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Reidunsdatter R.J.,Norwegian University of Science and Technology | Lund J.-A.,Norwegian University of Science and Technology | Fransson P.,Umea University | Widmark A.,Umea University | And 2 more authors.
International Journal of Radiation Oncology Biology Physics | Year: 2010

Purpose: Several treatment options are available for patients with prostate cancer. Applicable and valid self-assessment instruments for assessing health-related quality of life (HRQOL) are of paramount importance. The aim of this study was to explore the validity and responsiveness of the intestinal part of the prostate cancer-specific questionnaire QUFW94. Methods and Materials: The content of the intestinal part of QUFW94 was examined by evaluation of experienced clinicians and reviewing the literature. The psychometric properties and responsiveness were assessed by analyzing HRQOL data from the randomized study Scandinavian Prostate Cancer Group 7 (SPCG)/Swedish Association for Urological Oncology 3 (SFUO). Subscales were constructed by means of exploratory factor analyses. Internal consistency was assessed by Cronbach's alpha. Responsiveness was investigated by comparing baseline scores with the 4-year posttreatment follow-up. Results: The content validity was found acceptable, but some amendments were proposed. The factor analyses revealed two symptom scales. The first scale comprised five items regarding general stool problems, frequency, incontinence, need to plan toilet visits, and daily activity. Cronbach's alpha at 0.83 indicated acceptable homogeneity. The second scale was less consistent with a Cronbach's alpha at 0.55. The overall responsiveness was found to be very satisfactory. Conclusion: Two scales were identified in the bowel dimension of the QUFW94; the first one had good internal consistency. The responsiveness was excellent, and some modifications are suggested to strengthen the content validity. © 2010 Elsevier Inc. All rights reserved.


Cicarma E.,University of Oslo | Juzeniene A.,University of Oslo | Porojnicu A.C.,University of Oslo | Bruland O.S.,The Norwegian Radium Hospital | Moan J.,University of Oslo
Journal of Photochemistry and Photobiology B: Biology | Year: 2010

Latitude gradients and time trends for cutaneous malignant melanoma (CMM) were analyzed using incident cases from the Norwegian Cancer Registry for the period 1966-2007. Sex and various anatomic regions of the body were taken into account, for better understanding of the role of ultraviolet radiation in CMM etiology.There is a latitude gradient for CMM on all body sites included in the present study, with 2-2.5 times higher incidence rates in the south. The latitude gradients seem to be largest for the trunk. Melanomas on sites intermittently exposed to the sun (like the trunk) dominate both in the north and in the south and this distribution has not changed over the years. A leveling off of the incidence rates are observed for both sexes and for all sites studied, after 1985-1995, slightly more in the south than in the north, except for the head and neck where the incidence rates have continued to increase slowly in the north as well as in the south. The leveling off of melanoma trend is probably associated with melanoma prevention campaigns and with increasing awareness, although vitamin D could play a role. © 2010 Elsevier B.V.


Makar A.P.,The Middelheim Hospital | Makar A.P.,Ghent University | Trope C.G.,The Norwegian Radium Hospital | Tummers P.,Ghent University | And 2 more authors.
Oncologist | Year: 2016

Background. Standard treatment of stage III and IV advanced ovarian cancer (AOC) consists of primary debulking surgery (PDS) followed bychemotherapy. Since the publication of the European Organisation for Research and Treatment of Cancer/National Cancer Institute of Canada trial, clinical practice has changed and many AOC patients are now treated with neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS).The best option remains unclear. Ovarian cancer is a heterogenic disease. Should we use the diversity in biology of the tumorand patterns of tumor localization to better stratify patients between both approaches? Methods. This analysis was based on results of five phase III randomized controlled trials on PDS and IDS in AOC patients, three Cochrane reviews, and four meta-analyses. Results. There is still no evidence that NACT-IDS is superior to PDS. Clinical status, tumor biology, and chemosensitivity should be taken into account to individualize surgical approach. Nonserous (type 1) tumors with favorable prognosis are less chemo-sensitive, and omitting optimal PDS will lead to less favorable outcome. For patients with advanced serous ovarian cancer (type 2) associated with severe comorbidity or low performance status, NACT-IDS is the preferred option. Conclusion. We propose stratifying AOC patients into five categories according to patterns of tumor spread (reflecting the biologic behavior), response to chemotherapy, and prognosisto make a more rational decision between PDS and NACT-IDS. © AlphaMed Press 2016.


Pradhan M.,University of Oslo | Abeler V.M.,University of Oslo | Danielsen H.E.,University of Oslo | Sandstad B.,The Norwegian Radium Hospital | And 3 more authors.
Annals of Oncology | Year: 2012

Background: We evaluated the prognostic importance of DNA ploidy in stage I and II endometrioid adenocarcinoma (EAC) of the endometrium with a focus on DNA index. Patients and methods: High-resolution DNA ploidy analysis was carried out in tumor material from 937 consecutive patients with International Federation of Gynecology and Obstetrics (FIGO) stage I and II EAC of the endometrium. Results: Patients with diploid (N = 728), aneuploid tumor with DNA index ≤1.20 (N = 118), aneuploid tumors with DNA index >1.20 (N = 39) and tetraploid tumor (N = 52) had 5-year recurrence rates 8%, 14%, 20% and 12%, respectively. Patients with aneuploid tumor with DNA index >1.20 had a poorer 5-year progression-free survival (67%) and overall survival (72%) compared with the patients with aneuploid tumor with DNA index ≤1.20 (81% and 89%, respectively). Aneuploid tumors with DNA index ≤1.20 relapsed mainly in the vagina and pelvis, whereas aneuploid tumors with DNA index >1.20 relapsed predominantly outside pelvis. Conclusions: The recurrence risk for the patients with aneuploid tumor is higher than the patients with diploid tumor in EAC of the endometrium. Based on DNA index with cut-off 1.20, aneuploid tumors can be separated into two subgroups with different recurrence pattern and survival. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology.


Oldenburg J.,The Norwegian Radium Hospital | Oldenburg J.,Buskerud and Vestfold University College | Lorch A.,University of Marburg | Fossa S.D.,The Norwegian Radium Hospital | Fossa S.D.,University of Oslo
Hematology/Oncology Clinics of North America | Year: 2011

This article highlights relevant aspects of the rare late relapses of malignant germ cell tumors (MGCTs), which by definition occur at least 2 years after successful treatment. In most reports, 1% to 6% of patients with MGCT experience a late relapse. Surgery is the most important part in the treatment of late relapses. Viable MGCT or teratoma with malignant transformation may require multimodal treatment with chemotherapy, radiotherapy, and/or surgery. Salvage chemotherapy should be based on a representative biopsy. Referring patients with late relapse to high-volume institutions ensures the best chances of cure and enables multimodal treatment. © 2011 Elsevier Inc.

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