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J W Coebergh

Publications and source records attributed to J W Coebergh.

At least 37 records · Page 2Linked to original sources
PubMed2001

Tumor growth pattern and thymidine phosphorylase expression are related with the risk of hematogenous metastasis in patients with Astler Coller B1/B2 colorectal carcinoma.

BACKGROUND: The benefit of adjuvant chemotherapy appears to be limited for patients with Astler Coller B1/B2 colorectal carcinoma but may be better in a subgroup of patients with a high recurrence risk. In the current case-control analysis, the authors evaluated whether patients with a high risk of hematogenous metastasis could be identified by means of a thorough histologic and immunohistochemical examination of the resection specimens. METHODS: A database was built for all patients treated in a general teaching hospital for colorectal carcinoma between 1985 and 1995. From this database, all patients with an Astler Coller B1 or B2 tumor who subsequently had developed hematogenous metastases were taken as cases. For each case, three matched controls (age, Astler Coller, year of diagnosis) without metachronous metastases were selected. The resection specimens of cases and controls were blindly examined by two observers for the following: World Health Organization (WHO) classification; differentiation grade; growth pattern; lymphocytic, fibroblastic, and eosinophilic reaction; angioinvasion; number of lymph nodes examined; expression of E-cadherin, vascular endothelial growth factor and thymidine phosphorylase (TP); P53; microvessel density. RESULTS: Twenty-two cases and 65 controls were included in the analysis. Tumor growth pattern and tumor TP expression both independently contributed to recurrence risk. With these 2 variables, 4 subgroups could be identified with a recurrence risk ranging from 0% to 42%. CONCLUSIONS: Tumor growth pattern and degree of TP expression both appear to be related to the recurrence risk. Prospective trials should point out whether these variables can be implemented in the decision making concerning adjuvant chemotherapy.

Biomarkers, Tumor↗
PubMed2001

[Early diagnosis and prevention of malignant tumors in the head and neck region].

In the Netherlands more than 2000 new patients with head and neck cancer are diagnosed annually. Most of these cancers are squamous cell carcinomas. The use of tobacco and alcohol are well established aetiologic factors. Head and neck cancers usually affect patients above the age of 40 years and are somewhat more common in men than in women. The type of the initial symptoms of head and neck cancer depends largely on the exact location. Often, these symptoms are rather aspecific. However, laryngeal cancer is an exception. In this site cancer usually presents at an early stage with sudden hoarseness. Hoarseness of more than three weeks' duration requires laryngoscopic examination. Particularly the cancers of the floor of the mouth and the borders on the tongue can be detected early because of the accessibility of these sites, which allows proper inspection and palpation. The most common clinical manifestation of oral cancer is an indurated ulcer. An oral ulcer present for more than three weeks is an indication for biopsy. The prognosis of head and neck cancer in general depends largely on the stage at diagnosis. Small cancers carry a much better prognosis after surgical removal or radiotherapy than larger ones.

Alcohol Drinking↗
PubMed2001

Excess mortality from breast cancer 20 years after diagnosis when life expectancy is normal.

In a population-based study, causes of death were traced of 418 deceased breast cancer patients diagnosed in 1960-1979 who survived at least 10 years after diagnosis. The pattern of causes of death in these patients was compared with the general female population using standardized mortality ratios (SMRs). Of 418 patients surviving at least 10 years, 196 (47%) died from breast cancer and 50 (12%) died from another cancer. The SMR for breast cancer was 15.8 (95% CI: 13.1-18.8) 10-14 years after diagnosis; it was still 4.7 (95% CI: 2.6-7.8) after 20 years. Overall mortality was higher than expected 10-14 years after diagnosis (SMR: 1.3; 95% CI: 1.1-1.5), but lower after more than 20 years (SMR: 0.6; 95% CI: 0.4-0.7). Despite a normal (or even improved) life expectancy for breast cancer patients 20 years after diagnosis the risk of dying from this disease remained elevated.

Adult↗
PubMed2001

Cancer survival.

Explore the source record for details and available documents.

Humans↗
PubMed2001

Survival analysis in familial ovarian cancer, a case control study.

OBJECTIVE: familial ovarian cancer patients have been found to differ from sporadic cases, clinically as well as in the molecular make-up of the tumour. Here, a case control study is performed to analyse potential differences in survival. STUDY DESIGN: 31 families with a strong history of ovarian and/or breast cancer presenting to a family cancer clinic 44 ovarian cancer patients were included. Each patient was matched for age and stage with controls from a cancer registry. Survival rates and the effect of several prognostic factors were analysed. RESULTS: median survival in the study group differed significantly from controls. A survival benefit for familial cases was maintained up to 5 years after diagnosis. Long-term survival was equally poor in both groups. CONCLUSION: the difference in survival between familial ovarian cancer cases and matched controls may reflect differences in biological behaviour. This may have important implications for the management and prevention of familial ovarian cancer.

BRCA1 Protein↗
PubMed2001

Survival of childhood lymphomas in Europe, 1978--1992: a report from the EUROCARE study.

In most developed countries, malignant lymphomas account for 10--15% of all cancers occurring among children aged 0--14 years. The present study estimates survival after a diagnosis of lymphoma in childhood, based on the EUROCARE II database which includes 34 population-based cancer registries from 17 European countries. The survival pattern of children with malignant lymphoma diagnosed in 1985--1989 is reported, as well as the time trends since 1978. The analyses focus on Hodgkin's disease (HD, 1696 cases) and on non-Hodgkin's lymphoma (NHL, 2255 cases including Burkitt's lymphoma and unspecified lymphomas). For HD, the European weighted average 5-year survival rate was 93% (95% confidence interval (CI) 82--98) in 1985--1989. The survival rates were not affected by either age or gender. 5-year survival rates ranged from 68% (95% CI 34--90) in Estonia to 96% (95% CI 92--98) in Germany and 100% (95% CI 57--100) in Slovenia. Multivariate analyses for the time period 1978--1989 gave little suggestion of an improvement in survival over the later time periods of diagnosis. For NHL, the European weighted average 5-year survival rate was 74% (95% CI 67--80) in 1985--1989. Gender did not influence the survival rate. Children in the age group 0--4 years had a poorer prognosis compared with older cases (5-year rate: 66% versus 77% in the pool). 5-year survival rates ranged from 53% (95% CI 30--76) (Estonia) to 83% (95% CI 62--94) in France and 83% (95% CI 66--92) in Scotland. Multivariate analysis show a decreasing HR for the more recent periods of diagnosis from 1 in 1978--1981 to 0.67 (95% CI 0.56--0.79) in 1982--1985 to 0.48 (95% CI 0.40--0.57) in 1986--1989. Exploratory analysis, conducted including the cancer registries which provided cases diagnosed until 1992, show a positive trend over time for both types of lymphoma.

Adolescent↗
PubMed2001

Variation in survival of European children with acute lymphoblastic leukaemia, diagnosed in 1978--1992: the EUROCARE study.

The aim of this study was to provide a comparative description of geographical variations and time trends in the population-based survival of European children with acute lymphoblastic leukaemia (ALL). Data on 13344 newly diagnosed children (0--14 years) with ALL were included in the EUROCARE study and were collected were collected by 34 population-based cancer registries (four comprising only childhood malignancies), operating in 17 countries (four in Scandinavia, two in Southern Europe, three in Eastern Europe, six in Continental Europe and two in the UK). Age-specific crude survival rates were estimated for boys and girls according to country for the period 1985--1989 and in adjusted form to attain comparability. Overall pooled and weighted rates were estimated as European standards. Children dead at diagnosis or diagnosed only through a death certificate were excluded. Geographical variation was also estimated by calculating the relative death rate with respect to the pooled overall European rate. After adjustment for age, gender and country, a Cox regression analysis was used to estimate time trends in survival. Survival was compared with that in the USA, Japan, Canada and Australia. During 1985--1989, the 1-year survival rate varied from 99 to 79%, the 5-year survival rate from over 80 to 56% (with the exception of Estonia; 34%; 95% confidence interval (CI) 20--52) among the various countries; the European weighted means were 90 (95% CI 87--93) and 72% (95% CI 69--75), respectively. Survival was particularly favourable in (south) Sweden, Finland, Germany and The Netherlands and rather unfavourable in Estonia and (surprisingly) France, where only 4% of its population was covered by the participating registries. Compared with the period 1978--1981, the hazard ratio for the period 1986--1989 decreased to 0.59 (95% CI 0.54--0.64) and -- in a smaller set of registries -- to 0.49 (0.45--0.55) for 1990-1992, an annual decrease in this rate of approximately 3.5%. During 1985--1989, the 5-year survival rates for European children were largely similar to those found in the USA, Canada and Australia, but markedly better than those in Japan. Higher survival rates were found for countries with 'good' access to centrally organised diagnostic and treatment facilities which stimulated 'aggressive' treatments according to a protocol. However, a subdivision according to risk profiles, e.g. according to the initial white blood cell count at diagnosis, could not be made and this might have explained partially the geographical differences in survival, because a positive association appeared between incidence at age 1--4 years and 5-year survival in most countries.

Adolescent↗
PubMed2001

Childhood cancer survival in Europe: an overview.

Other articles in this issue of the European Journal of Cancer have described population-based survival analyses of specific types of childhood cancer included in the EUROCARE database, diagnosed since 1979. The present paper summarises the relevant estimates and comments on intercountry differences, focusing on possible distortions in the intercountry comparisons based on data produced by the cancer registries. Potential biases include a lack of exhaustiveness of both case ascertainment and follow-up for living status and also a lack of consistency in the use of classification of the childhood cancer types. Nevertheless, despite such biases, consistent differences are observed between European countries in the probability of survival following the diagnosis of a paediatric cancer. In most cases, poor population-based survival rates are probably explained by inadequacies in the adoption and implementation of therapeutic protocols that have been proved to be effective. In some instances, the cause of unsatisfactory estimates was the inclusion of a sizeable proportion of children with cancer in clinical trials which were found to be ineffective. A regression analysis of incidence, mortality and survival rates during 1978-1989 over the whole EUROCARE database strongly indicates that the prognostic improvements over time are real and cannot be attributed to changes in diagnostic procedures.

Adolescent↗
PubMed2001

Survival of children with Wilms' tumour in Europe.

A total 2535 cases of Wilms' tumours registered in children aged 0--14 years by 34 population-based cancer registries in 16 countries of Europe in 1978--1992 and followed-up until the end of 1994 were included in this EUROCARE study. Overall 5-year observed survival of all children diagnosed in 1985--1989 was 83%, 95% confidence interval (CI) 80--85. Relatively large differences were observed between the European countries, with significantly lower survival of patients registered in the formerly socialist countries, Estonia, Poland and Slovakia. Overall European survival was slightly lower in comparison with results reported from the USA and Australia, which demonstrate a potential for improvement. Over the study period, overall survival adjusted for age, sex and country has increased significantly. This favourable trend is attributed primarily to improvements in treatment, particularly to the introduction of new chemotherapeutic agents.

Adolescent↗
PubMed2001

Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer.

The aim of this study was to investigate the nature and severity of the arm complaints among breast cancer patients after axillary lymph node dissection (ALND) and to study the effects of this treatment-related morbidity on daily life and well-being. 400 women, who underwent ALND as part of breast cancer surgery, filled out a treatment-specific quality of life questionnaire. The mean time since ALND was 4.7 years (range 0.3-28 years). More than 20% of patients reported pain, numbness, or loss of strength and 9% reported severe oedema. None of the complaints appeared to diminish over time. Irradiation of the axilla and supraclavicular irradiation were associated with a 3.57-fold higher risk of oedema (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.66-7.69) causing many patients to give up leisure activities or sport. Women who underwent irradiation of the breast or chest wall more often reported to have a sensitive scar than women who did not receive radiotherapy. Women <45 years of age had an approximately 6 times higher risk of numbness of the arm (OR 6.49; 95% CI 2.58-16.38) compared with those > or = 65 years of age; they also encountered more problems doing their household chores. The results of the present study support the introduction of less invasive techniques for the staging of the axilla, sentinel node biopsy being the most promising.

Activities of Daily Living↗
PubMed2001

Cancer survival increases in Europe, but international differences remain wide.

The EUROCARE project analysed cancer survival data from 45 population-based cancer registries in 17 European countries, revealing wide international differences in cancer survival. We calculated 5-year relative survival for 1836287 patients diagnosed with one of 13 cancers during the period 1978-1989. The data, from 20 cancer registries in 13 countries, were grouped into four regions: Finland, Sweden, Iceland (Northern Europe); Denmark, England and Scotland (UK and Denmark); France, The Netherlands, Germany, Italy and Switzerland (Western Europe); Estonia and Poland (Eastern Europe), and broken down into four periods (1978-1980, 1981-1983, 1984-1986, 1987-1989). For each cancer, mean European and regional survival was estimated as the weighted mean of 5-year relative survival in each country. Survival increased with time for all tumours, particularly for cancers of testis (12% increase, i.e. from 79.9 to 91.9%), breast, large bowel, skin melanoma (approximately 9-10%), and lymphomas (approximately 7%). For most solid tumours, survival was highest in Northern Europe and lowest in Eastern Europe, and also low in the UK and Denmark. Regional variation was less marked for the lymphomas. Survival improved more in Western than Northern Europe, and the differences between these regions fell for bowel cancer (from 8.0% for those diagnosed in 1978-1980 to 2% for those diagnosed in 1987-1989), breast cancer (from 7.4% to 3.9%), skin melanoma (from 13.4% to 11.0%) and Hodgkin's disease (from 7.2 to 0.6%). For potentially curable malignancies such as Hodgkin's disease, large bowel, breast and testicular cancers, there were substantial increases in survival, suggesting an earlier diagnosis and more effective treatment. The persisting regional differences suggest there are corresponding differences in the availability of diagnostic and therapeutic facilities, and in the effectiveness of healthcare systems.

Adolescent↗
PubMed2001

The introduction of mammographical screening has had little effect on the trend in breast-conserving surgery: a population-based study in Southeast Netherlands.

In addition to reducing breast cancer mortality, breast cancer screening programmes are expected to increase the proportion of patients who can undergo breast-conserving surgery. Trends in the use of breast-conserving surgery (BCS) in Southeast Netherlands between 1990 and 1998 were studied in relation to the gradual introduction of mammographical screening for women 50-69 years of age between 1992 and 1996. The characteristics of the tumours detected by the screening programme or outside of the programme were compared, to see whether this might clarify the observed trends. In the period 1990-1998, 4788 patients were diagnosed with invasive, operable breast cancer, of whom 2341 were 50-69 years of age. Although the screening programme resulted in a larger proportion of patients with small tumours and more favourable tumour characteristics, no increase was observed in the use of BCS for patients 50-69 years of age in the period 1990-1998 (64% in 1990 and 1998). Patients with a screening-detected tumour, however, were more likely to undergo breast conservation compared with those presenting clinically (68% versus 54%; P<0.0001). In conclusion, no increase in the proportion of breast-conserving surgical procedures was observed in Southeast Netherlands among patients 50-69 years of age in the period 1990-1998, during the introduction of mass mammographical screening for this group. Screening, however, resulted in a larger proportion of patients with small tumours with more favourable characteristics, who are better candidates for breast conservation.

Adult↗
PubMed2001

The independent prognostic value of comorbidity among men aged < 75 years with localized prostate cancer: a population-based study.

OBJECTIVE: To investigate which prognostic factors apply in patients with localized prostate cancer diagnosed after the introduction of prostate-specific antigen (PSA) testing, as comorbidity has significant prognostic value for patients who were diagnosed with localized prostate cancer in the 1970s. Patients and methods Using the Eindhoven Cancer Registry, we assessed a population-based cohort of patients aged < 75 years with localized (T1-T3M0) prostate cancer diagnosed between 1993 and 1995 in a defined area with 2 million inhabitants in the southern Netherlands (n = 894). After a mean follow-up of 2.9 years, overall survival was modelled by Cox regression analyses. RESULTS: Comorbidity was the most important prognostic factor, especially for those aged < 70 years; at 60 years old, patients with one concomitant disease were twice as likely to die than those with no comorbidity (95% confidence interval, CI, 1.0-4.3), whereas the hazard ratio (HR) was 7.2 (3.1-16.6) for two or more diseases. This was not caused by a reduced use of curative treatment for these patients. At the age of 74 years, comorbidity was no longer a significant prognostic factor. Poor differentiation of the tumour was also an important prognostic factor at all ages; this became increasingly apparent 2 years after diagnosis (HR 3.4, CI 1.5-7.7). Conclusion Comorbidity had a decisive influence on the prognosis for patients with localized prostate cancer. Because this effect was stronger in younger patients the assessment of comorbidity seems most important when evaluating the risk of early death.

Aged↗
PubMed2001

Soft tissue carcinoma in the retroperitoneum: an often neglected diagnosis.

AIMS: Successful surgical treatment of patients with retroperitoneal soft tissue sarcoma (RSTS) is based on pre-operative planning that starts with a correct pre-operative diagnosis. In a population-based study, we determined which patients were initially treated for assumed other conditions. The effect of an erroneous diagnosis on the installed treatment was analysed. METHOD: With the help of the Dutch Network and National Database for Pathology (PALGA), data were collected on 143 patients in the Netherlands in whom a primary RSTS was found and confirmed histologically between 1 January 1989 and 1 January 1994. Satisfactory clinical information was obtained on 138 patients, 64 males and 74 females (54%). The median age was 60 (range 18-88) years. RESULTS: At the time of actual treatment 37% of the patients with RSTS were assumed to have another disorder (group 1 n=51), whereas 87 patients were diagnosed as having RSTS (group 2). In group 1, an acute presentation was more common (18 vs 2% P=0.002), and the tumour was less often palpable at physical examination (43 vs 69% P=0.004), while clinical work-up less frequently included CT-imaging (57 vs 89% P<0.001) and a biopsy (29 vs 77% P<0.001). Although tumours in group 1 were smaller (median diameter 13 vs 19 cm P<0.05), this was not reflected in a better operative result: less patients underwent complete tumour resection (51 vs 57%) and more patients underwent surgery for tumours that proved to be irresectable (14 vs 1% P=0.004). CONCLUSIONS: (1) More than one-third of patients with RSTS are misdiagnosed and inappropriately treated; and (2) biopsies and cross-sectional imaging improve diagnosis.

Adolescent↗
PubMed2001

Determinants of axillary recurrence after axillary lymph node dissection for invasive breast cancer.

AIM: This study was undertaken to gain insight into the risk factors for axillary recurrence among patients with invasive breast cancer who underwent breast-conserving treatment or mastectomy and axillary lymph node dissection. METHODS: In a matched case-control design, 59 patients with axillary recurrence and 295 randomly selected control patients without axillary recurrence were compared. Matching factors included age, year of incidence of the primary tumour and postsurgical axillary nodal status. RESULTS: For patients with negative axillary lymph nodes, those with a tumour in the medial part of the breast had a 73% (95% CI: 4-92%) lower risk of axillary recurrence compared to those with a tumour in the lateral part of the breast. For the patients with positive axillary lymph nodes the risk of axillary recurrence was 65% (95% CI: 16-86%) lower for those who had received axillary irradiation compared to those without axillary irradiation. Within the age group <50 years, the risk or axillary recurrence was 82% lower (95% CI: 45-94%) for patients with more than six lymph nodes found in the axillary specimen compared to those with six or less than six lymph nodes. CONCLUSIONS: Although based on a small number of patients, this study indicates that axillary irradiation is effective in reducing the risk of axillary recurrence for patients with positive lymph nodes. This favourable effect only applies to the subgroup with extranodal extension or nodal involvement in the apex of the axilla, as these were the only patients receiving axillary radiation during the study period.

Adult↗
PubMed2001

Is there a common etiology for the rising incidence of and decreasing survival with adenocarcinoma of the lung?

We studied possible explanations for the deteriorating survival for adenocarcinoma of the lung between 1975 and 1994 in relation with trends in incidence. The proportion of adenocarcinoma among men has been increasing since 1975 and for those born after 1920, while survival has decreased since 1975 and for those born since 1930. Among women, both the proportion of adenocarcinoma and survival have remained more or less constant. The rising incidence and the decreasing survival may both be related to changes in tobacco use, the increased use of low-tar filter cigarettes since the 1960s being the most likely candidate.

Adenocarcinoma↗