No improvement in long-term survival for epithelial ovarian cancer patients: A population-based study between 1989 and 2014 in the Netherlands

Publication date: January 2018
Source:European Journal of Cancer, Volume 88
Author(s): M. Timmermans, G.S. Sonke, K.K. Van de Vijver, M.A. van der Aa, R.F.P.M. Kruitwagen
AimThis study investigates changes in therapy and long-term survival for patients with epithelial ovarian cancer (EOC) in the Netherlands.MethodsAll patients with EOC, including peritoneal and fallopian tube carcinoma, diagnosed in the Netherlands between 1989 and 2014 were selected from the Netherlands Cancer Registry. Changes in therapy were studied and related to overall survival (OS) using multivariable Cox regression models.ResultsA total of 32,540 patients were diagnosed with EOC of whom 22,047 (68%) had advanced stage disease. In early stage, lymph node dissection as part of surgical staging procedures increased over time from 4% in 1989–1993 to 62% in 2009–2014 (P < 0.001). In advanced stage, the number of patients receiving optimal treatment with surgery and chemotherapy increased from 55% in 1989–1993 to 67% in 2009–2014 (P < 0.001). Five-year survival rates improved in both early stage (74% versus 79%) and advanced stage (16% versus 24%) as well as in all patients combined (31% versus 34%). Ten-year survival rates, however, slightly improved in early stage (62% versus 67%) and advanced stage (10% versus 13%) but remained essentially unchanged at 24% for all patients combined.ConclusionDespite intensified treatment and staging procedures, long-term survival for women with EOC has not improved in the last 25 years. The observed improvements in 5-year OS reflect a more prolonged disease control rather than better chances for cure. Furthermore, the apparent better long-term outcome, when early and advanced stage patients are analysed separately, is largely due to improved staging procedures and the ensuing stage migration. These effects disappear in a combined analysis of all patients.



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ASCO update on lymphoma

Summary

Abstracts concerning indolent and aggressive lymphoma and multiple myeloma with clinical relevance from the ASCO 2017 meeting are discussed.

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The first meeting of the Austrian Expert Panel for Molecular Cancer Profiling

Summary

Personalized medicine is rapidly changing the daily routine for the diagnostic work-up and treatment of cancer patients. Several clinical studies and programs are ongoing worldwide to implement personalized anticancer therapies particularly for relapsed/refractory malignancies. On 28 October 2016, the first meeting of the Austrian Expert Panel for Molecular Cancer Profiling was held in Salzburg with the purpose to identify clinical studies and registry programs focusing on comprehensive molecular tumor profiling and personalized cancer therapies in Austria. Representatives of the four Austrian academic centers and from two teaching hospitals were invited to present and debate the current status, challenges, and perspectives in precision oncology. To date, three clinical programs are recruiting patients with relapsed/refractory malignancies in Austria: the ONCO-T-PROFILE program at the Medical University of Innsbruck, the platform MONDTI at the Medical University of Vienna, and the ICT (Individualized Cancer Treatment) phase II trial at the Medical University of Graz. The aim of both research programs and the phase II trial is to investigate the efficacy of molecular profile-based personalized therapies in refractory and relapsed metastatic cancer patients. Furthermore, in cooperation with the AGMT (Study Group of Medical Tumor Therapy), a clinical registry will be established to monitor and to analyze the benefit of molecular profiling in real life.

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ASCO update on lymphoma

Summary

Abstracts concerning indolent and aggressive lymphoma and multiple myeloma with clinical relevance from the ASCO 2017 meeting are discussed.

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The first meeting of the Austrian Expert Panel for Molecular Cancer Profiling

Summary

Personalized medicine is rapidly changing the daily routine for the diagnostic work-up and treatment of cancer patients. Several clinical studies and programs are ongoing worldwide to implement personalized anticancer therapies particularly for relapsed/refractory malignancies. On 28 October 2016, the first meeting of the Austrian Expert Panel for Molecular Cancer Profiling was held in Salzburg with the purpose to identify clinical studies and registry programs focusing on comprehensive molecular tumor profiling and personalized cancer therapies in Austria. Representatives of the four Austrian academic centers and from two teaching hospitals were invited to present and debate the current status, challenges, and perspectives in precision oncology. To date, three clinical programs are recruiting patients with relapsed/refractory malignancies in Austria: the ONCO-T-PROFILE program at the Medical University of Innsbruck, the platform MONDTI at the Medical University of Vienna, and the ICT (Individualized Cancer Treatment) phase II trial at the Medical University of Graz. The aim of both research programs and the phase II trial is to investigate the efficacy of molecular profile-based personalized therapies in refractory and relapsed metastatic cancer patients. Furthermore, in cooperation with the AGMT (Study Group of Medical Tumor Therapy), a clinical registry will be established to monitor and to analyze the benefit of molecular profiling in real life.

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'You can keep your hat on: a giant forehead trichilemmal cyst

Description

A 70-year-old man was referred to plastic surgery with a progressively enlarging lesion to his forehead. A small nodule had been present since 30 years. The patient had presented to his general practitioner at the time and had been reassured that this was a sebaceous cyst which warranted no further attention. As the lesion continued to grow over the intervening years, the patient did not seek any further medical attention and concealed the lesion under a cap.

On examination, he had a 5x6x6 cm pedunculated, fleshy exophytic tumour on his central forehead (figure 1A), with further nodules each measuring 2–3 cm diameter dotted across his scalp.

Figure 1

(A) Anterior view of the pedunculated forehead lesion. (B) Axial CT showing no intracranial component or bony erosion.

CT showed a heterogeneous midline scalp lesion abutting the outer table of the skull but with...

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Traumatic pneumocephaly: trapped air from where?

Traumatic pneumocephaly is literally defined as 'air in the head' after trauma. While this phenomenon has been well described in the literature, our case report is unique in describing diffuse pneumocephalus in the subaponeurotic space, subdural space, subarachnoid space, brain and ventricles without a break in the cranial vault: a 26-year-old man fell from a =9 meter scaffolding in a water tower. Following an arduous and delayed extrication, the patient was unresponsive with loss of pulse requiring intubation, cardiopulmonary resuscitation and release of tension pneumothorax with bilateral thoracostomy tubes. Examination remained poor with a Glasgow Coma Scale of 3. Immediate exploratory laparotomy was performed for a small right retroperitoneal haematoma on Focused Assessment with Sonography for Trauma. Postoperative imaging revealed diffuse pneumocephaly without facial fractures. This case presentation explores unusual causes of fistulous connections with the atmosphere that may lead to air trapped in and around the cranial vault.

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