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Yagi A, Ueda Y, Ikeda S, Miyoshi A, Nakagawa S, Hiramatsu K, Kobayashi E, Kimura T, Ito Y, Nakayama T, Nakata K, Morishima T, Miyashiro I, Kimura T. Improved long-term survival of corpus cancer in Japan: A 40-year population-based analysis. Int J Cancer 2021; 150:232-242. [PMID: 34494658 PMCID: PMC9291773 DOI: 10.1002/ijc.33799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/13/2021] [Accepted: 08/31/2021] [Indexed: 11/21/2022]
Abstract
The incidence of uterine corpus cancer has been increasing globally due to increase in obesity. However, a detailed analysis of long‐term epidemiological trends of corpus cancer in Japan, where obesity is relatively minimal, has not been conducted. In this retrospective, population‐based study using the Osaka Cancer Registry, we analyzed 15 255 cases of corpus neoplasia registered between 1977 and 2016. We determined the age‐standardized incidence, mortality, relative survival and conditional survival rates, and the treatment trends for corpus cancer over the last 40 years in Japan. The age‐standardized incidence rate of corpus neoplasia increased sharply in 2000‐2011 (APC = 9.9, 95% CI: 8.4‐11.3), whereas the mortality rate trended to a much more modest increase (APC = 3.3, 95% CI: 2.7‐3.8). Compared to 1977‐2000, 10‐year survival rates for post‐2000 cases of localized and regional corpus cancers significantly improved (from 87.7% [95% CI: 85.8‐89.4] to 94.2% [95% CI: 92.7‐95.7] and from 47.5% [95% CI: 43.3‐51.6] to 64.4% [95% CI: 61.0‐67.6], respectively). This was largely associated with the significant increase in the percentage of localized and regional patients who received chemotherapy instead of radiation as an adjuvant therapy combined to surgery (P < .001 for both). We found that each histological type (endometrioid carcinoma, serous carcinoma, clear cell carcinoma and carcinosarcoma) has different characteristics of trend of age‐standardized incidence rate, relative survival and distribution of extent of disease. In endometrioid carcinoma, the age‐standardized incidence rate increased consistently after 1990, but the rate of increase was decreasing after 1997.
What's new?
For the past 40 years, age‐standardized incidence of corpus cancer in Japan, similar to other countries worldwide, has been increasing. However, whereas global increases in corpus cancer are linked to increasing obesity, obesity rates in Japan remain uniquely low. This population‐based study, drawing on data from the Osaka Cancer Registry, reveals a sharp increase in age‐standardized incidence of corpus neoplasia from 2000‐2011 in Japan. Each histological cancer type differed in incidence trend, relative survival, and distribution of extent of disease. Additional analyses indicate that recent changes in adjuvant therapy, particularly increased use of chemotherapy over radiation, have improved prognosis.
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Affiliation(s)
- Asami Yagi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Sayaka Ikeda
- Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Ai Miyoshi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Nakagawa
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kosuke Hiramatsu
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Eiji Kobayashi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toshihiro Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuri Ito
- Research and Development Center, Osaka Medical College, Osaka, Japan
| | - Tomio Nakayama
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
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Van Maele-Fabry G, Gamet-Payrastre L, Lison D. Residential exposure to pesticides as risk factor for childhood and young adult brain tumors: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2017. [PMID: 28623811 DOI: 10.1016/j.envint.2017.05.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Accumulating evidence suggests a positive association between exposure to non-agricultural pesticides and childhood brain tumors (CBT). OBJECTIVE (1) To conduct a systematic review and meta-analysis of published studies on the association between residential/household/domestic exposure to pesticides and childhood brain tumors. (2) To clarify variables that could impact the results. METHODS Publications in English were identified from a MEDLINE search through 28 February 2017 and from the reference list of identified publications. Risk estimates were extracted from 18 case-control studies published between 1979 and 2016 and study quality assessments were performed. Summary odds ratios (mOR) were calculated according to fixed and random-effect meta-analysis models. Separate analyses were conducted after stratification for study quality, critical exposure period, exposure location, specific exposures, pesticide category, application methods, type of pest treated, type of CBT, child's age at diagnosis and geographic location. RESULTS Statistically significant associations were observed with CBT after combining all studies (mOR: 1.26; 95% CI: 1.13-1.40) without evidence of inconsistency between study results or publication bias. Specifically, increased risks were observed for several groupings and more particularly for gliomas and exposure involving insecticides. Statistical significance was also reached for high quality studies, for all exposure periods, for indoor exposure and, more particularly, during the prenatal period for all stratifications involving insecticides (except for outdoor use), for pet treatments, for flea/tick treatment, for studies from USA/Canada and studies from Europe (borderline) as well as for data from studies including children of up to 10years at diagnosis and of up to 15years. CONCLUSIONS Our findings support an association between residential exposure to pesticides and childhood brain tumors. Although causality cannot be established, these results add to the evidence leading to recommend limiting residential use of pesticides and to support public health policies serving this objective.
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Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Avenue E. Mounier 53.02, B-1200 Brussels, Belgium.
| | - Laurence Gamet-Payrastre
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS 180 chemin de Tournefeuille, BP 93173 Toulouse, France
| | - Dominique Lison
- Université catholique de Louvain, Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Avenue E. Mounier 53.02, B-1200 Brussels, Belgium
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Schindler M, Belle FN, Grotzer MA, von der Weid NX, Kuehni CE. Childhood cancer survival in Switzerland (1976-2013): Time-trends and predictors. Int J Cancer 2016; 140:62-74. [PMID: 27632765 DOI: 10.1002/ijc.30434] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/05/2016] [Indexed: 01/08/2023]
Abstract
Population-based studies on childhood cancer survival are key to monitor progress against cancer and to detect potential differences between regions and other subgroups in the population. We investigated time trends and factors associated with childhood cancer survival on a national level in Switzerland, from 1976 to 2013. We extracted data from the population-based Swiss Childhood Cancer Registry of 5,776 children (age 0-14 years) diagnosed with cancer from 1985 to 2014 in Switzerland. We calculated age-adjusted 5-year survival, defined the annual reduction in risk of death (ARR), and explored associations of survival with clinical and demographic factors. Overall, 5-year survival improved significantly, from 64% in 1976-1983 to 88% in 2004-2013. ARR over the whole period was 4% for all diagnostic groups, greatest for Hodgkin lymphomas (8%), ependymomas (6%), Burkitt's lymphomas (6%) and germ cell tumours (6%). Children treated in hospitals without specialised paediatric cancer centre for leukaemia (HR 12.9), lymphoma (HR 5.0) and neuroblastoma (HR 3.7) were at higher risk of death. In French-speaking Switzerland, risk of death was lower for lymphoma (HR 0.6), CNS tumours (HR 0.7) and neuroblastoma (HR 0.5). Children with migration background had a higher risk of death from all tumours except bone tumours. Childhood cancer survival significantly improved from 1976 to 2013, but there is room for further improvement. Survival rates varied by type of clinical treatment, language region and nationality. All paediatric cancer patients should be referred to a specialised paediatric cancer centre. Further research is needed to intervene and completely eliminate inequalities in survival.
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Affiliation(s)
- Matthias Schindler
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
| | - Fabiën N Belle
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
| | - Michael A Grotzer
- Department of Oncology, University Children's Hospital of Zürich, Steinwiesstrasse 75, CH-8032 Züerich, Switzerland
| | - Nicolas X von der Weid
- Department of Paediatric Oncology and Haematology, University Children's Hospital Basel UKKB, Spitalstrasse 33, CH-4056 Basel, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012 Bern, Switzerland
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Karalexi MA, Papathoma P, Thomopoulos TP, Ryzhov A, Zborovskaya A, Dimitrova N, Zivkovic S, Eser S, Antunes L, Sekerija M, Zagar T, Bastos J, Demetriou A, Agius D, Cozma R, Coza D, Bouka E, Dessypris N, Belechri M, Dana H, Hatzipantelis E, Papakonstantinou E, Polychronopoulou S, Pourtsidis A, Stiakaki E, Chatziioannou A, Manolitsi K, Orphanidis G, Papadopoulos S, Papathanasiou M, Patsouris E, Sgouros S, Zountsas B, Moschovi M, Steliarova-Foucher E, Petridou ET. Childhood central nervous system tumour mortality and survival in Southern and Eastern Europe (1983-2014): Gaps persist across 14 cancer registries. Eur J Cancer 2015; 51:2665-77. [PMID: 26343313 DOI: 10.1016/j.ejca.2015.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/11/2015] [Accepted: 08/17/2015] [Indexed: 01/29/2023]
Abstract
AIM Childhood central nervous system (CNS) tumour registration and control programs in Southern and Eastern Europe remain thin, despite the lethal nature of the disease. Mortality/survival data were assembled to estimate the burden of malignant CNS tumours, as well as the potential role of sociodemographic survival determinants across 14 cancer registries of this region. METHODS Average age-adjusted mortality rates were calculated, whereas time trends were quantified through Poisson and Joinpoint regressions. Kaplan-Meier curves were derived for the maximum and the more recent (10 and 5 year) registration periods. Multivariate Cox regression models were used to assess demographic and disease-related determinants. RESULTS Variations in mortality (8-16 per million) and survival (5-year: 35-69%) were substantial among the participating registries; in most registries mortality trend was stable, whereas Bulgaria, having the highest starting rate, experienced decreasing annual mortality (-2.4%, p=0.001). A steep decrease in survival rates was evident before the second year of follow-up. After controlling for diagnostic subgroup, age, gender and diagnostic year, Greece seemed to present higher survival compared with the other contributing registries, although the follow-up period was short. Irrespective of country, however, rural residence was found to impose substantial adverse repercussions on survival (hazard ratio (HR): 1.2, 95% confidence interval (CI): 1.1-1.4). CONCLUSION Cross-country mortality and survival variations possibly reflect suboptimal levels of health care delivery and cancer control in some regions of Southern and Eastern Europe, notwithstanding questionable death certification patterns or follow-up procedures. Continuous childhood cancer registration and linkage with clinical data are prerequisite for the reduction of survival inequalities across Europe.
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Affiliation(s)
- Maria A Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Paraskevi Papathoma
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Thomas P Thomopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Anton Ryzhov
- National Cancer Registry of Ukraine, National Institute of Cancer, Kyiv, Ukraine
| | - Anna Zborovskaya
- Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Childhood Cancer Subregistry of Belarus, Minsk, Belarus
| | - Nadya Dimitrova
- Bulgarian National Cancer Registry, National Oncology Hospital, Sofia, Bulgaria
| | | | - Sultan Eser
- Izmir Cancer Registry, Izmir Hub, Izmir & Hacettepe University Institute of Public Health, Ankara, Turkey
| | - Luís Antunes
- North Region Cancer Registry of Portugal (NORTH), Portuguese Oncology Institute of Porto, Portugal
| | - Mario Sekerija
- Croatian National Cancer Registry, Croatian Institute of Public Health, Zagreb, Croatia
| | - Tina Zagar
- Cancer Registry of Republic of Slovenia, Institute of Oncology, Ljubljana, Slovenia
| | - Joana Bastos
- Registo Oncológico Regional do Centro, Instituto Português de Oncologia de Coimbra Francisco Gentil E.P.E, Coimbra, Portugal
| | - Anna Demetriou
- Cyprus Cancer Registry-Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | - Domenic Agius
- Malta National Cancer Registry, Department of Health Information and Research, Malta
| | - Raluca Cozma
- Epidemiology, Institute of Public Health, 16-18 Victor Babes Street, Timisoara 300226, Romania
| | - Daniela Coza
- Regional Cancer Registry of Cluj, Oncological Institute "Ion Chiricuta", Cluj-Napoca, Romania
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Nick Dessypris
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Maria Belechri
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
| | - Helen Dana
- Oncology Department, "Mitera" Childrens Hospital, Erythrou Stavrou 6 Marousi, Athens, Greece
| | - Emmanuel Hatzipantelis
- 2nd Department of Pediatrics, Aristotelion University of Thessaloniki, AHEPA General Hospital, Thessaloniki, Greece
| | | | - Sophia Polychronopoulou
- Department of Pediatric Haematology-Oncology, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Apostolos Pourtsidis
- Department of Pediatric Hematology-Oncology, "Pan. & Agl. Kyriakou" Children's Hospital, Athens, Greece
| | - Eftichia Stiakaki
- Department of Pediatric Hematology-Oncology, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Achilles Chatziioannou
- First Department of Radiology, Aretaieion Hospital, Medical School, University of Athens, Athens, Greece
| | - Katerina Manolitsi
- Department of Neurosurgery, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | | | - Mathilda Papathanasiou
- 2nd Department of Radiology, Radiotherapy Unit, Medical School, National Kapodistrian University of Athens, Athens, Greece
| | - Eustratios Patsouris
- Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Spyros Sgouros
- Department of Neurosurgery, "Mitera" Childrens Hospital, Erythrou Stavrou 6 Marousi, Athens, Greece
| | - Basilios Zountsas
- Department of Neurosurgery, St. Luke's Hospital, Panorama, Thessaloniki
| | - Maria Moschovi
- Haematology-Oncology Unit, First Department of Pediatrics, Athens University Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece.
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Poels J, Abou-Ghannam G, Herman S, Van Langendonckt A, Wese FX, Wyns C. In Search of Better Spermatogonial Preservation by Supplementation of Cryopreserved Human Immature Testicular Tissue Xenografts with N-acetylcysteine and Testosterone. Front Surg 2014; 1:47. [PMID: 25593971 PMCID: PMC4286969 DOI: 10.3389/fsurg.2014.00047] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 11/17/2014] [Indexed: 11/16/2022] Open
Abstract
Controlled slow-freezing is the procedure currently applied for immature testicular tissue (ITT) cryobanking in clinical practice. Vitrification has been proposed as a promising alternative, with a view to better preserve the spermatogonial stem cells for future fertility restoration by autografting in young boys suffering from cancer. It appears that besides the potential influence of the cryopreservation technique used, the transplantation procedure itself has a significant impact on spermatogonial loss observed in ITT xenografts. Eighteen ITT pieces issued from 6 patients aged 2–15 years were used. Fragments of fresh tissue (serving as ungrafted controls), frozen-thawed tissue, frozen-thawed tissue supplemented with N-acetylcysteine (NAC), and frozen-thawed tissue supplemented with testosterone xenografted to nude mice for 5 days were compared. Upon graft removal, histological and immunohistochemical analyses were performed to evaluate spermatogonia, intratubular proliferation, and intrinsic and extrinsic apoptosis. A significant decrease in the integrity of intact seminiferous tubules was found in all three grafted groups. Spermatogonia were observed by immunohistochemistry in all grafted groups, with recovery rates of 67, 63, and 53%, respectively, for slow-frozen tissue, slow-frozen tissue supplemented with NAC, and slow-frozen tissue supplemented with testosterone. Apoptosis evidenced by active caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling was similar in all grafts. The study is limited by the low availability of ITT samples of human origin, and no clear impact of graft supplementation was found. The mouse xenotransplantation model needs to be refined to investigate human spermatogenesis in human ITT grafts.
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Affiliation(s)
- Jonathan Poels
- Gynecology Unit, Medical School, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain , Brussels , Belgium ; Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc , Brussels , Belgium
| | - Gaël Abou-Ghannam
- Gynecology Unit, Medical School, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain , Brussels , Belgium ; Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc , Brussels , Belgium
| | - Sophie Herman
- Gynecology Unit, Medical School, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain , Brussels , Belgium ; Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc , Brussels , Belgium
| | - Anne Van Langendonckt
- Gynecology Unit, Medical School, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain , Brussels , Belgium ; Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc , Brussels , Belgium
| | | | - Christine Wyns
- Gynecology Unit, Medical School, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain , Brussels , Belgium ; Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc , Brussels , Belgium
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Ito Y, Miyashiro I, Ito H, Hosono S, Chihara D, Nakata-Yamada K, Nakayama M, Matsuzaka M, Hattori M, Sugiyama H, Oze I, Tanaka R, Nomura E, Nishino Y, Matsuda T, Ioka A, Tsukuma H, Nakayama T. Long-term survival and conditional survival of cancer patients in Japan using population-based cancer registry data. Cancer Sci 2014; 105:1480-6. [PMID: 25183551 PMCID: PMC4462379 DOI: 10.1111/cas.12525] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 08/17/2014] [Accepted: 08/24/2014] [Indexed: 02/05/2023] Open
Abstract
Although we usually report 5-year cancer survival using population-based cancer registry data, nowadays many cancer patients survive longer and need to be followed-up for more than 5 years. Long-term cancer survival figures are scarce in Japan. Here we report 10-year cancer survival and conditional survival using an established statistical approach. We received data on 1 387 489 cancer cases from six prefectural population-based cancer registries in Japan, diagnosed between 1993 and 2009 and followed-up for at least 5 years. We estimated the 10-year relative survival of patients who were followed-up between 2002 and 2006 using period analysis. Using this 10-year survival, we also calculated the conditional 5-year survival for cancer survivors who lived for some years after diagnosis. We reported 10-year survival and conditional survival of 23 types of cancer for 15–99-year-old patients and four types of cancer for children (0–14 years old) and adolescent and young adults (15–29 years old) patients by sex. Variation in 10-year cancer survival by site was wide, from 5% for pancreatic cancer to 95% for female thyroid cancer. Approximately 70–80% of children and adolescent and young adult cancer patients survived for more than 10 years. Conditional 5-year survival for most cancer sites increased according to years, whereas those for liver cancer and multiple myeloma did not increase. We reported 10-year cancer survival and conditional survival using population-based cancer registries in Japan. It is important for patients and clinicians to report these relevant figures using population-based data.
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Affiliation(s)
- Yuri Ito
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
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Mehrvar A, Faranoush M, Hedayati Asl AA, Tashvighi M, Fazeli MA, Qaddoumi I, Mehrvar N, Sobuti B, Jafarpour A, Ravan Parsa R, Zangooei R, Alebouyeh M, Vossough P. Childhood central nervous system tumors at MAHAK's Pediatric Cancer Treatment and Research Center (MPCTRC), Tehran, Iran. Childs Nerv Syst 2014; 30:491-6. [PMID: 23943227 DOI: 10.1007/s00381-013-2256-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/30/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE As central nervous system (CNS) tumors account for second most common childhood malignancies and the first cause of mortality in children with cancer, improving treatment modalities can lead to increase the health care of patients. In this study, we examined the prevalence of childhood brain tumors in patients who referred to MAHAK's Pediatric Cancer Treatment and Research Center (MPCTRC) for treatment. METHODS A retrospective review of all children less than 15 years old with a CNS histologically proven tumor, who presented to MPCTRC from April 2007 to April 2010, was performed. Data was analyzed by SPSS version 19 with Kolmogorov-Smirnov and Chi-square tests. RESULTS There were 198 (124 boys) children eligible for the study. The majority of the tumors were infratentorial (n = 134), and the rest were supratentorial (n = 60) and spinal (n = 4) cases. The median age was 6.11 ± 3.65 years old. Medulloblastoma (n = 66), low-grade glioma (n = 52), and high-grade glioma (n = 40) were the most common tumors. The mean duration of follow-up was 21 months. At the time of this analysis, there were 105 (53 %) children alive, 82 (41.4 %) deaths, and 11 (5.6 %) lost for follow-up. The survival rate was 51.68 ± 5.22 %. CONCLUSIONS In contrast of high rate of death in this study, other general characteristics can serve as benchmark for improving our care for children with brain tumors in Iran.
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Affiliation(s)
- Azim Mehrvar
- MAHAK's Pediatric Cancer Treatment and Research Center, MAHAK Blv, Oshan Blv, Aghdasieh Ave, Tehran, 1956943512, Iran
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9
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Gondos A, Doehler B, Opelz G, Brenner H. From cancer to transplantation: an evaluation of period analysis for calculating up-to-date long-term survival estimates. Am J Epidemiol 2010; 172:613-20. [PMID: 20650955 DOI: 10.1093/aje/kwq160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The timeliness of survival monitoring is particularly important in a field such as transplantation medicine, where progress occurs rapidly. Period analysis, a method successfully applied for improving the timeliness of survival monitoring in population-based cancer survival analysis, could potentially be useful in the field of transplantation as well. Using data from the Collaborative Transplant Study, the authors compared the ability of traditional, cohort-based analysis methods and the period analysis method to provide timely 5-year graft and patient survival estimates for kidney, heart, and liver transplants in 6 age groups (0-17, 18-29, 30-39, 40-49, 50-59, >or=60 years) on 378 occasions between 1990-1992 and 2000-2002. Overall, period estimates provided superior predictions for the survival of most recent transplants on 344 of 378 occasions (91%); in the organ-specific analysis, this proportion ranged between 83% for heart and 100% for kidney graft survival. This evaluation provides evidence that the period analysis method can improve the timeliness of survival monitoring in solid organ transplantation. The method appears useful for providing more up-to-date long-term survival estimates than traditional methods, and its use in pertinent studies is encouraged.
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Affiliation(s)
- Adam Gondos
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.
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Weber DC, Zilli T, Do HP, Nouet P, Gumy Pause F, Pause FG, Pica A. Intensity modulated radiation therapy or stereotactic fractionated radiotherapy for infratentorial ependymoma in children: a multicentric study. J Neurooncol 2010; 102:295-300. [PMID: 20725849 DOI: 10.1007/s11060-010-0318-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 07/19/2010] [Indexed: 10/19/2022]
Abstract
This study was to evaluate the treatment dosimetry, efficacy and toxicity of intensity modulated radiation therapy (IMRT) and fractionated stereotactic radiotherapy (FSRT) in the management of infratentorial ependymoma. Between 1999 and 2007, seven children (median age, 3.1 years) with infratentorial ependymoma were planned with either IMRT (3 patients) or SFRT (4 patients), the latter after conventional posterior fossa irradiation. Two children underwent gross total resection. Median prescribed dose was 59.4 Gy (range, 55.8-60). The median follow-up for surviving patients was 4.8 years (range, 1.3-8). IMRT (median dose, 59.4 Gy) and FSRT (median dose, 55.8 Gy) achieved similar optimal target coverage. Percentages of maximum doses delivered to the cochleae (59.5 vs 85.0% Gy; P = 0.05) were significantly inferior with IMRT, when compared to FSRT planning. Percentages of maximum doses administered to the pituitary gland (38.2 vs 20.1%; P = 0.05) and optic chiasm (38.1 vs 14.1%; P = 0.001) were, however, significantly higher with IMRT, when compared to FSRT planning. No recurrences were observed at the last follow-up. The estimated 3-year progression-free survival and overall survival were 87.5 and 100%, respectively. No grade >1 acute toxicity was observed. Two patients presented late adverse events (grade 2 hypoacousia) during follow-up, without cognitive impairment. IMRT or FSRT for infratentorial ependymomas is effective and associated with a tolerable toxicity level. Both treatment techniques were able to capitalize their intrinsic conformal ability to deliver high-dose radiation. Larger series of patients treated with these two modalities will be necessary to more fully evaluate these delivery techniques.
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Affiliation(s)
- Damien C Weber
- Département de l'Imagerie Médical et Science de l'Information, Geneva University Hospital, 1211, Geneva 14, Switzerland.
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Gondos A, Brenner H. Period Analysis for More Up-to-Date Graft and Patient Survival Estimates in Transplantation: An Evaluation Using United Network for Organ Sharing Data. Transplantation 2010; 89:580-8. [DOI: 10.1097/tp.0b013e3181caa38e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hamlat A, Saikali S, Diabira S, Messerer M, Riffaud L. Diagnosis of childhood astrocytomas. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2009; 3:501-522. [PMID: 23495981 DOI: 10.1517/17530050903032679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Astrocytomas are the most common brain tumours, accounting for 28 - 50% of all primary CNS tumours. Diagnosis of CNS tumours remains difficult because the varied and nonspecific presentations of CNS tumours in childhood. Objectives/method: The clinical presentations of CNS astrocytomas vary with their sites of location; therefore, a period of uncertainty often precedes diagnosis, and approximately 42% of patients with an intracranial process make several visits to various physicians between the onset and diagnosis. However, on clinical suspicion of a brain tumour, a wide range of neuroimaging techniques may be used to assess the diagnosis of paediatric brain lesions. In this review the authors, for ease of presentation, describe the clinical presentations of supratentorial, infratentorial and spinal cord astrocytomas as well as their radiological and pathological features, and discuss their differential diagnoses. RESULTS/CONCLUSIONS Understanding and mastering the numerous imaging features of several subtypes of primary brain tumours affecting children, in addition to radiological features of non-tumoural disorders, remains a significant challenge and demands increased awareness of the paediatric brain diseases.
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Affiliation(s)
- Abderrahmane Hamlat
- Department of Neurosurgery, CHU Pontchaillou, 2 Rue Henri Le Guilloux, 35000 Rennes Cedex 2, France +33 2 99 28 43 21 ; +33 2 99 28 41 80 ;
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Hox-D genes expression in pediatric low-grade gliomas: real-time-PCR study. Cell Mol Neurobiol 2008; 29:1-6. [PMID: 18404365 DOI: 10.1007/s10571-008-9282-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 03/27/2008] [Indexed: 01/13/2023]
Abstract
HOX genes encode transcription factors, which play a key role in morphogenesis and cell differentiation during embryogenesis. Several observations indicate that a deregulated expression of these genes may result in tumor development and progression. Actually, several HOX genes are aberrantly expressed in many tumors and cell lines derived from them. Little is known about the expression of HOX genes in brain tumors. In the present work, we study the relative expression of HOX-D genes (D1, D3, D4, D8, D9, D10, D11, D12, D13) with real-time polymerase chain reaction in a group of 14 pediatric low-grade gliomas. We compare the HOX-D expression level of the 14 tumors with the average expression level of six non-neoplastic human brain tissues. HOX-D1 and HOX-D12 resulted over-expressed in neoplastic samples with respect to non-neoplastic brain parenchyma. Conversely, HOX-D3 was expressed at a lower level in gliomas with respect to non-neoplastic brain. HOX-D4, HOX-D11, and HOX-D13 were never expressed. HOX-D8, HOX-D9, and HOX-D10 were exceptionally expressed in non-neoplastic samples and irregularly expressed in tumors. The observation that all but three HOX-D genes studied are expressed with different pattern in neoplastic and non-neoplastic brain tissue may support the hypothesis that HOX-D genes play a role in the pathogenesis of pediatric low-grade gliomas.
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