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Marina di Ragusa, Italy

Musk A.W.,University of Western Australia | Olsen N.,University of Western Australia | Alfonso H.,University of Western Australia | Reid A.,University of Western Australia | And 8 more authors.
European Respiratory Journal | Year: 2011

Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a sample of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis. Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2-1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1-1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0-198), 177 (48-350), 221 (97-504), 238 (108-502) and 301 (134-611) days; ∼4 weeks of this apparent improvement can be attributed to earlier diagnosis. With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions. Copyright©ERS 2011. Source


Fruh M.,Fachbereich Onkologie Hamatologie | Ess S.,Cancer Registry | Cerny T.,Fachbereich Onkologie Hamatologie
Strahlentherapie und Onkologie | Year: 2011

Information about extrapulmonary small cell carcinoma (EPSCC) is limited and the role of prophylactic cranial irradiation (PCI) is unknown. Patients and Methods: Disease presentation and outcome of all EPSCC at our hospital between 1990 and 2009 were retrospectively analyzed. Results: Of 30 EPSCC, the male:female ratio was 58%:42%; 83% had a performance status of 0-2. Median age was 71 years (32-80). Seventeen (57%) had limited stage (LS), 13 (43%) extensive stage (ES). The location of the primary tumor was gastrointestinal (n = 8), unknown (6), gynecological (6), urogenital (5), and ear nose throat (5). Four (13%) developed brain metastases (2 ES, 2 LS). In ES, first line chemotherapy (CT) was given in 85%, mostly platinum-etoposide (64%). Response rate was 90%. In LS, CT and radiotherapy (RT) ± resection resulted in persistent remissions in 67% of patients. Median survival was 16 months (1-107 months), 18 months (1-107 months), and 9 months (0.4-25 months) for LS + ES, LS, and ES, respectively. Weight loss = 5 % and ECOG performance status 3 + 4 were associated with poorer survival (p < 0.001 and p > 0.01, respectively). Conclusions: The incidence of brain metastases was relatively low (13%). More studies are necessary, before routinely offering PCI to patients with EPSCC. Best survival outcomes in LS were achieved with multimodality treatment including CT and RT. Prognosis was poor in patients with ES. © Urban & Vogel. Source


Grinshpoon A.,Technion - Israel Institute of Technology | Barchana M.,Cancer Registry | Lipshitz I.,Cancer Registry | Rosca P.,Ministry of Health | And 2 more authors.
Drug and Alcohol Dependence | Year: 2011

Objectives: This study explored cancer incidence rates in a large cohort of Israeli (Jewish and Arab) opioid-dependent individuals receiving methadone maintenance treatment (MMT), and how the incidences vary by ethnicity and sex. Method: The record linkage between the Israel National Addiction Registry (INAR) and the Israel National Cancer Registry (INCR) was performed. Information about the Israeli general population from the Central Bureau of Statistics was used for comparison to match sex and year of birth to the cohort under study. Age standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. Results: Though the SIR values for aggregated cancer sites for both men and women on MMT did not differ significantly from the corresponding figures in the general population (0.88, 95% CI 0.76-1.00, and 1.06, 95% CI 0.76-1.36, respectively), the risks were substantially increased for lung (1.97, 95% CI 1.13-2.82), larynx (3.62, 95% CI 1.11-6.13) and liver (6.8, 95% CI 1.76-11.83) cancers among Jewish men and for cervix uteri cancer among Jewish women (2.41, 95% CI 0.99-3.84). By contrast, the SIR values for colorectal cancer among Jewish men (0.46, 95% CI 0.09-0.82) and for breast cancer among Jewish women (0.36, 95% CI 0.00-0.71) were significantly lower than expected. Conclusions: The results suggest that the increased and reduced site-specific cancer risks are counterbalanced, resulting in the absence of the expected excess cancer risk for the entire cohort. The reduced risks for colorectal and breast cancers suggest a protective effect of MMT, warranting further investigation. © 2011 Elsevier Ireland Ltd. Source


Agnoli C.,Nutritional Epidemiology Unit | Krogh V.,Nutritional Epidemiology Unit | Grioni S.,Nutritional Epidemiology Unit | Sieri S.,Nutritional Epidemiology Unit | And 13 more authors.
Journal of Nutrition | Year: 2011

Stroke is a major cause of death. Several foods and nutrients have been linked to stroke, but their effects may be best investigated considering the entire diet. In the present EPICOR study, we investigated the association between stroke and adherence to 4 a priori-defined dietary patterns: Healthy Eating Index 2005 (HEI-2005), Dietary Approaches to Stop Hypertension (DASH), Greek Mediterranean Index, and Italian Mediterranean Index. We followed 40,681 volunteers and estimated the HR and 95%CI for stroke according to dietary pattern by using multivariate Cox models with adjustment for risk factors. During a mean follow-up of 7.9 y, 178 stroke cases were diagnosed (100 ischemic, 47 hemorrhagic). Scores of 3 dietary patterns (not HEI) were inversely associated with risk of all types of stroke, with the strongest association for the Italian Index [HR = 0.47 (95%CI = 0.30-0.75); third vs. first tertile]. All patterns were significantly inversely associated with ischemic stroke except the Greek Index, with the strongest association for the Italian Index [HR = 0.37 (95%CI = 0.19-0.70); third vs. first tertile]. Only the Italian Index tended to be inversely associated with hemorrhagic stroke [HR = 0.51 (95%CI = 0.22-1.20); P = 0.07)]. These epidemiological findings suggest that adherence to any one dietary pattern investigated would protect against at least one type of stroke. For our Italian population, a diet with a high score on the Italian Index was associated with the greatest risk reduction, probably because it was conceived to capture healthy eating in the context of foods typically available in Italy. © 2011 American Society for Nutrition. Source


Del Rio D.,University of Parma | Agnoli C.,Nutritional Epidemiology Unit | Pellegrini N.,University of Parma | Krogh V.,Nutritional Epidemiology Unit | And 13 more authors.
Journal of Nutrition | Year: 2011

Experimental studies suggest that oxidative stress and systemic inflammation are involved in the pathogenesis of ischemic stroke. Consuming a diet with a high total antioxidant capacity (TAC) has been related to reduced inflammation and increased circulating antioxidants in cross-sectional and randomized intervention studies. This study investigates the relation between dietary TAC and risk of ischemic and hemorrhagic stroke in 41,620 men and women not previously diagnosed with stroke or myocardial infarction, representing the Italian segment of the European Prospective Investigation into Cancer and Nutrition. Controlling for potential confounders, a diet rich in TAC was associated with a reduction in HR for all types of stroke, but this association was only marginally significant (P-trend = 0.054). When only ischemic stroke cases were considered, data suggest a stronger inverse association with dietary TAC, with HR = 0.41 (95% CI = 0.23-0.74). Regarding single antioxidants, data from subanalyses on stroke types suggest that vitamin C is significantly associated with a decreased risk of ischemic stroke [HR = 0.58 (95% CI = 0.34-0.99)], whereas vitamin E was associated with increased HR of hemorrhagic stroke in the highest tertile of intake [HR = 2.94 (95% CI = 1.13-7.62)]. In conclusion, our findings suggest that antioxidants may play a role in reducing the risk of cerebral infarction but not hemorrhagic stroke. However, a high intake of vitamin E could be positively associated to the risk of brain hemorrhagic events; therefore, more focused investigations about this observation are needed. © 2011 American Society for Nutrition. Source

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