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Two patients were seen with malignant neoplastic emboli to the coronary arteries. One, a 61-year-old woman with a malignant fibrous histiocytoma of the thigh and a solitary pulmonary metastatic lesion, died of an acute myocardial infarction due to a neoplastic coronary embolus after lobectomy. The other, a 51-year-old woman with bronchogenic adenocarcinoma, died of extensive cerebral metastases. At autopsy, she also was found to have had an acute myocardial infarction associated with a neoplastic coronary embolus. 相似文献
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Important increase of invasive lobular breast cancer incidence in Geneva,Switzerland 总被引:6,自引:0,他引:6
Verkooijen HM Fioretta G Vlastos G Morabia A Schubert H Sappino AP Pelte MF Schäfer P Kurtz J Bouchardy C 《International journal of cancer. Journal international du cancer》2003,104(6):778-781
A recent paper from the United States reported a sharp and unexplained increase in invasive lobular breast cancer incidence since 1977 (Li et al., Cancer 2000;88:2561-9). We investigated if this trend was also present in Geneva, Switzerland, where breast cancer incidence is one of the highest in Europe. We analyzed trends in breast cancer incidence according to histologic subtype, age and stage, to clarify the pattern. Our population-based study includes all histologically confirmed invasive breast carcinomas (n = 6,247) recorded between 1976 and 1999 at the Geneva Cancer Registry. Breast histology was classified as ductal carcinoma, lobular carcinoma and other. Incidence trends were studied by log-linear regression analyses. Models including effects of age, period and birth cohorts were used to describe rising incidence trends. The incidence of ductal carcinoma increased 1.2% per year (p(trend) < 0.001) from 85.2 to 110.1/100,000. This increase concerned women aged 50-69 years and early-stage tumors. Lobular cancer incidence increased disproportionately (14.4% per year, p(trend) < 0.01) and rose from 2.9 to 20.5/100,000. This increase affected all age categories and both localized and advanced stages. In addition, a strong age-cohort effect was present (p < 0.05), and women aged 50-59 years born after 1944 experienced the most marked increase. Our study shows a disproportionate increase of lobular breast cancer incidence compared to ductal cancer incidence. Contrary to ductal cancer, trends for lobular cancer are unlikely to be explained by increased use of screening mammography. Other explanations must be researched, in particular the role played by hormone replacement therapy. 相似文献
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Summary Numerous European cancer registries are working together to evaluate the current trends in the incidence of childhood leukemias after the Chernobyl accident. The study is coordinated by the International Agency for Research on Cancer. The primary objective is to establish whether the accident has resulted in an increase in the number of cases. The results will also allow an evaluation of the clusters which could be reported. According to the provisional estimations, the accident could lead to an increase of an average of 0.8% of the frequency of new cases in the European regions covered by the study. For the whole of Switzerland, this increase would correspond to 0.5 supplementary cases per year.
Die Inzidenz der Kinderleukämien in Europa: Eine gemeinsame Krebsregisterstudie im Gefolge von Tschernobyl
Zusammenfassung Im Gefolge des Kernkraftunfalls von Tschernobyl hat sich die Grosszahl der Europäischen Krebsregister dahin geeinigt, die Inzidenz der Kinderleukämien in Europa in einer gemeinsamen, von der Internationalen Krebsforschungsagentur (IARC) koordinierten Studie genauer zu verfolgen. Als erstes gilt es zu eruieren, ob im Gefolge des Unfalls mehr Kinderleukämien aufgetreten sind; es wird auch möglich sein, vermutliche Häufungen (Clusters) von Kindheitsleukämien zu überprüfen. Aus der Zusatzstrahlung nach Tschernobyl ergibt sich die Schätzung, dass die Anzahl Neuerkrankungen in den von der Studie erfassten Gebieten um 0,8% zunehmen könnte. Für die Schweiz würde das je eine zusätzliche Kinderleukämie in zwei Jahren bedeuten.
L'étude «post-Tchernobyl» des leucémies infantiles
Résumé De nombreux registres du cancer européens se sont associés pour évaluer avec précision les tendances actuelles de l'incidence des leucémies infantiles, suite à l'accident de Tchernobyl. L'étude est coordonnée par le Centre international de recherche sur le cancer. L'objectif premier est d'établir si l'accident provoque une augmentation du nombre de cas. Les résultats permettront également d'évaluer les clusters qui seraient signalés. D'après les estimations, l'accident pourrait conduire à une augmentation de 0.8% de la fréquence des nouveaux cas, en moyenne, dans les régions européennes couvertes par l'étude. Pour l'ensemble de la Suisse, cette augmentation correspondrait à 0.5 cas supplémentaires par an.相似文献
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Rapiti E Fioretta G Verkooijen HM Zanetti R Schmidlin F Shubert H Merglen A Miralbell R Bouchardy C 《International journal of cancer. Journal international du cancer》2008,123(5):1141-1145
Radiotherapy can induce second cancers. Controversies still exist regarding the risk of second malignancies after irradiation for prostate cancer. We evaluated the risk of developing colon and rectum cancers after prostate cancer in irradiated and nonirradiated patients. Using data from the population-based Geneva cancer registry, we included in the study all men with prostate cancer diagnosed between 1980 and 1998 who survived at least 5 years after diagnosis. Of the 1,134 patients, 264 were treated with external radiotherapy. Patients were followed for occurrence of colorectal cancer up to 31 December, 2003. We calculated standardized incidence ratios (SIR) using incidence rates for the general population to obtain the expected cancer incidence. The cohort yielded to 3,798 person-years. At the end of follow-up 19 patients had developed a colorectal cancer. Among irradiated patients the SIR for colorectal cancer was 3.4 (95% confidence intervals [CI] 1.7-6.0). Compared to the general population, the risk was significantly higher for colon cancer (SIR = 4.0, 95% CI: 1.8-7.6), but not for rectal cancer (SIR = 2.0, 95% CI: 0.2-7.2). The risk of colon cancer was increased in the period of 5-9 years after diagnosis (SIR = 4.7, 95% CI: 2.0-9.2). The overall SIR of secondary cancer in patients treated with radiotherapy was 1.35 (p = 0.056). Nonirradiated patients did not have any increased risk of rectal or colon cancer. This study shows a significant increase of colon but not rectum cancer after radiotherapy for prostate cancer. The risk of second cancer after irradiation, although probably small, needs nevertheless to be carefully monitored. 相似文献
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Editorial
Editorial choices: To expand or not to expand ... 相似文献8.
Background
Dobutamine myocardial perfusion perfusion imaging is being used increasingly for assessment of coronary artery disease. Heretofore, there have been no large series documenting its tolerance and safety. The aims of this study were to assess the tolerance, hemodynamic changes, and safety of dobutamine stress in conjunction with myocardial perfusion imaging.Methods and Results
The tolerance, hemodynamic changes, and safety of dobutamine myocardial perfusion imaging were investigated in a consecutive series of 1012 patients. Dobutamine was infused at incremental doses of 10, 20, 30, and 40 μg/kg/min at 3-minute intervals. Perfusion tomography was performed according to standard protocols with either 201Tl or 99mTc-labeled sestamibi. Seven hundred twenty-nine patients (72%) reached a maximal dobutamine dose of 40 μg/kg/min. Dobutamine significantly increased heart rate (76±14 beats/min to 127±20 beats/min; p<0.001) and systolic blood pressure (141±20 mm Hg to 168±36 mm Hg; p<0.001) from baseline to peak infusion rate. The most common side effects were chest pain (31%), headache (14%), dyspnea (12%), palpitations (10%), and flushing (10%). There was no death, myocardial infarction, pulmonary edema, ventricular fibrillation, sustained ventricular tachycardia, or cerebral vascular accident. Nonsustained ventricular tachycardia occurred in 43 patients (4.2%) but did not cause any hemodynamic instability.Conclusion
When done with the necessary caution, dobutamine myocardial perfusion imaging is a safe diagnostic test, although side effects are common. 相似文献9.
Sarp S Fioretta G Verkooijen HM Vlastos G Rapiti E Schubert H Sappino AP Bouchardy C 《Annals of surgical oncology》2007,14(3):1031-1039
Background There is growing evidence that tumors of the inner quadrants (especially the lower-inner quadrant) metastasize more often
to the internal mammary chain (IMC). As these metastases are not investigated, patients with lower-inner quadrant tumors have
an increased risk of being under-staged and under-treated and may therefore have a higher risk of death from breast cancer.
Methods We identified all 1522 women operated for stage I breast cancer between 1984 and 2002 recorded at the population-based Geneva
Cancer Registry. We compared breast cancer mortality risk by tumor location with multivariate Cox regression analysis that
accounted for all factors linked to tumor location and survival.
Results Ten-year disease-specific survival was 93% (95%CI: 91–94%). Patients with breast cancer of the lower-inner quadrant (n = 118;
7.8%) had an importantly increased risk of dying of breast cancer compared to women with breast cancer of the upper-outer
quadrant (multiadjusted Hazard Ratio: 2.3, 95%CI: 1.1–4.5, P = 0.0206). The over-mortality associated with this quadrant was particularly evident for tumors >10 mm (multiadjusted HR:
3.6, 95%CI: 1.6–7.9, P = 0.0016). There was no increased breast cancer mortality risk for tumors located in other quadrants.
Conclusions Tumor location in the lower-inner quadrant is an independent and important prognostic factor of stage I breast cancer. Further
research is needed to evaluate if the over-mortality of patients with stage I cancer of the lower-inner quadrant is indeed
a result of under-treatment due to undetected IMC metastases. If so, patients with stage I breast cancer of the lower-inner
quadrant are good candidates for systematic IMC investigation.
Part of this study was presented as a poster at the 28th San Antonio Breast Cancer Symposium, December 8-11, 2005. 相似文献
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Anne-Sophie Jannot Massimo Usel Christine Bouchardy Hyma Schubert Elisabetta Rapiti 《Cancer causes & control : CCC》2017,28(9):921-928