlMutlag, H., Buasom, R., Srisukho, S., Tanabodee, J., Wiangnon, S., Pongnikorn, D., Sriplung, H., Dirican, O., Eser, S., Le Hoang, M., Hackl, M., Zborovskaya, A., Dimitrova, N., Valerianova, Z., Sekerija, M., Pavlou, P., Dušek, M., Mägi, M., Clavel, J., Lacour, B., Guizard, A.V., Bouvier, V., Troussard, X., Woronoff, A.S., Tretarre, B., Colonna, M., Molinié, F., Bara, S., Velten, M., Marrer, E., Ganry, O., Grosclaude, P., Kaatsch, P., Zeissig, S.R., Holleczek, B., Katalinic, A., Jakab, Z., Birgisson, H., Walsh, P.M., Mangone, L., Merletti, F., Magoni, M., Ferretti, S., Serraino, D., Spagnoli, G., Fusco, M., Michiara, M., Tumino, R., Falcini, F., Sensi, F., Tisano, F., Piffer, S., Stracci, F., Tagliabue, G., Smailyte, G., Agius, D., Visser, O., Ursin, G., Didkowska, J., Trojanowski, M., Wojciechowska, U., Forjaz de Lacerda, G., Silva, M.A., Laranja Pontes, J., da Costa Miranda, A., Kaiserova, E., Primic Žakelj, M., Peris-Bonet, R., Vicente Raneda, M.L., Almar Marqués, E., Quirós Garcia, J.R., Ramos Monserrat, M., Errezola Saizar, M., Alemán Herrera, A., Díaz García, J.M., Marcos-Gragera, R., Sanchez-Perez, M.J., Ardanaz Aicua, E., Galceran, J., Klint, A., Kuehni, C.E., Bouchardy, C., Levi, F., Bordoni, A., Konzelmann, I., Rohrmann, S., Stiller, C.A., Gavin, A.T., Brewster, D.H., Phung, H., Rushton, S., Guthridge, S., Aitken, J., D'Onise, K., Venn, A., Farrugian, H., Threlfall, T.J., Laumond, S., Yen Kai Sun, L., Hendrix, J., Ballantine, K., Colombet, M., Dolya, A., Masuyer, E., Steliarova-Foucher, E., Ries, LAG, Bray, F., Hesseling, P., and Shin, H.Y.

Abstract

Cancer is a major cause of death in children worldwide, and the recorded incidence tends to increase with time. Internationally comparable data on childhood cancer incidence in the past two decades are scarce. This study aimed to provide internationally comparable local data on the incidence of childhood cancer to promote research of causes and implementation of childhood cancer control. This population-based registry study, devised by the International Agency for Research on Cancer in collaboration with the International Association of Cancer Registries, collected data on all malignancies and non-malignant neoplasms of the CNS diagnosed before age 20 years in populations covered by high-quality cancer registries with complete data for 2001-10. Incidence rates per million person-years for the 0-14 years and 0-19 years age groups were age-adjusted using the world standard population to provide age-standardised incidence rates (WSRs), using the age-specific incidence rates (ASR) for individual age groups (0-4 years, 5-9 years, 10-14 years, and 15-19 years). All rates were reported for 19 geographical areas or ethnicities by sex, age group, and cancer type. The regional WSRs for children aged 0-14 years were compared with comparable data obtained in the 1980s. Of 532 invited cancer registries, 153 registries from 62 countries, departments, and territories met quality standards, and contributed data for the entire decade of 2001-10. 385 509 incident cases in children aged 0-19 years occurring in 2·64 billion person-years were included. The overall WSR was 140·6 per million person-years in children aged 0-14 years (based on 284 649 cases), and the most common cancers were leukaemia (WSR 46·4), followed by CNS tumours (WSR 28·2), and lymphomas (WSR 15·2). In children aged 15-19 years (based on 100 860 cases), the ASR was 185·3 per million person-years, the most common being lymphomas (ASR 41·8) and the group of epithelial tumours and melanoma (ASR 39·5). Incidence varied

Published
2017

19. Highly sensitive and specific protein detection via combined capillary isoelectric focusing and proximity ligation

Author

Padhan, N., Yan, J., Boge, A., Scrivener, E., Birgisson, H., Zieba, A., Gullberg, M., Kamali-Moghaddam, M., Claesson-Welsh, L., Landegren, U., Padhan, N., Yan, J., Boge, A., Scrivener, E., Birgisson, H., Zieba, A., Gullberg, M., Kamali-Moghaddam, M., Claesson-Welsh, L., and Landegren, U.

Abstract

Detection and quantification of proteins and their post-translational modifications are crucial to decipher functions of complex protein networks in cell biology and medicine. Capillary isoelectric focusing together with antibody-based detection can resolve and identify proteins and their isoforms with modest sample input. However, insufficient sensitivity prevents detection of proteins present at low concentrations and antibody cross-reactivity results in unspecific detection that cannot be distinguished from bona fide protein isoforms. By using DNA-conjugated antibodies enhanced signals can be obtained via rolling circle amplification (RCA). Both sensitivity and specificity can be greatly improved in assays dependent on target recognition by pairs of antibodies using in situ proximity ligation assays (PLA). Here we applied these DNA-assisted RCA techniques in capillary isoelectric focusing to resolve endogenous signaling transducers and isoforms along vascular endothelial growth factor (VEGF) signaling pathways at concentrations too low to be detected in standard assays. We also demonstrate background rejection and enhanced specificity when protein detection depended on binding by pairs of antibodies using in situ PLA, compared to assays where each antibody preparation was used on its own.

Published
2017

22. [The effect of pregnancy on the survival of women diagnosed with breast cancer.]

Author

Birgisson H, Laufey Tryggvadottir, and Tulinius H

Abstract

To answer the question whether the prognosis of women with breast cancer is affected by pregnancy after diagnosis.We used information from the Icelandic Cancer Registry, the Birth Registry and the Genetic Committee. We identified all women who were diagnosed with breast cancer in the years 1927-1992 and who later became pregnant. Controls were women without a history of childbirth after diagnosis of breast cancer. They were matched on tumour size, axillary lymph node status and years of birth and diagnosis, with four year deviation.In the years 1927-1992, 838 women at ages below 50 were diagnosed with breast cancer in Iceland. Of those, 29 gave birth to a child after the diagnosis. Fourteen cases and 33 matched controls fulfilled the inclusion criteria of the study. Survival was better in the group of women who became pregnant after diagnosis, but the difference was not statistically significant (P=0.06).Our results do not indicate that the prognosis of women who become pregnant after the diagnosis of breast cancer is worse than of those who do not become pregnant. The group was too small to make definite conclusions. However, the results are in concordance with results from other studies.

Published
2006

23. Late gastrointestinal disorders after rectal cancer surgery with and without preoperative radiation therapy

Author

Birgisson, H, Påhlman, L, Gunnarsson, U, Glimelius, B, Birgisson, H, Påhlman, L, Gunnarsson, U, and Glimelius, B

Abstract

BACKGROUND: The aim of the study was to analyse late gastrointestinal disorders necessitating hospital admission following rectal cancer surgery and to determine their relationship to preoperative radiation therapy. METHODS: Curatively treated patients participating in the Swedish Rectal Cancer Trial during 1987-1990, randomized to preoperative irradiation (454 patients) or surgery alone (454), were matched against the Swedish Hospital Discharge Registry. Hospital records for patients admitted with gastrointestinal diagnoses were reviewed. RESULTS: Irradiated patients had an increased relative risk (RR) of late small bowel obstruction (RR 2.49 (95 per cent confidence interval (c.i.) 1.48 to 4.19)) and abdominal pain (RR 2.09 (95 per cent c.i. 1.03 to 4.24)) compared with patients treated by surgery alone. The risk of late small bowel obstruction requiring surgery was greatly increased (RR 7.42 (95 per cent c.i. 2.23 to 24.66)). Irradiated patients with postoperative anastomotic leakage were at increased risk for late small bowel obstruction (RR 2.99 (95 per cent c.i. 1.07 to 8.31)). The risk of small bowel obstruction was also related to the radiation technique and energy used. CONCLUSION: Small bowel obstruction is more common in patients with rectal cancer treated with preoperative radiation therapy.

Published
2008
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33. Long-term survival and cure fraction estimates for childhood cancer in Europe (EUROCARE-6): results from a population-based study

Author

Laura Botta, Gemma Gatta, Riccardo Capocaccia, Charles Stiller, Adela Cañete, Luigino Dal Maso, Kaire Innos, Ana Mihor, Friederike Erdmann, Claudia Spix, Brigitte Lacour, Rafael Marcos-Gragera, Deirdre Murray, Silvia Rossi, Monika Hackl, Elizabeth Van Eycken, Nancy Van Damme, Zdravka Valerianova, Mario Sekerija, Vasos Scoutellas, Anna Demetriou, Ladislav Dušek, Denisa Krejci, Hans Storm, Margit Mägi, Keiu Paapsi, Nea Malila, Janne Pitkäniemi, Valerie Jooste, Jacqueline Clavel, Claire Poulalhon, Emmanuel Desandes, Alain Monnereau, Alexander Katalinic, Eleni Petridou, Georgios Markozannes, Miklos Garami, Helgi Birgisson, Paul M Walsh, Guido Mazzoleni, Fabio Vittadello, Francesco Cuccaro, Rocco Galasso, Giuseppe Sampietro, Stefano Rosso, Cinzia Gasparotto, Giovanni Maifredi, Margherita Ferrante, Antonina Torrisi, Antonella Sutera Sardo, Maria Letizia Gambino, Monica Lanzoni, Paola Ballotari, Erica Giacomazzi, Stefano Ferretti, Adele Caldarella, Gianfranco Manneschi, Milena Sant, Paolo Baili, Franco Berrino, Annalisa Trama, Roberto Lillini, Alice Bernasconi, Simone Bonfarnuzzo, Claudia Vener, Fabio Didonè, Paolo Lasalvia, Giulia Del Monego, Lucia Buratti, Diego Serraino, Martina Taborelli, Roberta De Angelis, Elena Demuru, Corrado Di Benedetto, Mariano Santaquilani, Serenella Venanzi, Marco Tallon, Luca Boni, Silvia Iacovacci, Antonio Giampiero Russo, Federico Gervasi, Gianbattista Spagnoli, Luca Cavalieri d'Oro, Mario Fusco, Maria Francesca Vitale, Mario Usala, Francesco Vitale, Maria Michiara, Giorgio Chiranda, Carlotta Sacerdote, Milena Maule, Giuseppe Cascone, Eugenia Spata, Lucia Mangone, Fabio Falcini, Rossella Cavallo, Daniela Piras, Ylenia Dinaro, Marine Castaing, Anna Clara Fanetti, Sante Minerba, Giuseppina Candela, Tiziana Scuderi, Roberto Vito Rizzello, Fabrizio Stracci, Giovanna Tagliabue, Massimo Rugge, Angelita Brustolin, Santa Pildava, Giedre Smailyte, Miriam Azzopardi, Tom Børge Johannesen, Joanna Didkowska, Urszula Wojciechowska, Magdalena Bielska-Lasota, Ana Pais, Ana Maria Ferreira, Maria José Bento, Ana Miranda, Chakameh Safaei Diba, Vesna Zadnik, Tina Zagar, Carmen Sánchez-Contador Escudero, Paula Franch Sureda, Arantza Lopez de Munain, Marta De-La-Cruz, Marìa Dolores Rojas, Araceli Aleman, Ana Vizcaino, Fernando Almela, Arantza Sanvisens, Maria Josè Sanchez, Maria Dolores Chirlaque, Antonia Sanchez-Gil, Marcela Guevara, Eva Ardanaz, Adela Cañete-Nieto, Rafael Peris-Bonet, Jaume Galceran, Maria Carulla, Claudia Kuehni, Shelagh Redmond, Otto Visser, Henrike Karim-Kos, Sarah Stevens, Anna Gavin, David Morrison, Dyfed Wyn Huws, Botta, L, Gatta, G, Capocaccia, R, Stiller, C, Canete, A, Dal Maso, L, Innos, K, Mihor, A, Erdmann, F, Spix, C, Lacour, B, Marcos-Gragera, R, Murray, D, Rossi, S, Hackl, M, Van Eycken, E, Van Damme, N, Valerianova, Z, Sekerija, M, Scoutellas, V, Demetriou, A, Dusek, L, Krejci, D, Storm, H, Magi, M, Paapsi, K, Malila, N, Pitkaniemi, J, Jooste, V, Clavel, J, Poulalhon, C, Desandes, E, Monnereau, A, Katalinic, A, Petridou, E, Markozannes, G, Garami, M, Birgisson, H, Walsh, P, Mazzoleni, G, Vittadello, F, Cuccaro, F, Galasso, R, Sampietro, G, Rosso, S, Gasparotto, C, Maifredi, G, Ferrante, M, Torrisi, A, Sutera Sardo, A, Gambino, M, Lanzoni, M, Ballotari, P, Giacomazzi, E, Ferretti, S, Caldarella, A, Manneschi, G, Sant, M, Baili, P, Berrino, F, Trama, A, Lillini, R, Bernasconi, A, Bonfarnuzzo, S, Vener, C, Didone, F, Lasalvia, P, Del Monego, G, Buratti, L, Serraino, D, Taborelli, M, De Angelis, R, Demuru, E, Di Benedetto, C, Santaquilani, M, Venanzi, S, Tallon, M, Boni, L, Iacovacci, S, Russo, A, Gervasi, F, Spagnoli, G, Cavalieri d'Oro, L, Fusco, M, Vitale, M, Usala, M, Vitale, F, Michiara, M, Chiranda, G, Sacerdote, C, Maule, M, Cascone, G, Spata, E, Mangone, L, Falcini, F, Cavallo, R, Piras, D, Dinaro, Y, Castaing, M, Fanetti, A, Minerba, S, Candela, G, Scuderi, T, Rizzello, R, Stracci, F, Tagliabue, G, Rugge, M, Brustolin, A, Pildava, S, Smailyte, G, Azzopardi, M, Johannesen, T, Didkowska, J, Wojciechowska, U, Bielska-Lasota, M, Pais, A, Ferreira, A, Bento, M, Miranda, A, Safaei Diba, C, Zadnik, V, Zagar, T, Sanchez-Contador Escudero, C, Franch Sureda, P, Lopez de Munain, A, De-La-Cruz, M, Rojas, M, Aleman, A, Vizcaino, A, Almela, F, Sanvisens, A, Sanchez, M, Chirlaque, M, Sanchez-Gil, A, Guevara, M, Ardanaz, E, Canete-Nieto, A, Peris-Bonet, R, Galceran, J, Carulla, M, Kuehni, C, Redmond, S, Visser, O, Karim-Kos, H, Stevens, S, Gavin, A, Morrison, D, and Huws, D

Subjects
Retinal Neoplasms, Retinoblastoma, Bone Neoplasms, Sarcoma, Ewing, EUROCARE-6, survival, Burkitt Lymphoma, population-based cancer registrie, Europe, Oncology, Humans, cure fraction, childhood cancer, EUROCARE, Child, chidlhood cancer
Abstract

Background: The EUROCARE-5 study revealed disparities in childhood cancer survival among European countries, giving rise to important initiatives across Europe to reduce the gap. Extending its representativeness through increased coverage of eastern European countries, the EUROCARE-6 study aimed to update survival progress across countries and years of diagnosis and provide new analytical perspectives on estimates of long-term survival and the cured fraction of patients with childhood cancer. Methods: In this population-based study, we analysed 135 847 children (aged 0–14 years) diagnosed during 2000–13 and followed up to the end of 2014, recruited from 80 population-based cancer registries in 31 European countries. We calculated age-adjusted 5-year survival differences by country and over time using period analysis, for all cancers combined and for major cancer types. We applied a variant of standard mixture cure models for survival data to estimate the cure fraction of patients by childhood cancer and to estimate projected 15-year survival. Findings: 5-year survival for all childhood cancer combined in Europe in 2010–14 was 81% (95% CI 81–82), showing an increase of three percentage points compared with 2004–06. Significant progress over time was observed for almost all cancers. Survival remained stable for osteosarcomas, Ewing sarcoma, Burkitt lymphoma, non-Hodgkin lymphomas, and rhabdomyoscarcomas. For all cancers combined, inequalities still persisted among European countries (with age-adjusted 5-year survival ranging from 71% [95% CI 60–79] to 87% [77–93]). The 15-year survival projection for all patients with childhood cancer diagnosed in 2010–13 was 78%. We estimated the yearly long-term mortality rate due to causes other than the diagnosed cancer to be around 2 per 1000 patients for all childhood cancer combined, but to approach zero for retinoblastoma. The cure fraction for patients with childhood cancer increased over time from 74% (95% CI 73–75) in 1998–2001 to 80% (79–81) in 2010–13. In the latter cohort, the cure fraction rate ranged from 99% (95% CI 74–100) for retinoblastoma to 60% (58–63) for CNS tumours and reached 90% (95% CI 87–93) for lymphoid leukaemia and 70% (67–73) for acute myeloid leukaemia. Interpretation: Childhood cancer survival is increasing over time in Europe but there are still some differences among countries. Regular monitoring of childhood cancer survival and estimation of the cure fraction through population-based registry data are crucial for evaluating advances in paediatric cancer care. Funding: European Commission.

Published
2022

34. The Extent of Tumor in the Peritoneum and Liver Influences Outcomes After Surgery for Synchronous Liver and Peritoneal Colorectal Metastases: A Cohort Study.

Author

Salas PS, Urdzik J, Graf W, Isaksson B, and Birgisson H

Subjects
Humans, Male, Female, Middle Aged, Aged, Retrospective Studies, Cohort Studies, Treatment Outcome, Adult, Colorectal Neoplasms pathology, Colorectal Neoplasms mortality, Colorectal Neoplasms surgery, Liver Neoplasms secondary, Liver Neoplasms surgery, Liver Neoplasms mortality, Peritoneal Neoplasms secondary, Peritoneal Neoplasms mortality, Peritoneal Neoplasms therapy, Cytoreduction Surgical Procedures, Hepatectomy mortality, Hyperthermic Intraperitoneal Chemotherapy methods
Abstract

Purpose: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRSH) or liver resection have led to increased survival in patients with peritoneal or liver metastases of colorectal cancer. Selected patients undergo concomitant CRSH and liver resection. Differences in survival and morbidity between patients who underwent concomitant surgery, CRSH or liver resection for peritoneal and/or liver metastases were compared., Methods: Patients who underwent liver resection and/or CRSH for colorectal liver and/or peritoneal metastases, 2006-2016, were included. Regression analysis was used to evaluate the associations between baseline characteristics and survival., Results: Overall, 634 patients were studied. Twenty-eight patients had peritoneal and liver metastases, 121 patients had peritoneal metastases only, and 485 patients had isolated liver metastases. Median survival after concomitant treatment was 23.8 months (95% CI 12.8-43.8), after CRSH 34.5 months (95% CI 27.1-41.9), and after liver resection 54.2 months (95% CI 47.4-61.0) (p < 0.001). Increased hepatic tumor burden (HR 3.2, 95% CI 1.8-5.8) and high-volume peritoneal disease (HR 6.0, 95% CI 3.7-9.8) were associated with decreased survival in multivariate analysis. Postoperative complications according to a Clavien-Dindo score > 3a were observed in 11% in the liver resection group, 15% in the CRSH group, and 11% in the concomitant treatment group (p = 0.945)., Conclusions: Patients treated with concomitant surgery for liver and peritoneal metastases experienced a shorter median overall survival than patients treated for metastases at an isolated site but had a similar rate of severe postoperative complications. The extent of peritoneal spread seemed to impact survival more than the tumor burden in the liver., Competing Interests: Declarations Ethics Approval The study was approved by the Swedish Ethical Review Authority in Uppsala (Dnr. 2013/203 and 2018/086). Consent to Participate Not applicable. All patient data is presented at group level and is unidentifiable. Consent for publication Not applicable. Competing Interests The authors declare no competing interests., (© 2024. The Author(s).)

Published
2024
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35. Clinical significance of circulating tumor cells in colorectal cancer with peritoneal metastases: a prospective cohort study using a novel method for monitoring treatment response, and assessing minimal residual disease.

Author

Frühling P, Moberg L, Ghanipour L, Birgisson H, Graf W, Ericsson C, and Cashin PH

Subjects
Humans, Prospective Studies, Male, Female, Middle Aged, Aged, Adult, Hyperthermic Intraperitoneal Chemotherapy, Cohort Studies, Treatment Outcome, Clinical Relevance, Neoplastic Cells, Circulating pathology, Peritoneal Neoplasms secondary, Peritoneal Neoplasms therapy, Colorectal Neoplasms pathology, Colorectal Neoplasms therapy, Neoplasm, Residual, Cytoreduction Surgical Procedures
Abstract

Background: The treatment for patients with colorectal cancer with metastases to the peritoneum is complex and may involve both surgery and chemotherapy. Circulating tumor cells (CTCs) have been poorly investigated in peritoneal metastatic colorectal cancer. The aim of the study is to examine the role of CTCs as a biomarker for monitoring disease progression, treatment response, and residual disease using CellMate - a new promising in vitro diagnostic platform technology., Materials and Methods: The authors prospectively followed the clinical outcomes of 46 patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with peritoneal metastases and examined whether CTCs were present the week of surgery. The CTC measurements were made with the CellMate technology, which is a platform technology to detect CTCs based on the difference in biomechanical properties compared to blood resident cells. The study was registered online (ClinicalTrials.gov)., Results: CTCs were detected in 17 (37%) patients. The presence of CTCs was associated with shorter recurrence-free survival and overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Both recurrence-free survival (HR 4.00, 95% CI: 1.15-13.9; P =0.029) and overall survival (HR 5.91; 95% CI: 1.18-29.7; P =0.03) were significantly worse if CTCs were detected after neoadjuvant treatment. In the subgroup of patients with CTCs detected, adjuvant therapy tended to improve the prognosis while in CTC negative patients it did not., Conclusions: Pending a prospective multicenter trial to validate these findings, CTCs may in the future be used as a dynamic personalized biomarker for prognostication, predicting response to therapy, and for monitoring disease progression in colorectal cancer with metastases to the peritoneum., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Published
2024
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36. Prognostic genome and transcriptome signatures in colorectal cancers.

Author

Nunes L, Li F, Wu M, Luo T, Hammarström K, Torell E, Ljuslinder I, Mezheyeuski A, Edqvist PH, Löfgren-Burström A, Zingmark C, Edin S, Larsson C, Mathot L, Osterman E, Osterlund E, Ljungström V, Neves I, Yacoub N, Guðnadóttir U, Birgisson H, Enblad M, Ponten F, Palmqvist R, Xu X, Uhlén M, Wu K, Glimelius B, Lin C, and Sjöblom T

Subjects
Female, Humans, Male, Cell Hypoxia, Cohort Studies, DNA Copy Number Variations genetics, Gene Expression Profiling, Gene Expression Regulation, Neoplastic, Microsatellite Instability, Mutation, Precision Medicine, Prognosis, Stromal Cells metabolism, Stromal Cells pathology, Survival Analysis, Time Factors, Transforming Growth Factor beta genetics, Wnt Signaling Pathway genetics, Colorectal Neoplasms classification, Colorectal Neoplasms diagnosis, Colorectal Neoplasms genetics, Colorectal Neoplasms immunology, Colorectal Neoplasms mortality, Genetic Predisposition to Disease genetics, Genome, Human genetics, Transcriptome genetics
Abstract

Colorectal cancer is caused by a sequence of somatic genomic alterations affecting driver genes in core cancer pathways 1 . Here, to understand the functional and prognostic impact of cancer-causing somatic mutations, we analysed the whole genomes and transcriptomes of 1,063 primary colorectal cancers in a population-based cohort with long-term follow-up. From the 96 mutated driver genes, 9 were not previously implicated in colorectal cancer and 24 had not been linked to any cancer. Two distinct patterns of pathway co-mutations were observed, timing analyses identified nine early and three late driver gene mutations, and several signatures of colorectal-cancer-specific mutational processes were identified. Mutations in WNT, EGFR and TGFβ pathway genes, the mitochondrial CYB gene and 3 regulatory elements along with 21 copy-number variations and the COSMIC SBS44 signature correlated with survival. Gene expression classification yielded five prognostic subtypes with distinct molecular features, in part explained by underlying genomic alterations. Microsatellite-instable tumours divided into two classes with different levels of hypoxia and infiltration of immune and stromal cells. To our knowledge, this study constitutes the largest integrated genome and transcriptome analysis of colorectal cancer, and interlinks mutations, gene expression and patient outcomes. The identification of prognostic mutations and expression subtypes can guide future efforts to individualize colorectal cancer therapy., (© 2024. The Author(s).)

Published
2024
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37. Risk of Esophageal Adenocarcinoma After Helicobacter pylori Eradication Treatment in a Population-Based Multinational Cohort Study.

Author

Wiklund AK, Santoni G, Yan J, Radkiewicz C, Xie S, Birgisson H, Ness-Jensen E, von Euler-Chelpin M, Kauppila JH, and Lagergren J

Subjects
Humans, Male, Female, Middle Aged, Incidence, Aged, Adult, Risk Factors, Scandinavian and Nordic Countries epidemiology, Proton Pump Inhibitors therapeutic use, Proton Pump Inhibitors adverse effects, Risk Assessment, Registries, Esophageal Neoplasms epidemiology, Esophageal Neoplasms microbiology, Helicobacter Infections epidemiology, Helicobacter Infections drug therapy, Helicobacter Infections diagnosis, Adenocarcinoma epidemiology, Adenocarcinoma microbiology, Helicobacter pylori drug effects, Anti-Bacterial Agents therapeutic use
Abstract

Background & Aims: Helicobacter pylori infection is associated with a decreased risk of esophageal adenocarcinoma, and the decreasing prevalence of such infection might contribute to the increasing incidence of this tumor. We examined the hypothesis that eradication treatment of H pylori increases the risk of esophageal adenocarcinoma., Methods: This population-based multinational cohort, entitled "Nordic Helicobacter Pylori Eradication Project (NordHePEP)," included all adults (≥18 years) receiving H pylori eradication treatment from 1995-2018 in any of the 5 Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) with follow-up throughout 2019. Data came from national registers. We calculated standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) by dividing the cancer incidence in the exposed cohort by that of the entire Nordic background populations of the corresponding age, sex, calendar period, and country. Analyses were stratified by factors associated with esophageal adenocarcinoma (ie, education, comorbidity, gastroesophageal reflux, and certain medications)., Results: Among 661,987 participants who contributed 5,495,552 person-years after eradication treatment (median follow-up, 7.8 years; range, 1-24 years), 550 cases of esophageal adenocarcinoma developed. The overall SIR of esophageal adenocarcinoma was not increased (SIR = 0.89; 95% CI, 0.82-0.97). The SIR did not increase over time after eradication treatment, but rather decreased and was 0.73 (95% CI, 0.61-0.86) at 11-24 years after treatment. There were no major differences in the stratified analyses. The overall SIR of esophageal squamous cell carcinoma, calculated for comparison, showed no association (SIR = 0.99; 95% CI, 0.89-1.11)., Conclusions: This absence on an increased risk of esophageal adenocarcinoma after eradication treatment of H pylori suggests eradication is safe from a cancer perspective., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2024
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38. Clinical Significance of Circulating Tumor Cells in Epithelial Appendiceal Neoplasms with Peritoneal Metastases.

Author

Frühling P, Moberg L, Ghanipour L, Birgisson H, Graf W, Ericsson C, and Cashin PH

Abstract

Appendiceal tumors are uncommon and, at times, discovered incidentally during histological examination. The histopathological classification of the disease is complex and has generated some controversy. The analysis of circulating tumor cells can be used for the early detection of metastatic potential. The aim of the present study was to examine the prognostic value of circulating tumor cells in patients with appendiceal tumors and peritoneal metastases. To our knowledge, this is the first study to examine CTCs in appendiceal tumors. We performed a prospective cohort study of consecutive patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy between 2015 and 2019 at a HIPEC referral center. In total, 31 patients were included in the analysis, and circulating tumor cells were detected in 15 patients (48%). CTC positivity was not associated with overall or recurrence-free survival, nor was it correlated with PCI score or histopathological grading. Surprisingly, however, CTCs were found in almost half the patients. The presence or quantities of these cells did not, on their own, predict systemic metastatic potential during the observed time, and they did not appear to significantly correlate with the oncological outcomes recorded.

Published
2024
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39. [Prediction of cancer incidence and prevalence in Iceland up to the year 2040 - Icelandic Cancer Registry and Research Center].

Author

Gudmundsdottir EM, Olafsdottir E, Kristinsdottir NM, Haraldsdottir A, Sigurdardottir K, Tryggvadottir L, Birgisson H, and Gunnarsdottir S

Subjects
Humans, Iceland epidemiology, Time Factors, Prevalence, Incidence, Age Distribution, Forecasting, Risk Factors, Middle Aged, Male, Aged, Female, Age Factors, Adult, Registries, Neoplasms epidemiology, Neoplasms diagnosis, Cancer Survivors
Abstract

Introduction: A large increase in new cancer cases is predicted worldwide, due to population growth, ageing and increased cancer risk. The age distribution of the Icelandic population is different from the other Nordic countries. The purpose of this study was to predict the number of new cancer cases in Iceland and other Nordic countries, and cancer survivors in Iceland, up to the year 2040., Materials and Methods: Information on cancer diagnoses was retrieved from The Icelandic Cancer Registry and information on population projections from Statistics Iceland. Well known methods for population projection were used to predict the number of new cancer cases in 2040, but adjusted to consider Icelandic circumstances. It is also based on more recent data than is accessible elsewhere. Three different methods were used to estimate the number of survivors in 2040 and are presented here for the first time., Results: In 2040 the predicted yearly average number of new cancer cases in Iceland will be up to 2,903 [95% CI 2.841-2.956], a 57% increase compared with 2022. The increase is higher in Iceland than in other Nordic countries (Norway 41%, Sweden 24%, Denmark 23%, Finland 21%). In 2022, the number of cancer survivors was around 17,500 and is predicted to be between 24,500 and 31,000 in 2040., Conclusion: The main reason for the predicted increase of cancer cases and survivors is population trends, especially the ageing of the population. This expected increase in the number of cancer patients and improved survival will increase the demand for healthcare.

Published
2024
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40. Trends in lung cancer survival in the Nordic countries 1990-2016: The NORDCAN survival studies.

Author

Lundberg FE, Ekman S, Johansson ALV, Engholm G, Birgisson H, Ólafsdóttir EJ, Mørch LS, Johannesen TB, Andersson TM, Pettersson D, Seppä K, Virtanen A, Lambe M, and Lambert PC

Subjects
Humans, Male, Female, Aged, Middle Aged, Scandinavian and Nordic Countries epidemiology, Aged, 80 and over, Adult, Registries, History, 21st Century, Survival Rate, History, 20th Century, Survival Analysis, Age Factors, Lung Neoplasms mortality, Lung Neoplasms epidemiology
Abstract

Objectives: The aim of this study was to evaluate if the previously reported improvements in lung cancer survival were consistent across age at diagnosis and by lung cancer subtypes., Materials and Methods: Data on lung cancers diagnosed between 1990 and 2016 in Denmark, Finland, Iceland, Norway and Sweden were obtained from the NORDCAN database. Flexible parametric models were used to estimate age-standardized and age-specific relative survival by sex, as well as reference-adjusted crude probabilities of death and life-years lost. Age-standardised survival was also estimated by the three major subtypes; adenocarcincoma, squamous cell and small-cell carcinoma., Results: Both 1- and 5-year relative survival improved continuously in all countries. The pattern of improvement was similar across age groups and by subtype. The largest improvements in survival were seen in Denmark, while improvements were comparatively smaller in Finland. In the most recent period, age-standardised estimates of 5-year relative survival ranged from 13% to 26% and the 5-year crude probability of death due to lung cancer ranged from 73% to 85%. Across all Nordic countries, survival decreased with age, and was lower in men and for small-cell carcinoma., Conclusion: Lung cancer survival has improved substantially since 1990, in both women and men and across age. The improvements were seen in all major subtypes. However, lung cancer survival remains poor, with three out of four patients dying from their lung cancer within five years of diagnosis., Competing Interests: Declaration of competing interest PCL received support from the Swedish Cancer Society and the Swedish Research Council for the submitted work. ML received support from the Swedish Cancer Society for the submitted work. ML owns stock in Pfizer and Astra Zeneca. The authors have no other relationships of activities that could appear to have influenced the submitted work., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Published
2024
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41. [Cancer registration in Iceland for 70 years - incidence, mortality and survival].

Author

Haraldsdottir A, Birgisson H, Olafsdottir EJ, Gunnarsdottir S, and Tryggvadottir L

Subjects
Humans, Iceland epidemiology, Incidence, Male, Female, Time Factors, Risk Factors, Sex Distribution, Age Distribution, Aged, Sex Factors, Age Factors, Prognosis, Registries, Neoplasms mortality, Neoplasms epidemiology, Neoplasms diagnosis
Abstract

Introduction: The Icelandic Cancer Registry (ICR) was founded seventy years ago by the Icelandic Cancer Society. In 2007 the ICR became one of the health registers of the Directorate of Health. In this paper we present cancer incidence, mortality, and survival in Iceland over 70 years., Material and Methods: The ICR receives information on cancer diagnoses from histopathological laboratories, the Hospital Discharge Registry and the Cause of Death Registry. Iceland participates in the Nordic cancer database NORDCAN. Because of the small population size, random variation in numbers is very prominent. Therefore, data from ICR are published as five-year averages., Results: For all malignancies combined, age-standardized incidence (ASI) in men rose steadily until around 15 years ago when a decline started. This is in line with prostate- and lung cancer incidence trends. In women, the ASI was lower than in men, but it is still on the rise despite declining lung cancer incidence. ASI for breast cancer, the most common cancer in women, is increasing. Simultaneously, cancer mortality for both sexes has declined in recent years and cancer survival is improving., Conclusions: Population-based cancer registration for over 70 years makes it possible to monitor the epidemiology of cancer in Iceland and compare with other countries. The changes in trends in ASI are in line with changes of cancer risk factors and diagnostic policy. The decline in cancer mortality and improvement in survival reflects advances in cancer treatment as well as effects of early detection and prevention.

Published
2024
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42. No Indication for Routine Resection of Surgical Scars during Cytoreductive Surgery and HIPEC.

Author

Enblad M, Ghanipour L, Cashin P, Birgisson H, and Graf W

Abstract

Background: Careful macroscopic assessment of surgical scars is needed to avoid routine scar resection during cytoreductive surgery (CRS) for peritoneal metastases (PM). This study aimed to analyze the correlation between macroscopically suspected and microscopically confirmed scar metastases (SMs), and to analyze the prognostic impact of not undergoing routine scar resection., Method: All patients with previous surgery, treated with CRS and hyperthermic intraperitoneal chemotherapy, for colorectal PM or pseudomyxoma peritonei (PMP), at Uppsala University Hospital in 2013-2021, were included. Macroscopic SMs in surgical reports were compared with histopathological analyses., Results: In total, 227 patients were included. Among colorectal PM patients (n = 156), SM was macroscopically suspected in 41 (26%) patients, and 63 (40%) underwent scar resection. SM was confirmed in 19 (30%). Among patients with macroscopic suspicion, 45% had confirmed SM (positive predictive value, PPV). A total of 1 of 23 (4%) patients with no macroscopic suspicion had SM (negative predictive value, NPV = 96%). Among the PMP patients (n = 71), SM was macroscopically suspected in 13 (18%), and 28 (39%) underwent scar resection, of whom 12 (43%) had SM. The PPV was 77%. Occult SM was found in 1 of 14 (NPV = 93%). Not undergoing routine scar resection did not affect recurrence-free survival (RFS, p = 0.2) or overall survival (OS, p = 0.1) in colorectal PM patients or PMP patients (RFS p = 0.7, OS p = 0.7)., Conclusion: Occult SM is uncommon and scar resection does not affect RFS or OS. Therefore, macroscopically benign-appearing scars can be left without resection, though resection should be performed upon suspicion or uncertainty.

Published
2024
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43. Survival trends for patients diagnosed with cutaneous malignant melanoma in the Nordic countries 1990-2016: The NORDCAN survival studies.

Author

Lundberg FE, Birgisson H, Engholm G, Ólafsdóttir EJ, Mørch LS, Johannesen TB, Pettersson D, Lambe M, Seppä K, Lambert PC, Johansson ALV, Hölmich LR, and Andersson TM

Subjects
Male, Humans, Female, Melanoma, Cutaneous Malignant, Survival Rate, Risk Factors, Survival Analysis, Scandinavian and Nordic Countries epidemiology, Registries, Incidence, Denmark epidemiology, Melanoma, Skin Neoplasms
Abstract

Background: The survival in patients diagnosed with cutaneous malignant melanoma (CMM) has improved in the Nordic countries in the last decades. It is of interest to know if these improvements are observed in all ages and for both women and men., Methods: Patients diagnosed with CMM in the Nordic countries in 1990-2016 were identified in the NORDCAN database. Flexible parametric relative survival models were fitted, except for Iceland where a non-parametric Pohar-Perme approach was used. A range of survival metrics were estimated by sex, both age-standardised and age-specific., Results: The 5-year relative survival improved in all countries, in both women and men and across age. While the improvement was more pronounced in men, women still had a higher survival at the end of the study period. The survival was generally high, with age-standardised estimates of 5-year relative survival towards the end of the study period ranging from 85% in Icelandic men to 95% in Danish women. The age-standardised and reference-adjusted 5-year crude probability of death due to CMM ranged from 5% in Danish and Swedish women to 13% in Icelandic men., Conclusion: Although survival following CMM was relatively high in the Nordic countries in 1990, continued improvements in survival were observed throughout the study period in both women and men and across age., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could appear to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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44. Efficacy of hyperthermic intraperitoneal chemotherapy in colorectal cancer: A phase I and III open label randomized controlled registry-based clinical trial protocol.

Author

Ghanipour L, Jansson Palmer G, Nilsson PJ, Nordenvall C, Frödin JE, Bexe Lindskog E, Asplund D, Swartling T, Graf W, Birgisson H, Syk I, Verwaal V, Brändstedt J, and Cashin PH

Subjects
Humans, Clinical Trials, Phase I as Topic, Fluorouracil therapeutic use, Hyperthermic Intraperitoneal Chemotherapy, Irinotecan, Multicenter Studies as Topic, Oxaliplatin therapeutic use, Quality of Life, Randomized Controlled Trials as Topic, Registries, Retrospective Studies, Clinical Trials, Phase III as Topic, Colorectal Neoplasms drug therapy, Peritoneal Neoplasms drug therapy
Abstract

Standard treatment for patient with peritoneal metastases from colorectal cancer is cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). In recent years, the efficacy of oxaliplatin-based HIPEC has been challenged. An intensified HIPEC (oxaliplatin+irinotecan) in combination with early postoperative intraperitoneal chemotherapy (EPIC) has shown increased recurrence-free survival in retrospective studies. The aim of this trial is to develop a new HIPEC/EPIC regimen and evaluate its effect on morbidity, oncological outcome, and quality-of-life (QoL). This study is designed as a combined phase I/III multicenter randomized trial (RCT) of patients with peritoneal metastases from colorectal cancer eligible for CRS-HIPEC. An initial phase I dose escalation study, designed as a 3+3 stepwise escalation, will determine the maximum tolerable dose of 5-Fluorouracil (5-FU) as 1-day EPIC, enrolling a total of 15-30 patients in 5 dose levels. In the phase III efficacy study, patients are randomly assigned intraoperatively to either the standard treatment with oxaliplatin HIPEC (control arm) or oxaliplatin/irinotecan-HIPEC in combination with single dose of 1-day 5-FU EPIC (experimental arm). 5-FU is administered intraoperatively after CRS-HIPEC and closure of the abdomen. The primary endpoint is 12-month recurrence-free survival. Secondary endpoints include 5-year overall survival, 5-year recurrence-free survival (registry based), postoperative complications, and QoL up to 3 years after study treatment. This phase I/III trial aims to identify a more effective treatment of colorectal peritoneal metastases by combination of HIPEC and EPIC., Competing Interests: No authors have competing interests., (Copyright: © 2024 Ghanipour et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2024
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45. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases from Colorectal Cancer-An Overview of Current Status and Future Perspectives.

Author

Graf W, Ghanipour L, Birgisson H, and Cashin PH

Abstract

Peritoneal metastases (PM) are observed in approximately 8% of patients diagnosed with colorectal cancer, either synchronously or metachronously during follow-up. PM often manifests as the sole site of metastasis. PM is associated with a poor prognosis and typically shows resistance to systemic chemotherapy. Consequently, there has been a search for alternative treatment strategies. This review focuses on the global evolution of the combined approach involving cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of PM. It encompasses accepted clinical guidelines, principles for patient selection, surgical and physiological considerations, biomarkers, pharmacological protocols, and treatment outcomes. Additionally, it integrates the relevant literature and findings from previous studies. The role of CRS and HIPEC, in conjunction with other therapies such as neoadjuvant and adjuvant chemotherapy, is discussed, along with the management of patients presenting with oligometastatic disease. Furthermore, potential avenues for future development in this field are explored.

Published
2024
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46. Omental metastases in patients with pseudomyxoma peritonei or colorectal peritoneal metastases - is routine omentectomy justified?

Author

Enblad M, Birgisson H, Ghanipour L, Cashin P, and Graf W

Subjects
Humans, Male, Female, Middle Aged, Aged, Adult, Hyperthermic Intraperitoneal Chemotherapy methods, Cytoreduction Surgical Procedures methods, Aged, 80 and over, Pseudomyxoma Peritonei surgery, Pseudomyxoma Peritonei pathology, Colorectal Neoplasms pathology, Colorectal Neoplasms surgery, Peritoneal Neoplasms secondary, Peritoneal Neoplasms surgery, Omentum surgery, Omentum pathology
Abstract

Background: The greater omentum is routinely resected during cytoreductive surgery (CRS), but few studies have analyzed the rationale behind this. This study aimed to assess the prevalence of omental metastases (OM) and the correlation between macroscopically suspected and microscopically confirmed OM, in patients with pseudomyxoma peritonei (PMP) or colorectal peritoneal metastases (PM)., Method: All patients without previous omentectomy, treated with initial CRS and hyperthermic intraperitoneal chemotherapy for PMP or colorectal PM, at Uppsala University Hospital in 2013-2021, were included. Macroscopic OM in surgical reports was compared with histopathological analyses., Results: In all, 276 patients were included. In those with PMP, 112 (98%) underwent omentectomy and 67 (59%) had macroscopic suspicion of OM. In 5 (4%) patients, the surgeon was uncertain. Histopathology confirmed OM in 81 (72%). In patients with macroscopic suspicion, 96% had confirmed OM (positive predictive value, PPV). In patients with no suspicion, 24% had occult OM (negative predictive value, NPV = 76%). In patients with colorectal PM, 156 (96%) underwent omentectomy and 97 (60%) had macroscopic suspicion. For 5 (3%) patients, the surgeon was uncertain. OM was microscopically confirmed in 90 (58%). PPV was 85% and NPV was 89%. The presence of OM was a univariate risk factor for death in PMP (HR 3.62, 95%CI 1.08-12.1) and colorectal PM (HR 1.67, 95%CI 1.07-2.60), but not in multivariate analyses., Conclusion: OM was common and there was a high risk of missing occult OM in both PMP and colorectal PM. These results support the practice of routine omentectomy during CRS.

Published
2024
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47. Were cancer patients worse off than the general population during the COVID-19 pandemic? A population-based study from Norway, Denmark and Iceland during the pre-vaccination era.

Author

Johansson ALV, Skog A, Johannesen TB, Myklebust TÅ, Skovlund CW, Mørch LS, Friis S, Gamborg M, Kristiansen MF, Pettersson D, Ólafsdóttir EJ, Birgisson H, Palsson R, Eythorsson E, Irenaeus S, Lambe M, and Ursin G

Abstract

Background: In a population-based setting, we investigated the risks of testing positive for SARS-CoV-2 and developing severe COVID-19 outcomes among cancer patients compared with the general population., Methods: In nationwide cohorts, we identified all individuals in Norway, Denmark and Iceland who tested positive for SARS-CoV-2 or had a severe COVID-19 outcome (hospitalisation, intensive care, and death) from March until December 2020, using data from national health registries. We estimated standardised incidence ratios (SIRs) with 95% confidence intervals (CIs) comparing cancer patients with the general population., Findings: During the first wave of the pandemic, cancer patients in Norway and Denmark had higher risks of testing SARS-CoV-2 positive compared to the general population. Throughout 2020, recently treated cancer patients were more likely to test SARS-CoV-2 positive. In Iceland, cancer patients experienced no increased risk of testing positive. The risk of COVID-19-related hospitalisation was higher among cancer patients diagnosed within one year of hospitalisation (Norway: SIR = 2.43, 95% CI 1.89-3.09; Denmark: 2.23, 1.96-2.54) and within five years (Norway: 1.58, 1.35-1.83; Denmark: 1.54, 1.42-1.66). Risks were higher in recently treated cancer patients and in those diagnosed with haematologic malignancies, colorectal or lung cancer. Risks of COVID-19-related intensive care and death were higher among cancer patients., Interpretation: Cancer patients were at increased risk of testing positive for SARS-CoV-2 during the first pandemic wave when testing availability was limited, while relative risks of severe COVID-19 outcomes remained increased in cancer patients throughout 2020. Recent cancer treatment and haematologic malignancy were the strongest risk factors., Funding: Nordic Cancer Union., Competing Interests: ML declares stock or stock options in Astra Zeneca and Pfizer Inc. The other authors declare no competing interests., (© 2023 The Author(s).)

Published
2023
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48. Cohort profile: Nordic Helicobacter Pylori eradication project (NordHePEP).

Author

Pettersson AK, Santoni G, Yan J, Radkiewicz C, Xie S, Birgisson H, Ness-Jensen E, von Euler-Chelpin M, Kauppila JH, and Lagergren J

Subjects
Adult, Humans, Adolescent, Scandinavian and Nordic Countries epidemiology, Iceland epidemiology, Anti-Bacterial Agents therapeutic use, Helicobacter pylori, Helicobacter Infections drug therapy, Helicobacter Infections epidemiology, Neoplasms epidemiology
Abstract

Purpose: This cohort description presents the Nordic Helicobacter Pylori Eradication Project (NordHePEP), a population-based cohort of patients having received eradication treatment for Helicobacter pylori (HP). The cohort is created with the main purpose of examining whether and to what extent HP eradication treatment influences the risk of gastrointestinal cancer., Participants: NordHePEP includes all adults (aged ≥18 years) having been prescribed and dispensed HP eradication treatment according to the nationwide complete drug registries in any of the five Nordic countries (Denmark, Finland, Iceland, Norway, or Sweden) between 1994 and 2020 (start and end year varies between countries). We have retrieved and merged individual-level data from multiple national registries, including drug, patient, cancer, population, and death registries., Findings: The cohort includes 674,771 patients having received HP eradication treatment. During up to 23 years of follow-up, 59,292 (8.8%) participants were diagnosed with cancer (non-melanoma skin cancer excluded), whereof 15,496 (2.3%) in the gastrointestinal tract., Future Plans: We will analyse HP eradication treatment in relation to gastrointestinal cancer risk. Standardised incidence ratios will be calculated as the observed cancer incidence in the cohort divided by the expected cancer incidence, derived from the background population of the corresponding age, sex, and calendar year.

Published
2023
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49. Signet Ring Cell Colorectal and Appendiceal Cancer: A Small Signet Ring Cell Component Is Also Associated with Poor Outcome.

Author

Enblad M, Egerszegi PP, Birgisson H, Sjöblom T, Glimelius B, and Folkesson J

Abstract

Background: Colorectal signet ring cell (SRC) carcinoma with ≥50% SRCs (SRC ≥ 50) has a poor prognosis, but the prognostic role of SRCs < 50% (SRC < 50) is unclear. The aim of this study was to provide a clinicopathological characterization of SRC colorectal and appendiceal tumours and analyse the importance of the SRC component size., Methods: All patients in the Swedish Colorectal Cancer Registry diagnosed with colorectal or appendiceal cancer in 2009-2020 at Uppsala University Hospital, Sweden, were included. The SRCs were verified, and the components estimated by a gastrointestinal pathologist., Results: Of the 2229 colorectal cancers, 51 (2.3%) had SRCs, with a median component size of 30% (interquartile range of 12.5-40) and 10 (0.45%) had SRC ≥ 50. The SRC tumours were primarily localized in the right colon (59%) and appendix (16%). No patients with SRCs had stage I disease, and 26 (51%) had stage IV, of whom, 18 (69%) had peritoneal metastases. The SRC tumours were often high grade with perineural and vascular invasion. The 5-year overall survival (OS) rate for patients with SRC ≥ 50 were 20% (95% confidence interval (CI) 6-70), for SRC < 50, 39% (95% CI 24-61); and for non-SRCs, 55% (95% CI 55-60). Among the patients with SRC < 50 and <50% extracellular mucin, the 5-year OS was 34% (95% CI 19-61), while those with ≥50% extracellular mucin had an OS of 50% (95% CI 25-99). The 5-year recurrence-free survival rates were 51% (95% CI 13-83) for patients with SRC tumours, as compared to 83% (95% CI 77-89) and 81% (95% CI 79-84) for mucinous and non-mucinous adenocarcinoma, respectively., Conclusions: The presence of SRCs was strongly associated with aggressive clinicopathological features, peritoneal metastases, and poor prognosis, also when they make up <50% of a tumour.

Published
2023
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50. Noninvasive detection of any-stage cancer using free glycosaminoglycans.

Author

Bratulic S, Limeta A, Dabestani S, Birgisson H, Enblad G, Stålberg K, Hesselager G, Häggman M, Höglund M, Simonson OE, Stålberg P, Lindman H, Bång-Rudenstam A, Ekstrand M, Kumar G, Cavarretta I, Alfano M, Pellegrino F, Mandel-Clausen T, Salanti A, Maccari F, Galeotti F, Volpi N, Daugaard M, Belting M, Lundstam S, Stierner U, Nyman J, Bergman B, Edqvist PH, Levin M, Salonia A, Kjölhede H, Jonasch E, Nielsen J, and Gatto F

Subjects
Humans, Biomarkers, Tumor genetics, Liquid Biopsy, Early Detection of Cancer, Glycosaminoglycans, Neoplasms diagnosis
Abstract

Cancer mortality is exacerbated by late-stage diagnosis. Liquid biopsies based on genomic biomarkers can noninvasively diagnose cancers. However, validation studies have reported ~10% sensitivity to detect stage I cancer in a screening population and specific types, such as brain or genitourinary tumors, remain undetectable. We investigated urine and plasma free glycosaminoglycan profiles (GAGomes) as tumor metabolism biomarkers for multi-cancer early detection (MCED) of 14 cancer types using 2,064 samples from 1,260 cancer or healthy subjects. We observed widespread cancer-specific changes in biofluidic GAGomes recapitulated in an in vivo cancer progression model. We developed three machine learning models based on urine ( N urine = 220 cancer vs. 360 healthy) and plasma ( N plasma = 517 vs. 425) GAGomes that can detect any cancer with an area under the receiver operating characteristic curve of 0.83-0.93 with up to 62% sensitivity to stage I disease at 95% specificity. Undetected patients had a 39 to 50% lower risk of death. GAGomes predicted the putative cancer location with 89% accuracy. In a validation study on a screening-like population requiring ≥ 99% specificity, combined GAGomes predicted any cancer type with poor prognosis within 18 months with 43% sensitivity (21% in stage I; N = 121 and 49 cases). Overall, GAGomes appeared to be powerful MCED metabolic biomarkers, potentially doubling the number of stage I cancers detectable using genomic biomarkers.

Published
2022
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