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1.
Br J Haematol ; 189(6): 1093-1106, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32030738

RESUMO

Population-based studies that assess long-term patterns of incidence, major aspects of treatment and survival are virtually lacking for Hodgkin lymphoma (HL) at a younger age. This study assessed the progress made for young patients with HL (<25 years at diagnosis) in the Netherlands during 1990-2015. Patient and tumour characteristics were extracted from the population-based Netherlands Cancer Registry. Time trends in incidence and mortality rates were evaluated with average annual percentage change (AAPC) analyses. Stage at diagnosis, initial treatments and site of treatment were studied in relation to observed overall survival (OS). A total of 2619 patients with HL were diagnosed between 1990 and 2015. Incidence rates increased for 18-24-year-old patients (AAPC + 1%, P = 0·01) only. Treatment regimens changed into less radiotherapy and more 'chemotherapy only', different for age group and stage. Patients aged 15-17 years were increasingly treated at a paediatric oncology centre. The 5-year OS for children was already high in the early 1990s (93%). For patients aged 15-17 and 18-24 years the 5-year OS improved from 84% and 90% in 1990-1994 to 96% and 97% in 2010-2015, respectively. Survival for patients aged 15-17 years was not affected by site of treatment. Our present data demonstrate that significant progress in HL treatment has been made in the Netherlands since 1990.


Assuntos
Doença de Hodgkin/mortalidade , Sistema de Registros , Adolescente , Adulto , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/terapia , Humanos , Incidência , Masculino , Países Baixos/epidemiologia , Taxa de Sobrevida , Adulto Jovem
2.
Lancet Oncol ; 19(9): 1159-1169, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30098952

RESUMO

BACKGROUND: A deceleration in the increase in cancer incidence in children and adolescents has been reported in several national and regional studies in Europe. Based on a large database representing 1·3 billion person-years over the period 1991-2010, we provide a consolidated report on cancer incidence trends at ages 0-19 years. METHODS: We invited all population-based cancer registries operating in European countries to participate in this population-based registry study. We requested a listing of individual records of cancer cases, including sex, age, date of birth, date of cancer diagnosis, tumour sequence number, primary site, morphology, behaviour, and the most valid basis of diagnosis. We also requested population counts in each calendar year by sex and age for the registration area, from official national sources, and specific information about the covered area and registration practices. An eligible registry could become a contributor if it provided quality data for all complete calendar years in the period 1991-2010. Incidence rates and the average annual percentage change with 95% CIs were reported for all cancers and major diagnostic groups, by region and overall, separately for children (age 0-14 years) and adolescents (age 15-19 years). We examined and quantified the stability of the trends with joinpoint analyses. FINDINGS: For the years 1991-2010, 53 registries in 19 countries contributed a total of 180 335 unique cases. We excluded 15 162 (8·4%) of 180 335 cases due to differing practices of registration, and considered the quality indicators for the 165 173 cases included to be satisfactory. The average annual age-standardised incidence was 137·5 (95% CI 136·7-138·3) per million person-years and incidence increased significantly by 0·54% (0·44-0·65) per year in children (age 0-14 years) with no change in trend. In adolescents, the combined European incidence was 176·2 (174·4-178·0) per million person-years based on all 35 138 eligible cases and increased significantly by 0·96% (0·73-1·19) per year, although recent changes in rates among adolescents suggest a deceleration in this increasing trend. We observed temporal variations in trends by age group, geographical region, and diagnostic group. The combined age-standardised incidence of leukaemia based on 48 458 cases in children was 46·9 (46·5-47·3) per million person-years and increased significantly by 0·66% (0·48-0·84) per year. The average overall incidence of leukaemia in adolescents was 23·6 (22·9-24·3) per million person-years, based on 4702 cases, and the average annual change was 0·93% (0·49-1·37). We also observed increasing incidence of lymphoma in adolescents (average annual change 1·04% [0·65-1·44], malignant CNS tumours in children (average annual change 0·49% [0·20-0·77]), and other tumours in both children (average annual change 0·56 [0·40-0·72]) and adolescents (average annual change 1·17 [0·82-1·53]). INTERPRETATION: Improvements in the diagnosis and registration of cancers over time could partly explain the observed increase in incidence, although some changes in underlying putative risk factors cannot be excluded. Cancer incidence trends in this young population require continued monitoring at an international level. FUNDING: Federal Ministry of Health of the Federal German Government, the European Union's Seventh Framework Programme, and International Agency for Research on Cancer.


Assuntos
Neoplasias/epidemiologia , Adolescente , Distribuição por Idade , Idade de Início , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Neoplasias/diagnóstico , Sistema de Registros , Fatores de Risco , Fatores de Tempo , Adulto Jovem
3.
Cancer Causes Control ; 28(9): 981-984, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28748344

RESUMO

PURPOSE: Cigarette smoking is the leading preventable cause of death and disability from cancer in the U.S. Smoking prevalence varies by racial and ethnic group, and therefore the smoking-related burden of cancer is expected to vary accordingly. METHODS: We estimated the cigarette smoking-attributable Disability-Adjusted Life Years (DALYs) lost to cancer, overall and within racial/ethnic groups, using published DALY estimates, smoking prevalence from survey data, and relative risks from large cohort studies. RESULTS: In 2011, 2.6 million DALYs were lost to cancer due to cigarette smoking (27% of all DALYs lost to cancer). Smoking-attributable DALY rates were higher in men (968 per 100,000 people [95% confidence interval: 943-992]) than women (557 [540-574]). In combined sex analyses, DALY rates were higher in non-Hispanic Blacks (960 [934-983]) and non-Hispanic Whites (786 [768-802]) than in Hispanics (409 [399-421]) and non-Hispanic Asians (335 [320-350]). CONCLUSIONS: Smoking-attributable cancer burden was substantial in all racial and ethnic groups, underscoring the need for intensified tobacco cessation in all populations.


Assuntos
Fumar Cigarros/epidemiologia , Neoplasias/epidemiologia , Adulto , Fumar Cigarros/etnologia , Estudos de Coortes , Etnicidade , Feminino , Humanos , Masculino , Neoplasias/etnologia , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , Grupos Raciais , Estados Unidos/epidemiologia , Estados Unidos/etnologia
4.
Ann Surg Oncol ; 22(5): 1598-603, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25408275

RESUMO

PURPOSE: Based on prior studies, we concluded that the female advantage in melanoma survival is caused by biological factors and not by differences in patient behavior. In this study, we investigated whether this biological advantage was caused by more aggressive tumors in males, as measured by mitotic rate (MR). METHODS: Data for patients with complete information on MR, Breslow thickness, ulceration and primary tumor location were extracted from the database of Melanoma Institute Australia in Sydney. A negative binomial regression model was used to assess the independent predictive value of sex for MR. Also, the impact of MR on the sex survival advantage was investigated using Cox proportional hazards models. RESULTS: A total of 9,306 patients were included in the analysis. Although males had a slightly higher MR at diagnosis, sex was not an independent predictor of MR after adjustment for all other prognostic factors: incidence rate ratio 0.98, 95 % confidence interval (CI) 0.93-1.02, p = 0.32. After adjustment for all prognostic factors, females had a survival advantage of 36 % (hazard ratio 0.65, 95 % CI 0.55-0.75, p < 0.001). When added as a confounder, MR did not influence this sex hazard ratio. CONCLUSIONS: Sex did not independently predict the aggressiveness of a primary melanoma. Furthermore, MR did not influence the known female survival advantage. Based on these results, the biological trait underlying sex survival differences in melanoma seems not to be tumor-related and therefore is more likely to be caused by host factors.


Assuntos
Melanoma/mortalidade , Melanoma/patologia , Mitose , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Índice Mitótico , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores Sexuais , Taxa de Sobrevida
5.
Haematologica ; 100(4): 525-33, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25512643

RESUMO

Only a small number of patients with aggressive B-cell lymphoma take part in clinical trials, and elderly patients in particular are under-represented. Therefore, we studied data of the population-based nationwide Netherlands Cancer Registry to determine trends in incidence, treatment and survival in an unselected patient population. We included all patients aged 15 years and older with newly diagnosed diffuse large B-cell lymphoma or Burkitt lymphoma in the period 1989-2010 and mantle cell lymphoma in the period 2001-2010, with follow up until February 2013. We examined incidence, first-line treatment and survival. We calculated annual percentage of change in incidence and carried out relative survival analyses. Incidence remained stable for diffuse large B-cell lymphoma (n=23,527), while for mantle cell lymphoma (n=1,634) and Burkitt lymphoma (n=724) incidence increased for men and remained stable for women. No increase in survival for patients with aggressive B-cell lymphoma was observed during the period 1989-1993 and the period 1994-1998 [5-year relative survival 42% (95%CI: 39%-45%) and 41% (38%-44%), respectively], but increased to 46% (43%-48%) in the period 1999-2004 and to 58% (56%-61%) in the period 2005-2010. The increase in survival was most prominent in patients under 65 years of age, while there was a smaller increase in patients over 75 years of age. However, when untreated patients were excluded, patients over 75 years of age had a similar increase in survival to younger patients. In the Netherlands, survival for patients with aggressive B-cell lymphoma increased over time, particularly in younger patients, but also in elderly patients when treatment had been initiated. The improvement in survival coincided with the introduction of rituximab therapy and stem cell transplantation into clinical practice.


Assuntos
Linfoma de Células B/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Progressão da Doença , Feminino , História do Século XX , História do Século XXI , Humanos , Incidência , Linfoma de Células B/diagnóstico , Linfoma de Células B/história , Linfoma de Células B/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Países Baixos/epidemiologia , Vigilância da População , Sistema de Registros , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
6.
Ann Hematol ; 94(1): 45-56, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25038918

RESUMO

As survival of patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) increases and the number of patients who live long rises, health-related quality of life (HRQoL) becomes a relevant endpoint. Few studies investigated this, mainly as a secondary endpoint in randomized clinical trials where patients with early stage CLL/SLL, and elderly/frail patients were underrepresented. The aim of our study was to assess HRQoL in a population-based setting, including these previously underrepresented patients. Out of 175 patients diagnosed with CLL/SLL between 2004 and 2011, 136 (78 %) returned the HRQoL questionnaire. The outcomes were compared to an age- and sex-matched norm population. Detailed data on stage and treatment were extracted from a population-based hematological registry (PHAROS). Patients ever treated for CLL/SLL reported significantly poorer HRQoL than the norm population (p < 0.01 with large clinically important differences. Interestingly, no differences were observed between the norm population and patients under active surveillance. In contrast to our hypothesis, patients treated with chlorambucil reported the lowest HRQoL scores. Drastic, long-lasting negative effects of starting treatment on HRQoL cannot be excluded, whereas active surveillance does not seem to provoke worrying, anxiety, or depressive symptoms. Further elaborate research into the impact of starting therapy on HRQoL is needed, especially in patients that are underrepresented in most clinical trials, and thoroughly consider its results during revision of treatment guidelines.


Assuntos
Antineoplásicos Alquilantes/uso terapêutico , Clorambucila/uso terapêutico , Leucemia Linfocítica Crônica de Células B/epidemiologia , Leucemia Linfocítica Crônica de Células B/terapia , Vigilância da População , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/diagnóstico , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Vigilância da População/métodos , Qualidade de Vida/psicologia , Sistema de Registros
7.
Int J Cancer ; 134(3): 674-81, 2014 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-23873096

RESUMO

Cancer of the larynx is a frequently occurring head and neck cancer in The Netherlands. The main risk factors are smoking and excessive alcohol consumption. The aim of our study was to evaluate the progress against laryngeal cancer by studying trends in incidence, mortality and survival in The Netherlands. All patients in The Netherlands Cancer Registry diagnosed with invasive primary squamous cell carcinoma of the larynx during the period 1989-2010 were included for analysis. Time trends in incidence, mortality, treatment and survival were described for the total group and stratified by sex and subsite: glottis, supraglottis and subglottis. The most frequently affected subsite for men was the glottis (69%) and for women the supraglottis (55%). Glottic cancer was diagnosed at lower stages than supraglottic cancer. Incidence and mortality rates decreased for males with -2.5 and -2.8% per year, respectively, but remained stable for women, except for an increasing mortality rate in older women (EAPC: +2.5%). Five-year relative survival rates were stable for glottic (85%) and supraglottic (50%) cancer, whereas patients with high-staged cancers more often received radiotherapy. Multivariable analysis showed lower relative excess risks of dying for women, younger patients (<75 years), glottic cancer, lower stage cancer and those undergoing surgery. Changes in incidence and mortality rates are in line with changing smoking habits in The Netherlands. Declining incidence with stable survival rates gives rise to hope and worry at the same time.


Assuntos
Carcinoma de Células Escamosas/prevenção & controle , Neoplasias Laríngeas/prevenção & controle , Idoso , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/mortalidade , História do Século XX , História do Século XXI , Humanos , Incidência , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/mortalidade , Países Baixos/epidemiologia
8.
Int J Cancer ; 135(4): 905-12, 2014 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-24420527

RESUMO

Our study assessed whether rising age, socioeconomic status (SES) and the presence of serious comorbidity affected treatment choice and survival in a population-based series of patients with muscle-invasive bladder cancer (MIBC) in The Netherlands. Therefore, a consecutive series was studied, including all patients diagnosed with MIBC between 1995 and 2009 in the Eindhoven Cancer Registry, preceding centralization of cystectomy. The independent effects of age, SES and serious comorbidity on therapy choice and their effects on overall survival were estimated by multivariate logistic regression and multivariate Cox proportional hazard analyses, respectively. Out of the 2,445 patients, 38% were aged ≥ 75 years at diagnosis and 63% had at least one serious comorbid condition. Higher age and serious comorbidity were independent predictors for abstaining from cystectomy, where SES was not (61-74 vs. ≤ 60: odds ratio [OR], 0.8; 95% confidence interval [CI], 0.6-1.0; ≥ 75 vs. ≤ 60: OR, 0.1; 95% CI,0.1-0.2; one comorbid condition vs. none: OR, 0.7; 95% CI, 0.5-0.9; two vs. none: OR, 0.6; 95% CI, 0.5-0.8). Patients undergoing cystectomy, external beam radiotherapy or interstitial radiotherapy survived longer independent of age, SES and serious comorbidity (hazard ratio [HR]: 0.4; 95% CI: 0.4-0.5; HR: 0.8; 95% CI: 0.7-0.9; HR: 0.4; 95% CI: 0.3-0.5, respectively). Consequently, preceding centralization of cystectomy, higher age and serious comorbidity were independent predictors for abstaining from cystectomy owing to an expected high rate of short-term medical problems. As cystectomy is associated with a better survival, independently of age, SES and serious comorbidity, it can be questioned whether cystectomy has been underutilised in elderly and in patients with serious comorbidity. Centralization might be a solution for this suggested underutilisation.


Assuntos
Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Cistectomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Músculo Liso/patologia , Invasividade Neoplásica , Países Baixos , Razão de Chances , Prognóstico , Modelos de Riscos Proporcionais , Classe Social , Resultado do Tratamento , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/epidemiologia
9.
Int J Cancer ; 135(1): 157-65, 2014 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-24285345

RESUMO

Observational and intervention studies suggest that low dose aspirin use may prevent cancer. The objective of this study was to investigate the protective effect of long term low dose aspirin use (≤100 mg daily) on cancer in general and site-specific cancer among low dose aspirin users in the Dutch general population. We conducted a population-based cohort study with detailed information on aspirin exposure and cancer incidence. Only incident (new) low dose aspirin users, who were included in the linkage between PHARMO and the Eindhoven Cancer Registry (1998-2010) and free of cancer before the start of follow up were included. A Cox proportional hazard model with cumulative aspirin use as a time-varying determinant was used to obtain hazard ratios (HR). Duration of aspirin use amongst 109,276 incident low dose aspirin users was not associated with a decreased risk of any of the site-specific cancers or cancer in general (adjusted HR per year of aspirin use for all cancers: 1.02, 95% confidence interval [CI] 1.00-1.04, HR of >6 years aspirin use compared to <2 years: 1.17, 95% CI 1.02-1.34). After adjusting for current and past aspirin use, 2-6 years of low dose aspirin use was associated with a reduced colorectal cancer risk compared to <2 years of aspirin use (adjusted HR 0.75, 95% CI 0.59-0.96). However, a clear dose-response relationship was not observed (adjusted HR >6 years aspirin use 0.95, 95% CI 0.60-1.49). Our results do not support the primary prevention of cancer among long term aspirin users.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Aspirina/uso terapêutico , Neoplasias/tratamento farmacológico , Adulto , Idoso , Estudos de Coortes , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/patologia , Modelos de Riscos Proporcionais , Fatores de Risco
10.
Breast Cancer Res Treat ; 145(2): 429-37, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24748569

RESUMO

We determined the re-attendance rate at screening mammography after a single or a repeated false positive recall and we assessed the effects of transition from screen-film mammography (SFM) to full-field digital mammography (FFDM) on screening outcome in women recalled twice for the same mammographic abnormality. The study population consisted of a consecutive series of 302,912 SFM and 90,288 FFDM screens. During a 2 years follow-up period (until the next biennial screen), we collected the breast imaging reports and biopsy results of all recalled women. Re-attendance at biennial screening mammography was 93.2 % (95 % CI 93.1-93.3 %) for women with a negative screen (i.e., no recall at screening mammography), 65.4 % (95 % CI 64.0-66.8 %) for women recalled once, 56.7 % (95 % CI 47.1-66.4 %) for women recalled twice but for different lesions and 44.3 % (95 % CI 31.4-57.1 %) for women recalled twice for the same lesion. FFDM recalls comprised a significantly larger proportion of women who had been recalled twice for the same lesion (1.9 % of recalls (52 women) at FFDM vs. 0.9 % of recalls (37 women) at SFM, P < 0.001) and the positive predictive value of these recalls (PPV) was significantly lower at FFDM (15.4 vs. 35.1 %, P = 0.03). At review, 20 of 52 women (39.5 %, all with benign outcome) would not have been recalled for a second time at FFDM if the previous hard copy SFM screen had been available for comparison. We conclude that a repeated false positive recall for the same lesion significantly lowered the probability of screening re-attendance. The first round of FFDM significantly increased the proportion of women recalled twice for the same lesion, with a significantly lower PPV of these lesions. Almost 40 % of repeatedly recalled women would not have been recalled the second time if the previous hard copy SFM screen had been available for comparison at the time of FFDM.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Reações Falso-Positivas , Mamografia/métodos , Participação do Paciente/estatística & dados numéricos , Neoplasias da Mama/patologia , Feminino , Humanos , Programas de Rastreamento/estatística & dados numéricos , Países Baixos
12.
Haematologica ; 99(2): 339-45, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24038025

RESUMO

Survival rates determined at diagnosis are often too negative for cancer survivors. Conditional relative survival reflects actual prognosis during follow-up better. Data from all 54,015 patients newly diagnosed in the Netherlands with B-cell non-Hodgkin lymphoma during 1989-2008, aged 15-89 years (Netherlands Cancer Registry), were used. Five-year conditional relative survival was computed for every additional year of survival up to 16 years after diagnosis, according to entity, grade, gender, age, and Ann Arbor stage. The prognosis for survivors of indolent B-cell non-Hodgkin lymphoma improved slightly with each additional year survived up to 91%. For patients with aggressive non-Hodgkin lymphoma conditional relative survival improved strongly during the first year after diagnosis (from 48% to 68%) and gradually thereafter to 93% after 16 years. There were differences between morphological entities. Initial differences in conditional relative survival at diagnosis between groups with different disease stages became smaller with increasing number of years survived. Age remained a prognostic indicator, also after prolonged follow-up. These results help caregivers to plan optimal surveillance and inform patients about their actual prognosis during follow-up. Long-lasting excess mortality among patients with B-cell non-Hodgkin lymphoma indicates the need for additional care long after their diagnosis.


Assuntos
Linfoma de Células B , Sistema de Registros , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Seguimentos , Humanos , Linfoma de Células B/diagnóstico , Linfoma de Células B/mortalidade , Linfoma de Células B/patologia , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
13.
Ann Hematol ; 93(10): 1705-15, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24807105

RESUMO

The increasing number of longer-living patients with diffuse large B-cell lymphoma (DLBCL) and serious side effects of treatment urged us to study the health-related quality of life (HRQoL) and persistent (treatment-related) symptoms in unselected patients after different treatment modalities and compare HRQoL of patients with a normative population. The population-based Eindhoven Cancer Registry was used to select all patients diagnosed with DLBCL from 2004 to 2010. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) was completed twice, with a 1-year interval. Detailed data on treatment were extracted from the Population-based HAematological Registry for Observational Studies. Two hundred fifty-six patients responded (84 %, T1). Compared to patients treated with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone every 21 days ((R-)CHOP21), those who underwent (R-)CHOP14 more often reported tingling in the hands and feet (27 vs 42 %, p = 0.02) and fatigue (35 vs 46 %, p = 0.03) and reported a lower global health status/HRQoL. Mean HRQoL was statistically and clinically relevantly lower among DLBCL patients compared to a normative population (p < 0.01). Persistent tingling in hands/feet was reported more often by older patients and patients treated with (R-)CHOP14 independently of the other characteristics. Furthermore, patients who reported symptoms exhibited significantly lower HRQoL compared to patients without symptoms/worries. Patients treated with (R-)CHOP14 reported more neuropathic symptoms, more fatigue, and a lower HRQoL than patients treated with (R-)CHOP21. Alertness for persistent symptoms that occur during and after treatment of DLBCL patients is needed and may help to avoid lasting negative influence on their HRQoL.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Qualidade de Vida , Sobreviventes/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Murinos/administração & dosagem , Anticorpos Monoclonais Murinos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Ansiedade/epidemiologia , Ansiedade/etiologia , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Fadiga/induzido quimicamente , Fadiga/epidemiologia , Feminino , Seguimentos , Gastroenteropatias/induzido quimicamente , Gastroenteropatias/epidemiologia , Humanos , Linfoma Difuso de Grandes Células B/economia , Linfoma Difuso de Grandes Células B/epidemiologia , Linfoma Difuso de Grandes Células B/psicologia , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Neuralgia/induzido quimicamente , Neuralgia/epidemiologia , Parestesia/induzido quimicamente , Parestesia/epidemiologia , Satisfação do Paciente , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Sistema de Registros , Rituximab , Inquéritos e Questionários , Avaliação de Sintomas , Vincristina/administração & dosagem , Vincristina/efeitos adversos
14.
BJU Int ; 114(5): 691-7, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24131890

RESUMO

OBJECTIVE: To estimate the population-based conditional 5-year relative survival rates for patients with prostate cancer (PCa). PATIENTS AND METHODS: All 98 672 patients, aged 45-89 years, diagnosed in the Netherlands with PCa (clinical T stage 1-4) in the period 1989-2008 were selected from the Netherlands Cancer Registry and followed up until 2010. The conditional 5-year relative survival rate was estimated for every subsequent year of survival up to 15 years after diagnosis. RESULTS: The conditional 5-year relative survival rate decreased with survival time from diagnosis. Excess mortality (conditional 5-year relative survival rate <95%) for patients with clinical T1 stage only became manifest 5 years after diagnosis and increased to almost 10% after 10 years. Patients with more advanced disease (cT2-cT4) were found to have an excess mortality rate of 6-12% at diagnosis, which increased to 15-22% after 10 years. Excess mortality occurred earlier for the older age groups. The 5-year relative survival rate at diagnosis was <90% for all age groups of patients with cT3/cT4 disease and excess mortality for this group increased to >20% for those who had already survived for 5 years since diagnosis. CONCLUSIONS: Patients with PCa were found to have excess mortality within 10 years of diagnosis. Excess mortality was found at an earlier timepoint for patients with a more advanced stage and for older age groups. Quantitative insight into conditional survival is useful for caregivers to help plan optimum cancer treatment and surveillance and to inform patients about their actual prognosis during follow-up, taking the current condition of the patient into account.


Assuntos
Neoplasias da Próstata/mortalidade , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prognóstico , Neoplasias da Próstata/diagnóstico , Sistema de Registros , Análise de Sobrevida
15.
Eur J Haematol ; 93(3): 229-38, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24702126

RESUMO

OBJECTIVES: The increasing number of longer living patients with follicular lymphoma (FL) and serious side effects of treatment urged us to study the health-related quality of life (HRQoL) and persistent (treatment-related) symptoms in unselected patients after different treatment modalities and compare HRQoL of patients with a normative population. METHODS: The population-based Eindhoven Cancer Registry was used to select patients diagnosed with FL during 2004-2010. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) was completed twice, with a 1-yr interval. This questionnaire was also completed by an age- and sex-matched normative population (N = 580). Detailed data on treatment were extracted from the cancer registry and Population-based HAematological Registry for Observational Studies (PHAROS). RESULTS: Of the 181 patients who were invited, 148 responded (82%, T1). Patients treated with immunochemotherapy reported clinically relevant higher mean fatigue scores than those who underwent radiotherapy (P = 0.02). No differences were observed on the other HRQoL scales between treatment groups. Mean HRQoL scores were worse for FL patients treated with immunochemotherapy compared with a normative population (P < 0.01). A quarter to 50% of patients persistently reported to be slowed down, lethargic, or persistently worried about future health or was limited in social activities. Subsequently, patients reporting these symptoms/worries had a lower global health status/HRQoL. CONCLUSION: Alertness for persistent symptoms that occur during and after treatment of FL patients is needed and may help to avoid lasting negative influence on their HRQoL.


Assuntos
Linfoma Folicular/psicologia , Qualidade de Vida/psicologia , Sistema de Registros , Sobreviventes/psicologia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Ansiedade/fisiopatologia , Ansiedade/psicologia , Estudos de Casos e Controles , Fadiga/fisiopatologia , Fadiga/psicologia , Feminino , Raios gama/uso terapêutico , Transplante de Células-Tronco Hematopoéticas/psicologia , Humanos , Imunoterapia/psicologia , Linfoma Folicular/patologia , Linfoma Folicular/terapia , Masculino , Pessoa de Meia-Idade , Dor/fisiopatologia , Dor/psicologia , Inquéritos e Questionários
16.
Acta Oncol ; 53(3): 342-50, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23992111

RESUMO

BACKGROUND: Worldwide marked changes have been observed in the incidence and survival of testicular cancer (TC) during the last decades. We conducted a study on trends in TC incidence, treatment, survival, and mortality in the Netherlands during the period 1970-2009 with specific focus on trends according to age, histology and stage of disease. METHODS: Data from the Eindhoven cancer registry, the Netherlands cancer registry and Statistics Netherlands was used. Age-standardized incidence and mortality rates and five-year relative survival were calculated. Treatment was categorized into five major groups. RESULTS: TC incidence showed a substantial annual increase of 3.9% in the period 1989-2009. The incidence increased for all stages of both seminoma and non-seminoma TC. Stage distribution for the non-seminoma patients shifted towards more localized disease. Most patients received primary treatment according to the guidelines. Five-year relative survival improved (non-significantly) for most groups of stage and histology. TC mortality dropped sharply in the 1970s and 1980s and remained relatively stable thereafter. CONCLUSION: This study shows that incidence of TC has increased sharply in the Netherlands. Relative survival is high and improved in most disease stages. There is a growing demand for medical care of newly diagnosed TC patients and for the rapidly increasing number of prevalent TC patients.


Assuntos
Neoplasias Testiculares/epidemiologia , Neoplasias Testiculares/mortalidade , Adolescente , Adulto , Distribuição por Idade , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Seminoma/epidemiologia , Seminoma/mortalidade , Seminoma/patologia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/terapia , Adulto Jovem
17.
Acta Oncol ; 53(1): 138-42, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23829603

RESUMO

BACKGROUND: Gastric cardia and non-cardia cancer exhibit differences in biological and epidemiological features across the world. The aims of this study were to analyze trends in incidence, stage distribution, and survival over a 20-year period in the Netherlands, separately for both types of gastric cancer. METHODS: Data on all patients with a diagnosis of gastric cancer in the period 1989-2008 were obtained from the nationwide Netherlands Cancer Registry. Time trends in incidence [analyzed as European Standard Rate per 100 000 (ESR)] and relative survival were separately analyzed for cardia and non-cardia gastric cancer. RESULTS: A total of 47 295 patients were included. Incidence rates per 100 000 for cardia cancer declined from 5.7 to 4.3 for males and remained stable for females (1.2). For non-cardia cancer, the incidence in males declined from 25 to 14 and in females from 10 to 7. Proportional incidence in stage IV cardia and non-cardia cancer increased in 2004-2008 (cardia 32-42%, non-cardia 33-45%). Five-year survival rates for stage I-III and X (unknown) remained stable (cardia cancer: 20%, non-cardia gastric cancer: 31%). Five-year survival for stage IV disease was 1.9% and 1.0% for cardia and non-cardia gastric cancer. CONCLUSION: The incidence of gastric cancer in the Netherlands markedly decreased over the past decades, in particular of non-cardia cancer. Survival remained dismal. Improvement of survival remains a challenge for the multidisciplinary team involved in gastric cancer treatment.


Assuntos
Adenocarcinoma/epidemiologia , Cárdia/patologia , Neoplasias Gástricas/epidemiologia , Adenocarcinoma/secundário , Idoso , Feminino , Seguimentos , Humanos , Incidência , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Países Baixos/epidemiologia , Prognóstico , Sistema de Registros , Neoplasias Gástricas/patologia , Taxa de Sobrevida , Fatores de Tempo
18.
Cancer ; 119 Suppl 11: 2109-23, 2013 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-23695923

RESUMO

BACKGROUND: With the increasing number and diversity of cancer survivors, studies of survivors' physical, emotional, and social health and well being are of growing importance. Population-based cancer registries, which collect data on incident cases, can play an important role in quality-of-life (QoL) studies. In this review, the authors provide an overview of QoL studies that have used cancer registry data in this emerging area of research. METHODS: Publication databases were searched for relevant peer-reviewed original articles published between 2001 and mid-2011. Inclusion criteria were articles published in English that used cancer registries as the sampling frame and/or that used registry data in analyses with QoL data. All included articles were assessed on the quality of information provided, cancer registry procedures, and study design. RESULTS: In total, 173 articles from 13 countries were reviewed, and a large proportion were from the United States (n = 72) and Europe (n = 70). Fourteen different malignancies were studied, and the most frequent were breast cancer. Most studies focused on adult survivors, and only 4 focused on the elderly (aged >70 years). Of the reviewed articles, 110 (64%) provided a good amount of information on the cancer registry. Information less frequently reported included mainly follow-up of vital status and characteristics of respondents/nonrespondents. CONCLUSIONS: QoL studies increasingly use population-based registries, which provide important clinical variables and an excellent sampling frame for identifying subgroups. Until now, most studies have tended to focus on more prevalent cancers, and surprisingly few studies have focused on QoL of elderly survivors, who remain understudied in clinical trials.


Assuntos
Neoplasias/mortalidade , Neoplasias/psicologia , Europa (Continente)/epidemiologia , Humanos , Neoplasias/reabilitação , Qualidade de Vida , Sistema de Registros , Taxa de Sobrevida , Sobreviventes , Estados Unidos/epidemiologia
19.
Cancer Causes Control ; 24(6): 1111-8, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23529470

RESUMO

PURPOSE: Within Europe, incidence and mortality rates of childhood leukemia and lymphoma are rather heterogeneous. The present study comprising data from five Southern and Eastern European Cancer Registries aims to compare time trends and examine whether sociodemographic variables, clinical parameters, and proxies of efficient care affect survival. METHODS: Data spanning 1996-2010 were obtained for a total of 3,041 newly diagnosed childhood leukemia and 1,183 lymphoma cases reported by the Greek Nationwide Registry for Childhood Hematological Malignancies, Bulgarian National Cancer Registry, Moscow Region and Turkey (Antalya and Izmir) Cancer Registries. Poisson modeling for the evaluation of time trends and multivariate Cox regression analysis for the assessment of prognostic factors were performed. RESULTS: The incidence of leukemia was increasing in all cases, with Bulgaria and Greece presenting statistically significant annual changes (+3.5, and +1.7 %, respectively), followed by marginally increasing trends in Izmir and Moscow; by contrast, there was a remarkable, statistically significant, decreasing mortality trend for leukemia. Rates for lymphoma remained flat. Greece experienced almost twofold better survival rates for both leukemia and lymphoma, probably due to its higher socioeconomic status during the study period. Overall, patients with leukemia living in rural areas had a 28 % lower prognosis (RR: 1.28, 95 % CI 1.03-1.59), pointing to effects of remoteness, when the most privileged country (Greece) was excluded from the analysis. CONCLUSIONS: The favorable mortality trends highlight the progress in Southern-Eastern European countries along their trajectory to converge with Northern-Western EU counterpart states. Socioeconomic status may act as a multipotent factor underlying the study findings.


Assuntos
Leucemia/mortalidade , Linfoma/mortalidade , Adolescente , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Humanos , Incidência , Lactente , Leucemia/epidemiologia , Linfoma/epidemiologia , Sistema de Registros , Classe Social , Análise de Sobrevida
20.
Haematologica ; 98(3): 479-86, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22929981

RESUMO

The course of fatigue and quality of life in survivors of non-Hodgkin's lymphoma is unknown. The aims of this study were, therefore, to assess fatigue and quality of life in patients with non-Hodgkin's lymphoma following primary treatment, compare fatigue and quality of life in these patients with those of an age- and sex matched normative population to assess the severity of concerns and identify associations with fatigue of survivors who remained fatigued. The population-based Eindhoven Cancer Registry was used to select all patients diagnosed with non-Hodgkin's lymphoma from 1999-2009. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the Fatigue Assessment Scale were completed once by 824 survivors of non-Hodgkin's lymphoma (80% response rate); 434 survivors completed these questionnaires again 1 year later. Survivors of non-Hodgkin's lymphoma reported more clinically relevant fatigue up till 10 years post-diagnosis compared to a normative population (P<0.001). Mean fatigue scores remained fairly stable over time (T1: x=28, SD=26; T2: x=30, SD=27, P=0.14): 22-28% of survivors reported deterioration, 19-23% reported improvement and 44-54% reported constant fatigue. Survivors who reported constant fatigue were more often diagnosed with stage IV disease and had more comorbid diseases. They were additionally more often female and divorced. Having comorbidities and being without a partner were also associated with constant fatigue in the normative population. In conclusion, six out of every ten responding non-Hodgkin's lymphoma survivors reported a high level of fatigue up till 10 years after diagnosis. Mean fatigue scores remained stable over time and survivors reporting constant fatigue more often had stage IV disease at diagnosis and comorbidities.


Assuntos
Fadiga/epidemiologia , Fadiga/etiologia , Linfoma não Hodgkin/complicações , Sobreviventes , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Razão de Chances , Vigilância da População , Qualidade de Vida , Sistema de Registros , Fatores de Risco , Inquéritos e Questionários
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