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Odense, Denmark

Jensen L.H.,Vejle Hospital | Altaf R.,Herlev Hospital | Harling H.,Bispebjerg Hospital | Jensen M.,Aalborg Hospital | And 6 more authors.
European Journal of Surgical Oncology

Aim: The purpose of this study was to analyse the results of preoperative short course radiotherapy in a consecutive, national cohort of patients with rectal cancer. Methods: Through a validated, prospective national database we identified 520 Danish patients who presented with high-risk mobile tumours in the lower two thirds of the rectum and were referred for preoperative radiotherapy with 5 × 5 Gy. The inclusion period was 56 months. Radiotherapy data was retrospectively collected. Results: Of the 520 patients, 514 completed radiotherapy and 506 had surgery. Surgery was considered curative in 439 patients. The 3-year local recurrence rate was 4.0% (95% CI 2.5-6.5%) and the distant recurrence rate at 3 years was 18.7% (95% CI 15.4-22.5%). The 5-year disease free survival rate was 40.2% (95% CI 27.0-53.1%) and overall survival 50.4% (95% CI 36.1-63.1%). Most tumours (61%) were classified as T3 or T4 and 41% of the local recurrences occurred in patients with a fixed tumour at surgery. Conclusion: This study confirms data from randomised studies that the short course 5 × 5 Gy regime is a feasible treatment for locally advanced rectal cancer even when applied in a population outside clinical trials. © 2009 Elsevier Ltd. All rights reserved. Source

Lunding S.,Helsingor Hospital | Kronborg G.,Hvidovre Hospital | Lindberg J.A.,Skejby Hospital | Jensen J.,Kolding Hospital | And 3 more authors.
Sexually Transmitted Diseases

BACKGROUND: Studies indicate that antiretroviral postexposure prophylaxis (PEP) after sexual exposure to HIV reduce the risk of infection considerably. Since 1998 PEP after sexual HIV exposure within the preceding 24 hours, has been available in Denmark. PEP can only be prescribed at clinical centers with specialists experienced in HIV treatment. The objective of this study is to describe the use of PEP after sexual exposure from 1998 to 2006. METHODS: The Danish PEP registry collects data from all cases of PEP use in Denmark after exposure to HIV through a structured questionnaire. RESULTS: There were 374 cases of PEP use after sexual exposure. The incidence increased from 5 cases in 1997 to 87 in 2006. PEP was used by heterosexuals (40%) as well as men who have sex with men (57%). The HIV-status of the source was unknown in 41% of the cases of which 90% involved a source belonging to a high risk group, and 63% involved exposure by receptive anal intercourse. PEP was administered within 24 hours in 95% of the cases and the median time to initiation (N = 225) was 11.0 hours (range 0.5-60.0). PEP was completed by 65%. CONCLUSIONS: This nationwide study showed a steady but moderate increase in the use of PEP after sexual HIV-exposure from 1998 to 2006. Time to initiation of PEP was low and the PEP prescription practice was targeted toward high risk exposures. Copyright © 2009 American Sexually Transmitted Diseases Association All rights reserved. Source

Leon O.,Skane University Hospital | Guren M.,University of Oslo | Hagberg O.,Regional Cancer Center South | Glimelius B.,Uppsala Academic Hospital | And 13 more authors.
Radiotherapy and Oncology

Objective To evaluate treatment outcome in a large population-based cohort of patients with anal cancer treated according to Nordic guidelines. MaterialClinical data were collected on 1266 patients with anal squamous cell carcinoma diagnosed from 2000 to 2007 in Sweden, Norway and Denmark. 886 of the patients received radiotherapy 54-64 Gy with or without chemotherapy (5-fluorouracil plus cisplatin or mitomycin) according to different protocols, stratified by tumor stage.Results High age, male gender, large primary tumor, lymph node metastases, distant metastases, poor performance status, and non-inclusion into a protocol were all independent factors associated with worse outcome. Among patients treated according to any of the protocols, the 3-year recurrence-free survival ranged from 63% to 76%, with locoregional recurrences in 17% and distant metastases in 11% of patients. The highest rate of inguinal recurrence (11%) was seen in patients with small primary tumors, treated without inguinal irradiation.Conclusions Good treatment efficacy was obtained with Nordic, widely implemented, guidelines for treatment of anal cancer. Inguinal prophylactic irradiation should be recommended also for small primary tumors. © 2014 Elsevier Ireland Ltd. Source

Illemann M.,Copenhagen University | Laerum O.D.,Copenhagen University | Hasselby J.P.,Copenhagen University | Thurison T.,Copenhagen University | And 8 more authors.
Cancer Medicine

Patients were identified from a population-based prospective study of 4990 individuals with symptoms associated with colorectal cancer (CRC). A total of 244 CRC tissue samples were available for immunohistochemical staining of uPAR, semiquantitatively scored at the invasive front, and in the tumor core on cancer cells, macrophages, and myofibroblasts. In addition, the levels of the intact and cleaved uPAR-forms in blood from the same patients are evaluated in this study. In a univariate analysis, the number of uPAR-positive versus uPAR-negative macrophages (HR = 2.26, [95% CI: 1.39-3.66, P = 0.0009]) and cancer cells (HR=1.49, [95% CI: 1.01-2.20, P = 0.047]) located in the tumor core were significantly associated to overall survival. In a multivariate analysis, uPAR-positive versus uPAR-negative macrophages located in the tumor core showed the best separation of patients with positive score associated to poor prognosis (HR = 1.84 [95% CI: 1.12-3.04, P = 0.017]). In a multivariate analysis including clinical covariates and soluble uPAR(I), the latter was significantly associated to overall survival (HR = 2.68 [95% CI: 1.90-3.79, P < 0.0001]) and uPAR-positive macrophages in the tumor core remained significantly associated to overall survival (HR = 1.81 [95% CI: 1.08-3.01, P = 0.023]). Membrane-bound uPAR showed additive effects with the circulating uPAR(I) and stage, giving a hazard ratio of 12 between low and high scores. Thus, combining stage, uPAR(I) in blood and uPAR on macrophages in the tumor core increase the prognostic precision more than tenfold, as compared to stage alone. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.. Source

Gonzalez-Bofill N.,Aarhus University Hospital | Husted L.B.,Aarhus University Hospital | Harslof T.,Aarhus University Hospital | Tofteng C.L.,Hvidovre University Hospital | And 4 more authors.
Osteoporosis International

Summary: One thousand seven hundred seventeen perimenopausal women from the Danish Osteoporosis Prevention Study were genotyped for the -1997G/T, -1663indelT and +1245G/T polymorphisms in the COLIA1 gen. We found that the -1997T allele and a haplotype containing it were associated with reduced bone mineral density (BMD) and increased bone turnover at menopause and after 10 years of follow-up. Introduction: We wanted to investigate whether the -1997G/T, -1663indelT and +1245G/T polymorphisms in the COLIA1 gene are associated with perimenopausal bone mass, early postmenopausal bone loss and interact with hormone treatment. Methods: One thousand seven hundred seventeen perimenopausal women from the Danish Osteoporosis Prevention Study were genotyped, and haplotypes were determined. BMD was examined by dual X-ray absorptiometry. Results: Women carrying the -1997T variant had lower BMD at all measured sites: lumbar spine BMD 1.030±0.137 g/cm 2, 1.016±0.147 g/cm 2 and 0.988±0.124 g/cm 2 in women with the GG, GT and TT genotypes, respectively (p<0.05) and total hip BMD 0.921±0.116 g/cm 2, 0.904±0.123 g/cm 2 and 0.887±0.109 g/cm 2 in women with the GG, GT and TT genotypes, respectively (p=0.01). The effect remained after 10 years although statistical significance was lost. Haplotype 3 (-1997T-1663ins+1245G) was associated with lower bone mass and higher levels of bone turnover. Compared with haplotype 1, haplotype 3 carriers had lower BMD at the lumbar spine, femoral neck and total hip by 0.016±0.007 g/cm 2, 0.015±0.006 g/cm 2 and 0.017±0.006 g/cm 2, respectively (p<0.05-0.005). No association with postmenopausal changes in bone mass and fracture risk and no overall interaction with the effects of hormone therapy could be demonstrated for any of the polymorphisms in COLIA1. Conclusions: The -1997G/T polymorphism and haplotype 3 are significantly associated with perimenopausal bone mass, and these effects were sustained up to 10 years after menopause. No association between the -1663indelT or +1245G/T polymorphisms and peri- or postmenopausal bone mass could be demonstrated. © 2010 International Osteoporosis Foundation and National Osteoporosis Foundation. Source

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