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Souza MACD, Zacchi SR, Viana KCG, Souza CBD, Zandonade E, Amorim MHC. Survival analysis of penile cancer patients treatedat a tertiary oncology hospital. CIENCIA & SAUDE COLETIVA 2018; 23:2479-2486. [PMID: 30137117 DOI: 10.1590/1413-81232018238.17692016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 08/18/2016] [Indexed: 11/21/2022] Open
Abstract
This article aims to estimate the specific survival of patients with penile cancer treated at a state tertiary oncology hospital. The study included 100 cases incidents patients with penile cancer treated at a cancer center, from 2000 to 2011, follow-up to December 31, 2012. The hospital-based cancer registry and medical records were used as data sources. We used the Kaplan-Meier method to estimate survival and the Cox model was used to assess prognostic factors. All had histology for penile cancer as a basis for diagnosis. For location of the 75% tumor were not specified, followed by 18% located in the glans, 04% in the foreskin. The median survival time was 49 months, 89% presented themselves between stages I and II. Patients with rural occupations had a mean survival time of 75.02 months, patients with non-rural occupations 42.14 months; Patients residing in metropolitan area - Espírito Santo had a mean survival time of 26.03 months, other patients 71.42 months; In patients with compromised lymph nodes, the mean survival time was 30.59 months, and in patients with no compromised lymph nodes, the mean survival time was 75.83 months. This study demonstrates reduced survival in non-rural workers who reside in metropolitan area and who present with compromised lymph nodes and metastasis.
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Affiliation(s)
- Marco Antônio Comper de Souza
- Programa de Pós-Graduação em Saúde Coletiva pela Universidade Federal do Espírito Santo. Av. Fernando Ferrari s/n, Goiabeiras. 29060-900 Vitoria ES Brasil.
| | - Sérgio Riguete Zacchi
- Programa de Pós-Graduação em Saúde Coletiva pela Universidade Federal do Espírito Santo. Av. Fernando Ferrari s/n, Goiabeiras. 29060-900 Vitoria ES Brasil.
| | | | - Camila Brandão de Souza
- Programa de Pós-Graduação de Enfermagem, Universidade Federal de São Paulo. São Paulo SP Brasil
| | - Eliana Zandonade
- Programa de Pós-Graduação em Saúde Coletiva pela Universidade Federal do Espírito Santo. Av. Fernando Ferrari s/n, Goiabeiras. 29060-900 Vitoria ES Brasil.
| | - Maria Helena Costa Amorim
- Programa de Pós-Graduação em Saúde Coletiva pela Universidade Federal do Espírito Santo. Av. Fernando Ferrari s/n, Goiabeiras. 29060-900 Vitoria ES Brasil.
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Darcey E, Boyle T. Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis. Cancer Treat Rev 2018; 70:30-40. [PMID: 30055462 DOI: 10.1016/j.ctrv.2018.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND While a number of studies indicate tobacco smoking has a detrimental impact on survival and recurrence after a prostate cancer diagnosis, there has been no quantitative review of this literature and it is unclear whether tobacco smoking affects clinical populations differentially. We conducted a systematic review and meta-analysis to investigate the associations between tobacco smoking and overall (OM) and prostate cancer-specific (PSM) mortality and recurrence after a prostate cancer diagnosis. METHODS EMBASE and ISI Web of Science were searched for English-language studies, published up to August 17, 2017, which conducted a survival analysis to estimate the association between tobacco smoking and OM, PSM and/or recurrence. A random-effects meta-analysis was conducted to estimate the summary hazard ratios (HRs) for the associations between tobacco smoking and the three outcomes. RESULTS A total of 28 studies met the inclusion criteria. The results of the primary meta-analysis indicate current smokers have significantly poorer overall survival (Summary HR = 1.96, 95% CI = 1.69, 2.28), prostate cancer-specific survival (Summary HR = 1.79, 95% CI = 1.47, 2.20) and recurrence-free survival (Summary HR = 1.48, 95% CI = 1.28, 1.72) than never smokers. Similar results were found in population-based studies and in studies conducted in specific clinical populations. CONCLUSIONS The results of this systematic review and meta-analysis indicate that tobacco smoking at prostate cancer diagnosis is associated with a significantly increased risk of overall mortality, prostate-cancer specific mortality and recurrence. We recommend future studies collect more detailed information about tobacco smoking to further understanding of the association between tobacco smoking and PCa prognosis. In addition, further research should concentrate on the impact of smoking cessation post-diagnosis and post-treatment on prognosis, and the feasibility and effectiveness of smoking cessation programs.
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Affiliation(s)
- Ellie Darcey
- School of Public Health, Curtin University, Perth, Western Australia, Australia; Centre for Genetic Origins of Health and Disease, The University of Western Australia, Perth, Western Australia, Australia.
| | - Terry Boyle
- School of Public Health, Curtin University, Perth, Western Australia, Australia; Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; Cancer Control Research, BC Cancer Agency, Vancouver, Canada.
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Abstract
This study provides updates of net survival (NS) estimates at 5, 10, and 15 years as well as survival trends for 35 solid cancers in France using data from 19 population-based cancer registries. The study considered all cases of solid cancer diagnosed between 1989 and 2010 in patients older than 15 years of age who were actively followed up until 30 June 2013. NS was estimated using the Pohar-Perme method. The age-standardized NS used the international cancer survival standard weights. The 5-year age-standardized NSs ranged from 4% (pleural mesothelioma) to 93% (prostate) in men and from 10% (pancreas) to 97% (thyroid) in women. The 10-year age-standardized NSs ranged from 2% (pleural mesothelioma) in both sexes to 95% (testis) in men and 91% (thyroid) in women. The most frequent cancers (namely, breast and prostate cancers) had the highest NSs: 87 and 93% at 5 years and 78 and 84% at 10 years, respectively. Several cancers (especially lung, pancreas, and liver cancer) had very poor prognoses (5-year NSs under 20%). Fifteen-year NSs remained high for testis cancer. In most cancers, 5- and 10-year age-standardized NSs increased between 1989 and 2010. Advanced age was associated with a poor prognosis and little improvement in survival. The increases in cancer survival are probably related to earlier diagnosis and therapeutic advances over the last decade. However, poor prognoses are still found in some alcohol-related and tobacco-related cancers and in elderly patients, highlighting the need for more prevention, diagnosis, and treatment efforts.
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Ávila M, Patel L, López S, Cortés-Sanabria L, Garin O, Pont À, Ferrer F, Boladeras A, Zamora V, Fosså S, Storås AH, Sanda M, Serra-Sutton V, Ferrer M. Patient-reported outcomes after treatment for clinically localized prostate cancer: A systematic review and meta-analysis. Cancer Treat Rev 2018; 66:23-44. [PMID: 29673922 DOI: 10.1016/j.ctrv.2018.03.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/23/2018] [Accepted: 03/23/2018] [Indexed: 01/31/2023]
Abstract
BACKGROUND The aim of this systematic review is to assess the impact of primary treatments with curative intention in patients with localized prostate cancer, measured with Patient-Reported Outcomes (PROs), and to examine differences among modalities within treatments. METHODS We conducted a systematic literature search for January 2005-March 2017 following PRISMA guidelines, including longitudinal studies measuring disease-specific PROs in localized prostate cancer patients with a follow-up from pre- to post-treatment (≥1 year). Two reviewers independently extracted data and assessed risk of bias. The study is registered in PROSPERO: CRD42015019747. RESULTS Of 148 identified studies, 60 were included in the meta-analyses. At the 1st year, radical prostatectomy patients showed small urinary irritative-obstructive improvement (0.37SD 95%CI 0.30, 0.45), but large deterioration for sexual function and incontinence with high heterogeneity (I2 = 77% and 93%). Moderate worsening in external radiotherapy patients for sexual function (-0.46SD 95%CI -0.55, -0.36), small urinary incontinence (-0.16SD 95%CI -0.23, -0.09) and bowel impairment (-0.31SD 95%CI -0.39, -0.23). Brachytherapy patients presented small deterioration in urinary incontinence (-0.29SD 95%CI -0.39, -0.19), irritative obstructive symptoms (-0.35SD 95%CI -0.47, -0.23), sexual function (-0.12SD 95%CI -0.24, -0.002), and bowel bother (-0.27SD 95%CI -0.42, -0.11). These patterns persisted up to the 5th year. High-intensity focused ultrasound and active surveillance only have results at 1st year, showing no statistically significant worsening. CONCLUSIONS No remarkable differences in PRO appeared between modalities within each treatment. Nowadays, available evidence supports brachytherapy as possible alternative to radical prostatectomy for patients seeking an attempted curative treatment limiting the risk for urinary incontinence and sexual dysfunction.
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Affiliation(s)
- Mónica Ávila
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Silvia López
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Laura Cortés-Sanabria
- Unidad de Investigación Médica en Enfermedades Renales, Hospital de Especialidades, CMNO, IMSS, Guadalajara, Mexico
| | - Olatz Garin
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
| | - Àngels Pont
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | | | | | - Victor Zamora
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona University UB, Barcelona, Spain
| | - Sophie Fosså
- Oslo University Hospital, University of Oslo, Norway
| | - Anne H Storås
- Oslo University Hospital, University of Oslo, Norway
| | - Martin Sanda
- Department of Urology, Emory University School of Medicine, United States
| | - Vicky Serra-Sutton
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Universitat Autònoma de Barcelona, Bellaterra, Spain.
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Umbehr MH, Bachmann LM, Poyet C, Hammerer P, Steurer J, Puhan MA, Frei A. The German version of the Expanded Prostate Cancer Index Composite (EPIC): translation, validation and minimal important difference estimation. Health Qual Life Outcomes 2018; 16:36. [PMID: 29458434 PMCID: PMC5819270 DOI: 10.1186/s12955-018-0859-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 02/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND No official German translation exists for the 50-item Expanded Prostate Cancer Index Composite (EPIC), and no minimal important difference (MID) has been established yet. The aim of the study was to translate and validate a German version of the EPIC with cultural adaptation to the different German speaking countries and to establish the MID. METHODS We translated and culturally adapted the EPIC into German. For validation, we included a consecutive subsample of 92 patients with localized prostate cancer undergoing radical prostatectomy who participated the Prostate Cancer Outcomes Cohort. Baseline and follow-up assessments took place before and six weeks after prostatectomy in 2010 and 2011. We assessed the EPIC, EORTC QLQ-PR25, Feeling Thermometer, SF-36 and a global rating of health state change variable. We calculated the internal consistency, test-retest reliability, construct validity, responsiveness and MID. RESULTS For most EPIC domains and subscales, our a priori defined criteria for reliability were fulfilled (construct reliability: Cronbach's alpha 0.7-0.9; test-retest reliability: intraclass-correlation coefficient ≥ 0.7). Cross-sectional and longitudinal correlations between EPIC and EORTC QLQ-PR25 domains ranged from 0.14-0.79, and 0.06-0.5 and 0.08-0.72 for Feeling Thermometer and SF-36, respectively. We established MID values of 10, 4, 12, and 6 for the urinary, bowel, sexual and hormonal domain. CONCLUSION The German version of the EPIC is reliable, responsive and valid to measure HRQL in prostate cancer patients and is now available in German language. With the suggested MID we provide interpretation to what extent changes in HRQL are clinically relevant for patients. Hence, study results are of interest beyond German speaking countries.
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Affiliation(s)
- Martin H. Umbehr
- Department of Urology, City Hospital Triemli of Zurich, Birmensdorferstrasse 497, 8063 Zurich, Switzerland
- Horten Centre of patient orientated research and knowledge transfer, University of Zurich, Zurich, Switzerland
| | | | - Cedric Poyet
- Department of Urology, University Hospital of Zurich, Zurich, Switzerland
| | - Peter Hammerer
- Clinic of Urology, Städtisches Klinikum Braunschweig, Braunschweig, Germany
| | - Johann Steurer
- Horten Centre of patient orientated research and knowledge transfer, University of Zurich, Zurich, Switzerland
| | - Milo A. Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Lycken M, Drevin L, Garmo H, Stattin P, Adolfsson J, Lissbrant IF, Holmberg L, Bill-Axelson A. The use of palliative medications before death from prostate cancer: Swedish population-based study with a comparative overview of European data. Eur J Cancer 2018; 88:101-108. [DOI: 10.1016/j.ejca.2017.10.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/17/2017] [Accepted: 10/22/2017] [Indexed: 11/16/2022]
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Innos K, Baburin A, Kotsar A, Eiche IE, Lang K. Prostate cancer incidence, mortality and survival trends in Estonia, 1995–2014. Scand J Urol 2017; 51:442-449. [DOI: 10.1080/21681805.2017.1392600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Andres Kotsar
- Department of Urology and Kidney Transplantation, Clinic of Surgery, Tartu University Clinics, Tartu, Estonia
| | - Ivar-Endrik Eiche
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Katrin Lang
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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Cancer survival in adult patients in Spain. Results from nine population-based cancer registries. Clin Transl Oncol 2017; 20:201-211. [DOI: 10.1007/s12094-017-1710-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 06/20/2017] [Indexed: 01/24/2023]
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Gatta G, Capocaccia R, Botta L, Mallone S, De Angelis R, Ardanaz E, Comber H, Dimitrova N, Leinonen MK, Siesling S, van der Zwan JM, Van Eycken L, Visser O, Žakelj MP, Anderson LA, Bella F, Kaire I, Otter R, Stiller CA, Trama A. Burden and centralised treatment in Europe of rare tumours: results of RARECAREnet-a population-based study. Lancet Oncol 2017; 18:1022-1039. [PMID: 28687376 DOI: 10.1016/s1470-2045(17)30445-x] [Citation(s) in RCA: 250] [Impact Index Per Article: 35.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/10/2017] [Accepted: 05/12/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rare cancers pose challenges for diagnosis, treatments, and clinical decision making. Information about rare cancers is scant. The RARECARE project defined rare cancers as those with an annual incidence of less than six per 100 000 people in European Union (EU). We updated the estimates of the burden of rare cancers in Europe, their time trends in incidence and survival, and provide information about centralisation of treatments in seven European countries. METHODS We analysed data from 94 cancer registries for more than 2 million rare cancer diagnoses, to estimate European incidence and survival in 2000-07 and the corresponding time trends during 1995-2007. Incidence was calculated as the number of new cases divided by the corresponding total person-years in the population. 5-year relative survival was calculated by the Ederer-2 method. Seven registries (Belgium, Bulgaria, Finland, Ireland, the Netherlands, Slovenia, and the Navarra region in Spain) provided additional data for hospitals treating about 220 000 cases diagnosed in 2000-07. We also calculated hospital volume admission as the number of treatments provided by each hospital rare cancer group sharing the same referral pattern. FINDINGS Rare cancers accounted for 24% of all cancers diagnosed in the EU during 2000-07. The overall incidence rose annually by 0.5% (99·8% CI 0·3-0·8). 5-year relative survival for all rare cancers was 48·5% (95% CI 48·4 to 48·6), compared with 63·4% (95% CI 63·3 to 63·4) for all common cancers. 5-year relative survival increased (overall 2·9%, 95% CI 2·7 to 3·2), from 1999-2001 to 2007-09, and for most rare cancers, with the largest increases for haematological tumours and sarcomas. The amount of centralisation of rare cancer treatment varied widely between cancers and between countries. The Netherlands and Slovenia had the highest treatment volumes. INTERPRETATION Our study benefits from the largest pool of population-based registries to estimate incidence and survival of about 200 rare cancers. Incidence trends can be explained by changes in known risk factors, improved diagnosis, and registration problems. Survival could be improved by early diagnosis, new treatments, and improved case management. The centralisation of treatment could be improved in the seven European countries we studied. FUNDING The European Commission (Chafea).
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Affiliation(s)
- Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy.
| | - Riccardo Capocaccia
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Botta
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Sandra Mallone
- Centro Nazionale Prevenzione delle malattie e Promozione della Salute (CNAPPS) Istituto Superiore di Sanità, Rome, Italy
| | - Roberta De Angelis
- Dipartimento di Oncologia e Medicina Molecolare, Istituto Superiore di Sanità, Rome, Italy
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Instituto de Salud Pública de Navarra, Pamplona, Spain
| | | | | | - Maarit K Leinonen
- Cancer Society of Finland, Finnish Cancer Registry, Helsinki, Finland
| | - Sabine Siesling
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Jan M van der Zwan
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | | | - Otto Visser
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Maja P Žakelj
- Institute of Oncology Ljubljana, Epidemiology and Cancer Registry, Ljubljana, Slovenia
| | - Lesley A Anderson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, UK
| | - Francesca Bella
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuale, Catania, Italy
| | - Innos Kaire
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Renée Otter
- Belgian Cancer Center, Department of Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
| | - Charles A Stiller
- National Cancer Registration and Analysis Service, Public Health England, Oxford, UK
| | - Annalisa Trama
- Evaluative Epidemiology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
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Eleven-year management of prostate cancer patients on active surveillance: what have we learned? TUMORI JOURNAL 2017. [PMID: 28623636 PMCID: PMC6379800 DOI: 10.5301/tj.5000649] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate the outcomes of active surveillance (AS) on patients with low-risk prostate cancer (PCa) and to identify predictors of disease reclassification. METHODS In 2005, we defined an institutional AS protocol (Sorveglianza Attiva Istituto Nazionale Tumori [SAINT]), and we joined the Prostate Cancer Research International: Active Surveillance (PRIAS) study in 2007. Eligibility criteria included clinical stage ≤T2a, initial prostate-specific antigen (PSA) <10 ng/mL, and Gleason Pattern Score (GPS) ≤3 + 3 (both protocols); ≤25% positive cores with a maximum core length containing cancer ≤50% (SAINT); and ≤2 positive cores and PSA density <0.2 ng/mL/cm3 (PRIAS). Switching to active treatment was advised for a worsening of GPS, increased positive cores, or PSA doubling time <3 years. Active treatment-free survival (ATFS) was assessed using the Kaplan-Meier method. Factors associated with ATFS were evaluated with a multivariate Cox proportional hazards model. RESULTS A total of 818 patients were included: 200 in SAINT, 530 in PRIAS, and 88 in personalized AS monitoring. Active treatment-free survival was 50% after a median follow-up of 60 months. A total of 404/818 patients (49.4%) discontinued AS: 274 for biopsy-related reclassification, 121/404 (30%) for off-protocol reasons, 9/404 (2.2%) because of anxiety. Biopsy reclassification was associated with PSA density (hazard ratio [HR] 1.8), maximum percentage of core involvement (HR 1.5), positive cores at diagnostic biopsy (HR 1.6), older age (HR 1.5), and prostate volume (HR 0.6) (all p<0.01). Patients from SAINT were significantly more likely to discontinue AS than were the patients from PRIAS (HR 1.65, p<0.0001). CONCLUSIONS Five years after diagnosis, 50% of patients with early PCa were spared from active treatment. Wide inclusion criteria are associated with lower ATFS. However, at preliminary analysis, this does not seem to affect the probability of unfavorable pathology.
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Nayan M, Jewett MA, Hosni A, Anson-Cartwright L, Bedard PL, Moore M, Hansen AR, Chung P, Warde P, Sweet J, O’Malley M, Atenafu EG, Hamilton RJ. Conditional Risk of Relapse in Surveillance for Clinical Stage I Testicular Cancer. Eur Urol 2017; 71:120-127. [DOI: 10.1016/j.eururo.2016.07.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
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Taborelli M, Polesel J, Parpinel M, Stocco C, Birri S, Serraino D, Zucchetto A. Fruit and vegetables consumption is directly associated to survival after prostate cancer. Mol Nutr Food Res 2016; 61. [DOI: 10.1002/mnfr.201600816] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Martina Taborelli
- Unit of Cancer Epidemiology; CRO Aviano National Cancer Institute; Aviano (PN) Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology; CRO Aviano National Cancer Institute; Aviano (PN) Italy
| | - Maria Parpinel
- Unit of Hygiene and Epidemiology; Department of Biological and Medical Sciences; Udine University; Udine Italy
| | - Carmen Stocco
- Venetian Cancer Registry; Veneto Region; Padua Italy
| | - Silvia Birri
- Unit of Cancer Epidemiology; CRO Aviano National Cancer Institute; Aviano (PN) Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology; CRO Aviano National Cancer Institute; Aviano (PN) Italy
| | - Antonella Zucchetto
- Unit of Cancer Epidemiology; CRO Aviano National Cancer Institute; Aviano (PN) Italy
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Racial Disparities Differ for African Americans and Hispanics in the Diagnosis and Treatment of Penile Cancer. Urology 2016; 96:22-28. [DOI: 10.1016/j.urology.2016.06.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 05/27/2016] [Accepted: 06/30/2016] [Indexed: 02/07/2023]
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Prognostic Factors and Treatment Results After Bleomycin, Etoposide, and Cisplatin in Germ Cell Cancer: A Population-based Study. Eur Urol 2016; 71:290-298. [PMID: 27649970 DOI: 10.1016/j.eururo.2016.09.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 09/05/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND First-line treatment for patients with disseminated germ cell cancer (GCC) is bleomycin, etoposide, and cisplatin (BEP). A prognostic classification of patients receiving chemotherapy was published by the International Germ Cell Cancer Collaborative Group (IGCCCG) in 1997, but only a small proportion of the patients received BEP. OBJECTIVE To estimate survival probabilities after BEP, evaluate the IGCCCG prognostic classification, and propose new prognostic factors for outcome. DESIGN, SETTING, AND PARTICIPANTS Of a Danish population-based cohort of GCC patients (1984-2007), 1889 received first-line BEP, with median follow-up of 15 yr. Covariates evaluated as prognostic factors were age, year of treatment, primary site, non-pulmonary visceral metastases, pulmonary metastases, and tumor markers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Outcomes measured were 5-yr progression-free survival (PFS), 5-yr disease-specific survival (DSS), and 5-yr overall survival (OS) as calculated using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS AND LIMITATIONS The 5-yr PFS, DSS, and OS were 87%, 95%, and 93%, respectively, for patients with seminomatous GCC (SGCC) and good prognosis. For nonseminomatous GCC (NSGCC) with good, intermediate, and poor prognosis, the 5-yr probabilities were 90%, 76%, and 55% for PFS; 97%, 87%, and 66% for DSS; and 95%, 85%, and 64% for OS, respectively. For SGCC patients, new adverse prognostic factors not included in the IGCCCG classification were higher age and lactate dehydrogenase ≥1.5 times the upper limit of normal. For NSGCC patients, higher age and pulmonary metastases were additional adverse prognostic factors. Treatment in earlier years was associated with higher mortality. Limitations include the small number of patients in the prognostic groups, and the inability to adjust for performance status and comorbidity. CONCLUSIONS Our study reveals improved survival for disseminated GCC throughout the study period. We propose new prognostic factors for outcome for validation in larger cohorts of patients. PATIENT SUMMARY In this study of testicular cancer patients, we evaluated prognostic factors for outcome and calculated survival after standard chemotherapy. We find that survival has improved over the years and we propose new prognostic factors for outcome for validation in larger patient cohorts.
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Ondrusova M, Spanikova B, Sevcikova K, Ondrus D. Testosterone Deficiency and Bone Metabolism Damage in Testicular Cancer Survivors. Am J Mens Health 2016; 12:628-633. [PMID: 27489147 DOI: 10.1177/1557988316661986] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of the study was to investigate the influence of therapeutic modalities and sexual hormone levels on changes in bone mineral density (BMD) in testicular cancer (TC) survivors. In a cross-sectional descriptive, long-term follow-up study, a total of 1,249 long-term TC survivors were evaluated according to treatment modality: orchiectomy (OE) only, OE + chemotherapy (CT), or OE + radiotherapy (RT). Luteinizing hormone (LH), total testosterone (TST), marker of bone resorption (β-carboxyl-terminal cross-linking telopeptide of type I collagen-CTx), and BMD were evaluated. Standard statistical techniques were used to test the differences between groups of patients. TST decrease was observed in 46/313 TC survivors after OE alone, in 103/665 after OE + CT, and in 66/271 after OE + RT. LH increase was observed in 23/313 TC survivors after OE alone, in 154/665 after OE + CT, and in 43/271 after OE + RT. CTx increase was observed in 116/313 TC survivors after OE alone, in 324/665 after OE + CT, and in 82/271 after OE + RT. Osteopenia/osteoporosis occurred in 136/313 TC survivors after OE alone, in 298/665 after OE + CT, and in 139/271 after OE + RT. TC survivors after RT have statistically significant decreased TST levels, increased LH and nonsignificant worse BMD (osteopenia/osteoporosis) in comparison with TC survivors after OE alone or CT. TST decrease and LH increase were statistically significant, more frequently observed in patients with osteopenia/osteoporosis. Examination of TST is an important part of follow-up in TC survivors with bilateral as well as unilateral disease. The important part of standard examination algorithm should be also the osteological examination of TC survivors mainly in patients with androgen deficiency.
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Affiliation(s)
- Martina Ondrusova
- 1 St. Elisabeth University of Health and Social Science, Bratislava, Slovak Republic
| | - Beata Spanikova
- 2 St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | | | - Dalibor Ondrus
- 2 St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
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66
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Zucchetto A, Gini A, Shivappa N, Hébert JR, Stocco C, Dal Maso L, Birri S, Serraino D, Polesel J. Dietary inflammatory index and prostate cancer survival. Int J Cancer 2016; 139:2398-404. [PMID: 27242333 DOI: 10.1002/ijc.30208] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/06/2016] [Accepted: 05/19/2016] [Indexed: 01/10/2023]
Abstract
Systemic inflammatory status has been reported to impact survival of prostate cancer (PCa) patients; however, evidence is lacking on whether the inflammatory potential of diet can influence prognosis of PCa patients. To investigate the association between a dietary inflammatory index (DII) and PCa survival, we conducted a retrospective cohort study including 726 men with PCa originally enrolled, between 1995 and 2002, in an Italian case-control study. Information on diet and Gleason score was collected at PCa diagnosis. DII was derived from a food frequency questionnaire using a validated algorithm. Adjusted hazard ratios (HRs) of death with 95% confidence intervals (CIs) were estimated using a Fine-Gray model. DII scores were not significantly associated with all-cause mortality of PCa patients (HR highest vs. lowest DII tertile = 1.25; 95% CI: 0.86-1.83). However, considerable heterogeneity emerged according to Gleason score (p < 0.01): no associations emerged among men with Gleason score 2-6 PCa; whereas, among patients with Gleason score 7-10 PCa, DII was directly associated with both all-cause and PCa-specific mortality (HR highest vs. lowest DII tertile: 2.78; 95% CI: 1.41-5.48; and 4.01; 95% CI: 1.25-12.86; respectively). Among patients with Gleason score 7-10 PCa, ten-year all-cause survival probabilities were 58% (95% CI: 47-67%) for highest and 78% (95% CI: 67-86%) for lowest DII tertile. Study findings support the hypothesis that diet, through its inflammatory potential, may influence the prognosis of patients with more aggressive PCa. Dietary interventions aimed at decreasing inflammation may be considered to improve survival of men with PCa.
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Affiliation(s)
- Antonella Zucchetto
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Andrea Gini
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Connecting Health Innovations LLC, Columbia, SC, USA
| | - Carmen Stocco
- Venetian Cancer Registry, Veneto Region, Padua, Italy
| | - Luigino Dal Maso
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Silvia Birri
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Diego Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy.
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67
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Capocaccia R, Foschi R, Zucchetto A, Valdagni R, Nicolai N, Maffezzini M, Gatta G. Estimates of prostate cancer burden in Italy. Cancer Epidemiol 2015; 40:166-72. [PMID: 26771313 DOI: 10.1016/j.canep.2015.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 10/16/2015] [Accepted: 12/09/2015] [Indexed: 11/25/2022]
Abstract
Age-standardized incidence rates of prostate cancer (PC) sharply increased during the period 1990-2005 in Italian areas covered by cancer registries, while corresponding mortality rates remained nearly constant. The latest observations have reported on a reversal of the incidence trend with decreasing values after 2005. We provided incidence, mortality, and prevalence estimates at national and geographical area levels, together with time projections up to the year 2020. We applied the MIAMOD method, using as input national mortality data for the years 1970-2010 and population-based survival data for the period of diagnosis (1985-2002). We assumed relative survival of prostate cancer remained constant after the year of diagnosis (2005). The age-standardized incidence rates of PC were estimated to increase during the period 1984-2005, from 31 per 100,000 in 1984 to 93 per 100,000 in 2005. From 2005 onwards, the estimated rates declined to 71 in 2015 and to 62 in 2020. Age-standardized mortality rates slightly increased from 1970 up to about 19 per 100,000 in 1999 and then started to decrease with an estimated reduction of about 2.3% per year. Mortality projections indicated a continuing reduction, with a predicted age-standardized rate of about 12 per 100,000 in 2020. Prevalence was estimated to continuously increase up to a crude prevalence value of 1.2% in the year 2020. The results indicate that the epidemic peak of PC was reached around the year 2005 followed by declining incidence rates, while a substantial decrease in mortality, starting during the early 2000s, is expected to continue during the 2010s.
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Affiliation(s)
- R Capocaccia
- Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
| | - R Foschi
- Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - A Zucchetto
- Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy
| | - R Valdagni
- Division of Radiation Oncology 1, Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - N Nicolai
- Urological Surgical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - M Maffezzini
- Urological Surgical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - G Gatta
- Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Gravina GL, Mancini A, Sanita P, Vitale F, Marampon F, Ventura L, Landesman Y, McCauley D, Kauffman M, Shacham S, Festuccia C. KPT-330, a potent and selective exportin-1 (XPO-1) inhibitor, shows antitumor effects modulating the expression of cyclin D1 and survivin [corrected] in prostate cancer models. BMC Cancer 2015; 15:941. [PMID: 26620414 PMCID: PMC4666032 DOI: 10.1186/s12885-015-1936-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 11/16/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIMS Increased expression of Chromosome Region Maintenance (CRM-1)/exportin-1 (XPO-1) has been correlated with poor prognosis in several aggressive tumors, making it an interesting therapeutic target. Selective Inhibitor of Nuclear Export (SINE) compounds bind to XPO-1 and block its ability to export cargo proteins. Here, we investigated the effects of a new class of SINE compounds in models of prostate cancer. MATERIAL AND METHODS We evaluated the expression of XPO-1 in human prostate cancer tissues and cell lines. Next, six SINE (KPT-127, KPT-185, KPT-205, KPT-225, KPT-251 and KPT-330) compounds having different potency with broad-spectrum, tumor-selective cytotoxicity, tolerability and pharmacokinetic profiles were tested in a panel of prostate cancer cells representing distinct differentiation/progression states of disease and genotypes. Two SINE candidates for clinical trials (KPT-251 and KPT-330) were also tested in vivo in three cell models of aggressive prostate cancer engrafted in male nude mice. RESULTS AND CONCLUSIONS XPO-1 is overexpressed in prostate cancer compared to normal or hyperplastic tissues. Increased XPO-1 expression, mainly in the nuclear compartment, was associated with increased Gleason score and bone metastatic potential supporting the use of SINEs in advanced prostate cancer. SINE compounds inhibited proliferation and promoted apoptosis of tumor cells, but did not affect immortalized non-transformed prostate epithelial cells. Nuclei from SINE treated cells showed increased protein localization of XPO-1, survivin and cyclin D1 followed by degradation of these proteins leading to cell cycle arrest and apoptosis. Oral administration of KPT-251 and KPT-330 in PC3, DU145 and 22rv1 tumor-bearing nude mice reduced tumor cell proliferation, angiogenesis and induced apoptosis. Our results provide supportive evidence for the therapeutic use of SINE compounds in advanced/castration resistant prostate cancers and warrants further clinical investigation.
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Affiliation(s)
- Giovanni Luca Gravina
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, L'Aquila, Italy.
| | - Andrea Mancini
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, L'Aquila, Italy.
| | - Patrizia Sanita
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, L'Aquila, Italy.
| | - Flora Vitale
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, L'Aquila, Italy.
| | - Francesco Marampon
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, L'Aquila, Italy.
| | - Luca Ventura
- Pathology Division, San Salvatore Hospital, L'Aquila, Italy.
| | | | | | | | | | - Claudio Festuccia
- Department of Biotechnological and Applied Clinical Sciences, Laboratory of Radiobiology, University of L'Aquila, L'Aquila, Italy.
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69
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Rossi S, Baili P, Capocaccia R, Caldora M, Carrani E, Minicozzi P, Pierannunzio D, Santaquilani M, Trama A, Allemani C, Belot A, Buzzoni C, Lorez M, De Angelis R. The EUROCARE-5 study on cancer survival in Europe 1999-2007: Database, quality checks and statistical analysis methods. Eur J Cancer 2015; 51:2104-2119. [PMID: 26421815 DOI: 10.1016/j.ejca.2015.08.001] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/03/2015] [Accepted: 08/05/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since 25years the EUROCARE study monitors the survival of cancer patients in Europe through centralised collection, quality check and statistical analysis of population-based cancer registries (CRs) data. The European population covered by the study increased remarkably in the latest round. The study design and statistical methods were also changed to improve timeliness and comparability of survival estimates. To interpret the EUROCARE-5 results on adult cancer patients better here we assess the impact of these changes on data quality and on survival comparisons. METHODS In EUROCARE-5 the survival differences by area were studied applying the complete cohort approach to data on nearly nine million cancer patients diagnosed in 2000-2007 and followed up to 2008. Survival time trends were analysed applying the period approach to data on about 10 million cancer cases diagnosed from 1995 to 2007 and followed up to 2008. Differently from EUROCARE-4, multiple primary cancers were included and relative survival was estimated with the Ederer II method. RESULTS EUROCARE-5 covered a population of 232 million resident persons, corresponding to 50% of the 29 participating countries. The population coverage increased particularly in Eastern Europe. Cases identified from death certificate only (DCO) were on average 2.9%, range 0-12%. Microscopically confirmed cases amounted to over 85% in most CRs. Compared to previous methods, including multiple cancers and using the Ederer II estimator reduced survival estimates by 0.4 and 0.3 absolute percentage points, on average. CONCLUSIONS The increased population size and registration coverage of the EUROCARE-5 study ensures more robust and comparable estimates across European countries. This enlargement did not impact on data quality, which was generally satisfactory. Estimates may be slightly inflated in countries with high or null DCO proportions, especially for poor prognosis cancers. The updated methods improved the comparability of survival estimates between recently and long-term established registries and reduced biases due to informative censoring.
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Affiliation(s)
- Silvia Rossi
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy.
| | - Paolo Baili
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Riccardo Capocaccia
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy; Department of Preventive and Predictive Medicine, Evaluative epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Massimiliano Caldora
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Eugenio Carrani
- Servizio informatico, documentazione, biblioteca ed attività editoriali, Settore I - Informatica Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Pamela Minicozzi
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Daniela Pierannunzio
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Mariano Santaquilani
- Servizio informatico, documentazione, biblioteca ed attività editoriali, Settore I - Informatica Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
| | - Annalisa Trama
- Department of Preventive and Predictive Medicine, Evaluative epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy
| | - Claudia Allemani
- Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK
| | - Aurelien Belot
- Cancer Research UK Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK; Service de Biostatistique, Hospices Civils de Lyon, F-69003 Lyon, France; Université de Lyon, F-69000 Lyon, France; Université de Lyon 1, F-69100 Villeurbanne, France; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, F-69100 Villeurbanne, France
| | - Carlotta Buzzoni
- Registro Tumori Toscano, Istituto per lo studio e la prevenzione oncologica, Via Cosimo il Vecchio 2, 50141 Florence, Italy
| | - Matthias Lorez
- Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zürich, Seilergraben 49, CH-8001 Zürich, Switzerland
| | - Roberta De Angelis
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, viale Regina Elena 299, 00161 Rome, Italy
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Baili P, Di Salvo F, Marcos-Gragera R, Siesling S, Mallone S, Santaquilani M, Micheli A, Lillini R, Francisci S. Age and case mix-standardised survival for all cancer patients in Europe 1999-2007: Results of EUROCARE-5, a population-based study. Eur J Cancer 2015; 51:2120-2129. [PMID: 26421816 DOI: 10.1016/j.ejca.2015.07.025] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 07/08/2015] [Accepted: 07/17/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Overall survival after cancer is frequently used when assessing a health care service's performance as a whole. It is mainly used by the public, politicians and the media, and is often dismissed by clinicians because of the heterogeneous mix of different cancers, risk factors and treatment modalities. Here we give survival details for all cancers combined in Europe, correlating it with economic variables to suggest reasons for differences. METHODS We computed age and cancer site case-mix standardised relative survival for all cancers combined (ACRS) for 29 countries participating in the EUROCARE-5 project with data on more than 7.5million cancer cases from 87 population-based cancer registries, using complete and period approach. RESULTS Denmark, United Kingdom (UK) and Eastern European countries had lower survival than neighbouring countries. Five-year ACRS has been increasing throughout Europe, and substantial increases, between 1999-2001 and 2005-2007, have been achieved in countries where survival was lower in the past. Five-year ACRS for men and women are positively correlated with macro-economic variables like the Gross Domestic Product (GDP) and Total National Expenditure on Health (TNEH) (R2 about 70%). Countries with recent larger increases in GDP and TNEH had greater increases in cancer survival. CONCLUSIONS ACRS serves to compare all cancer survival in Europe taking account of the geographical variability in case-mixes. The EUROCARE-5 data on ACRS confirm previous EUROCARE findings. Survival appears to correlate with macro-economic determinants, particularly with investments in the health care system.
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Affiliation(s)
- Paolo Baili
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori", via Venezian 1, 20133 Milan, Italy
| | - Francesca Di Salvo
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori", via Venezian 1, 20133 Milan, Italy.
| | - Rafael Marcos-Gragera
- Epidemiology Unit and Girona Cancer Registry (Oncology Coordination Plan). Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute, Girona, Spain
| | - Sabine Siesling
- Netherlands Comprehensive Cancer Organisation (Department of Research), PO Box 19079, 3501 DB Utrecht, The Netherlands; MIRA Institute of Biomedical Technology and Technical Medicine, University of Twente (Department of Health Technology and Services Research), Enschede, The Netherlands
| | - Sandra Mallone
- National Centre for Epidemiology Surveillance and Health Promotion (CNESPS), National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Mariano Santaquilani
- Informatics service, National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Andrea Micheli
- Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS "Istituto Nazionale dei Tumori", via Venezian 1, 20133 Milan, Italy; Department of Health Sciences (DISS), University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Roberto Lillini
- PhD School in Applied Sociology and Methodology of Research, Department of Sociology, University of Milan-Bicocca, Milan, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Silvia Francisci
- National Centre for Epidemiology Surveillance and Health Promotion (CNESPS), National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
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