126
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Lyratzopoulos G, West CR, Williams EMI. Socioeconomic variation in colon cancer tumour factors associated with poorer prognosis. Br J Cancer 2003; 89:828-30. [PMID: 12942112 PMCID: PMC2394465 DOI: 10.1038/sj.bjc.6601192] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Analysis of population-based registry data (n=7393) showed that more deprived colon cancer patients had lower risk of the mucin-producing adenocarcinoma subtype, proximal subsite (to the descending colon), and no greater risk of high-grade tumours. Tumour factors therefore appear unlikely to account for socioeconomic gradients in survival.
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127
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Goodman MT, Tung KH. Active and passive tobacco smoking and the risk of borderline and invasive ovarian cancer (United States). Cancer Causes Control 2003; 14:569-77. [PMID: 12948288 DOI: 10.1023/a:1024828309874] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE A population-based case-control study was conducted to examine the hypothesis that active and passive tobacco smoking were associated with the risk of epithelial ovarian cancer. METHODS In-person interviews were obtained from 558 women with epithelial ovarian cancer (431 invasive, 127 borderline) and 607 population controls regarding active lifetime tobacco smoking, environmental tobacco smoke exposure in utero and during childhood, and other factors that may be related to the development of ovarian cancer. RESULTS No significant associations of ever or former tobacco smoking with the risk of invasive or borderline ovarian cancer were found, although long-term ex-smokers of 20 years or more were at significantly reduced risk of invasive cancer. Significant, positive dose-response relations of the number of cigarettes smoked per day and pack-years with the odds ratios for borderline cancer were evident. No association of active tobacco smoking with risk was found by histologic subtype of invasive ovarian cancer. Smokers were at significantly increased risk for borderline serous cystadenoma (OR: 1.91; 95% confidence intervals, CI: 1.09-3.34), but not for borderline mucinous cystadenoma. When we limited the analyses to current smokers, age-started smoking was significantly inversely related to the risk of invasive, but not borderline ovarian cancer. We found no association of gestational or childhood environmental tobacco smoke exposure with the risk of invasive or borderline ovarian cancer among never smokers. CONCLUSIONS These findings do not support an association of active tobacco smoking with the risk of invasive ovarian cancer. An increased risk of borderline serous cystadenoma among smokers must be viewed with caution.
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128
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El-Hennawy MM, Moussa MEM, El-Saeidy MK, Shawky AM, Bessa SS, Badour NM. Rectal carcinoma in Egyptian patients less than 40 years of age. Int Surg 2003; 88:137-44. [PMID: 14584768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
In Egypt, there is an increasing incidence of colorectal cancer, especially among patients < or = 40 years of age. The aim of this work was to study the characteristics of rectal cancer in a group of young Egyptian patients treated at Alexandria Main University hospital, Alexandria, Egypt, from June 1998 to June 2001. This study included 50 rectal cancer patients. They were divided into two groups. Group I was patients < 40 years of age (26 patients), and group II was patients > 40 years of age (24 patients). Both groups were evaluated regarding history taking and physical examination, the gross tumor characteristics, the presence or absence of metastases, the histopathological characteristics of the tumor, and the treatment failure within the 3-year period of this study. Group I patients had a significantly longer duration of complaint. A total of 15.4% of patients in this group presented with intestinal obstruction compared with 8.3% in group II. A total of 30.8% of patients in group I presented with metastatic disease compared with 20.8% in group II. More patients in group I had fixed and/or circumferential lesions than did those of group II (38.5% and 53.8% versus 20.8% and 8.3%, respectively). More patients in group I had nonresectable tumors. A total of 62.5% of group II patients underwent curative resection compared with 53.8% of the patients in group I. A total of 38.5% of patients in group I had mucoid carcinoma compared with 8.3% in group II. At the end of the 3-year period of this study, only 38.5% of group I patients were alive and free of disease compared with 45.8% in group II. In Egypt, rectal cancer patients <40 years of age have more advanced disease at presentation and a higher incidence of treatment failure caused by both a delay in the diagnosis and a more aggressive pattern of the disease.
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129
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Seidman JD, Kurman RJ, Ronnett BM. Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis. Am J Surg Pathol 2003; 27:985-93. [PMID: 12826891 DOI: 10.1097/00000478-200307000-00014] [Citation(s) in RCA: 271] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mucinous carcinomas are reported to comprise 6-25% of ovarian carcinomas (mean 12%), but recent refinements in the interpretation of histologic features of noninvasive and metastatic mucinous carcinomas suggest that this may be an overestimate. Mucinous carcinomas in the ovaries are commonly metastatic, but the proportion of primary versus metastatic mucinous carcinomas in unselected patients is unknown. To evaluate the histologic-type distribution of ovarian surface epithelial carcinomas, a consecutive series of 124 ovarian carcinomas was reviewed using uniform current criteria. Microinvasive and intraepithelial carcinomas and carcinomas arising in germ cell and stromal tumors were excluded. To evaluate the proportions of primary and metastatic tumors among the mucinous carcinomas, 52 consecutive mucinous carcinomas from nonreferral patients were reviewed. Three of 124 primary ovarian carcinomas were pure mucinous carcinomas (2.4%). Among 52 cases of mucinous carcinomas in the ovaries, 40 (77%) were metastatic and 12 (23%) were primary. Among the 12 primary mucinous tumors, three were atypical proliferative mucinous tumors with microinvasion and nine were invasive mucinous carcinomas. Among the 40 metastatic mucinous tumors, 18 (45%) were from the gastrointestinal tract, 8 (20%) were pancreatic, 7 (18%) were gynecologic malignancies (5 cervical, 2 endometrial), 3 (8%) were from the breast, and 4 (10%) were of unknown primary site. A simple rule that classifies all bilateral mucinous carcinomas as metastatic, unilateral mucinous carcinomas <10 cm as metastatic, and unilateral mucinous carcinomas >or=10 cm as primary correctly classified 90% of the neoplasms. This algorithm for distinguishing primary and metastatic mucinous carcinomas in the ovary can be used at the time of intraoperative consultation to guide surgical management. After careful exclusion of noninvasive, microinvasive, and metastatic tumors, pure mucinous adenocarcinoma primary in the ovary appears to be substantially less common than previously reported.
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130
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Kim SP, Hwang MS, Cho YR, Kwon SY, Kang YN, Kim IH, Sohn SS, Mun KC, Kwon TK, Lee SR, Suh SI. Mutations of the BAK gene are infrequent in advanced gastric adenocarcinomas in Koreans. Cancer Lett 2003; 195:87-91. [PMID: 12767516 DOI: 10.1016/s0304-3835(02)00585-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The bcl-2 homologue antagonist/killer (BAK) is a potently apoptosis-inducing gene and plays an important role in modulating apoptosis in epithelial cells. We have analyzed the mutation of the entire coding region of BAK gene in 107 Korean advanced gastric adenocarcinomas by polymerase chain reaction-single strand conformation polymorphism and sequencing. Homozygous deletions were not found in these samples. Only three cases of 107 gastric adenocarcinomas (2.8%) exhibited the BAK mutations. Two of them exhibited missense mutations and the remaining one had a silent mutation. All of these mutations were exclusively detected in exon 2. Mutations in the BAK gene were observed only in advanced gastric adenocarcinomas with extensive metastases of regional lymph nodes. The data presented here suggest that the mutations of BAK gene rarely occurred in advanced gastric adenocarcinomas.
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131
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Goodman MT, Howe HL. Descriptive epidemiology of ovarian cancer in the United States, 1992-1997. Cancer 2003; 97:2615-30. [PMID: 12733127 DOI: 10.1002/cncr.11339] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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132
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Roffers SD, Wu XC, Johnson CH, Correa CN. Incidence of extraovarian primary cancers in the United States, 1992-1997. Cancer 2003; 97:2643-7. [PMID: 12733129 DOI: 10.1002/cncr.11346] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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133
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Adsay NV. The "new kid on the block": Intraductal papillary mucinous neoplasms of the pancreas: current concepts and controversies. Surgery 2003; 133:459-63. [PMID: 12773972 DOI: 10.1067/msy.2003.127] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
MESH Headings
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/physiopathology
- Adenocarcinoma, Mucinous/therapy
- Adenocarcinoma, Papillary/epidemiology
- Adenocarcinoma, Papillary/pathology
- Adenocarcinoma, Papillary/physiopathology
- Adenocarcinoma, Papillary/therapy
- Carcinoma, Pancreatic Ductal/epidemiology
- Carcinoma, Pancreatic Ductal/pathology
- Carcinoma, Pancreatic Ductal/physiopathology
- Carcinoma, Pancreatic Ductal/therapy
- Humans
- Incidence
- Pancreatic Neoplasms/epidemiology
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/physiopathology
- Pancreatic Neoplasms/therapy
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134
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Tollefson MK, Libsch KD, Sarr MG, Chari ST, DiMagno EP, Urrutia R, Smyrk TC. Intraductal papillary mucinous neoplasm: did it exist prior to 1980? Pancreas 2003; 26:e55-8. [PMID: 12657965 DOI: 10.1097/00006676-200304000-00023] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Intraductal papillary mucinous neoplasm (IPMN) of the pancreas was first reported in 1982. It is not clear whether the appearance of this neoplasm is a new epidemic or an old disease previously overlooked. AIM To determine whether IPMN existed as a separate entity before 1982. METHODOLOGY We reviewed our pathology reports from all cases of pancreatic cancer diagnosed between 1960 and 1980. Pathologic specimens with descriptors--"mucinous," "cystic," or "papillary"--underwent histologic reexamination. Medical records for patients given a new diagnosis of IPMN from this pathologic review were assessed. RESULTS Eighty-four of more than 4,000 pathology reports reviewed contained a key word triggering histologic review. IPMN was identified in 21 patients. Patients had a mean age of 63 years (range, 44-77 years) with symptoms present for a mean of 76 months (median, 15 months; range, 1-516 months). Reported symptoms were abdominal pain in 17, jaundice in 13, weight loss in 12, and pancreatic insufficiency in 7 patients. On pathologic review, the in situ component was graded as adenoma in 4, borderline in 4, and carcinoma in 13. Parenchymal invasion was present in 11/21 (52%). Excluding four postoperative mortalities, mean time to death was 58 months (median, 15 months; range, 2-264 months). Seven patients died of IPMN, 4 of other causes without evidence of recurrence, and 6 of unknown causes. CONCLUSIONS IPMN existed in its current known form prior to 1982. Our study cannot determine whether the prevalence or incidence has changed since that time.
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135
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Clay KA, Fickling WE, Delegge MH. Intraductal papillary mucinous tumor of the pancreas and multiple adenomas of the colon. Gastrointest Endosc 2003; 57:420-3. [PMID: 12612535 DOI: 10.1067/mge.2003.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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136
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Faught W, Le T, Fung Kee Fung M, Krepart G, Lotocki R, Heywood M. Early ovarian cancer: what is the staging impact of retroperitoneal node sampling? JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2003; 25:18-21. [PMID: 12548321 DOI: 10.1016/s1701-2163(16)31078-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Comprehensive surgical staging of apparent early-stage epithelial ovarian cancer includes peritoneal washings, biopsies, and retroperitoneal lymph node dissection. Unresolved is the relative frequency or importance of the lymph node dissection. OBJECTIVES (1) To determine the site(s) of microscopic metastatic disease in women undergoing a comprehensive staging for apparent early-stage cancer of the ovary; (2) to identify those women with metastases in the retroperitoneal lymph nodes alone. METHODS Between 1985 and 2000, we reviewed all records of women at cancer centres in Winnipeg, Ottawa, and Saskatoon who had undergone a "staging laparotomy" for an apparent early-stage IA epithelial cancer of the ovary. Histology, tumour grade, initial and final surgical stage, and the site(s) of metastatic disease were recorded for all cases. RESULTS Forty-three of the 128 women (34%) had a final surgical stage of II or III. Sixteen women had positive pelvic biopsies, while 19 had microscopic upper abdominal disease. Eight women had positive retroperitoneal nodes, and in only 2 of these women, disease was found in the retroperitoneal nodes alone. In the 8 women with nodal disease, 5 had grade 3 tumours and 6 had serous histology tumours. CONCLUSION Comprehensive staging is important to identify women with metastatic disease. Solitary nodal metastases are predominantly found in grade 3 and serous tumours.
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Abstract
Neoplastic cysts of the pancreas have been recognized since the nineteenth century, and although differences between neoplastic and proliferative cysts were acknowledged, they were treated similarly, first by marsupialization and later by internal drainage. Increased awareness of the malignant potential of neoplastic cysts, as well as advances in surgical techniques, made excision the preferred treatment for these lesions as early as the 1940s, but errors in diagnosis were frequent, and even to this date, continue to account for cases of pancreatic cystic tumors treated by drainage.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/surgery
- Boston/epidemiology
- Cystadenoma, Mucinous/diagnosis
- Cystadenoma, Mucinous/epidemiology
- Cystadenoma, Mucinous/surgery
- Cystadenoma, Serous/diagnosis
- Cystadenoma, Serous/epidemiology
- Cystadenoma, Serous/surgery
- Diagnosis, Differential
- Diagnostic Errors
- Drainage/methods
- Drainage/standards
- Hospitals, General
- Humans
- Pancreatectomy/methods
- Pancreatectomy/standards
- Pancreatectomy/statistics & numerical data
- Pancreatic Cyst/diagnosis
- Pancreatic Cyst/epidemiology
- Pancreatic Cyst/surgery
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/epidemiology
- Pancreatic Neoplasms/surgery
- Papilloma, Intraductal/diagnosis
- Papilloma, Intraductal/epidemiology
- Papilloma, Intraductal/surgery
- Survival Analysis
- Treatment Outcome
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138
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Bounds BC. Diagnosis and fine needle aspiration of intraductal papillary mucinous tumor by endoscopic ultrasound. Gastrointest Endosc Clin N Am 2002; 12:735-45, vii. [PMID: 12607783 DOI: 10.1016/s1052-5157(02)00031-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A recently established clinical entity, intraductal papillary mucinous tumor (IPMT) of the pancreas embraces a spectrum of pathology ranging from benign to malignant disease. IPMT must be differentiated from other cystic neoplasms of the pancreas, as well as inflammatory cystic lesions. As the pancreas lies in close proximity to the gastric and duodenal walls, endoscopic ultrasonography (EUS) is ideally suited for imaging the pancreas. Additionally, EUS facilitates fine needle aspiration of pancreatic cysts and/or a dilated pancreatic duct for cytologic and tumor marker analysis. This article presents a brief history of IPMT, differential diagnosis, current imaging modalities, findings of cytologic and tumor marker analysis, prognosis, and treatment strategy. Special emphasis is dedicated to the role of EUS, as well as EUS with fine needle aspiration.
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MESH Headings
- Adenocarcinoma, Mucinous/classification
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/epidemiology
- Biopsy, Needle/adverse effects
- Biopsy, Needle/methods
- Biopsy, Needle/standards
- Cholangiopancreatography, Endoscopic Retrograde
- Diagnosis, Differential
- Endosonography/adverse effects
- Endosonography/methods
- Endosonography/standards
- Humans
- Neoplasm Staging/methods
- Neoplasm Staging/standards
- Pancreatic Neoplasms/classification
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/epidemiology
- Papilloma, Intraductal/classification
- Papilloma, Intraductal/diagnosis
- Papilloma, Intraductal/epidemiology
- Prognosis
- Reproducibility of Results
- Sensitivity and Specificity
- Ultrasonography, Interventional/adverse effects
- Ultrasonography, Interventional/methods
- Ultrasonography, Interventional/standards
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139
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Modugno F, Ness RB, Cottreau CM. Cigarette smoking and the risk of mucinous and nonmucinous epithelial ovarian cancer. Epidemiology 2002; 13:467-71. [PMID: 12094103 DOI: 10.1097/00001648-200207000-00016] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The association between cigarette smoking and ovarian cancer may vary according to the histologic type of tumor. METHODS We examined cigarette smoking as a risk factor for both mucinous and nonmucinous tumors in a population-based case-control study comparing 767 incident cases of epithelial ovarian cancer with 1,367 community controls frequency matched to cases by age and race. RESULTS Smoking was associated with mucinous tumors (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.3-2.9) but not with nonmucinous tumors (OR = 1.1; CI = 0.9-1.3). Furthermore, the odds ratios for smokers with mucinous tumors increased with increasing pack-years of smoking (OR = 1.0, 1.9, and 2.7 for <5, 5-24, and > 24+ pack-years, respectively; P for trend = 0.01) CONCLUSIONS Cigarette smoking appears to be a risk factor for mucinous but not for nonmucinous tumors.
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140
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Riman T, Dickman PW, Nilsson S, Correia N, Nordlinder H, Magnusson CM, Weiderpass E, Persson IR. Hormone replacement therapy and the risk of invasive epithelial ovarian cancer in Swedish women. J Natl Cancer Inst 2002; 94:497-504. [PMID: 11929950 DOI: 10.1093/jnci/94.7.497] [Citation(s) in RCA: 138] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Estrogen replacement therapy (ERT), which is mainly used to relieve climacteric symptoms, increases a woman's risk for uterine endometrial cancer and epithelial ovarian cancer (EOC). Estrogens are often combined with progestins in hormone replacement therapy (HRT) to reduce the risk of uterine endometrial cancer. Data on the association between HRT including progestins and EOC risk are limited. This nationwide case-control study examined EOC risk in relation to HRT regimens with sequentially added progestins (HRTsp) and continuously added progestins (HRTcp). METHODS Between 1993 and 1995, we enrolled 655 histologically verified incident case patients with EOC and 3899 randomly selected population controls, all 50-74 years of age. Data on HRT use were collected through mailed questionnaires. Multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by the use of unconditional logistic regression. RESULTS Risks of EOC were elevated among ever users as compared with never users of both ERT (OR = 1.43, 95% CI = 1.02 to 2.00) and HRTsp (OR = 1.54, 95% CI = 1.15 to 2.05); risks were elevated for serous, mucinous, and endometrioid subtypes. For all EOC types combined, the greatest risk increases were seen with hormone use exceeding 10 years. Ever use of HRTcp was not associated with increased EOC risk relative to HRTcp never use (OR = 1.02, 95% CI = 0.73 to 1.43). The risk of EOC was elevated among HRTsp ever users as compared with HRTcp ever users (OR = 1.78, 95% CI = 1.05 to 3.01). ORs for EOC after ever use of low-potency estrogens were 1.18 (95% CI = 0.89 to 1.55) for oral and 1.33 (95% CI = 1.03 to 1.72) for vaginal applications, but no relationship was seen between EOC risk and duration of use. CONCLUSION Ever users of ERT and HRTsp but not HRTcp may be at increased risk of EOC.
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141
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Paramo JC, Wilson C, Velarde D, Giraldo J, Poppiti RJ, Mesko TW. Pure mucinous carcinoma of the breast: is axillary staging necessary? Ann Surg Oncol 2002; 9:161-4. [PMID: 11888873 DOI: 10.1007/bf02557368] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mucinous carcinoma of the breast (MCB) may be associated with a low risk of axillary metastases. METHODS To evaluate the incidence of axillary nodal metastasis in MCB, a review of all cases from January 1990 to July 2000 was performed. Pure MCB was defined as all tumor cells being completely surrounded by mucin. Patient demographics, tumor size, estrogen receptor status, total number of dissected lymph nodes, and incidence of nodal metastasis were studied. Deeper sections on the lymph nodes from the pure tumors were performed and stained with low-molecular cytokeratin. RESULTS Nineteen cases of pure MCB and 41 cases of mixed MCB were identified. Patients with pure MCB were older than those with mixed MCB. Tumor size and estrogen receptor status showed no statistically significant differences between the two groups. None of the patients with pure MCB demonstrated lymph node metastases, whereas 12 of 41 cases with mixed MCB demonstrated metastatic lymph node involvement. CONCLUSIONS Because pure MCB seems unlikely to metastasize, axillary lymph node staging in these patients may not be necessary. The presence of lymph node metastases strongly indicates the presence of a mixed MCB.
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142
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Hemminki K, Granström C. Morphological types of breast cancer in family members and multiple primary tumours: is morphology genetically determined? Breast Cancer Res 2002; 4:R7. [PMID: 12100745 PMCID: PMC116721 DOI: 10.1186/bcr444] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2002] [Accepted: 03/22/2002] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND We conducted the present study to determine whether breast cancer morphology is genetically determined. METHODS Using the nationwide Swedish Family Cancer Database, which includes data on 10.2 million individuals and over 25,000 morphology-specific breast cancers, we followed morphological types in familial cancers between mothers and daughters and between sisters. Additionally, we recorded morphological data in women who presented with two primary breast cancers and in those who presented with an invasive and in situ breast cancer. We used kappa statistics to examine the association between genetics and morphology. A kappa value of 0 indicates that the process is random and a value of 1 indicates that it is completely determined (i.e. genetic); values between 0.40 and 0.60 are considered to indicate a moderately determined process. RESULTS The study sample included a total of 25,730 first and 3394 second invasive breast cancers, and 2990 in situ breast cancers. Ductal, lobular, tubuloductal and comedo were the most common invasive types. We identified 164 mother-daughter pairs with breast cancer of a defined morphology, yielding a low kappa value of 0.08. Among 100 sister pairs the kappa value was 0.002. In individuals with two primary breast cancers the kappa values were 0.22 and 0.01 for two invasive and in situ-invasive pairs, respectively. However, for a tumour with a subsequent tumour detected in the contralateral breast less than 1 year later the kappa value was 0.47. CONCLUSION The data suggest that breast cancer morphology is not genetically determined. However, because of mixed morphologies and the overwhelming prevalence of ductal morphology, the results for rare morphologies should be interpreted with caution.
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MESH Headings
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/pathology
- Breast Neoplasms/epidemiology
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/epidemiology
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/genetics
- Carcinoma, Lobular/pathology
- Carcinoma, Papillary/epidemiology
- Carcinoma, Papillary/genetics
- Carcinoma, Papillary/pathology
- Databases, Factual
- Female
- Humans
- Neoplasms, Multiple Primary/epidemiology
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Second Primary/epidemiology
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Neoplastic Syndromes, Hereditary/epidemiology
- Neoplastic Syndromes, Hereditary/genetics
- Neoplastic Syndromes, Hereditary/pathology
- Paget's Disease, Mammary/epidemiology
- Paget's Disease, Mammary/genetics
- Paget's Disease, Mammary/pathology
- Phyllodes Tumor/epidemiology
- Phyllodes Tumor/genetics
- Phyllodes Tumor/pathology
- Registries
- Sweden/epidemiology
- Time Factors
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143
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Green A, Purdie D, Bain C, Siskind V, Webb PM. Cigarette smoking and risk of epithelial ovarian cancer (Australia). Cancer Causes Control 2001; 12:713-9. [PMID: 11562111 DOI: 10.1023/a:1011297403819] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We studied the association between cigarette smoking and ovarian cancer in a population-based case control study. METHODS A total of 794 women with histologically confirmed epithelial ovarian cancer who were aged 18-79 years and resident in one of three Australian states were interviewed, together with 855 controls aged 18-79 years selected at random from the electoral roll from the same states. Information was obtained about cigarette smoking and other factors including age, parity, oral contraceptive use, and reproductive factors. We estimated the relative risk of ovarian cancer associated with cigarette smoking, accounting for histologic type, using multivariable logistic regression to adjust for confounding factors. RESULTS Women who had ever smoked cigarettes were more likely to develop ovarian cancer than women who had never smoked (adjusted odds ratio (OR) = 1.5; 95% confidence interval (CI) = 1.2-1.9). Risk was greater for ovarian cancers of borderline malignancy (OR = 2.4; 95% CI = 1.4-4.1) than for invasive tumors (OR = 1.7; 95% CI = 1.2-2.4) and the histologic subtype most strongly associated overall was the mucinous subtype among both current smokers (OR = 3.2; 95% CI = 1.8-5.7) and past smokers (OR = 2.3; 95% CI = 1.3-3.9). CONCLUSIONS These data extend recent findings and suggest that cigarette smoking is a risk factor for ovarian cancer, especially mucinous and borderline mucinous types. From a public health viewpoint, this is one of the few reports of a potentially avoidable risk factor for ovarian cancer.
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144
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Belly RT, Rosenblatt JD, Steinmann M, Toner J, Sun J, Shehadi J, Peacock JL, Raubertas RF, Jani N, Ryan CK. Detection of mutated K12-ras in histologically negative lymph nodes as an indicator of poor prognosis in stage II colorectal cancer. Clin Colorectal Cancer 2001; 1:110-6. [PMID: 12445369 DOI: 10.3816/ccc.2001.n.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Stage II colorectal carcinoma is characterized by negative lymph node pathology as determined by conventional microscopic examination. These patients generally do not receive adjuvant therapy although 20%-30% will die from metastatic disease. To determine whether K-ras mutations at codon 12 could be used as a sensitive indicator of occult lymph node metastasis in stage II colon carcinoma, a retrospective study was performed using restriction endonuclease-mediated selective polymerase chain reaction (REMS-PCR) amplification. Of 106 colonic tumors analyzed, 46 were identified as positive for a K12-ras mutation in the primary tumor. Multiple lymph node samples from 38 of these 46 patients were examined by a sensitive nested PCR protocol for the presence of a K12-ras mutation. Of these 38 patients, 14 had 1 or more positive lymph nodes by PCR (37%) and 24 were negative for the mutation (63%). Of the 14 patients with a K12-ras mutation detected in lymph nodes, 8 died of the disease within 5 years (57%) compared to only 4 of the 24 patients with ras-negative lymph nodes (17%). The difference in time to death from disease, stratified using K12-ras status of lymph nodes, was statistically significant (P = 0.036; log-rank test). These results suggest K-ras mutation status of lymph nodes in patients with stage II colon cancer might identify a subgroup of patients who are more likely to develop recurrent and/or metastatic disease and benefit from adjuvant therapy. Larger studies are indicated to determine whether detection of K-ras mutation positivity in histologically negative lymph nodes portends a poor prognosis and to determine whether more aggressive use of adjuvant therapy is warranted.
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145
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Rubio CA, Befrits R, Ljung T, Jaramillo E, Slezak P. Colorectal carcinoma in ulcerative colitis is decreasing in Scandinavian countries. Anticancer Res 2001; 21:2921-4. [PMID: 11712787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
A total of 31 cases with Ulcerative Colitis (UC) and colorectal carcinoma were retrieved from the files of the Karolinska Hospital, Stockholm between 1951 and 1998. Sections from 16 colectomy specimens (operable cases) and 15 biopsies obtained at laparotomy (inoperable cases), were available for the study. Of the 31 patients reported here, 22 (71%) were 49 years of age or younger at the time of surgery for carcinoma. In comparison only 47 (5.5 %) of the 855 colorectal carcinomas without UC reported in the Stockholm area in 1990 were 49years of age oryounger. When this hospital was a referral Center (1951 through 1969) 18 cases of carcinoma in UC were operated between 1951 and 1960 (1.8 patients/year), but only 4 between 1961 and 1969 (0.44 patients/year). During the surveillance period of 29 years (1970 to March 1998) only 9 patients (0.31 cases/year) were found to have carcinoma complicating UC. Notably, 8 of the 9 patients were operated on between 1970 and December 1989 (0.42 patients/year), but only one case between January 1990 and March 1998 (0.11 patients/year). The data presented indicate that the frequency of carcinoma cases in pancolitics has decreased at this hospital, not only during the referral period, from 1.8 patients/year during the 50's to 0.40 patients/year during the 60's, but also during the surveillance period (from 0.44 patients/year/during the 70's and 80's to 0.11 patients/year between 1990 and March 1998). This, despite the incidence of UC in the Stockholm County remained stable for the past 40 years (4.2 to 5 patients/10(5) inhabitants) and that the population in the Stockholm County has steady increased since 1950. A review of the present literature indicated that the ris for colorectal carcinoma in pancolitics is presently decreasing, not only in Sweden but also in other Scandinavian countries.
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146
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Yamaguchi K, Tanaka M. Intraductal papillary-mucinous tumor of the pancreas: a historical review of the nomenclature and recent controversy. Pancreas 2001; 23:12-9. [PMID: 11451142 DOI: 10.1097/00006676-200107000-00002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A number of studies on mucin-producing cystic neoplasm of the pancreas have been reported since the first report of the tumor in 1982. There has been some controversy about nomenclatures and clinicopathologic entities of mucin-producing cystic tumor, mucinous cystic tumor, and intraductal papillary tumor of the pancreas. In 1996 and 1997, new classifications of pancreatic neoplasms were published by the World Health Organization (WHO) and Armed Forces Institute of Pathology (AFIP). According to the new WHO and AFIP classifications, mucin-producing cystic neoplasm of the pancreas corresponds mainly to intraductal papillary-mucinous tumor and mucinous cystic tumor of the pancreas. and these two diseases are independent conditions. Intraductal papillary-mucinous tumor is regarded as a unique clinical entity, but controversy remains about the term and clinicopathologic entity. Some confusion and problems remain betweeen the two lesions. In this review, we review their historical background, terminology, WHO and AFIP classification, and problems with classification.
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MESH Headings
- Adenocarcinoma, Mucinous/classification
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/history
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Papillary/classification
- Adenocarcinoma, Papillary/epidemiology
- Adenocarcinoma, Papillary/history
- Adenocarcinoma, Papillary/pathology
- Adult
- Aged
- Carcinoma, Pancreatic Ductal/classification
- Carcinoma, Pancreatic Ductal/epidemiology
- Carcinoma, Pancreatic Ductal/history
- Carcinoma, Pancreatic Ductal/pathology
- Cystadenoma/classification
- Cystadenoma/pathology
- Cystadenoma, Mucinous/classification
- Cystadenoma, Mucinous/pathology
- Female
- History, 20th Century
- Humans
- Male
- Middle Aged
- Ovary/pathology
- Pancreatic Cyst/pathology
- Pancreatic Ducts/pathology
- Pancreatic Neoplasms/classification
- Pancreatic Neoplasms/epidemiology
- Pancreatic Neoplasms/history
- Pancreatic Neoplasms/pathology
- Stromal Cells/pathology
- Terminology as Topic
- World Health Organization
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147
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Valette O, Cuilleron M, Debelle L, Antunes L, Mosnier JF, Régent D, Veyret C. [Imaging of intraductal papillary mucinous tumor of the pancreas: literature review]. JOURNAL DE RADIOLOGIE 2001; 82:633-45. [PMID: 11449165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Intraductal papillary-mucinous tumor (IPMT) is defined as a syndrome consisting of dilatation of the main pancreatic duct and/or branch ducts associated with mucin overproduction. The purpose was to evaluate the usefulness of different imaging techniques (CT, EUS, ERCP) for determination of tumor invasion and pancreatic extension. Diagnosis often is delayed because it is confused with chronic pancreatitis or cystic neoplasms of the pancreas. It is difficult to rule out invasive malignancy. MRCP can be an essential imaging modality because it is a non-invasive technique. Intraductal ultrasound or pancreatoscopy could become in the future an additional useful preoperative procedure. A high frequency of invasive carcinoma in patients operated for pancreatic IPMT is observed. Surgical resection should be extended until a normal tissue margin is encountered.
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MESH Headings
- Adenocarcinoma, Mucinous/classification
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/therapy
- Carcinoma, Pancreatic Ductal/classification
- Carcinoma, Pancreatic Ductal/diagnosis
- Carcinoma, Pancreatic Ductal/epidemiology
- Carcinoma, Pancreatic Ductal/therapy
- Carcinoma, Papillary/classification
- Carcinoma, Papillary/diagnosis
- Carcinoma, Papillary/epidemiology
- Carcinoma, Papillary/therapy
- Cholangiography
- Cholangiopancreatography, Endoscopic Retrograde/methods
- Cholangiopancreatography, Endoscopic Retrograde/standards
- Diagnosis, Differential
- Endosonography/methods
- Endosonography/standards
- Humans
- Magnetic Resonance Imaging/methods
- Magnetic Resonance Imaging/standards
- Pancreatic Neoplasms/classification
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/epidemiology
- Pancreatic Neoplasms/therapy
- Prognosis
- Reproducibility of Results
- Sensitivity and Specificity
- Tomography, X-Ray Computed/methods
- Tomography, X-Ray Computed/standards
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148
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Stern RC, Dash R, Bentley RC, Snyder MJ, Haney AF, Robboy SJ. Malignancy in endometriosis: frequency and comparison of ovarian and extraovarian types. Int J Gynecol Pathol 2001; 20:133-9. [PMID: 11293158 DOI: 10.1097/00004347-200104000-00004] [Citation(s) in RCA: 231] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
One thousand consecutive cases of surgically proven endometriosis were reviewed to evaluate the frequency and types of pelvic cancers that were associated with ovarian and extraovarian endometriosis. The frequency and types of histologic abnormalities present in the eutopic endometrium when cancers were noted in endometriosis were also evaluated. In the large subset of cases for which the authors were the primary pathologists and all foci of endometriosis were recorded, the frequency of malignancy was 10.8%. In contrast, the frequency was only 3.2% in cases diagnosed by others previously in our institution. Cancers were more commonly found in ovaries when endometriosis was present in that ovary (5%) compared to when endometriosis was present at other sites (1%). Clear cell and endometrioid carcinomas were the malignancies most commonly seen in ovaries containing endometriosis, while clear cell adenocarcinoma and adenosarcoma were most commonly seen in conjunction with extraovarian endometriosis. The association of endometriosis with endometrioid and clear cell carcinoma was much stronger than that of serous and mucinous tumors (p < .01). Concurrent endometrial pathology was commonly seen in cases of malignant transformation of endometriosis (32% of cases).
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149
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Abstract
Despite many similarities to colorectal cancer in adults, the rare childhood form has some peculiarities. Childhood mortality is greater among Negroes than Caucasians, particularly in boys, reflecting the rising incidence of this tumor in the young Negro population. In addition, the percentage of childhood cases with precancerous diseases (polyposis, colitis) appears greater than in adults. Most striking is the high percentage of mucin-producing tumors in young people with colorectal cancer. The mucoid tumors tend to occur after the age of 10 years, whereas younger children are more likely to develop non-mucoid carcinoma in an adenomatous polyp.
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150
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Yoshikawa H, Jimbo H, Okada S, Matsumoto K, Onda T, Yasugi T, Taketani Y. Prevalence of endometriosis in ovarian cancer. Gynecol Obstet Invest 2001; 50 Suppl 1:11-7. [PMID: 11093056 DOI: 10.1159/000052873] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Endometriosis may be the precursor of clear cell or endometrioid ovarian cancer. In this review, we focus on the prevalence of endometriosis in ovarian cancer and related clinical and epidemiological issues. According to 15 published reports, the rank order of the prevalence of endometriosis in each histologic type was clear cell (39.2%) > endometrioid (21.2%) > serous (3.3%) > mucinous type (3.0%). The high prevalence of endometriosis in clear cell and endometrioid types is a consistent finding in Japan and western countries. However, the incidence of the clear cell type is much higher (15-20% vs. 7-8%), and that of the endometrioid type is lower (7-16% vs. 18-26%), in Japan compared with western countries. This review is also concerned with the relationship between the presence of ovarian endometriosis and clinical features such as age, parity, menopausal status, clinical stage, and survival in ovarian cancer patients.
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