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2. The Modular X- and Gamma-Ray Sensor (MXGS)of the ASIM Payload on the International Space Station

Author

Østgaard, Nikolai, Balling, Jan E., Bjørnsen, Thomas, Brauer, Peter, Budtz-Jørgensen, Carl, Bujwan, Waldemar, Carlson, Brant, Christiansen, Freddy, Connell, Paul, Eyles, Chris, Fehlker, Dominik, Genov, Georgi, Grudziński, Pawel, Kochkin, Pavlo, Kohfeldt, Anja, Kuvvetli, Irfan, Thomsen, Per Lundahl, Pedersen, Søren Møller, Navarro-Gonzalez, Javier, Neubert, Torsten, Njøten, Kåre, Orleanski, Piotr, Qureshi, Bilal Hasan, Cenkeramaddi, Linga Reddy, Reglero, Victor, Reina, Manuel, Rodrigo, Juan Manuel, Rostad, Maja, Sabau, Maria D., Kristensen, Steen Savstrup, Skogseide, Yngve, Solberg, Arne, Stadsnes, Johan, Ullaland, Kjetil, and Yang, Shiming

Subjects
Physics - Instrumentation and Detectors, Astrophysics - Instrumentation and Methods for Astrophysics, Physics - Space Physics
Abstract

The Modular X- and Gamma-ray Sensor (MXGS) is an imaging and spectral X- and Gamma-ray instrument mounted on the starboard side of the Columbus module on the International Space Station. Together with the Modular Multi-Spectral Imaging Assembly (MMIA) (Chanrion et al. this issue) MXGS constitutes the instruments of the Atmosphere-Space Interactions Monitor (ASIM) (Neubert et al. this issue). The main objectives of MXGS are to image and measure the spectrum of X- and $\gamma$-rays from lightning discharges, known as Terrestrial Gamma-ray Flashes (TGFs), and for MMIA to image and perform high speed photometry of Transient Luminous Events (TLEs) and lightning discharges. With these two instruments specifically designed to explore the relation between electrical discharges, TLEs and TGFs, ASIM is the first mission of its kind.

Published
2019
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10. Effect of radium-223 dichloride on symptomatic skeletal events in patients with castration-resistant prostate cancer and bone metastases: results from a phase 3, double-blind, randomised trial

Author

Sartor, Oliver, Coleman, Robert, Nilsson, Sten, Heinrich, Daniel, Helle, Svein I, O'Sullivan, Joe M, Fosså, Sophie D, Chodacki, Aleš, Wiechno, Paweł, Logue, John, Widmark, Anders, Johannessen, Dag Clement, Hoskin, Peter, James, Nicholas D, Solberg, Arne, Syndikus, Isabel, Vogelzang, Nicholas J, O'Bryan-Tear, C Gillies, Shan, Minghua, Bruland, Øyvind S, and Parker, Christopher

Published
2014
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14. Detection of Recurrent Prostate Cancer With 18F-Fluciclovine PET/MRI

Author

Selnæs, Kirsten Margrete, primary, Krüger-Stokke, Brage, additional, Elschot, Mattijs, additional, Johansen, Håkon, additional, Steen, Per Arvid, additional, Langørgen, Sverre, additional, Aksnessæther, Bjørg Yksnøy, additional, Indrebø, Gunnar, additional, Sjøbakk, Torill Anita Eidhammer, additional, Tessem, May-Britt, additional, Moestue, Siver Andreas, additional, Knobel, Heidi, additional, Tandstad, Torgrim, additional, Bertilsson, Helena, additional, Solberg, Arne, additional, and Bathen, Tone Frost, additional

Published
2020
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16. 5. Production Geophysics

Author

Payne, Michael A., primary, Abriel, William L., additional, Wilt, Michael, additional, Gouveia, Wences P., additional, Johnston, David H., additional, Solberg, Arne, additional, Lauritzen, Morten, additional, Kloosterman, H. J., additional, Kelly, R. S., additional, Stammeijer, J., additional, Hartung, M., additional, van Waarde, J., additional, Chajecki, C., additional, Gonzalez-Carballo, Angel, additional, Guyonnet, Pierre-Yves, additional, Levallois, Benoit, additional, Veillerette, Antoine, additional, Deboiasne, Renaud, additional, Soroka, William L., additional, Melville, Peter, additional, Kleiss, Erik, additional, Al-Jenaibi, Mahfoud, additional, Hafez, Hafez H., additional, Al-Jeelani, Abu Baker, additional, Modavi, Abi, additional, Gomes, Jorge S., additional, Rickett, James, additional, Duranti, Luca, additional, Hudson, Thomas, additional, Regel, Bernard, additional, Hodgson, Neil, additional, Stewart, Jonathan, additional, Shatilo, Andrew, additional, Jing, Charlie, additional, Rape, Tommie, additional, Duren, Richard, additional, Lewallen, Kyle, additional, Szurek, Gary, additional, Thompson, Mark, additional, Arntsen, Børge, additional, Amundsen, Lasse, additional, Szydlik, Teresa, additional, Smith, Patrick, additional, Way, Simon, additional, Aamodt, Lars, additional, Friedrich, Christina, additional, Hornby, Brian E., additional, Yu, Jianhua, additional, Sharp, John A., additional, Burch, Tom, additional, Ray, Amal, additional, Roberts, Mark, additional, Quist, Yan, additional, Brandsberg-Dahl, Sverre, additional, Al-Anboori, A., additional, Kendall, J. -M., additional, Hoversten, G. Michael, additional, Milligan, Paul, additional, Byun, Joongmoo, additional, Washbourne, John, additional, Knauer, Larry C., additional, Harness, Paul, additional, Ferguson, J. F., additional, Chen, T., additional, Brady, J., additional, Aiken, C. L. V., additional, Seibert, J., additional, Brady, J. L., additional, Hare, J. L., additional, Seibert, J. E., additional, Klopping, F. J., additional, and Niebauer, T., additional

Published
2010
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17. RADIUM-223 CHLORIDE (ALPHARADIN) IMPACT ON OVERALL SURVIVAL AND SKELETAL-RELATED EVENTS IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER WITH BONE METASTASES A PHASE III RANDOMIZED TRIAL (ALSYMPCA): 684

Author

Sartor, Oliver, Heinrich, Daniel, Helle, Svein Inge, OʼSullivan, Joe M., Chodacki, Aleš, Demkow, Tomasz, Logue, John, Seke, Mihalj, Widmark, Anders, Johannessen, Dag Clement, Nilsson, Sten, Hoskin, Peter, Solberg, Arne, James, Nicholas D., Syndikus, Isabel, Vogelzang, Nicholas, OʼBryan-Tear, Charles Gillies, Garcia-Vargas, Jose, Shan, Minghua, and Parker, Chris

Published
2012

18. In Reply to Sari et al

Author

Aksnessæther, Bjørg Y., primary, Myklebust, Tor Åge, additional, Solberg, Arne, additional, Klepp, Olbjørn H., additional, Skovlund, Eva, additional, Hoff, Solveig Roth, additional, Fosså, Sophie D., additional, Widmark, Anders, additional, and Lund, Jo-Åsmund, additional

Published
2020
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24. The Modular X- and Gamma-Ray Sensor (MXGS) of the ASIM Payload on the International Space Station

Author

Østgaard, Nikolai, primary, Balling, Jan E., additional, Bjørnsen, Thomas, additional, Brauer, Peter, additional, Budtz-Jørgensen, Carl, additional, Bujwan, Waldemar, additional, Carlson, Brant, additional, Christiansen, Freddy, additional, Connell, Paul, additional, Eyles, Chris, additional, Fehlker, Dominik, additional, Genov, Georgi, additional, Grudziński, Pawel, additional, Kochkin, Pavlo, additional, Kohfeldt, Anja, additional, Kuvvetli, Irfan, additional, Thomsen, Per Lundahl, additional, Pedersen, Søren Møller, additional, Navarro-Gonzalez, Javier, additional, Neubert, Torsten, additional, Njøten, Kåre, additional, Orleanski, Piotr, additional, Qureshi, Bilal Hasan, additional, Cenkeramaddi, Linga Reddy, additional, Reglero, Victor, additional, Reina, Manuel, additional, Rodrigo, Juan Manuel, additional, Rostad, Maja, additional, Sabau, Maria D., additional, Kristensen, Steen Savstrup, additional, Skogseide, Yngve, additional, Solberg, Arne, additional, Stadsnes, Johan, additional, Ullaland, Kjetil, additional, and Yang, Shiming, additional

Published
2019
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25. Detection of Recurrent Prostate Cancer With 18F-Fluciclovine PET/MRI.

Author

Selnæs, Kirsten Margrete, Krüger-Stokke, Brage, Elschot, Mattijs, Johansen, Håkon, Steen, Per Arvid, Langørgen, Sverre, Aksnessæther, Bjørg Yksnøy, Indrebø, Gunnar, Sjøbakk, Torill Anita Eidhammer, Tessem, May-Britt, Moestue, Siver Andreas, Knobel, Heidi, Tandstad, Torgrim, Bertilsson, Helena, Solberg, Arne, and Bathen, Tone Frost

Subjects
ENDORECTAL ultrasonography, MAGNETIC resonance imaging, PROSTATE cancer patients, PROSTATE cancer
Abstract

Objective: Simultaneous PET/MRI combines soft-tissue contrast of MRI with high molecular sensitivity of PET in one session. The aim of this prospective study was to evaluate detection rates of recurrent prostate cancer by 18F-fluciclovine PET/MRI. Methods: Patients with biochemical recurrence (BCR) or persistently detectable prostate specific antigen (PSA), were examined with simultaneous 18F-fluciclovine PET/MRI. Multiparametric MRI (mpMRI) and PET/MRI were scored on a 3-point scale (1-negative, 2-equivocal, 3-recurrence/metastasis) and detection rates (number of patients with suspicious findings divided by total number of patients) were reported. Detection rates were further stratified based on PSA level, PSA doubling time (PSAdt), primary treatment and inclusion criteria (PSA persistence, European Association of Urology (EAU) Low-Risk BCR and EAU High-Risk BCR). A detailed investigation of lesions with discrepancy between mpMRI and PET/MRI scores was performed to evaluate the incremental value of PET/MRI to mpMRI. The impact of the added PET acquisition on further follow-up and treatment was evaluated retrospectively. Results: Among patients eligible for analysis (n=84), 54 lesions were detected in 38 patients by either mpMRI or PET/MRI. Detection rates were 41.7% for mpMRI and 39.3% for PET/MRI (score 2 and 3 considered positive). There were no significant differences in detection rates for mpMRI versus PET/MRI. Disease detection rates were higher in patients with PSA≥1ng/mL than in patients with lower PSA levels but did not differ between patients with PSAdt above versus below 6 months. Detection rates in patients with primary radiation therapy were higher than in patients with primary surgery. Patients categorized as EAU Low-Risk BCR had a detection rate of 0% both for mpMRI and PET/MRI. For 15 lesions (27.8% of all lesions) there was a discrepancy between mpMRI score and PET/MRI score. Of these, 10 lesions scored as 2-equivocal by mpMRI were changed to a more definite score (n=4 score 1 and n=6 score 3) based on the added PET acquisition. Furthermore, for 4 of 10 patients with discrepancy between mpMRI and PET/MRI scores, the added PET acquisition had affected the treatment choice. Conclusion: Combined 18F-fluciclovine PET/MRI can detect lesions suspicious for recurrent prostate cancer in patients with a range of PSA levels. Combined PET/MRI may be useful to select patients for appropriate treatment, but is of limited use at low PSA values or in patients classified as EAU Low-Risk BCR, and the clinical value of 18F-fluciclovine PET/MRI in this study was too low to justify routine clinical use. [ABSTRACT FROM AUTHOR]

Published
2020
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27. Three-year Safety of Radium-223 Dichloride in Patients with Castration-resistant Prostate Cancer and Symptomatic Bone Metastases from Phase 3 Randomized Alpharadin in Symptomatic Prostate Cancer Trial

Author

Parker, Christopher C., primary, Coleman, Robert E., additional, Sartor, Oliver, additional, Vogelzang, Nicholas J., additional, Bottomley, David, additional, Heinrich, Daniel, additional, Helle, Svein I., additional, O'Sullivan, Joe M., additional, Fosså, Sophie D., additional, Chodacki, Aleš, additional, Wiechno, Paweł, additional, Logue, John, additional, Seke, Mihalj, additional, Widmark, Anders, additional, Johannessen, Dag Clement, additional, Hoskin, Peter, additional, James, Nicholas D., additional, Solberg, Arne, additional, Syndikus, Isabel, additional, Kliment, Jan, additional, Wedel, Steffen, additional, Boehmer, Sibylle, additional, Dall’Oglio, Marcos, additional, Franzén, Lars, additional, Bruland, Øyvind S., additional, Petrenciuc, Oana, additional, Staudacher, Karin, additional, Li, Rui, additional, and Nilsson, Sten, additional

Published
2018
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29. MP57-10 RELATIONSHIP BETWEEN QUALITY OF LIFE AND OVERALL SURVIVAL IN METASTATIC CASTRATION-RESISTANT PROSTATE CANCER PATIENTS IN ALSYMPCA: ANALYSIS BY PRIOR DOCETAXEL SUBGROUP

Author

Shore, Neal D., primary, Nilsson, Sten, additional, Sartor, Oliver, additional, Vogelzang, Nicholas J., additional, Coleman, Robert E., additional, O'Sullivan, Joe M., additional, Heinrich, Daniel, additional, Bottomley, David, additional, Hoskin, Peter, additional, Franzen, Lars, additional, Solberg, Arne, additional, Reuning-Scherer, Jonathan, additional, Zhan, Lin, additional, and Parker, Christopher, additional

Published
2017
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30. Relationship between quality of life and overall survival in metastatic castration-resistant prostate cancer (mCRPC) patients in ALSYMPCA.

Author

Nilsson, Sten, primary, Sartor, A. Oliver, additional, Vogelzang, Nicholas J., additional, Coleman, Robert E., additional, O'Sullivan, Joe M., additional, Shore, Neal D., additional, Heinrich, Daniel, additional, Bottomley, David, additional, Hoskin, Peter, additional, Franzen, Lars, additional, Solberg, Arne, additional, Reuning-Scherer, Jonathan D., additional, Zhan, Lin, additional, and Parker, Chris, additional

Published
2017
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31. Ten- and 15-yr Prostate Cancer-specific Mortality in Patients with Nonmetastatic Locally Advanced or Aggressive Intermediate Prostate Cancer, Randomized to Lifelong Endocrine Treatment Alone or Combined with Radiotherapy: Final Results of The Scandinavian Prostate Cancer Group-7

Author

Fosså, Sophie D., primary, Wiklund, Fredrik, additional, Klepp, Olbjørn, additional, Angelsen, Anders, additional, Solberg, Arne, additional, Damber, Jan-Erik, additional, Hoyer, Morten, additional, and Widmark, Anders, additional

Published
2016
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33. Outcome Assessments in Non- Metastatic Prostate Cancer

Author

Solberg, Arne and Norges teknisk-naturvitenskapelige universitet, Det medisinske fakultet, Institutt for kreftforskning og molekylær medisin

Abstract

Metoder for å måle utfall av behandling hos pasienter med prostatakreft uten spredning. Prostatakreft uten påvist spredning kan behandles med operasjon, strålebehandling med eller uten hormonbehandling, eller hormonbehandling alene. Svært mange menn med nylig påvist prostatakreft vil imidlertid kunne leve i mange år uten plager av sykdommen også uten behandling, og en stor andel dør til slutt av helt andre årsaker enn prostatkreft. Man mangler imidlertid helt sikre metoder for å velge ut pasienter som ikke trenger behandling, men i noen tilfeller hvor sykdommen er i tidlig fase er et regelmessig kontrollopplegg hvor kurativ behandling iverksettes først hvis sykdomen viser tegn til utvikling, forsvarlig. Imidlertid kan prostatakreft også være en agressiv sykdom med stor risiko for spredning og forkortet levetid. Pasienter med nylig påvist prostatakreft uten spredning og intermediær til høy risiko for progresjon regnes derfor å være behandlingstrengende. Det kan ta mange år før man merker symptomer på et tibakefall etter en behandling som ikke har gitt ønsket kurasjon. Da vil sykdommen ofte ha kommet for langt til å kunne helbredes. Påvisning av manglende behandlingseffekt før et tilbakefall av sykdommen gir symptomer er imidlertid kun viktig hvis det da finnes effektiv tileggsbehandling. Siden overlevelse vanligvis ansees som det viktigste effektmålet ved kurativ kreftbehandling, blir det også viktig å avklare om det å påvise et tidlig tilbakefall eller manglende behandlingseffekt virkelig kan forutsi om pasienten på sikt vil utvikle plager av kreftsykdommen og i verste fall dø av den. I tillegg er det også svært viktig at bivirkningene ved utredning og behandling er så lite plagsomme som mulig. Denne avhandlingen omhandler metoder for å måle effekt/utfall av behandling hos pasienter med prostatakreft uten spredning. Avhandlingen inbefatter 4 studier hvor hovedvekten er lagt på resultater av vevsundersøkelser av prostatkjertelen etter åpen radikal prostatectomi (operasjon) samt resultater i form av overlevelse og bivirkninger når kombinert strålebehandling og hormonbehandling sammenlignes med hormonbehandling alene. Videre undersøkes hvor hyppig det påvises kreftceller i systematiske vevsprøver fra prostata 3-4 år etter at de to sistnevne behandlingene ble iverksatt. Endelig undersøkes bivirkninger av vevsprøvetakning etter kombinert strålebehandling og hormonbehandlig sammenlignet med hormonbehandling alene. Resultatene av studiene viser at andel pasienter som fikk prostatakreften fullstendig fjernet ved operasjon bedømt ut fra kirurgiske marginer gradvis økte de første årener etter at operasjonsmetoden ble innført. Det gir en indikasjon på at operasjonsteknikken bedret seg vesentlig i samme periode. Strålebehandling kombinert med hormonbehandling ga vesentlig bedre totaloverlevelse enn hormonbehandling alene. Kombinasjonsbehandlingen ga en lett øktning av bivirkninger, men bivirkningene var akseptable. De pasientene som fikk denne kombinasjonsbehandlingen hadde vesentlig skjeldnere gjenværende kreftceller i vevsprøvene sammenlignet med de som bare fikk hormonbehandling. Videre hadde pasienter med gjennværende kreftceller i prostatakjertelen vesentlig høyere risiko for tilbakefall påvist med blodprøve (stigende PSA) . Bivirkningene ved å ta systematiske vevsprøver fra prostata etter hormonbehandling med eller uten stråleterapi var små og gikk stort sett over i løpet av en uke.

Published
2011

35. Re: Ulike retningslinjer for behandling av prostatakreft

Author

Solberg, Arne, primary, Angelsen, Anders, primary, Berge, Viktor, primary, Lilleby, Wolfgang, primary, Iversen, Jon, primary, Klepp, Olbjørn, primary, Brennhovd, Bjørn, primary, Johannessen, Dag, primary, Nygård, Yngve, primary, Larsen, Kari, primary, and Stensvold, Andreas, primary

Published
2015
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36. Abstract 1346: Investigation of six testicular germ cell tumor susceptibility genes reveals a parent-of-origin effect in SPRY4.

Author

Grotmol, Tom, primary, Karlsson, Robert, additional, Andreassen, Kristine, additional, Kristiansen, Wenche, additional, Aschim, Elin, additional, Bremnes, Roy, additional, Dahl, Olav, additional, Fosså, Sophie, additional, Klepp, Olbjørn, additional, Langberg, Carl, additional, Solberg, Arne, additional, Tretli, Steinar, additional, Magnusson, Patrik, additional, Adami, Hans-Olov, additional, Haugen, Trine, additional, and Wiklund, Fredrik, additional

Published
2013
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40. Low-energy CZT detector array for the ASIM mission

Author

Cenkeramaddi, Linga Reddy, primary, Genov, Georgi, additional, Kohfeldt, Anja, additional, Njoten, Kare, additional, Rostad, Maja Elise, additional, Skogseide, Yngve, additional, Roscoe, Magnus, additional, Solberg, Arne, additional, Stadsnes, Johan, additional, Ullaland, Kjetil, additional, Østgaard, Nikolai, additional, Budtz-Jorgensen, Carl, additional, Kuvvetli, Irfan, additional, Mikkelsen, Sindre, additional, and Maehlum, Gunnar, additional

Published
2012
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41. 684 RADIUM-223 CHLORIDE (ALPHARADIN) IMPACT ON OVERALL SURVIVAL AND SKELETAL-RELATED EVENTS IN PATIENTS WITH CASTRATION-RESISTANT PROSTATE CANCER WITH BONE METASTASES A PHASE III RANDOMIZED TRIAL (ALSYMPCA)

Author

Sartor, Oliver, primary, Heinrich, Daniel, additional, Helle, Svein Inge, additional, O'Sullivan, Joe M., additional, Chodacki, Aleš, additional, Demkow, Tomasz, additional, Logue, John, additional, Seke, Mihalj, additional, Widmark, Anders, additional, Johannessen, Dag Clement, additional, Nilsson, Sten, additional, Hoskin, Peter, additional, Solberg, Arne, additional, James, Nicholas D., additional, Syndikus, Isabel, additional, Vogelzang, Nicholas, additional, O'Bryan-Tear, Charles Gillies, additional, Garcia-Vargas, Jose, additional, Shan, Minghua, additional, and Parker, Chris, additional

Published
2012
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42. Overall survival benefit and safety profile of radium-223 chloride, a first-in-class alpha-pharmaceutical: Results from a phase III randomized trial (ALSYMPCA) in patients with castration-resistant prostate cancer (CRPC) with bone metastases.

Author

Parker, Chris, primary, Heinrich, Daniel, additional, O'Sullivan, Joe M., additional, Fossa, Sophie D., additional, Chodacki, Ales, additional, Demkow, Tomasz, additional, Logue, John P., additional, Seke, Mihalj, additional, Widmark, Anders, additional, Johannessen, Dag Clement, additional, Nilsson, Sten, additional, Hoskin, Peter, additional, Solberg, Arne, additional, James, Nicholas David, additional, Syndikus, Isabel, additional, Cross, Andrew, additional, O'Bryan-Tear, C. Gillies, additional, Garcia-Vargas, Jose E., additional, and Sartor, A. Oliver, additional

Published
2012
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43. Radium-223 chloride impact on skeletal-related events in patients with castration-resistant prostate cancer (CRPC) with bone metastases: A phase III randomized trial (ALSYMPCA).

Author

Sartor, A. Oliver, primary, Heinrich, Daniel, additional, Helle, Svein Inge, additional, O'Sullivan, Joe M., additional, Fossa, Sophie D., additional, Chodacki, Ales, additional, Demkow, Tomasz, additional, Logue, John P., additional, Seke, Mihalj, additional, Widmark, Anders, additional, Johannessen, Dag Clement, additional, Nilsson, Sten, additional, Hoskin, Peter, additional, Solberg, Arne, additional, James, Nicholas David, additional, Syndikus, Isabel, additional, Vogelzang, Nicholas J., additional, O'Bryan-Tear, C. Gillies, additional, Shan, Minghua, additional, and Parker, Chris, additional

Published
2012
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44. Population-Based Study of Treatment Guided by Tumor Marker Decline in Patients With Metastatic Nonseminomatous Germ Cell Tumor: A Report From the Swedish-Norwegian Testicular Cancer Group

Author

Olofsson, Sven-Erik, primary, Tandstad, Torgrim, additional, Jerkeman, Mats, additional, Dahl, Olav, additional, Ståhl, Olof, additional, Klepp, Olbjørn, additional, Bremnes, Roy M., additional, Cohn-Cedermark, Gabriella, additional, Langberg, Carl W., additional, Laurell, Anna, additional, Solberg, Arne, additional, Stierner, Ulrika, additional, Wahlqvist, Rolf, additional, Wijkström, Hans, additional, Anderson, Harald, additional, and Cavallin-Ståhl, Eva, additional

Published
2011
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46. Management of Seminomatous Testicular Cancer: A Binational Prospective Population-Based Study From the Swedish Norwegian Testicular Cancer Study Group

Author

Tandstad, Torgrim, primary, Smaaland, Rune, additional, Solberg, Arne, additional, Bremnes, Roy M., additional, Langberg, Carl W., additional, Laurell, Anna, additional, Stierner, Ulrika K., additional, Ståhl, Olof, additional, Cavallin-Ståhl, Eva K., additional, Klepp, Olbjørn H., additional, Dahl, Olav, additional, and Cohn-Cedermark, Gabriella, additional

Published
2011
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47. Risk-Adapted Treatment in Clinical Stage I Nonseminomatous Germ Cell Testicular Cancer: The SWENOTECA Management Program

Author

Tandstad, Torgrim, primary, Dahl, Olav, additional, Cohn-Cedermark, Gabriella, additional, Cavallin-Stahl, Eva, additional, Stierner, Ulrika, additional, Solberg, Arne, additional, Langberg, Carl, additional, Bremnes, Roy M., additional, Laurell, Anna, additional, Wijkstrøm, Hans, additional, and Klepp, Olbjørn, additional

Published
2009
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48. Bilateral testicular germ cell tumors in patients treated for clinical stage I non-seminoma within two risk-adapted SWENOTECA protocols.

Author

Tandstad, Torgrim, Solberg, Arne, Håkansson, Ulf, Stahl, Olof, Haugnes, Hege Sagstuen, Oldenburg, Jan, Dahl, Olav, Kjellman, Anders, Angelsen, Anders, and Cohn-Cedermark, Gabriella

Subjects
*BIOPSY, *GERM cells, *MULTIVARIATE analysis, *PUBLIC health surveillance, *RADIOTHERAPY, *STATISTICS, *PROPORTIONAL hazards models, *TESTIS tumors, *DATA analysis software, *DESCRIPTIVE statistics, *LOG-rank test, *DIAGNOSIS
Abstract

Background. A contralateral tumor occurs in 3.5-5% of men diagnosed with testicular germ cell cancer (TGCC). Biopsy of the contralateral testis may detect intratubular germ cell neoplasia ITGCNU, a precursor of TGCC. Biopsy of the contralateral testis to detect ITGCNU is controversial. If adjuvant chemotherapy (ACT) protects against bilateral cancer is debated. Material and methods. A total of 1003 patients with clinical stage I (CS I) non-seminomatous testicular germ cell cancer (NSGCT) were included in two prospective, population-based protocols. Fifteen patients were excluded. Treatment was either adjuvant chemotherapy (n = 494), or surveillance (n = 494). Contralateral testicular biopsy was recommended for all patients, but was performed only in 282 patients. In case of ITGCNU radiotherapy (RT) to 16 Gy was recommended. Results. During a follow-up of 8.3 years, 31 (3.6%) patients developed contralateral TGCC. ITGCNU was detected in 3.2% (9/282) of biopsied patients. The incidence of bilateral TGCC was similar following ACT, 2.5% (11/494), and surveillance, 3.4% (13/494), p = 0.41. Young age was a risk factor for metachronous TGCC (HR 0.93; 95% CI 0.88-0.99, p = 0.02). In total 2.2% (6/273) of patients without ITGCNU in the biopsy developed contralateral TGCC. One irradiated patient developed contralateral cancer, and one developed contralateral tumor before RT was given. Conclusion. ACT did not reduce the incidence of contralateral TGCC. Young patients had the highest risk of developing contralateral TGCC. The proportion of false negatives biopsies was higher than reported in earlier trials, but this may in part be related to patient selection, single biopsies and lack of mandatory immunohistochemistry. [ABSTRACT FROM AUTHOR]

Published
2015
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