Abstract P2-04-03: Usefulness of Perioperative Screening of Patients with pN0 Invasive Breast Carcinoma: Results on 1058 pN0 Patients of a Population-Based Study of the French Cancer Registry

Background: Usefulness of baseline routine bone scanning (BS), liver ultrasonography (LUS) and chest radiography (CXR) in asymptomatic women with pN0 Invasive Breast Carcinoma is not evidence-based. Methods: A random sample of 1883 cases of invasive breast cancer diagnosed in 2003 from 10 French counties covered by a cancer registry was analyzed. Clinico-pathological features, staging tests and results were retrospectively collected from the medical record. Results: 1058 pN0 patients were identified. At baseline, CXR, LUS, BS were carried out pre or post-operative in respectively 785 (74%), 782 (74%), and 618 (58%) patients. Data summarizing results with the three imaging techniques are listed in [Table 1]. Initial suspicion was confirmed by other independant tests (bone X-ray, computerized tomography scan). After the initial staging investigation procedures and the further diagnostic procedures if necessary (computerized tomograhy scan or bone X-ray), only 3 (0.3%) patients were diagnosed having metastatic disease. CXR, LUS, BS detected metastasis respectively in 1 (0.13%), 0 (0%), and 2 (0.3%) of patients.

Diagnostic accuracy in the diagnosis of metastatic disease by chest radiography, liver ultrasonography and chest radiography

Conclusion: In asymptomatic pN0 invasive breast cancer, screening for metastases is not warranted because of low frequency of metastases, false positive findings and high cost.

[Prostate cancer management and factors associated with radical prostatectomy in France in 2001]

INTRODUCTION

Prostate cancer was the most common cancer in men in France in 2005, and the second cause of male death from cancer. In this study, we analyzed clinical characteristics of patients with prostate cancer diagnosed in France in 2001 with a focus on therapeutic management of localized prostate cancers.

PATIENTS AND METHODS

A total of 2181 cases of prostate cancer diagnosed in 2001 from 11 French counties covered by a cancer registry were analyzed. A descriptive study of the clinical characteristics of patients was performed. Parameters studied included age, county, TNM stage, PSA value, Gleason score, D'Amico prognostic group, Charlson's comorbidity index and initial treatment modalities. For localized cancers, multivariate logistic regression analysis identified factors associated with radical prostatectomy.

RESULTS

The proportion of localized prostate cancer (T1 or T2) was 86.6 %. The use of invasive curative treatment (radical prostatectomy and radiotherapy) was 58.4 % for localized cancers. Significant differences in therapeutic management were found between counties. Radical prostatectomy was associated with age at diagnosis, D'Amico prognostic group and the presence of comorbidities.

CONCLUSIONS

Most of prostate cancers diagnosed in France in 2001 were clinically localized and were treated by invasive therapy. The consequences of these practices remain to be determined given the limited evolution of many prostate cancers and the frequency of adverse events related to invasive treatments.

A time trend analysis of papillary and follicular cancers as a function of tumour size: a study of data from six cancer registries in France (1983-2000)

The incidence of thyroid cancers, and in particular the papillary forms, has been increasing sharply for many years in Western countries. However, the factors explaining this increase have not been clearly established. Some studies mention the effects of radioactive fallout, particularly after the accident in Chernobyl. Another probable cause is related to progress in medical practice, and particularly in diagnosis. In this article, we describe time trends in the incidence of papillary and follicular cancers, taking into account the size of the tumour at the time of diagnosis. The analysis was carried out on cases from six French cancer registries for the period 1983-2000. Anatomopathological reports concerning 3381 cancer cases were systematically recoded and centralised, following ICDO-3 rules. Over the whole period, the annual percent change of the incidence of papillary cancers was +8.13% and +8.98%, respectively in men and in women. For micropapillary carcinomas (< or = 10 mm), this increase was respectively +12.05% and +12.85%. There is no significant effect of period apart from micropapillary carcinomas in women. However, a birth cohort effect exists for some groups. This effect corresponds to an acceleration in the risk for people born after the 1930s. For the most recent period (1998-2000), half the cases of papillary cancer were micropapillary carcinomas, and for one third of these, the tumour was < or = 5 mm. Our description of a time trend of incidence as a function of tumour size supports the hypothesis of the role of medical practice in a context of high prevalence. Obviously, these findings do not exclude the possible role of other factors.

Survival of cancer patients in France: a population-based study from The Association of the French Cancer Registries (FRANCIM)

We present the main results of the first population-based cancers survival study gathering all French registry data. Survival data on 205,562 cancer cases diagnosed between 01/01/1989 and 31/12/1997 were analysed. Relative survival was estimated using an excess rate model. The evolution of the excess mortality rate over the follow-up period was graphed. The analysis emphasised the effect of age at diagnosis and its variation with time after diagnosis. For breast and prostate cancers, the age-standardised five-year relative survivals were 84% and 77%, respectively. The corresponding results in men and women were 56% versus 58% for colorectal cancer and 12% versus 16% for lung cancer. For some cancer sites, the excess mortality rate decreased to low values by five years after diagnosis. For most cancer sites, age at diagnosis was a negative prognostic factor but this effect was often limited to the first year after diagnosis.