Trends in Incidence and Mortality of Gynecological and Breast Cancers in Poland (1980-2018).

BACKGROUND: This study aimed to analyze and determine the incidence and mortality trends in gynecological and breast cancers (BCs) in Poland. The gynecological cancers assessed were cervical cancer (CC), corpus uteri cancer (CUC), ovarian cancer (OC), vaginal cancer (VAC), and vulvar cancer (VUC). PATIENTS AND METHODS: Data concerning the incidence and mortality for the period of 1980-2018 were obtained from the Polish National Cancer Registry (PNCR). Joinpoint regression analysis was performed to identify trends, which were described using the annual percentage change (APC) and the average annual percent change (AAPC). RESULTS: Statistically significant increases were observed in BC incidence (AAPC: 2.3; CI: 1.8 to 2.9; p<0.05), CUC incidence (AAPC: 2.3; CI: 1.9 to 2.7; p<0.05), CUC mortality (AAPC: 0.4; CI: 0.1 to 0.7; p<0.05) and VUC mortality (AAPC: 1.16, CI: 0.1 to 2.2; p<0.05). VAC mortality decreased (AAPC: -3.5, CI: -5.0 to -2.0; p<0.05), as did CC incidence and mortality (AAPC: -2.1, CI: -2.3 to -1.8; p<0.05, AAPC: -2.0, CI: -2.2 to -1.8; p<0.05, respectively). Between 1980 and 1993, OC incidence initially increased and then stabilized (AAPC: 0.9; CI: 0.7 to 1.1; p<0.05). After 2007, OC mortality decreased (AAPC: 0.0; CI: -0.2 to 0.2; p=0.8). Trends in VUC and VAC incidence and BC mortality were not statistically significant. CONCLUSION: The results of this study showed a significant increase in OC, CUC, and BC incidence, and a decrease in the incidence of CC and VAC. The VUC trends were stable. Mortality trends for BC initially fluctuated and, since 2010, has begun to increase. Throughout the observed period, mortality due to VUC and CUC increased, whereas decreased among patients with CC. OC mortality was stable, but not significant. Furthermore, the study showed a correlation between age group and rate of incidence and mortality of each assessed cancer.

A prospective study to validate the Polish language version of the European Organisation for Research and Treatment of Cancer (EORTC) Colorectal Liver Metastases (QLQ-LMC21) module.

PURPOSE: This validation study was designed to assess the psychometric validity and quality of the Polish translation of the EORTC QLQ-LMC21 questionnaire in Polish colorectal patients suffering with liver metastases. METHODS: Patients with either histopathological or imaging confirmation of colorectal cancer with liver metastases, with a minimum of three months survival, were eligible for this study. These patients completed the Polish version of the EORTC core QLQ-C30, the QLQ-LMC21 module, and a demographic data questionnaire. The questionnaires were completed twice, once before undergoing either hepatectomy (n = 63) or palliative treatment (n = 97) and three months after the primary treatment. Standardized analyses of validity and reliability were performed. RESULTS: One hundred and sixty patients were enrolled in this study with the mean age of the hepatectomy group 64.3 ± 14.1 and 66.1 ± 12.7 for the palliative treatment group. The QLQ-LMC21 exhibited positive internal consistency with Cronbach's alpha coefficients ranging from 0.72 to 0.90. The multi-trait scaling analysis demonstrated adequate convergent and discriminant validity. Test-retest reliability was undertaken with 40 patients (25%) with the ICCs for each item ranging from 0.64 to 0.88. The hepatectomy group had a significantly greater Karnofsky Performance Score than the palliative treatment group (p.<0.001). Overall there were weak correlations between the two questionnaires which confirm that the QLQ-LMC21 addresses health issues not assessed in the QLQ-C30. CONCLUSION: The Polish version of the QLQ-LMC21 proved to be a valid and reliable questionnaire to use in conjunction with the QLQ-C30 core questionnaire.

Validation of the Polish version of the EORTC Head and Neck module (QLQ-H&N35).

AIM: The aim of this study was to psychometrically validate the EORTC translated, Polish version of the EORTC QLQ-H&N35 questionnaire to support using it in the Polish clinical setting in patients with head and neck malignancies. MATERIALS AND METHODS: Patients with histologically confirmed head and neck malignancies were included in the study. All patients filled in the Polish version of the EORTC QLQ-C30, the EORTC QLQ-H&N35 module, and a demographic questionnaire. Standardized validity and reliability analyses were performed. RESULTS: During the recruitment period a total of 176 patients (82 females - 46.6%) were enrolled into the study, with a mean age of 54.3 ± 11.2 years. Cronbach alpha values ranged from 0.71 to 0.87. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. CONCLUSIONS: The Polish version of the EORTC QLQ-H&N35 module is a reliable and valid tool for measuring HRQoL in Polish patients with head and neck malignancies. It can be fully recommended for use in the Polish clinical setting.

Evaluation of tolerance and toxicity of high-dose-rate brachytherapy boost combined with interstitial hyperthermia for prostate cancer.

Purpose The aim of this retrospective study was to evaluate the tolerance and early as well as late toxicity of high dose rate brachytherapy (HDRBT) boost combined with interstitial hyperthermia (IHT) in patients treated for prostate cancer. Material and methods Between January 2011 and June 2013 76 patients diagnosed with prostate cancer received treatment consisting of external beam radiotherapy (EBRT), followed by a HDRBT boost combined with IHT. IHT was performed before each brachytherapy fraction. Results The median follow-up time was 26.3 months (range 7-43 months). Early genitourinary (GU) grade 1 and 2 toxicities were common, but only two patients (2.6%) experienced acute urinary retention requiring temporary catheterisation (grade 2 toxicity). No grade 3 or 4 genitourinary or gastrointestinal toxicities were observed. In the group analysed, 59 of 76 patients had follow-up times longer than 18 months. The incidence of grade 2 late toxicity in the group studied did not exceed 23.7%. There were no late grade 2 or higher complications from the gastrointestinal tract. Conclusions The tolerance of HDRBT boost combined with IHT is good. The profile and the percentage of early and late complications are acceptable.

Gastroscopy in patients with hiatal hernia with and without gastroesophageal mucosal prolapse.

There are still many doubts in the literature regarding gastroesophageal mucosal prolapse (GEMP) and its clinical course. We still do not know what determines mucosal wedging in esophagogastric junction, and what is the role of the anatomy of that site. To investigate that problem we performed 120 upper digestive tract endoscopies in which a hiatal hernia was diagnosed. Patients referred to our unit with different complaints most frequently of typical or atypical gastroesophageal (GE) reflux symptoms. The aim of that study was to assess hernia dimensions in patients with and without GEMP diagnosed during endoscopy. Additionally we analyzed the type and prevalence of gastrointestinal symptoms reported by patients to confirm the observation that GEMP symptoms differ from gastroesophageal reflux disease (GERD) symptoms. METHODS: One-hundred and twenty patients were included in this study. All of the patients were diagnosed with a hiatal hernia during routine gastroscopy. Using standardized methodology the region of the hiatal hernia was photographed, and hernia longitudinal and transverse dimensions were measured. RESULTS: The study group comprised 57 females (52.5%) and 63 males - mean age (SD) 58.5 ± 18.4. Most of the patients had standard GERD symptoms (n = 96; 80%). The average length of hiatus, in patients with GEMP (n = 24; 20%) was 3.56 ± 0.59 cm, and the average width was 2.32 ± 0.62 cm (n = 96; 80%) vs. 4.64 ± 0.74 cm and 2.98 ± 0.68 cm respectively in patients without GEMP (p <0.001). CONCLUSIONS: GEMP occurs in smaller sized hiatal hernias. We confirmed that disease symptoms of the majority of patients with GEMP differ from patient with GERD but without GEMP. However this difference was not significant enough to allow to differentiate between diagnoses based solely on the symptoms.

Validation of the Polish version of the EORTC QLQ-BM22 module for the assessment of health-related quality of life in patients with bone metastases.

PURPOSE: The aim of our study was to undertake a prospective validation study of the Polish version of the European Organization for Research and Treatment of Cancer (EORTC) bone metastases (QLQ-BM22) module used alongside the EORTC core measure. METHODS: The translated module was pilot-tested according to the established EORTC guidelines. Patients with histological confirmation of malignancy and bone metastases, diagnosed by imaging studies, were eligible for the study. All patients filled out the Polish version of the QLQ-BM22 module in addition to QLQ-C30 and a demographic questionnaire. Standard validity and reliability analyses were performed. RESULTS: One hundred and fifty-five patients were enrolled into the study, including 94 women (60.7 %) and 61 men (mean age ± SD; 59.1 ± 12.1). Cronbach's alpha coefficients, range 0.68-0.93, showed positive internal consistency. Re-test was undertaken with fifty patients (32.3 %). Interclass correlations for the EORTC QLQ-BM22 ranged from 0.91 to 0.93 and proved sufficient test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. CONCLUSIONS: Our study provides new and robust evidence which shows that the Polish version of the QLQ-BM22 module is a valid and reliable instrument for measuring health-related quality of life in patients with bone metastases. It is suitable for use in clinical trials and in research.

Validation of the Polish version of the EORTC QLQ-OV28 module for the assessment of health-related quality of life in women with ovarian cancer.

The aim of our study was to undertake a prospective validation study of the Polish version of the EORTC ovarian cancer (EORTC QLQ-OV28) module used together with the EORTC QLQ-C30. The translated module was pilot-tested according to the EORTC guidelines. Patients with histological confirmation of ovarian cancer were eligible for the study. All patients filled out the Polish version of the EORTC QLQ-OV28, the EORTC QLQ-C30 and a demographic questionnaire. Standard validity and reliability analyses were performed. One-hundred and forty patients agreed to take part in the study (mean age ± standard deviation: 63.3 ± 10.2 years). Cronbach's alpha coefficients showed positive internal consistency (0.78-0.91). Interclass correlations for the EORTC QLQ-OV28 ranged from 0.77 to 0.93 and proved appropriate test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. The Polish version of the EORTC QLQ-OV28 module proved to be a reliable and valid tool for measuring health-related quality of life in patients with ovarian cancer.