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Wiegell S.R.,Copenhagen University | Fabricius S.,Copenhagen University | Heydenreich J.,Copenhagen University | Enk C.D.,Hebrew University of Jerusalem | And 4 more authors.
British Journal of Dermatology | Year: 2013

Background Photodynamic therapy (PDT) is an attractive therapy for nonmelanoma skin cancers and actinic keratoses (AKs). Daylight-mediated methyl aminolaevulinate PDT (daylight-PDT) is a simple and painless treatment procedure for PDT. All daylight-PDT studies have been performed in the Nordic countries. To be able to apply these results in other parts of the world we have to compare the daily protoporphyrin IX (PpIX) light dose in other countries with the PpIX light doses found in Nordic countries. Objectives To calculate where and when daylight-PDT of AKs was possible in six different geographical locations using ground stations measuring PpIX-weighted daylight doses. Methods PpIX-weighted daylight doses were measured using a dosimeter with a customer-specific photodiode with a detector sensitivity that mimics the PpIX absorption spectrum and measures in 'PpIX doses'. The dosimeters were built into ground stations that were placed in six geographical locations measuring from July to December 2008. Temperature data for each location were obtained from the internet. The maximal ultraviolet (UV) index for Copenhagen was obtained for the measuring period of the dosimeters. Results If the PpIX light dose should be above 8 J cm-2 and the maximum temperature of the day at least 10 °C, it was possible to treat patients on nearly all days until the middle of September in Reykjavik and Oslo, until the last week of October in Copenhagen and Regensburg, until the middle of November in Turin and all year in Israel. Conclusions Where and when to perform daylight-PDT depends on the PpIX light dose and outdoor temperature. The PpIX light dose was influenced by the geographical location (latitude), weather condition and time of year. The UV index was not more suitable than temperature and weather to predict if the intensity of daylight would be sufficient for daylight-PDT. © 2012 The Authors. BJD © 2012 British Association of Dermatologists. Source

Ferlay J.,International Agency for Research on Cancer IARC | Steliarova-Foucher E.,International Agency for Research on Cancer IARC | Lortet-Tieulent J.,International Agency for Research on Cancer IARC | Rosso S.,Center for Epidemiology and Prevention in Oncology in Piedmont | And 5 more authors.
European Journal of Cancer | Year: 2013

Introduction: Cancer incidence and mortality estimates for 25 cancers are presented for the 40 countries in the four United Nations-defined areas of Europe and for the European Union (EU-27) for 2012. Methods: We used statistical models to estimate national incidence and mortality rates in 2012 from recently-published data, predicting incidence and mortality rates for the year 2012 from recent trends, wherever possible. The estimated rates in 2012 were applied to the corresponding population estimates to obtain the estimated numbers of new cancer cases and deaths in Europe in 2012. Results: There were an estimated 3.45 million new cases of cancer (excluding non-melanoma skin cancer) and 1.75 million deaths from cancer in Europe in 2012. The most common cancer sites were cancers of the female breast (464,000 cases), followed by colorectal (447,000), prostate (417,000) and lung (410,000). These four cancers represent half of the overall burden of cancer in Europe. The most common causes of death from cancer were cancers of the lung (353,000 deaths), colorectal (215,000), breast (131,000) and stomach (107,000). In the European Union, the estimated numbers of new cases of cancer were approximately 1.4 million in males and 1.2 million in females, and around 707,000 men and 555,000 women died from cancer in the same year. Conclusion: These up-to-date estimates of the cancer burden in Europe alongside the description of the varying distribution of common cancers at both the regional and country level provide a basis for establishing priorities to cancer control actions in Europe. The important role of cancer registries in disease surveillance and in planning and evaluating national cancer plans is becoming increasingly recognised, but needs to be further advocated. The estimates and software tools for further analysis (EUCAN 2012) are available online as part of the European Cancer Observatory (ECO) (http://eco.iarc.fr). © 2013 Elsevier Ltd. All rights reserved. Source

Verhoeven R.H.A.,Comprehensive Cancer Center South | Janssen-Heijnen M.L.G.,Comprehensive Cancer Center South | Janssen-Heijnen M.L.G.,Viecuri Medical Center | Saum K.U.,German Cancer Research Center | And 8 more authors.
European Journal of Cancer | Year: 2013

Introduction: Penile cancer is a rare neoplasm in Western countries, and detailed studies on trends in population-based survival of penile cancer have never been published before. We examined population-based trends in survival in Europe and the United States of America (USA). Methods: Data from 3297 European and 1820 American penile cancer patients, contributed by 12 European cancer registries and the Surveillance, Epidemiology, and End Results (SEER) Program of the USA were included in this study. Period analysis techniques were used to examine relative survival trends overall, as well as for four geographic regions in Europe, and for the age groups 15-54, 55-64, 65-74 and 75+ for both populations between 1990-1995 and 2002-2007. Survival trends were assessed in a multiple regression model of relative excess risk including period of diagnosis, age and continent. Results: The 5-year relative survival of penile cancer patients increased statistically non-significantly from 65% to 70% in Europe and decreased (significantly) from 72% to 63% in the USA. Trends in age-specific 5-year relative survival did not find any significant improvement in either Europe or the USA. The multiple regression analysis confirmed the lack of survival trend, and found significantly higher relative excess risk with age, and, apparently due to lower survival before 2002-2007, higher risk in Europe. Conclusion: Survival for penile cancer patients has not improved in either Europe or the USA since at least 1990. The reasons for the decrease of survival in the USA remain unknown and to be explored. Stronger international cooperation in clinical research may be important to facilitate clinical progress in treatment and thereby improvement of survival of this rare malignancy. © 2012 Elsevier Ltd. All rights reserved. Source

Verhoeven R.H.A.,Comprehensive Cancer Center South | Gondos A.,German Cancer Research Center | Janssen-heijnen M.L.G.,Comprehensive Cancer Center South | Janssen-heijnen M.L.G.,Viecuri Medical Center | And 13 more authors.
Annals of Oncology | Year: 2013

Background: Despite high curability, some testicular cancer (TC) patient groups may have increased mortality. We provide a detailed age- and histology-specific comparison of population-based relative survival of TC patients in Europe and the USA. Design: Using data from 12 European cancer registries and the USA Surveillance, Epidemiology and End Results 9 database, we report survival trends for patients diagnosed with testicular seminomas and nonseminomas between 1993-1997 and 2003-2007. Additionally, a model-based analysis was used to compare survival trends and relative excess risk (RER) of death between Europe and the USA adjusting for differences in age and histology. Results: In 2003-2007, the 5-year relative survival of patients with testicular seminoma was at least 98% among those aged <50 years, survival of patients with nonseminoma remained 3%-6% units lower.Despite improvements in the relative survival of nonseminoma patients aged ≥50 years by 13%-18% units, survival remained markedly lower than the survival of seminoma patients of the same age. Model-based analyses showed increased RERs for nonseminomas, older, and European patients. Conclusions: There remains little room for survival improvement among testicular seminoma patients, especially for those aged <50 years. Older TC patients remain at increased risk of death, which seems mainly attributable to the lower survival among the nonseminoma patients. © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. Source

Ribero D.,Ospedale Mauriziano Umberto I | Amisano M.,Ospedale Mauriziano Umberto I | Lo Tesoriere R.,Ospedale Mauriziano Umberto I | Rosso S.,Center for Epidemiology and Prevention in Oncology in Piedmont | And 2 more authors.
Annals of Surgery | Year: 2011

OBJECTIVE: To assess the survival benefit of additional resection of an intraoperative positive proximal bile duct margin (BDMarg) in patients undergoing hepatectomy for hilar cholangiocarcinoma (HCCA). SUMMARY BACKGROUND DATA: Intraoperative evidence of invasive cancer at the proximal BDMarg is associated with a dismal survival irrespective of whether a final negative BDMarg is achieved with an additional resection. METHODS: Clinicopathologic, operative, and survival data of consecutive patients undergone curative intent hepatectomy with bile duct resection (n = 75) for HCC (1989-2010) were analyzed. RESULTS: Frozen-section examination of the proximal BDMarg revealed invasive cancer in 19 of the 67 patients. After additional resection, which was possible in 18 cases, a secondary R0 BDMarg resection was achieved in 15 patients (83.3%), with 2 of these having, at final pathology, positive radial and distal margins. Eventually, 8 patients were classified as R1 and 67 as R0 (54 primary R0 and 13 secondary R0). Median survival of patients who had a secondary R0 resection (30.6 months) was similar to that of primarily R0-resected patients (29.3 months) and significantly better than that of R1 patients (14.9 months) (P = 0.026). Median time to recurrence and site of recurrence were similar in R0 patients independently of the performance of an additional resection. The incidence of biliary fistula was significantly increased (44.4% vs 17.5%; P = 0.02) in patients necessitating a margin re-resection. CONCLUSIONS: Additional resection of a positive proximal BDMarg, albeit associated with an increased risk of biliary fistula, offers a significant survival benefit and should be attempted whenever possible. Copyright © 2011 by Lippincott Williams &Wilkins. Source

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