Ändra sökning
Avgränsa sökresultatet
1 - 38 av 38
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1.
    Bjurberg, Maria
    et al.
    Lund Univ, Sweden.
    Holmberg, Erik
    Reg Canc Ctr West, Sweden; Sahlgrens Acad, Sweden.
    Borgfeldt, Christer
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Floter-Radestad, Angelique
    Karolinska Inst, Sweden.
    Dahm-Kahler, Pernilla
    Sahlgrens Univ Hosp, Sweden.
    Hjerpe, Elisabet
    Visby Hosp, Sweden.
    Hogberg, Thomas
    Lund Univ, Sweden.
    Kjölhede, Preben
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Marcickiewicz, Janusz
    Reg Canc Ctr West, Sweden; Halland Hosp, Sweden.
    Rosenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Stalberg, Karin
    Uppsala Univ, Sweden.
    Tholander, Bengt
    Uppsala Univ Hosp, Sweden.
    Hellman, Kristina
    Karolinska Univ Hosp, Sweden.
    Åvall Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Primary treatment patterns and survival of cervical cancer in Sweden: A population-based Swedish Gynecologic Cancer Group Study2019Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 155, nr 2, s. 229-236Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Survival in cervical cancer has improved little over the last decades. We aimed to elucidate primary treatment patterns and survival. Methods: Population-based study of patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed 2011-2015. Main outcome was 5-year relative survival (RS). Age-standardised RS (AS-RS) was estimated for the total cohort and for the pooled study population of squamous, adenosquamous-, adenocarcinoma. Results: Median follow-up time was 4.6 years. The study population consisted of 2141 patients; 97% of the 2212 patients in the total cohort and the 5-year AS-RS was 71% and 70%, respectively. RS stage IB1: surgery alone 95% vs. 72% for definitive chemoradiotherapy (CT-RT) (p amp;lt; 0.001). In stage IIA1 74% had CTRL, and 47% of operated patients received adjuvant (CT)-RT. RS stage IB2: surgically treated 81% (69% received adjuvant (CT)-RT) vs. 76% for (CT)-RT (p = 0.73). RS stage IIB: 77% for CT-RT + brachytherapy BT), 37% for RT + BT (p = 0.045) and 27% for RT-BT (p amp;lt; 0.001). Stages III-IVA; amp;lt;40% received CT-RT + BT, RS 45% vs. 18% for RT-BT (RR 4.1, p amp;lt; 0.001). RS stage IVB 7%. Conclusion: Primary treatment of cervical cancer in Sweden adhered to evidence-based standard of care. Areas of improvement include optimising treatment for stages III-IVA, and avoiding combining surgery and radiotherapy. (C) 2019 Elsevier Inc. All rights reserved.

  • 2.
    Bjurberg, Maria
    et al.
    Lund Univ, Skane Univ Hosp, Dept Haematol Oncol & Radiat Phys, Lasarettsgatan 23, SE-22185 Lund, Sweden;Lund Univ, Dept Clin Sci, Lasarettsgatan 23, SE-22185 Lund, Sweden.
    Holmberg, Erik
    Reg Canc Ctr West, Reg Vastra Gotaland, SE-41345 Gothenburg, Sweden;Sahlgrens Acad, Inst Clin Sci, Dept Oncol, SE-41345 Gothenburg, Sweden.
    Borgfeldt, Christer
    Skane Univ Hosp, Dept Obstet & Gynaecol, SE-22185 Lund, Sweden;Lund Univ, SE-22185 Lund, Sweden.
    Flöter-Rådestad, Angelique
    Karolinska Inst, Karolinska Univ Hosp, Dept Womens & Childrens Hlth, Div Obstet & Gynaecol, SE-17176 Stockholm, Sweden.
    Dahm-Kähler, Pernilla
    Sahlgrens Univ Hosp, Dept Obstet & Gynaecol, SE-41345 Gothenburg, Sweden.
    Hjerpe, Elisabet
    Visby Hosp, Dept Gynaecol & Obstet, SE-62155 Visby, Sweden.
    Högberg, Thomas
    Lund Univ, Dept Canc Epidemiol, SE-22100 Lund, Sweden.
    Kjolhede, Preben
    Linkoping Univ Hosp, Dept Obstet & Gynaecol, SE-58185 Linkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, SE-58185 Linkoping, Sweden.
    Marcickiewicz, Janusz
    Reg Canc Ctr West, Reg Vastra Gotaland, SE-41345 Gothenburg, Sweden;Halland Hosp, Dept Obstet & Gynaecol, SE-43281 Varberg, Sweden.
    Rosenberg, Per
    Linkoping Univ, Dept Clin & Expt Med, SE-58185 Linkoping, Sweden;Linkoping Univ, Dept Oncol, SE-58185 Linkoping, Sweden.
    Stålberg, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Tholander, Bengt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi.
    Hellman, Kristina
    Karolinska Univ Hosp, Dept Gynaecol Canc, Theme Canc, SE-17176 Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Linkoping Univ, Dept Clin & Expt Med, SE-58185 Linkoping, Sweden;Linkoping Univ, Dept Oncol, SE-58185 Linkoping, Sweden.
    Primary treatment patterns and survival of cervical cancer in Sweden: A population-based Swedish Gynecologic Cancer Group Study2019Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 155, nr 2, s. 229-236Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Survival in cervical cancer has improved little over the last decades. We aimed to elucidate primary treatment patterns and survival. Methods: Population-based study of patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed 2011-2015. Main outcome was 5-year relative survival (RS). Age-standardised RS (AS-RS) was estimated for the total cohort and for the pooled study population of squamous, adenosquamous-, adenocarcinoma. Results: Median follow-up time was 4.6 years. The study population consisted of 2141 patients; 97% of the 2212 patients in the total cohort and the 5-year AS-RS was 71% and 70%, respectively. RS stage IB1: surgery alone 95% vs. 72% for definitive chemoradiotherapy (CT-RT) (p < 0.001). In stage IIA1 74% had CTRL, and 47% of operated patients received adjuvant (CT)-RT. RS stage IB2: surgically treated 81% (69% received adjuvant (CT)-RT) vs. 76% for (CT)-RT (p = 0.73). RS stage IIB: 77% for CT-RT + brachytherapy BT), 37% for RT + BT (p = 0.045) and 27% for RT-BT (p < 0.001). Stages III-IVA; <40% received CT-RT + BT, RS 45% vs. 18% for RT-BT (RR 4.1, p < 0.001). RS stage IVB 7%. Conclusion: Primary treatment of cervical cancer in Sweden adhered to evidence-based standard of care. Areas of improvement include optimising treatment for stages III-IVA, and avoiding combining surgery and radiotherapy. (C) 2019 Elsevier Inc. All rights reserved.

  • 3.
    Bohr Mordhorst, Louise
    et al.
    Region Örebro län. Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Ahlin, Cecilia
    Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Sorbe, Bengt
    Region Örebro län. Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Prognostic impact of the expression of Hedgehog proteins in cervical carcinoma FIGO stages I-IV treated with radiotherapy or chemoradiotherapy2014Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 135, nr 2, s. 305-311Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Hedgehog signaling proteins were assessed in patients with cervical carcinoma receiving chemoradiation. Associations between five Hedgehog proteins and prognosis were studied.

    Methods: In all, 131 cases of cervical carcinomas (FIGO stages I-IV) were immunohistochemically (IHC) analyzed for Patched (PTCH), Smoothened (SMO), and GLI1, GLI2 and GLI3 protein expression. Associations between Hedgehog protein expressions, clinicopathological factors, and clinical outcome data were examined.

    Results: Positive IHC staining for the five Hedgehog proteins was recorded in 8% to 37% of the tumor cells. The highest frequency was noted for SMO and the lowest for all. There was a significant association between low SMO- and GLI2-expression and KRAS-mutation. Tumors with overexpressed SMO had a higher frequency of residual tumor or local recurrences than tumors with low SMO expression. Patients with tumors expressing PTCH in more than 75% of the cells had significantly (P = 0.023) better recurrence-free survival than patients with tumors with low expression. The opposite situation was true for SMO. For GLI2, there was a statistically significant difference with regard to overall (P = 0.004) and distant (P = 0.015) relapse rate for groups with expression of GLI2 in the range of 5-25% compared to higher rates.

    Conclusions: A predictive and prognostic value was found for PTCH, SMO, and GLI2 with regard to residual carcinoma, local recurrences, and for GLI2 distant relapses. The Hedgehog signaling pathway also seems to play an important role in cervical carcinogenesis together with HPV16-infection and KRAS-mutation.

  • 4.
    Carlsson, Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet.
    Strang, Peter
    Facts, misconceptions, and myths about cancer.: What do patients with gynecological cancer and the female public at large know?1997Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 65, s. 46-53Artikel i tidskrift (Refereegranskat)
  • 5.
    Dahm-Kahler, Pernilla
    et al.
    Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Gothenburg, Sweden..
    Borgfeldt, Christer
    Lund Univ, Skane Univ Hosp, Dept Obstet & Gynecol, Lund, Sweden..
    Holmberg, Erik
    Sahlgrens Univ Hosp, Reg Canc Ctr Western Sweden, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Gothenburg, Sweden..
    Staf, Christian
    Sahlgrens Univ Hosp, Reg Canc Ctr Western Sweden, Gothenburg, Sweden..
    Falconer, Henrik
    Karolinska Univ Hosp, Div Obstet & Gynecol, Dept Womens & Childrens Hlth, Stockholm, Sweden.;Karolinska Inst, Stockholm, Sweden..
    Bjurberg, Maria
    Skane Univ Hosp, Dept Clin Sci, Lund, Sweden..
    Kjolhede, Preben
    Linkoping Univ, Dept Clin & Expt Med, Dept Obstet & Gynecol, Linkoping, Sweden..
    Rosenberg, Per
    Linkoping Univ Hosp, Dept Oncol, Linkoping, Sweden..
    Stålberg, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Hogberg, Thomas
    Lund Univ, Dept Canc Epidemiol, Lund, Sweden..
    Avall-Lundqvist, Elisabeth
    Linkoping Univ, Dept Oncol, Linkoping, Sweden.;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden.;Karolinska Inst, Dept Pathol & Oncol, Stockholm, Sweden..
    Population-based study of survival for women with serous cancer of the ovary, fallopian tube, peritoneum or undesignated origin - on behalf of the Swedish gynecological cancer group (SweGCG)2017Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 144, nr 1, s. 167-173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. The aim of the study was to determine survival outcome in patients with serous cancer in the ovary, fallopian tube, peritoneum and of undesignated origin. Methods. Nation-wide population-based study of women 18 years with histologically verified non-uterine serous cancer, included in the Swedish Quality Registry for primary cancer of the ovary, fallopian tube and peritoneum diagnosed 2009-2013. Relative survival (RS) was estimated using the Ederer II method. Simple and multivariable analyses were estimated by Poisson regression models. Results. Of 5627 women identified, 1246 (22%) had borderline tumors and 4381 had malignant tumors. In total, 2359 women had serous cancer; 71% originated in the ovary (OC), 9% in the fallopian tube (FTC), 9% in the peritoneum (PPC) and 11% at an undesignated primary site (UPS). Estimated RS at 5-years was 37%; for FTC 54%, 40% for OC, 34% for PPC and 13% for UPS. In multivariable regression analyses restricted to women who had undergone primary or interval debulldng surgery for OC, FTC and PPC, site of origin was not independently associated with survival. Significant associations with worse survival were found for advanced stages (RR 2.63, P<0.001), moderate (RR 1.90, P<0.047) and poor differentiation (RR 2.20, P<0.009), neoadjuvant chemotherapy (RR1.33, P<0.022), residual tumor (RR 2.65, P<0.001) and platinum single (2.34, P<0.001) compared to platinum combination chemotherapy. Conclusion. Survival was poorer for serous cancer at UPS than for ovarian, fallopian tube and peritoneal cancer. Serous cancer at UPS needs to be addressed when reporting and comparing survival rates of ovarian cancer.

  • 6.
    Dahm-Kähler, Pernilla
    et al.
    Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden. Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Borgfeldt, Christer
    Department of Obstetrics and Gynecology, Skane University Hospital, Lund University, Lund, Sweden.
    Holmberg, Erik
    Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden. Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Staf, Christian
    Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Falconer, Henrik
    Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
    Bjurberg, Maria
    Department of Clinical Sciences, Skåne University Hospital, Lund, Sweden.
    Kjölhede, Preben
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Rosenberg, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US.
    Stålberg, Karin
    Department of Women's and Children's health Uppsala University, Uppsala, Sweden.
    Högberg, Thomas
    Department of Cancer Epidemiology, Lund University, Lund, Sweden.
    Åvall-Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US. Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.
    Population-based study of survival for women with serous cancer of the ovary, fallopian tube, peritoneum or undesignated origin - on behalf of the Swedish gynecological cancer group (SweGCG).2017Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 144, nr 1, s. 167-173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim of the study was to determine survival outcome in patients with serous cancer in the ovary, fallopian tube, peritoneum and of undesignated origin.

    METHODS: Nation-wide population-based study of women≥18years with histologically verified non-uterine serous cancer, included in the Swedish Quality Registry for primary cancer of the ovary, fallopian tube and peritoneum diagnosed 2009-2013. Relative survival (RS) was estimated using the Ederer II method. Simple and multivariable analyses were estimated by Poisson regression models.

    RESULTS: Of 5627 women identified, 1246 (22%) had borderline tumors and 4381 had malignant tumors. In total, 2359 women had serous cancer; 71% originated in the ovary (OC), 9% in the fallopian tube (FTC), 9% in the peritoneum (PPC) and 11% at an undesignated primary site (UPS). Estimated RS at 5-years was 37%; for FTC 54%, 40% for OC, 34% for PPC and 13% for UPS. In multivariable regression analyses restricted to women who had undergone primary or interval debulking surgery for OC, FTC and PPC, site of origin was not independently associated with survival. Significant associations with worse survival were found for advanced stages (RR 2.63, P<0.001), moderate (RR 1.90, P<0.047) and poor differentiation (RR 2.20, P<0.009), neoadjuvant chemotherapy (RR1.33, P<0.022), residual tumor (RR 2.65, P<0.001) and platinum single (2.34, P<0.001) compared to platinum combination chemotherapy.

    CONCLUSION: Survival was poorer for serous cancer at UPS than for ovarian, fallopian tube and peritoneal cancer. Serous cancer at UPS needs to be addressed when reporting and comparing survival rates of ovarian cancer.

  • 7. Edqvist, P. -HD.
    et al.
    Huvila, J.
    Forsström, Björn
    KTH, Skolan för bioteknologi (BIO), Proteomik och nanobioteknologi.
    Talve, L.
    Carpén, O.
    Salvesen, H. B.
    Krakstad, C.
    Grénman, S.
    Johannesson, H.
    Ljungqvist, O.
    Uhlén, Mathias
    KTH, Skolan för bioteknologi (BIO), Proteomik och nanobioteknologi. KTH, Centra, Science for Life Laboratory, SciLifeLab.
    Pontén, F.
    Auranen, A.
    Loss of ASRGL1 expression is an independent biomarker for disease-specific survival in endometrioid endometrial carcinoma2015Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 137, nr 3, s. 529-537Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective For endometrial carcinoma, prognostic stratification methods do not satisfactorily identify patients with adverse outcome. Currently, histology, tumor grade and stage are used to tailoring surgical treatment and to determine the need for adjuvant treatment. Low-risk patients are not considered to require adjuvant therapy or staging lymphadenectomy. For patients with intermediate or high risk, some guidelines recommend tailoring adjuvant treatment according to additional negative prognostic factors. Our objective was to evaluate the biomarker potential of the ASRGL1 protein in endometrial carcinoma. Methods Using The Human Protein Atlas (www.proteinatlas.org), the l-asparaginase (ASRGL1) protein was identified as an endometrial carcinoma biomarker candidate. ASRGL1 expression was immunohistochemically evaluated with an extensively validated antibody on two independent endometrial carcinoma cohorts (n = 229 and n = 286) arranged as tissue microarrays. Staining results were correlated with clinical features. Results Reduced expression of ASRGL1, defined as < 75% positively stained tumor cells, was significantly associated with poor prognosis and reduced disease-specific survival in endometrioid endometrial adenocarcinoma (EEA). In multivariate analysis the hazard ratios for disease-specific survival were 3.55 (95% CI = 1.10-11.43; p = 0.003) and 3.23 (95% CI = 1.53-6.81; p = 0.002) in the two cohorts, respectively. Of the 48 cases with Grade 3 Stage I tumor all disease-related deaths were associated with low ASRGL1 expression. Conclusions Loss of ASRGL1 in EEA is a powerful biomarker for poor prognosis and retained ASRGL1 has a positive impact on survival. ASRGL1 immunohistochemistry has potential to become an additional tool for prognostication in cases where tailoring adjuvant treatment according to additional prognostic factors besides grade and stage is recommended.

  • 8.
    Edqvist, Per-Henrik D.
    et al.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Huvila, Jutta
    Forsstrom, Bjorn
    Talve, Lauri
    Carpen, Olli
    Salvesen, Helga B.
    Krakstad, Camilla
    Grenman, Seija
    Johannesson, Henrik
    Ljungqvist, Oscar
    Uhlen, Mathias
    Ponten, Fredrik
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Auranen, Annika
    Loss of ASRGL1 expression is an independent biomarker for disease-specific survival in endometrioid endometrial carcinoma2015Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 137, nr 3, s. 529-537Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. For endometrial carcinoma, prognostic stratification methods do not satisfactorily identify patients with adverse outcome. Currently, histology, tumor grade and stage are used to tailoring surgical treatment and to determine the need for adjuvant treatment Low-risk patients are not considered to require adjuvant therapy or staging lymphadenectomy. For patients with intermediate or high risk, some guidelines recommend tailoring adjuvant treatment according to additional negative prognostic factors. Our objective was to evaluate the biomarker potential of the ASRGL1 protein in endometrial carcinoma. Methods. Using The Human Protein Atlas (www.proteinatlas.org), the L-asparaginase (ASRGL1) protein was identified as an endometrial carcinoma biomarker candidate. ASRGL1 expression was immunohistochemically evaluated with an extensively validated antibody on two independent endometrial carcinoma cohorts (n = 229 and n = 286) arranged as tissue microarrays. Staining results were correlated with clinical features. Results. Reduced expression of ASRGL1, defined as <75% positively stained tumor cells, was significantly associated with poor prognosis and reduced disease-specific survival in endometrioid endometrial adenocarcinoma (EEA). In multivariate analysis the hazard ratios for disease-specific survival were 3.55 (95% CI = 1.10-11.43; p = 0.003) and 323 (95% Cl = 1.53-6.81; p = 0.002) in the two cohorts, respectively. Of the 48 cases with Grade 3 Stage I tumor all disease-related deaths were associated with low ASRGL1 expression. Conclusions. Loss of ASRGL1 in EEA is a powerful biomarker for poor prognosis and retained ASRGL1 has a positive impact on survival. ASRGL1 immunohistochemistry has potential to become an additional tool for prognostication in cases where tailoring adjuvant treatment according to additional prognostic factors besides grade and stage is recommended.

  • 9.
    Fonnes, Tina
    et al.
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Berg, Hege F.
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Bredholt, Therese
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Edqvist, Per-Henrik D.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi.
    Sortland, Kristina
    Univ Bergen, Dept Biomed, Bergen.
    Berg, Anna
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Salvesen, Helga B.
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Akslen, Lars A.
    Haukeland Hosp, Dept Pathol, Bergen; Univ Bergen, Ctr Canc Biomarkers, Dept Clin Med, Sect Pathol, Bergen.
    Werner, Henrica M. J.
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Trovik, Jone
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Tangen, Ingvild L.
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Krakstad, Camilla
    Univ Bergen, Ctr Canc Biomarkers, Dept Clin Sci, Bergen; Haukeland Hosp, Dept Obstet & Gynecol, Bergen.
    Asparaginase-like protein 1 is an independent prognostic marker in primary endometrial cancer, and is frequently lost in metastatic lesions2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 148, nr 1, s. 197-203Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    Loss of Asparaginase-like protein 1 (ASRGL1) has been suggested as a prognostic biomarker in endometrial carcinoma. Our objective was to validate this in a prospectively collected, independent patient cohort, and evaluate ASRGL1 expression in endometrial carcinoma precursor lesion and metastases.

    Methods

    782 primary endometrial carcinomas, 90 precursor lesions (complex atypical hyperplasia), and 179 metastases (from 87 patients) were evaluated for ASRGL1 expression by immunohistochemistry in relation to clinical and histopathological data. ASRGL1 mRNA level was investigated in 237 primary tumors and related to survival and ASRGL1 protein expression.

    Results

    Low expression of ASRGL1 protein and ASRGL1 mRNA predicted poor disease specific survival (P < 0.001). In multivariate survival analyses ASRGL1 had independent prognostic value both in the whole patient cohort (Hazard ratio (HR): 1.53, 95% confidence interval (CI): 1.04–2.26, P = 0.031) and within the endometrioid subgroup (HR: 2.64, CI: 1.47–4.74, P = 0.001). Low ASRGL1 expression was less frequent in patients with low grade endometrioid primary tumors compared to high grade endometrioid and non-endometrioid primary tumors, and ASRGL1 was lost in the majority of metastatic lesions.

    Conclusions

    In a prospective setting ASRGL1 validates as a strong prognostic biomarker in endometrial carcinoma. Loss of ASRGL1 is associated with aggressive disease and poor survival, and is demonstrated for the first time to have independent prognostic value in the entire endometrial carcinoma patient population.

  • 10.
    Gyllensten, Ulf
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Gustavsson, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Lindell, Monica
    Wilander, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Molekylär och morfologisk patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Primary high-risk HPV screening for cervical cancer in post-menopausal women2012Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 125, nr 2, s. 343-345Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. The present study was conducted to examine the value of screening for high-risk HPV in post-menopausal women.

    Methods. A cohort of post-menopausal women (n =2113), age range 55-76 years, from Uppsala County, Sweden, were offered testing for both high-risk HPV and a Pap smear in the gynaecological screening during 2008-2010. For the HPV test the cervical smear sample was applied to a filter paper matrix, an indicating FTA elute card and HPV typing performed using a real-time PCR assay. Histological verified CIN2+ lesion was used as an end-point measurement.

    Results. High-risk HPV were found in 6.2% (95% CI 5.2-7.3%) of the women (n = 130) and 22% (95% CI 14-32%) (n = 17) of these had CIN2 + lesions based on histology. The Pap smear taken in conjunction with the HPV test was abnormal in 9.7% (95% CI 5.7-16.3%) (n = 12) of HPV positive women. Among HPV positive women with an abnormal Pap smear, the frequency of histology verified CIN2+ lesions was 67% (95% Cl 38-86%) (n = 8), as compared to 14% (95% CI 7-24%) (n = 9) in HPV positive women with a normal smear. The prevalence of HPV16 in CIN2+ lesions (29%, 95% CI 22-37%) in post-menopausal women was less than half of previous estimates in pre-menopausal women from this population.

    Conclusions. Most histological CIN2+ lesions in post-menopausal women are not recognized by a single Pap smear. A large fraction of pre-invasive cervical cancer cases in post-menopausal women result from infections by HPV types not included in the present vaccine formulas.

  • 11.
    Heitz, F.
    et al.
    Evangelische Huyssens Stiftung, Germany; Charite Univ Med Berlin, Germany; Free Univ Berlin, Germany; Humboldt Unive Berlin, Germany; Berlin Inst Hlth, Germany; AGO Study Grp, Germany.
    Harter, P.
    Evangelische Huyssens Stiftung, Germany; AGO Study Grp, Germany.
    Åvall Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Linkoping, Sweden; NSGO Study Grp, Germany.
    Reuss, A.
    Coordinating Ctr Clin Trials, Germany; AGO Study Grp, Germany.
    Pautier, P.
    Inst Gustave Roussy, France; GINECO Study Grp, Germany.
    Cormio, G.
    Univ Bari, Italy; Natl Canc Inst Giovanni Paolo II, Italy; MITO Study Grp, Germany.
    Colombo, N.
    Univ Milano Bicocca, Italy; Inst Europeo Oncol, Italy; MaNGO Study Grp, Germany.
    Reinthaller, A.
    Med Univ Vienna, Austria; AGO Austria Study Grp, Austria.
    Vergote, I.
    Univ Leuven, Belgium; BGOG Study Grp, Austria.
    Poveda, A.
    Inst Valenciano Oncol, Spain; GEICO Study Grp, Spain.
    Ottevanger, P. B.
    Radboud Univ Nijmegen, Netherlands; DGOG Study Grp, Spain.
    Hanker, L. C.
    Univ Schleswig Holstein, Germany; AGO Study Grp, Germany.
    Leminen, A.
    Womens Hosp Med Ctr, Finland; NSGO Study Grp, Germany.
    Alexandre, J.
    Hop Univ Paris Ctr, France; GINECO Study Grp, Germany.
    Canzler, U.
    Tech Univ Dresden, Germany; AGO Study Grp, Germany.
    Sehouli, J.
    Charite Campus Virchow Klinikum, Germany; AGO Study Grp, Germany.
    Herrstedt, J.
    Odense Univ Hosp, Denmark; Zealand Univ, Denmark; NSGO Study Grp, Germany.
    Fiane, B.
    Stavanger Univ Hosp, Norway; NSGO Study Grp, Germany.
    Merger, M.
    Boehringer Ingelheim Pharma GmbH and Co KG, Germany.
    du Bois, A.
    AGO Study Grp, Germany.
    Early tumor regrowth is a contributor to impaired survival in patients with completely resected advanced ovarian cancer. An exploratory analysis of the Intergroup trial AGO-OVAR 122019Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 152, nr 2, s. 235-242Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Surgical assessment of residual tumor provides the strongest prognostic information in advanced ovarian cancer (AOC), with the best outcome observed after complete resection. Postoperative radiological assessment before initiation of chemotherapy can supplement the information obtained by surgical assessment; however, it may also reveal conflicting findings. Methods. Patients with AOC enrolled in the AGO-OVAR 12 trial underwent baseline imaging before the first chemotherapy cycle. The findings from surgical and radiologic assessment for disease extend were compared. Additionally, an integrated approach was assessed. Results. Complete data from all 3 assessment methods were available for 1345 patients. Of 689 patients with complete resection, tumor was observed in 28% and 22% of patients undergoing radiologic and integrated assessment, respectively. Patients with surgical- radiological and surgical-integrated concordant findings showed a 5-year overall survival (5Y-OS) of 72% and 71%, whereas patients with surgical-radiological and surgical-integrated discordant results showed inferior 5Y-OS of 47% and 49%, respectively. Patients with surgically assessed residual disease had a 5-YOS of 37%. The interval between surgery and baseline assessment was independently associated with discordance between assessment methods, which might reflect early tumor regrowth. Conclusions. Baseline tumor assessment before chemotherapy provides information that stratifies patients with complete resection into different prognostic groups. Integrating the data from different assessment methods might lead to improved definitions of prognostic groups. Further investigation to determine if earlier initiation of chemotherapy after debulking surgery could increase survival of patients with early tumor regrowth is warranted. (C) 2018 Published by Elsevier Inc.

  • 12.
    Hellberg, Dan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Tot, Tibor
    Dept of Pathology and Clincal Cytology, Falun Central Hospital, Falun Sweden.
    Stendahl, Ulf
    Pitfalls in immunohistochemical validation of tumor marker expression: exemplified in invasive cancer of the uterine cervix2009Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 112, nr 1, s. 235-240Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To study if immunohistochemical expression of tumor markers as prognostic predictors is influenced by clinical stage, adjustments for expression of other tumor markers and histological type in cervical cancer. METHODS: The study included 129 women with squamous cell cancer and 29 women with adenocarcinomas. Expression of 9 tumor markers relevant for cervical cancer and selected to represent different mechanisms in carcinogenesis was analysed. These were Ki-67, c-myc, LRIG1, p-53, p-27, CD44, VEGF, Cox-2 and CD4+. RESULTS: In late-stage cancer a higher number of tumor-infiltrating CD4 positive cells were associated with a favourable prognosis while a higher Ki-67 index with a poor prognosis. In early-stage cancer a high LRIG1 expression was associated with a favourable prognosis. Significantly different expressions were found at early-stage versus at late-stage squamous cell cancer for VEGF, p27 and LRIG1 which were all more strongly expressed in early stages. Adjustments for all selected tumor markers and clinical stage converted VEGF and LRIG1 expression from non-significant to significant prognostic predictors while the association between p53 expression and good prognosis was strengthened. Adjustments for Cox-2 and c-myc had the strongest impact on VEGF as a prognosis predictor and LRIG1 was most influenced by adjustment for p53. All correlations became non-significant when women with adenocarcinoma and other invasive tumor types were included. CONCLUSIONS: Failure to analyse clinical stages separately, failure to adjust for expression of relevant concurrent tumor markers and inclusion of different histological subtypes into the same study group may lead to false conclusions regarding the significance of prognostic tumor markers.

  • 13. Hellberg, Dan
    et al.
    Tot, Tibor
    Stendahl, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Pitfalls in immunohistochemical validation of tumor marker expression--exemplified in invasive cancer of the uterine cervix.2009Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 112, nr 1, s. 235-240Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES:

    To study if immunohistochemical expression of tumor markers as prognostic predictors is influenced by clinical stage, adjustments for expression of other tumor markers and histological type in cervical cancer.

    METHODS:

    The study included 129 women with squamous cell cancer and 29 women with adenocarcinomas. Expression of 9 tumor markers relevant for cervical cancer and selected to represent different mechanisms in carcinogenesis was analysed. These were Ki-67, c-myc, LRIG1, p-53, p-27, CD44, VEGF, Cox-2 and CD4+.

    RESULTS:

    In late-stage cancer a higher number of tumor-infiltrating CD4 positive cells were associated with a favourable prognosis while a higher Ki-67 index with a poor prognosis. In early-stage cancer a high LRIG1 expression was associated with a favourable prognosis. Significantly different expressions were found at early-stage versus at late-stage squamous cell cancer for VEGF, p27 and LRIG1 which were all more strongly expressed in early stages. Adjustments for all selected tumor markers and clinical stage converted VEGF and LRIG1 expression from non-significant to significant prognostic predictors while the association between p53 expression and good prognosis was strengthened. Adjustments for Cox-2 and c-myc had the strongest impact on VEGF as a prognosis predictor and LRIG1 was most influenced by adjustment for p53. All correlations became non-significant when women with adenocarcinoma and other invasive tumor types were included.

    CONCLUSIONS:

    Failure to analyse clinical stages separately, failure to adjust for expression of relevant concurrent tumor markers and inclusion of different histological subtypes into the same study group may lead to false conclusions regarding the significance of prognostic tumor markers.

  • 14.
    Herzog, Thomas J.
    et al.
    Columbia University College of Physicians and Surgeons, New York, NY, USA.
    Vermorken, Jan B.
    Antwerp University Hospital, Edegem, Belgium.
    Pujade-Lauraine, Eric
    Hôspital Hotel-Dieu, Paris, France.
    Provencher, Diane M.
    Hôpital Notre-Dame, Montréal (Qc) H2L 4M1, Canada.
    Jagiello-Gruszfeld, Agnieszka
    Memorial Cancer Center, Warszawa, Poland.
    Kong, Beihua
    Qilu Hospital, Shandong University, Shandong, China.
    Boman, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Park, Youn Choi
    Johnson and Johnson Pharmaceutical Research and Development, L.L.C., Raritan, NJ, USA.
    Parekh, Trilok
    Johnson and Johnson Pharmaceutical Research and Development, L.L.C., Raritan, NJ, USA.
    Lebedinsky, Claudia
    PharmaMar, Colmenar Viejo, Madrid, Spain.
    Gomez, Javier
    PharmaMar, Colmenar Viejo, Madrid, Spain.
    Monk, Bradley J.
    Creighton University School of Medicine at St. Joseph's Hospital and Medical Center, a member of Catholic Healthcare West, Phoenix, AZ, USA.
    Correlation between CA-125 serum level and response by RECIST in a phase III recurrent ovarian cancer study2011Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 122, nr 2, s. 350-355Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To evaluate in a large phase III recurrent ovarian cancer trial (OVA-301): 1) the concordance between CA-125 level vs. best overall response (OR) and progression-free survival (PFS) determined by radiological assessment 2) the impact of early CA-125 changes over the subsequent radiological response, and 3) the prognostic value of CA-125 response and CA-125 PFS to predict radiological response and PFS.

    Methods: Assessment of response in the entire randomized population was performed by the Response Evaluation Criteria in Solid Tumors 1.0 (RECIST) and modified Rustin criteria for CA-125 determination.

    Results: Most CA-125 decreases were observed in RECIST responders (82% of patients treated with the combination and 74% in the PLD alone). CA-125 progression preceded REC1ST progression in 35% of patients with a median lead time of 8.4 weeks. A high concordance rate between CA-125 PFS status at 4 months (PFS4) and CA-125 response as a predictor of PFS4 (87%) and radiological response (79%) was found in the combination, with high positive predictive value for radiological PFS4 (92%) and high negative predictive value for OR (90%). An early CA-125 decrease was predictive for the ultimate response since it was found in a high rate of RECIST responders.

    Conclusion: Radiological response was preceded by a favorable predictive CA-125 decrease in a high proportion of patients, suggesting that CA-125 evaluation may be an appropriate tool for tumor assessment in patients with ovarian cancer.

  • 15. Huvila, J.
    et al.
    Laajala, T. D.
    Edqvist, P. -H
    Mardinoglu, Adil
    KTH, Centra, Science for Life Laboratory, SciLifeLab. Department of Biology and Biological Engineering, Chalmers University of Technology, 41296 Gothenburg, Sweden.
    Talve, L.
    Pontén, F.
    Grénman, S.
    Carpén, O.
    Aittokallio, T.
    Auranen, A.
    Combined ASRGL1 and p53 immunohistochemistry as an independent predictor of survival in endometrioid endometrial carcinoma2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 149, nr 1, s. 173-180Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: In clinical practise, prognostication of endometrial cancer is based on clinicopathological risk factors. The use of immunohistochemistry-based markers as prognostic tools is generally not recommended and a systematic analysis of their utility as a panel is lacking. We evaluated whether an immunohistochemical marker panel could reliably assess endometrioid endometrial cancer (EEC) outcome independent of clinicopathological information. Methods: A cohort of 306 EEC specimens was profiled using tissue microarray (TMA). Cost- and time-efficient immunohistochemical analysis of well-established tissue biomarkers (ER, PR, HER2, Ki-67, MLH1 and p53) and two new biomarkers (L1CAM and ASRGL1) was carried out. Statistical modelling with embedded variable selection was applied on the staining results to identify minimal prognostic panels with maximal prognostic accuracy without compromising generalizability. Results: A panel including p53 and ASRGL1 immunohistochemistry was identified as the most accurate predictor of relapse-free and disease-specific survival. Within this panel, patients were allocated into high- (5.9%), intermediate- (29.5%) and low- (64.6%) risk groups where high-risk patients had a 30-fold risk (P < 0.001) of dying of EEC compared to the low-risk group. Conclusions: P53 and ASRGL1 immunoprofiling stratifies EEC patients into three risk groups with significantly different outcomes. This simple and easily applicable panel could provide a useful tool in EEC risk stratification and guiding the allocation of treatment modalities. 

  • 16.
    Huvila, Jutta
    et al.
    Univ Turku, Turku Univ Hosp, Dept Pathol, Pl 52, FIN-20520 Turku, Finland.
    Laajala, Teemu D.
    Univ Turku, Dept Math & Stat, Pl20, Helsinki 00014, Finland;Univ Helsinki, FIMM, Inst Mol Med Finland, Pl20, FIN-00014 Helsinki, Finland.
    Edqvist, Per-Henrik D
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Mardinoglu, Adil
    KTH Royal Inst Technol, Sci Life Lab, S-10044 Stockholm, Sweden;Chalmers Univ Technol, Dept Biol & Biol Engn, S-41296 Gothenburg, Sweden.
    Talve, Lauri
    Univ Turku, Turku Univ Hosp, Dept Pathol, Pl 52, FIN-20520 Turku, Finland.
    Pontén, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Klinisk och experimentell patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Grenman, Seija
    Univ Turku, Turku Univ Hosp, Dept Gynaecol & Obstet, Pl52, FIN-20520 Turku, Finland.
    Carpen, Olli
    Univ Turku, Turku Univ Hosp, Dept Pathol, Pl 52, FIN-20520 Turku, Finland;Univ Helsinki, Dept Pathol, Helsinki, Finland;Finland HUSIAB, Pl720, Helsinki 00029, Finland.
    Aittokallio, Tero
    Univ Turku, Dept Math & Stat, Pl20, Helsinki 00014, Finland;Univ Helsinki, FIMM, Inst Mol Med Finland, Pl20, FIN-00014 Helsinki, Finland.
    Auranen, Annika
    Univ Tampere, Tampere Univ Hosp, Dept Gynaecol & Obstet, Pl2000, Tampere 33521, Finland.
    Combined ASRGL1 and p53 immunohistochemistry as an independent predictor of survival in endometrioid endometrial carcinoma2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 149, nr 1, s. 173-180Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. In clinical practise, prognostication of endometrial cancer is based on clinicopathological risk factors. The use of immunohistochemistry-based markers as prognostic tools is generally not recommended and a systematic analysis of their utility as a panel is lacking. We evaluated whether an immunohistochemical marker panel could reliably assess endometrioid endometrial cancer (EEC) outcome independent of clinicopathological information. Methods. A cohort of 306 EEC specimens was profiled using tissue microarray (TMA). Cost- and time-efficient immunohistochemical analysis of well-established tissue biomarkers (ER, PR, HER2, Ki-67, MLH1 and p53) and two new biomarkers (L1CAM and ASRGL1) was carried out. Statistical modelling with embedded variable selection was applied on the staining results to identify minimal prognostic panels with maximal prognostic accuracy without compromising generalizability. Results. A panel including p53 and ASRGL1 immunohistochemistry was identified as the most accurate predictor of relapse-free and disease-specific survival. Within this panel, patients were allocated into high- (5.9%), intermediate- (295%) and low- (64.6%) risk groups where high-risk patients had a 30-fold risk (P < 0.001) of dying of EEC compared to the low-risk group. Conclusions. P53 and ASRGL1 immunoprofiling stratifies EEC patients into three risk groups with significantly different outcomes. This simple and easily applicable panel could provide a useful tool in EEC risk stratification and guiding the allocation of treatment modalities.

  • 17. Huvila, Jutta
    et al.
    Talve, Lauri
    Carpen, Olli
    Edqvist, Per-Henrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Molekylär och morfologisk patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Pontén, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Molekylär och morfologisk patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Grenman, Seija
    Auranen, Annika
    Progesterone receptor negativity is an independent risk factor for relapse in patients with early stage endometrioid endometrial adenocarcinoma2013Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 130, nr 3, s. 463-469Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. In endometrioid endometrial adenocarcinoma (EEA), the currently established prognostic factors in clinical guidelines are stage and grade. Many guidelines include lymphovascular invasion (LVI) and tumor size as prognostic factors. Although several studies have associated lack of estrogen (ER) and progesterone receptor (PR) expression with reduced outcome, the prognostic use of these markers is uncommon. Better prognostication of clinical behavior would be useful in patients with early stage (I-II) disease. In this study we evaluated ER and PR as prognostic factors in EEA, and compared their expression with other potential biomarkers and clinical parameters. Methods. Tissue microarrays were constructed from 182 patients with stages I-II EEA. ER, PR, p53, Ki-67, PTEN, MLH and HER-2 expression were assessed by immunohistochemical staining and HER-2 was confirrried with SISH. The results were correlated with clinicopathologic parameters and to disease-free survival. Results. Eleven patients (6%) developed recurrent disease during a median follow up time of 62.8 months. In univariate analysis FIGO grade (p = 0.019), positive expression of p53 (p = 0.010) and negative PR expression (p = 0.001) were associated with a shorter disease-free survival. In multivariate analysis only negative PR expression (p = 0.019) was significantly associated with a shorter disease-free survival. LVI and tumor size where not of prognostic value. Conclusions. Lack of PR expression is a strong, independent risk factor for tumor recurrence in patients with stages I-II endometrioid endometrial cancer. The use of this easily measurable biomarker as a prognostic factor in the clinical context should be considered and tested in a larger patient population. 

  • 18.
    Idahl, Annika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Hermansson, Andrea
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Lalos, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Social support and ovarian cancer incidence: a Swedish prospective population-based study2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 149, nr 2, s. 324-328Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Low social support is associated with worse prognosis for epithelial ovarian cancer (EOC) patients. However, few studies have explored the relation between low social support and incidence of EOC. The aim of this prospective nested case-control study was to examine whether self-perceived low social support was associated with the incidence of EOC.

    Methods: The Swedish Cancer Registry was used to identify participants in the Vasterbotten Intervention Programme (VIP) comprising 58,000 women, who later developed EOC. Each case was matched to four cancer free controls. The VIP uses the Social Support questionnaire, a modified version of the validated questionnaire "The Interview Schedule for Social Interaction" (ISSI) measuring quantitative (AVSI) and qualitative (AVAT) aspects of social support.

    Results: The risk of EOC in relation to AVSI and AVAT was similar between the 239 cases and the 941 controls after adjustment for educational level, smoking, BMI, Cambridge Physical Activity Index and age (aOR 0.85, 95% CI 0.72-1.01 and aOR 0.54, 95% CI 0.16-1.81). Lagtime was found to have no impact. A decreased risk of serous ovarian cancer was seen in women with fewer persons available for informal socializing (aOR 0.75, 95% CI 0.59-0.95). Adjusted analyses showed non-significant odds ratios below 1.0 in the vast majority of histotypes.

    Conclusions: A general trend towards a decreased risk of ovarian cancer associated with low AVSI and AVAT was identified. Solely the serous subtype was significantly associated with low scores of AVSI. Prospective pathophysiological and epidemiological studies regarding social support are needed.

  • 19.
    Ivansson, Emma L.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för genetik och patologi.
    Juko-Pecirep, Ivana
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för genetik och patologi.
    Gyllensten, Ulf B.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för genetik och patologi.
    Interaction of immunological genes on chromosome 2q33 and IFNG in susceptibility to cervical cancer2010Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 116, nr 3, s. 544-548Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Cervical cancer is caused by persistent infection with human papillomavirus and genetic susceptibility factors may augment disease risk. The immune response consists of complex interactions and it was recently proposed that the association of combinations of genotypes at several genes should be examined. In support of this the combination CD28+17(TT)/IFNG+874(AA) was shown to increase cervical cancer risk in a Brazilian population (VB Guzman et al. New approach reveals CD28 and IFNG gene interaction in the susceptibility to cervical cancer. Hum Mol Genet 2008;17:1838-44) and our aim was to replicate this finding. METHODS: We re-examined the proposed associations by analysis of polymorphisms at CD28, IFNG, TNF, PDCD1, ICOS and CTLA4 in 1306 Swedish cases and 811 controls. RESULTS: Logistic regression analysis detected association at single SNP level for CD28+17 (p=0.01), IFNG+874 (p=0.02), and PDCD1+7785 (p=0.04). The two locus combination CD28+17(TT)/IFNG+874(AA) (OR=0.76 (0.60-0.96, empirical p=0.03) and the three-locus combination CD28+17(TT)/IFNG+874(AA)/ICOS+1564(TT) (OR=0.65(0.49-0.87), empirical p=0.006) were associated with decreased risk. The strongest association was detected for the combination CTLA4-319 (CC)/IFNG (AA) (OR=0.67(0.53-0.84), empirical p=0.0007). CONCLUSION: The observation that these combinations of loci are associated in different populations supports their importance in cervical cancer development although the opposite directions of the effect call for clarification. The polymorphisms studied might not be the functional variants per se, but linked to those exerting a functional effect. The opposite associations in the two populations could then be explained by differences in linkage disequilibrium and population structure.

  • 20.
    Joly, Florence
    et al.
    Centre François Baclesse, Medical Oncology Department, Caen, France.
    Ray-Coquard, Isabelle
    Centre Leon Bérard, Lyon, France .
    Fabbro, Michel
    CRLC Val d'Aurelle, Montpellier, France .
    Donoghoe, Mark
    NHMRC Clinical Trials Centre, Sydney, Australia.
    Boman, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Sugimoto, Akira
    London Regional Cancer Centre, London, UK.
    Vaughan, Michelle
    Christchurch Hospital, Christchurch, New Zealand .
    Reinthaller, Alexander
    Medical University Vienna, Department of Obstetrics and Gynecology, Vienna, Austria.
    Vergote, Ignace
    University Hospital Leuven, Department of Obstetrics and Gynecology, Leuven, Belgium .
    Ferrandina, Gabriella
    Università Cattolica del Sacro Cuore, Campobasso, Italy.
    Dell'anna, Tiziana
    San Gerardo Hospital, Gynecology Department, Monza, Italy.
    Huober, Jens
    University Hospital of Tübingen, Department of Gynecology, Tübingen, Germany .
    Pujade-Lauraine, Eric
    Université Paris Descartes, AP-HP, Hôpitaux Universitaires Paris Centre site Hôtel-Dieu, France.
    Decreased hypersensitivity reactions with carboplatin-pegylated liposomal doxorubicin compared to carboplatin-paclitaxel combination: analysis from the GCIG CALYPSO relapsing ovarian cancer trial2011Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 122, nr 2, s. 226-232Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To describe and analyze observed hypersensitivity reactions (HSR) from the randomized, multicenter phase III CALYPSO trial that evaluated the efficacy and safety of the combination of carboplatin and pegylated liposomal doxorubicin (CD) compared with standard carboplatin–paclitaxel (CP) in patients with platinum-sensitive relapsed ovarian cancer (ROC).

    Methods: HSR documented within case report forms and SAE reports were specifically analyzed. Analyses were based on the population with allergy of any grade and for grade > 2 allergy.

    Results: Overall 976 patients were recruited to this phase III trial, with toxicity data available for 466 and 502 on the CD and CP arms, respectively. There was a 15.5% HSR rate associated with CD (2.4% grade > 2) versus 33.1% with CP (8.8% grade > 2), p < 0.001. HSRs occurred more often during first cycle in the CD (46%) arm than in the CP arm (16%). Multivariate predictors of allergy were chemotherapy regimen and age; patients randomized to CD and patients ≥ 70 years old on CP had less allergy. Few patients (< 6%) stopped treatment due to allergy. Allergy rates were higher in patients who did not receive prior supportive treatment; however there was no relationship between allergy and the type of carboplatin product received, or response rate.

    Conclusions: Use of PLD with carboplatin instead of paclitaxel and older age were the only 2 factors predicting a low rate of HSRs in patients with ROC. CD has previously demonstrated superior progression-free survival and therapeutic index than CP. Taken together these data support the use of CD as a safe and effective therapeutic option for platinum-sensitive ROC.

  • 21.
    Juko-Pecirep, Ivana
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik.
    Ivansson, Emma L.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Gyllensten, Ulf B.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Genomik. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Evaluation of Fanconi anaemia genes FANCA, FANCC and FANCL in cervical cancer susceptibility2011Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 122, nr 2, s. 377-381Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Disrupting the function of any of the 13 Fanconi anaemia (FA) genes causes a DNA repair deficiency disorder, with patients being susceptible to a number of cancer types. Variation in the family of FA genes has been suggested to affect risk of cervical cancer. The current study evaluates the influence of three genes in the FA pathway on cervical cancer risk in Swedish women. Methods. TagSNPs in FANCA, FANCC and FANCL were selected using the Tagger algorithm in Haploview. A total of 81 tagSNPs were genotyped in 782 cases (CIN3 or ICC) and 775 controls using the Illumina GoldenGate Assay and statistically analyzed for association with cervical cancer. Results. 72 SNPs were successfully genotyped in >98% of the samples. Nominal associations were detected for FANCA rs11649196 (p = 0.05) and rs4128763 in FANCC (p = 0.02). The associations did not withstand correction for multiple testing. Conclusions. The current study does not support that genetic variation in FANCA, FANCC or FANCL genes affects susceptibility to cervical cancer in the Swedish population.

  • 22.
    Lillsunde-Larsson, Gabriella
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Helenius, Gisela
    Örebro universitet, Institutionen för läkarutbildning. Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Andersson, Sören
    Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Sorbe, Bengt
    Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Karlsson, Mats G.
    Region Örebro län. Örebro universitet, Institutionen för hälsovetenskap och medicin. Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Prognostic impact of human papilloma virus (HPV) genotyping and HPV-16 subtyping in vaginal carcinoma2013Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 129, nr 2, s. 406-411Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    The objectives of this study are to investigate the human papilloma virus (HPV) distribution in vaginal cancer and to evaluate HPV-genotype as well as HPV16-variant impact on prognosis.

    Methods

    Sixty-nine patients diagnosed with primary vaginal carcinoma (1975-2002) were included in the study. Detection of twelve high-risk HPV (hr HPV) and two low-risk HPV (lr HPV) was performed with realtime-PCR. Samples positive for HPV-16 were analyzed for variants in the E6-gene with PCR and pyrosequencing.

    Results

    53.6% (37/69) of the tumors were found to be HPV-positive, mostly for HPV-16 (N=26). Other HPV-types were HPV-18 (N=2), HPV-31 (N=2), HPV-33 (N=2), HPV-45 (N=1), HPV-52 (N=2), HPV-56 (N=1) and HPV-58 (N=1). Only European subtypes of HPV-16 were represented and the two most common HPV-16-variants were E-p (N=13) and E-G350 (N=11). Patients with HPV-positive tumors (N=37) had a significantly (log-rank test=3341; p = 0.0008) superior 5-year overall survival rate as well as cancer-specific survival rate and progression-free survival rate (p = 0.0002; p = 0.0004), compared with patients with HPV-negative tumors (N=32). Interestingly, patients with HPV-16-positive tumors had a superior overall survival compared with patients with tumors containing other HPV-genotypes. In a Cox proportional multivariate analysis age, tumor size, and HPV-status were independent and significant prognostic factors with regard to overall survival rate.

    Conclusions

    HPV-status is of prognostic importance in vaginal carcinoma and varies with viral genotype. In this era of HPV-vaccination, genotypes other than those included in the vaccination program could still lead to vaginal carcinoma with unfavorable prognosis.

  • 23.
    Lindström, Annika K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Asplund, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Molekylär och morfologisk patologi.
    Hellberg, Dan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Correlation between LRIG1 and LRIG2 expressions and expression of 11 tumor markers, with special reference to tumor suppressors, in CIN and normal cervical epithelium2011Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 122, nr 2, s. 372-376Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Novel biological markers LRIG1 and LRIG2 have been associated with favorable as well as poor prognosis, respectively, in different cancer types, including cervical cancer. The aim of this study was to investigate possible interactions between these proteins and other tumor markers, and as diagnostic adjuncts in CIN. Methods. Cervical biopsies from 171 women, with normal epithelium, and low-grade and high-grade CIN were stained for LRIG1 and LRIG2, and 11 additional tumor markers. The tumor markers were chosen to be relevant in cervical neoplasms. Staining was evaluated semiquantitatively. Results. Expression of LRIG1 and LRIG2 was found to correlate with increasing CIN grade, as well as with expression of tumor suppressor FHIT, independent of histological grade. In addition, tumor promoter LRIG2 expression correlated negatively with expression of tumor suppressor retinoblastoma protein and positively with IL-10. The latter correlation did not however remain after adjustment for CIN grade. p53 and p16 expressions correlated positively with LRIG1 expression in univariate analyses, but significance did not hold after adjustment for CIN grade. Conclusion. LRIG1 and LRIG2 expressions were seen in precancerous cervical epithelium and found to increase with increasing grade. There was an association between expression of these glycoproteins and FHIT tumor suppressor protein, independently of histological grade.

  • 24.
    Mattsson, Elisabet
    et al.
    Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Einhorn, Kim
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    Ljungman, Lisa
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Sundström Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Stålberg, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Wikman, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Women treated for gynaecological cancer during young adulthood: A mixed-methods study of perceived psychological distress and experiences of support from health care following end-of-treatment2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 149, nr 3, s. 464-469Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To investigate the prevalence and predictors of cancer-related distress in younger women treated for gynaecological cancer, and to explore women's needs and experiences of psychosocial support following end-of-treatment.

    METHODS:

    Data were collected from 337 gynaecological cancer survivors, 19-39years at diagnosis, using a study-specific questionnaire and the Swedish Quality Register of Gynaecologic Cancer. Predictors of distress were investigated with multivariable logistic regression analysis. Open-ended questions were analysed with content analysis.

    RESULTS:

    The prevalence of cancer-related distress was 85% (n=286) including fear of cancer-recurrence (n=175, 61%), anxiety (n=152, 53%), depression (n=145, 51%), fear of death (n=91, 32%), concerns regarding sexuality (n=87, 34%) and fertility (n=78, 27%), and changed body image (n=78, 27%). Multi-modal treatment (OR 2.25, 95% CI 1.13-4.49) and a history of psychological distress (OR 3.44, 95% CI 1.41-8.39) predicted cancer-related distress. The majority of women experiencing distress also reported a need for support after end-of-treatment (n=205, 71%). One-third of those receiving support reported the received support as inadequate (n=55, 34%). Eight categories described reasons for not seeking support, e.g., lacked strength to seek professional support and too busy managing every-day life and, wanted help but did not know who to turn to. Four categories described reasons for not receiving sought support e.g., found it difficult to openly express feelings, psychosocial care was under-dimensioned, insufficient and unprofessional.

    CONCLUSION:

    Results identify the importance of support and longer-term follow-up for young survivors of gynaecological cancer. The support needs to be organised to meet this group's specific needs.

  • 25.
    Mattsson, Elisabet
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Einhorn, Kim
    Uppsala universitet.
    Ljungman, Lisa
    Karolinska institutet.
    Sundström-Poromaa, Inger
    Uppsala universitet.
    Stålberg, Karin
    Uppsala universitet.
    Wikman, Anna
    Uppsala universitet.
    Women treated for gynaecological cancer during young adulthood: A mixed-methods study of perceived psychological distress and experiences of support from health care following end-of-treatment.2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 149, nr 3, s. 464-469, artikel-id S0090-8258(18)30235-XArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the prevalence and predictors of cancer-related distress in younger women treated for gynaecological cancer, and to explore women's needs and experiences of psychosocial support following end-of-treatment.

    METHODS: Data were collected from 337 gynaecological cancer survivors, 19-39years at diagnosis, using a study-specific questionnaire and the Swedish Quality Register of Gynaecologic Cancer. Predictors of distress were investigated with multivariable logistic regression analysis. Open-ended questions were analysed with content analysis.

    RESULTS: The prevalence of cancer-related distress was 85% (n=286) including fear of cancer-recurrence (n=175, 61%), anxiety (n=152, 53%), depression (n=145, 51%), fear of death (n=91, 32%), concerns regarding sexuality (n=87, 34%) and fertility (n=78, 27%), and changed body image (n=78, 27%). Multi-modal treatment (OR 2.25, 95% CI 1.13-4.49) and a history of psychological distress (OR 3.44, 95% CI 1.41-8.39) predicted cancer-related distress. The majority of women experiencing distress also reported a need for support after end-of-treatment (n=205, 71%). One-third of those receiving support reported the received support as inadequate (n=55, 34%). Eight categories described reasons for not seeking support, e.g., lacked strength to seek professional support and too busy managing every-day life and, wanted help but did not know who to turn to. Four categories described reasons for not receiving sought support e.g., found it difficult to openly express feelings, psychosocial care was under-dimensioned, insufficient and unprofessional.

    CONCLUSION: Results identify the importance of support and longer-term follow-up for young survivors of gynaecological cancer. The support needs to be organised to meet this group's specific needs.

  • 26. Mattsson, Elisabet
    et al.
    Wikman, Anna
    women tresteg for gynaecological cancer during Young adulthood2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859Artikel i tidskrift (Refereegranskat)
  • 27.
    Nelson, G.
    et al.
    Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary AB, Canada.
    Altman, A. D.
    Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg MB, Canada.
    Nick, A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, USA.
    Meyer, L. A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, USA.
    Ramirez, P. T.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, USA.
    Achtari, C.
    Department of Obstetrics and Gynecology, Lausanne University Hospital, Lausanne, Switzerland.
    Antrobus, J.
    Department of Anesthesiology, Borders General Hospital, Melrose, United Kingdom.
    Huang, J.
    Anesthesiologists of Greater Orlando, Orlando FL, USA.
    Scott, M.
    Department of Anaesthesia and Intensive Care Medicine, Royal Surrey County NHS Foundation Hospital, Guildford, United Kingdom; Surrey Peri-operative Anaesthesia Critical Care Research group (SPACeR) Clinical Academic Group, FHMS, University of Surrey, Guildford, United Kingdom.
    Wijk, Lena
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Obstetrics and Gynecology, Örebro University Hospital, Örebro, Sweden.
    Acheson, N.
    Department of Gynaecologic Oncology, Royal Devon & Exeter NHS Foundation Trust, Exeter, United Kingdom.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för läkarutbildning. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Dowdy, S. C.
    Division of Gynecologic Surgery, Mayo Clinic College of Medicine, Rochester MN, USA.
    Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS (R)) Society recommendations - Part II2016Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 140, nr 2, s. 323-332Artikel i tidskrift (Refereegranskat)
  • 28.
    Nelson, G.
    et al.
    Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
    Altman, A. D.
    Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg MB, Canada.
    Nick, A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, United States.
    Meyer, L. A.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, United States.
    Ramirez, P. T.
    Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, United States.
    Achtari, C.
    Department of Obstetrics and Gynecology, Lausanne University Hospital, Lausanne, Switzerland.
    Antrobus, J.
    Department of Anesthesiology, Borders General Hospital, Melrose, United Kingdom.
    Huang, J.
    Anesthesiologists of Greater Orlando, Orlando FL, United States.
    Scott, M.
    Department of Anaesthesia and Intensive Care Medicine, Royal Surrey County NHS Foundation Hospital, Guildford, United Kingdom; Surrey Peri-operative Anaesthesia Critical Care Research group (SPACeR), Clinical Academic Group, FHMS, University of Surrey, Guildford, United Kingdom.
    Wijk, Lena
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Obstetrics and Gynecology,, Örebro University Hospital, Örebro, Sweden.
    Acheson, N.
    Department of Gynaecologic Oncology, Royal Devon & Exeter NHS Foundation Trust, Exeter, United Kingdom.
    Ljungqvist, Olle
    Örebro universitet, Institutionen för läkarutbildning. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Dowdy, S. C.
    Division of Gynecologic Surgery, Mayo Clinic College of Medicine, Rochester MN, United States.
    Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS (R)) Society recommendations - Part I2016Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 140, nr 2, s. 313-322Artikel i tidskrift (Refereegranskat)
  • 29.
    Roncolato, Felicia T
    et al.
    NHMRC Clinical Trials Centre, University of Sydney, Australia; Macarthur Cancer Therapy Centre, NSW, Australia; Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia.
    Berton-Rigaud, Dominique
    ICO Centre René Gauducheau, Saint Herblain, France.
    O'Connell, Rachel
    NHMRC Clinical Trials Centre, University of Sydney, Australia.
    Lanceley, Anne
    University College London, United Kingdom.
    Sehouli, Jalid
    Charite Berlin, Germany.
    Buizen, Luke
    NHMRC Clinical Trials Centre, University of Sydney, Australia.
    Okamoto, Aikou
    Jikei University School of Medicine, Japan.
    Aotani, Eriko
    Kitasato Academic Research Organization, Japan.
    Lorusso, Domenica
    MITO, Rome, Italy.
    Donnellan, Paul
    Galway University Hospital, Ireland; All-Ireland Oncology Research Group (ICORG), Ireland.
    Oza, Amit
    Princess Margaret Hospital, Canada.
    Åvall-Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Onkologiska kliniken US. Karolinska Institutet, Stockholm, Sweden.
    Berek, Jonathan
    Stanford Women's Cancer Center, USA.
    Hilpert, Felix
    Klinik fur Gynakologie und Geburtshilfe, UKSH, Germany.
    Ledermann, Jonathan A
    CRUK and UCL Cancer Trials Centre, NCRI UK, United Kingdom.
    Kaminsky, Marie Christine
    ICL Institut de Cancérologie de Lorraine, Vandoeuvre-Les-Nancy, France.
    Stockler, Martin R
    NHMRC Clinical Trials Centre, University of Sydney, Australia.
    King, Madeleine T
    Psycho-oncology Research Group (PoCoG), School of Psychology, Central Clinical School, Sydney Medical School, University of Sydney, Australia.
    Friedlander, Michael
    Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Prince of Wales Hospital, Sydney, Australia.
    Validation of the modified Glasgow Prognostic Score (mGPS) in recurrent ovarian cancer (ROC): Analysis of patients enrolled in the GCIG Symptom Benefit Study (SBS)2018Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 148, nr 1, s. 36-41, artikel-id S0090-8258(17)31422-1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Modified Glasgow Prognostic Score (mGPS) is predictive of survival in many advanced cancers, but has not been evaluated in recurrent ovarian cancer (ROC). The aim was to determine validity of mGPS in ROC, investigate its associations with health related quality of life (HRQL) and ECOG performance status (PS).

    METHODS: mGPS is based on serum C reactive protein (CRP) and albumin, with scores ranging from 0 (least) to 2 (most). HRQL was measured with EORTC QLQ C-30 and OV-28. χ2 tests for trend were used to examine the relationship between HRQL, PS and mGPS. Cox proportional hazards regression was used to assess associations between mGPS, HRQL, clinicopathological factors, and overall survival (OS).

    RESULTS: Inflammatory markers were available in 516 of 948 patients in GCIG SBS. 200(39%) had potentially platinum sensitive ROC with ≥3 lines of chemotherapy, 316(61%) had platinum resistant ROC. 282(55%), 123(24%), 111(22%) had mGPS of 0, 1, 2, respectively. Median OS (months) was 18.1, 9.6, and 6.6 for mGPS 0, 1, and 2 respectively. mGPS was an independent predictor of OS after adjusting for PS and platinum sensitivity (p<0.001). mGPS remained a predictor of OS after adjusting for physical function, role function, global health status, abdominal/GI symptoms, and multiple clinicopathologic factors (p=0.02). Worse PS and higher mGPS were associated with poorer HRQL (p<0.001). Higher mGPS was associated with worse HRQL, independent of PS.

    CONCLUSION: The mGPS is an independent predictor of OS in ROC after adjusting for HRQL and clinicopathological factors. Higher mGPS is associated with worse HRQL independent of PS. mGPS is simple, inexpensive and may be suitable for clinical practice, clinical trial patient selection and stratification.

  • 30.
    Silins, Ilvars
    et al.
    Oncology Center of Latvia, Riga, Latvia / Department of Gynecologic Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden / Department of Medical Microbiology, MAS University Hospital, Malmö, Sweden.
    Wang, Xiaodong
    Linköpings universitet, Institutionen för teknik och naturvetenskap, Fysik och elektroteknik. Linköpings universitet, Tekniska högskolan. Department of Medical Microbiology, MAS University Hospital, Malmö, Sweden.
    Tadesse, Amha
    Merck Research Laboratories, West Point, PA 19486, USA.
    Jansen, Kathrin U
    Merck Research Laboratories, West Point, PA 19486, USA.
    Schiller, John T
    Laboratory of Cellular Oncology, The National Cancer Institute, Bethesda, MD 20892, USA.
    Åvall-Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Department of Gynecologic Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
    Frankendal, Bo
    Department of Gynecologic Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
    Dillner, Joakim
    Department of Medical Microbiology, MAS University Hospital, Malmö, Sweden.
    A population-based study of cervical carcinoma and HPV infection in Latvia.2004Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 93, nr 2, s. 484-492Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: We wished to quantify the population-based importance of cervical carcinoma risk factors in Latvia.

    METHODS: Totally, 223 of 224 eligible cases of incident invasive cervical carcinoma were enrolled during July 1998-February 2001 in Latvia. An age-matched sample of 300 healthy control women was selected from the Latvian population registry and 239 of these women (79%) were enrolled. A demographic and life-style questionnaire was completed, cervical brush samples were analyzed for human papillomavirus (HPV) DNA by PCR and serum samples for HPV antibodies.

    RESULTS: Risk factors for cervical cancer in multivariate analysis were HPV type 16 or 18 DNA positivity (OR = 32.4; CI 95% 16.5-63.6) and living in the capital (OR = 2.4; CI 95% 1.2-4.7). Oral contraceptive use was not a risk factor (OR = 0.4; CI 95% 0.2-1.1). A strong protective effect was found for having had more than three Pap smears in the last 5 years (OR = 0.07 CI 95% 0.03-0.19).

    CONCLUSIONS: Inadequate population coverage of Pap smears, in spite of excessive smear usage, caused 28.4% of cervical cancers in age groups eligible for screening. HPV type 16 infection was the most important risk factor for cervical cancer in Latvia, with a population-attributable risk percent for all ages of 58.5%.

  • 31.
    Silins, Ilvars
    et al.
    Department of Medical Microbiology, MAS University Hospital, S-20502, Malmö, Sweden / Department of Gynaecologic Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
    Åvall-Lundqvist, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Department of Gynaecologic Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
    Tadesse, Amha
    Merck Research Laboratories, West Point, Pennsylvania, USA.
    Jansen, Kathrin U
    Merck Research Laboratories, West Point, Pennsylvania, USA.
    Stendahl, Ulf
    Department of Oncology, Umeå University, Umeå, Sweden.
    Lenner, Per
    Department of Oncology, Umeå University, Umeå, Sweden.
    Zumbach, Klaus
    Applied Tumour Virology, Deutsches Krebsforschungszentrum, Heidelberg, Germany.
    Pawlita, Michael
    Department of Medical Microbiology, MAS University Hospital, S-20502, Malmö, Sweden.
    Dillner, Joakim
    Department of Medical Microbiology, MAS University Hospital, S-20502, Malmö, Sweden.
    Frankendal, Bo
    Department of Gynaecologic Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
    Evaluation of antibodies to human papillomavirus as prognostic markers in cervical cancer patients.2002Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 85, nr 2, s. 333-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: We wished to evaluate whether the presence of antibodies to HPV or to the HPV oncoproteins E6 and E7 or type of HPV DNA is related to prognosis among cervical cancer patients.

    METHODS: Blood samples were drawn from 313 patients with incident, untreated cervical cancer on admission to two hospitals in Sweden. Patients were followed from enrollment in 1984-1991 until death or up to June 1999. Clinical information was obtained from a review of medical records. Survival and cause of death were ascertained from both medical records and population-based cancer registries. The correlation of survival with antibodies to HPV16, to oncoproteins E6 and E7, and to type of HPV DNA was evaluated using multivariate Cox regression analysis, including stage, age, histology, and hospital in the model.

    RESULTS: Stage was the only significant prognostic factor influencing cervical cancer patient survival (OR = 3.62, 95% CI = 2.71-4.83). Age over 50 was associated with increased death rate among stage I-IIa patients (OR = 2.29, 95% CI = 1.12-4.68). Presence of antibodies to the oncoproteins E6 and E7 or to the HPV16 capsid or type of HPV DNA did not associate significantly with disease prognosis.

    CONCLUSIONS: Antibodies to HPV16 capsids and to oncoproteins E6 and E7 or type of HPV DNA do not appear to be useful as indicators of cervical cancer prognosis.

  • 32.
    Singh, Neha
    et al.
    Department of Biotechnology, Panjab University, Chandigarh, India / Centre for Stem Cell and Tissue Engineering, Panjab University, Chandigarh, India.
    Sobti, R. C.
    Department of Biotechnology, Panjab University, Chandigarh, India.
    Suri, Vanita
    Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
    Nijhawan, Raje
    Department of Cytology and Gynae Pathology, PGIMER, Sector-12, Chandigarh, India.
    Sharma, Shweta
    Division of Molecular Genetics and Biochemistry, Institute of Cytology and Preventive Oncology (ICMR), NOIDA, India.
    Das, B. C.
    Dr. B.R. Ambedkar Research Centre for Biomedical Research (ACBR), University of Delhi (North Campus), Delhi, 110 007, INDIA.
    Bharadwaj, Mausumi
    Division of Molecular Genetics and Biochemistry, Institute of Cytology and Preventive Oncology (ICMR), NOIDA, India.
    Hussain, Showket
    Division of Molecular Genetics and Biochemistry, Institute of Cytology and Preventive Oncology (ICMR), NOIDA, India.
    Downregulation of tumor suppressor gene PML in uterine cervical carcinogenesis: impact of human papillomavirus infection (HPV)2013Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 128, nr 3, s. 420-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Cervical cancer is a leading gynecological cancer in Indian women and is caused due to infection with high risk human pappilloma virus (HR-HPV) 16 and 18. It has been well documented that PML (promyelocytic leukemia) enhances viral infectivity and plays a crucial role in antiviral response mechanisms. The aim of the present study was to evaluate the role of PML gene with context to HPV infection in cervical carcinogenesis.

    METHODS: The expression pattern of PML was analyzed by western blotting and immunohistochemistry in a total of 170 fresh surgically resected cervical tissue specimens comprising precancer (n=12), cancer (n=118) and normal controls (n=40) recruited from PGIMER, Chandigarh, India. HPV status was analyzed by L1 consensus PCR followed by type specific PCR for HR-HPV types 16 and 18 and low risk types 6 and 11.

    RESULTS: A significant downregulation of PML protein was observed in the majority of cervical cancer and precancer cases 68% (89/130) compared to normal controls. The loss of expression pattern of PML gene was significantly increased with severity of disease both clinically and pathologically (p<0.001). HPV infection was detected in the majority of cancer cases 96% (113/118) and in 83% (10/12) of precancer lesions whereas no infection could be detected in normal controls. Interestingly, all the 68% (89/130) cervical cancer cases that showed downregulation of PML were HPV infected (p=0.0001).

    CONCLUSION: Taken together, these observations suggest that the downregulation of PML gene and its synergism with HPV infection may play an important role and may serve as a new marker for early diagnosis and therapeutic intervention for cervical carcinogenesis.

  • 33.
    Skírnisdóttir, Ingiridur
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Garmo, Hans
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Holmberg, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Non-genital tract metastases to the ovaries presented as ovarian tumors in Sweden 1990-2003: occurrence, origin and survival compared to ovarian cancer2007Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 105, nr 1, s. 166-171Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim of this register study was to determine occurrence of non-genital ovarian metastasis detected by gynecologic surgery presented as ovarian neoplasm in Sweden from 1 January 1990 to 31 December 2003. Origin of metastases and time of detection in relation to surgery were recorded. Age at diagnosis, survival for ovarian metastasis compared to ovarian cancer and prognostic factors were evaluated. METHODS: Utilizing the population-based Swedish In-Patient Registry, Cancer Registry and Causes of Death Registry, we identified 255 cases with non-genital tract metastases to the ovaries detected at gynecological surgery. During the study period, 10,955 newly diagnosed cases of ovarian cancer were reported to the Swedish Cancer Registry. RESULTS: The proportion of ovarian metastases detected at surgery of all ovarian neoplasm increased from 1.7% to 3.0% during the study period. The patients with ovarian metastasis of non-GI origin were younger than patients with primary ovarian cancer. The most common primary diseases were breast cancer (29%), colon cancer (27%) and gastric cancer (16%). Ovarian metastasis of GI origin preceded primary diagnosis in 51% of patients but for women with disease of non-GI origin the primary diagnosis was made in 18% of patients after surgery. Five-year survival for patients with ovarian metastasis of GI origin was 11% and it was 24% if metastases were of non-GI origin. Five-year survival for women with ovarian metastases from breast cancer was 26%. In a multivariate analysis, GI surgery at primary surgery for ovarian metastasis was unfavorable prognostic factor. Diagnosis of primary disease known before surgery, primary disease of non-GI or unknown origin and operation at university hospital all had favorable prognostic impact for overall survival. CONCLUSIONS: Detection of non-genital ovarian metastasis at gynecologic surgery is associated with poor prognosis, and prognosis is worse in tumors with GI origin and if the primary is not detected prior to surgery. The results indicate that a thorough patient evaluation is very important before surgery for suspected ovarian neoplasm.

  • 34.
    Stålberg, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Svensson, T.
    Lonn, S.
    Kieler, H.
    The influence of comorbidity on mortality in ovarian cancer patients2014Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 133, nr 2, s. 298-303Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Ovarian cancer is a severe disease with a peak incidence in the older age groups where concurrent morbidity is common and could potentially influence mortality rates. Objectives. The aim was to study the influence of common comorbidity diagnoses on mortality in ovarian cancer patients. Methods. The study population was patients with ovarian cancer in Sweden 1993-2006 (n = 11.139) identified in the national Cancer Register. Comorbidity data was obtained from the Patient Register and mortality from Cause of Death Register. Mortality was analyzed with Cox' proportional hazards models and subgroup analyses were performed by age and tumor histology. Results. Almost all of the assessed comprbidities increased mortality in ovarian cancer patients. Thromboembolism was the most hazardous comorbidity (HR = 1.95, <1 year after cancer diagnosis and HR = 7.83, 1-5 years after cancer diagnosis) followed by hematologic complications (HR = 1.84 and 7.11 respectively) and infectious disease (HR = 1.48 and 5.28 respectively). The occurrence of diabetes mellitus and hypertension had less impact on mortality. Conclusion. Thromboembolism, hematologic complications and infections had a pronounced effect on mortality rates in women with ovarian cancer. The impact of comorbidity was mainly apparent among those with a more prosperous prognosis, such as longer time since cancer diagnosis, less aggressive tumors and younger age. (C) 2014 Elsevier Inc. All rights reserved.

  • 35. Sörensen, Peter
    et al.
    Höjer, Morten
    Jakobsen, Anders
    Malmström, Henric
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Onkologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Onkologiska kliniken US.
    Havsteen, Hanne
    Bertelsen, Kamma
    Phase II study of vinorelbine in the treatment of platinum-resistant ovarian carcinoma2001Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 81, nr 1, s. 58-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. The purpose of this phase II study was to evaluate on an intent-to-treat basis the activity and toxicity of single-agent vinorelbine (VRL) as second-line chemotherapy of patients with platinum-resistant ovarian cancer. Platinum-resistant disease was defined as disease refractory to or relapsing within 12 months after finishing platinum-containing chemotherapy. Methods. VRL (30 mg/m2) was administered intravenously as a bolus injection days 1 and 8 every 21 days. Initially, four courses of VRL were given. Patients with responding or stable disease received four more courses of VRL to a maximum of eight courses. Results. Twenty-eight of 33 eligible patients were considered evaluable for response. The overall response rate was 21% (7/33) (95% CI: 7-35). Median time to progression was 3.1 months and median survival was 10.1 months. Toxicity was generally mild. Leukopenia was the dose-limiting toxicity. CALGB grade III/IV infection was observed in 15/0% of patients. The most important nonhematologic toxicities were nausea and constipation. Grade III/IV nausea was observed in 6/0% and grade III/IV constipation in 3/3% of patients. Peripheral neurotoxicity was only a minor problem with no grade III/IV toxicity. No patients stopped treatment because of toxicity and no toxic death was reported. Conclusion. VRL was generally well tolerated, but the activity in platinum-resistant ovarian cancer was only modest, although fully comparable to other second-line treatments. Further studies are required to define the role of VRL in combination chemotherapy for ovarian cancer.

  • 36.
    Tzortzatos, Gerasimos
    et al.
    Karolinska Inst, Karolinska Univ Hosp, Dept Womens & Childrens Hlth, Div Obstet & Gynecol, S-17176 Solna, Sweden..
    Andersson, Emil
    Karolinska Inst, Karolinska Univ Hosp, Dept Womens & Childrens Hlth, Div Obstet & Gynecol, S-17176 Solna, Sweden..
    Soller, Maria
    Skane Univ Hosp, Dept Clin Genet, S-21428 Malmo, Sweden..
    Askmalm, Marie Stenmark
    Linkoping Univ, Dept Clin Pathol & Clin Genet, Fac Hlth Sci, Cty Council Ostergotland, S-58185 Linkoping, Sweden.;Linkoping Univ, Dept Clin & Expt Med, Cty Council Ostergotland, Fac Hlth Sci, S-58185 Linkoping, Sweden..
    Zagoras, Theofanis
    Univ Gothenburg, Sahlgrenska Univ Hosp, Sahlgrenska Acad, Dept Clin Genet,Inst Biomed, S-41345 Gothenburg, Sweden..
    Georgii-Hemming, Patrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi.
    Lindblom, Annika
    Karolinska Inst, Karolinska Univ Hosp, Dept Clin Genet, S-17176 Solna, Sweden.;Karolinska Inst, Dept Mol Med & Surg, S-17176 Solna, Sweden..
    Tham, Emma
    Karolinska Inst, Karolinska Univ Hosp, Dept Clin Genet, S-17176 Solna, Sweden.;Karolinska Inst, Dept Mol Med & Surg, S-17176 Solna, Sweden..
    Mints, Miriam
    Karolinska Inst, Karolinska Univ Hosp, Dept Womens & Childrens Hlth, Div Obstet & Gynecol, S-17176 Solna, Sweden..
    The gynecological surveillance of women with Lynch Syndrome in Sweden2015Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 138, nr 3, s. 717-722Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Women with Lynch syndrome (LS) have up to a 60% lifetime risk of endometrial cancer (EC) and up to a 24% risk of ovarian cancer (OC). Gynecological surveillance is recommended, but the benefit and how it should be performed remain unclear. The purpose of this study was to assess diagnostic modalities for gynecological screening of LS patients in Sweden and clinical outcome. Methods. A retrospective nationwide study of 170 women with molecularly confirmed LS. Data including gynecological LS screening history, biopsy results (if any), genetic records, number of screening visits, results from screening including transvaginal ultrasound (TVUS), endometrial biopsy (EB), blood test for tumor marker cancer antigen (CA) 125, prophylactic surgery including age at procedure, and setting from which screening data were obtained from medical records. Results. A total of 117 women were eligible for gynecological screening and of these, 86 patients attended screening visits. Of these, 41 underwent prophylactic hysterectomy and/or bilateral salpingo-oophorectomy. Two patients (4.9%) were diagnosed with EC and two (4.9%) with precancerous lesions in conjunction with prophylactic surgery. Total incidence of gynecological cancer in the surveillance group (45 women) was 20% EC, 4% OC. Five patients had endometrial cancer or complex hyperplasia with atypia (n = 2) detected by endometrial biopsy. Four additional cases were detected due to interval bleeding. Both cases of ovarian cancer were detected by transvaginal ultrasound in patients with ovarian cysts under surveillance. The youngest woman with endometrial cancer was diagnosed at 35 years of age, before she was aware of her diagnosis of Lynch syndrome. Conclusions. Gynecological surveillance of women with Lynch syndrome may lead to earlier detection of precancerous lesions, which might have some impact on the morbidity from endometrial cancer although further studies are needed to prove this. Prophylactic hysterectomy with or without bilateral salpingo-oophorectomy reduces the cancer incidence. A practical approach to surveillance in Lynch syndrome women would be to offer annual surveillance beginning at age 30 years including probably both TVUS and EB in order to increase diagnostic yield with prospective data registry for follow-up studies. Prophylactic surgery could be performed at a suitable age after childbearing to obtain a balance between reducing the risk of cancer and minimizing long-term complications from premature menopause. (C) 2015 Elsevier Inc. All rights reserved.

  • 37.
    Tzortzatos, Gerasimos
    et al.
    Karolinska Institute, Sweden.
    Andersson, Emil
    Karolinska Institute, Sweden.
    Soller, Maria
    Skåne University Hospital, Sweden.
    Stenmark Askmalm, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för cellbiologi. Region Östergötland, Diagnostikcentrum, Klinisk patologi och klinisk genetik. Linköpings universitet, Medicinska fakulteten.
    Zagoras, Theofanis
    University of Gothenburg, Sweden.
    Georgii-Hemming, Patrik
    Uppsala University, Sweden.
    Lindblom, Annika
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Tham, Emma
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Mints, Miriam
    Karolinska Institute, Sweden.
    The gynecological surveillance of women with Lynch Syndrome in Sweden2015Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 138, nr 3, s. 717-722Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Women with Lynch syndrome (LS) have up to a 60% lifetime risk of endometrial cancer (EC) and up to a 24% risk of ovarian cancer (OC). Gynecological surveillance is recommended, but the benefit and how it should be performed remain unclear. The purpose of this study was to assess diagnostic modalities for gynecological screening of LS patients in Sweden and clinical outcome. Methods. A retrospective nationwide study of 170 women with molecularly confirmed LS. Data including gynecological LS screening history, biopsy results (if any), genetic records, number of screening visits, results from screening including transvaginal ultrasound (TVUS), endometrial biopsy (EB), blood test for tumor marker cancer antigen (CA) 125, prophylactic surgery including age at procedure, and setting from which screening data were obtained from medical records. Results. A total of 117 women were eligible for gynecological screening and of these, 86 patients attended screening visits. Of these, 41 underwent prophylactic hysterectomy and/or bilateral salpingo-oophorectomy. Two patients (4.9%) were diagnosed with EC and two (4.9%) with precancerous lesions in conjunction with prophylactic surgery. Total incidence of gynecological cancer in the surveillance group (45 women) was 20% EC, 4% OC. Five patients had endometrial cancer or complex hyperplasia with atypia (n = 2) detected by endometrial biopsy. Four additional cases were detected due to interval bleeding. Both cases of ovarian cancer were detected by transvaginal ultrasound in patients with ovarian cysts under surveillance. The youngest woman with endometrial cancer was diagnosed at 35 years of age, before she was aware of her diagnosis of Lynch syndrome. Conclusions. Gynecological surveillance of women with Lynch syndrome may lead to earlier detection of precancerous lesions, which might have some impact on the morbidity from endometrial cancer although further studies are needed to prove this. Prophylactic hysterectomy with or without bilateral salpingo-oophorectomy reduces the cancer incidence. A practical approach to surveillance in Lynch syndrome women would be to offer annual surveillance beginning at age 30 years including probably both TVUS and EB in order to increase diagnostic yield with prospective data registry for follow-up studies. Prophylactic surgery could be performed at a suitable age after childbearing to obtain a balance between reducing the risk of cancer and minimizing long-term complications from premature menopause. (C) 2015 Elsevier Inc. All rights reserved.

  • 38. Ulmer, Hanno
    et al.
    Björge, Tone
    Concin, Hans
    Lukanova, Annekatrin
    Manjer, Jonas
    Hallmans, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Borena, Wegene
    Häggström, Christel
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Engeland, Anders
    Almquist, Martin
    Jonsson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Selmer, Randi
    Stattin, Pär
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Tretli, Steinar
    Kleiner, Andrea
    Stocks, Tanja
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Nagel, Gabriele
    Metabolic risk factors and cervical cancer in the metabolic syndrome and cancer project (Me-Can)2012Ingår i: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859, Vol. 125, nr 2, s. 330-335Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Little is known about the association between metabolic risk factors and cervical cancer carcinogenesis.

    MATERIAL AND METHODS: During mean follow-up of 11years of the Me-Can cohort (N=288,834) 425 invasive cervical cancer cases were diagnosed. Hazard ratios (HRs) were estimated by the use of Cox proportional hazards regression models for quintiles and standardized z-scores (with a mean of 0 and a SD of 1) of BMI, blood pressure, glucose, cholesterol, triglycerides and MetS score. Risk estimates were corrected for random error in the measurements.

    RESULTS: BMI (per 1SD increment) was associated with 12%, increase of cervical cancer risk, blood pressure with 25% and triglycerides with 39%, respectively. In models including all metabolic factors, the associations for blood pressure and triglycerides persisted. The metabolic syndrome (MetS) score was associated with 26% increased corrected risk of cervical cancer. Triglycerides were stronger associated with squamous cell carcinoma (HR 1.48; 95% CI, 1.20-1.83) than with adenocarcinoma (0.92, 0.54-1.56). Among older women cholesterol (50-70years 1.34; 1.00-1.81), triglycerides (50-70years 1.49, 1.03-2.16 and ≥70years 1.54, 1.09-2.19) and glucose (≥70years 1.87, 1.13-3.11) were associated with increased cervical cancer risk.

    CONCLUSION: The presence of obesity, elevated blood pressure and triglycerides were associated with increased risk of cervical cancer.

1 - 38 av 38
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf