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Nagasawa DT, Bergsneider M, Kelly D, Shafa B, Duong D, Ausman J, Liau L, McBride D, Yang I, Mann BS, Yabroff R, Harlan L, Zeruto C, Abrams J, Gondi V, Eickhoff J, Tome WA, Kozak KR, Mehta MP, Field KM, Drummond K, Yilmaz M, Gibbs P, Rosenthal MA, Allaei R, Johnson KJ, Hooten AJ, Kaste E, Ross JA, Largaespada DA, Johnson DR, O'Neill BP, Rice T, Zheng S, Xiao Y, Decker PA, McCoy LS, Smirnov I, Patoka JS, Hansen HM, Wiemels JL, Tihan T, Prados MD, Chang SM, Berger MS, Pico A, Rynearson A, Voss J, Caron A, Kosel ML, Fridley BL, Lachance DH, O'Neill BP, Giannini C, Wiencke JK, Jenkins RB, Wrensch MR, Xiao Y, Decker PA, Rice T, Hansen HM, Wiemels JL, Tihan T, Prados MD, Chang SM, Berger MS, Kosel ML, Fridley BL, Lachance DH, O'Neill BP, Buckner JC, Burch PA, Thompson RC, Nabors LB, Olson JJ, Brem S, Madden MH, Browning JE, Wiencke JK, Egan KM, Jenkins RB, Wrensch MR, Pereira EA, Livermore J, Alexe DM, Ma R, Ansorge O, Cadoux-Hudson TA, Johnson DR, O'Neill BP, Wang M, Dignam J, Won M, Curran W, Mehta M, Gilbert M, Terry AR, Barker FG, Leffert LR, Bateman B, Souter I, Plotkin SR, Ishaq O, Montgomery J, Terezakis S, Wharam M, Lim M, Holdhoff M, Kleinberg L, Redmond K, Kruchko C, Paker AM, Chi TL, Kamiya-Matsuoka C, Loghin ME, Lautenschlaeger T, Dedousi-Huebner V, Chakravarti A. EPIDEMIOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gilliland FD, Hoffman RM, Hamilton A, Albertsen P, Eley JW, Harlan L, Stanford JL, Hunt WC, Potosky A, Stephenson RA. Predicting extracapsular extension of prostate cancer in men treated with radical prostatectomy: results from the population based prostate cancer outcomes study. J Urol 1999; 162:1341-5. [PMID: 10492193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE We investigated whether clinical information routinely available in community practice could predict extracapsular extension of clinically localized prostate cancer in men undergoing radical prostatectomy. MATERIALS AND METHODS We examined prostate cancer outcomes in a population based sample of 3,826 patients with primary prostate cancer in 6 regions of the United States covered by the Surveillance, Epidemiology, and End Results program. Stratified and weighted logistic regression was used to identify predictors of and probabilities for extracapsular extension of clinically localized tumors treated with radical prostatectomy. RESULTS Nearly 47% of men undergoing radical prostatectomy had extraprostatic extension. The strongest predictors were elevated prostate specific antigen (PSA) greater than 20 versus less than 4 ng./ml. (odds ratio 5.88, 95% confidence interval 2.90 to 11.15), Gleason score greater than 8 versus less than 6 (1.73, 1.04 to 2.87) and age greater than 70 versus less than 50 years (1.91, 0.98 to 3.70). Ethnicity and region were not associated with increased risk of extraprostatic extension. A nomogram developed from our model predicts extracapsular extension ranging from 24% in men younger than 50 years with PSA less than 4 ng./ml. and a Gleason score of less than 7 to 85% in those 70 years old or older with PSA greater than 20 ng./ml. and a Gleason score of 8 or more. If prostatectomy were limited to patients with less than 60% probability of extraprostatic extension based on the nomogram, 95% of those with organ confined cancers would undergo definitive surgery and 18% of those with extracapsular extension would be spared the morbidity of surgery. CONCLUSIONS In a population based analysis of prostate cancer practice patterns PSA, Gleason score and age are clinically useful predictors of extracapsular extension. Although extracapsular extension may be an imperfect predictor of cancer outcomes, our nomogram provides more realistic probabilities for extracapsular extension than those based on institutional series.
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Affiliation(s)
- F D Gilliland
- Department of Preventive Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, USA
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Meadows AT, Varricchio C, Crosson K, Harlan L, McCormick P, Nealon E, Smith M, Ungerleider R. Research issues in cancer survivorship: report of a workshop sponsored by the Office of Cancer Survivorship, National Cancer Institute. Cancer Epidemiol Biomarkers Prev 1998; 7:1145-51. [PMID: 9865434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
- A T Meadows
- Office of Cancer Survivorship, Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, Bethesda, Maryland 20892-7340, USA
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Harlan L, Brawley O, Pommerenke F, Wali P, Kramer B. Geographic, age, and racial variation in the treatment of local/regional carcinoma of the prostate. J Clin Oncol 1995; 13:93-100. [PMID: 7799048 DOI: 10.1200/jco.1995.13.1.93] [Citation(s) in RCA: 163] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Prostate cancer is one of the most common cancers in men. Incidence rates increase with age and are substantially higher in black men than white men. This study examines the variations in the use of radical prostatectomy and radiation by geographic area, age, and race. MATERIALS AND METHODS Data from the National Cancer Institute's Surveillance, Epidemiology, and End-Results Program (SEER) were used to examine treatment differences. Current treatments generally consist of prostatectomy, radiation, or careful observation for clinically localized or regional disease. RESULTS The age-adjusted proportion of men, age 50 and older, who received radical prostatectomy increased sharply between 1984 and 1991, from 11.0% to 32.3% among men with local/regional disease. The choice of treatment varied widely by geographic regions. In 1991, the proportion that received prostatectomy was highest in Utah (47.8%) and lowest in Connecticut (22.5%) among men with localized and regional disease. The increase in radical prostatectomy was not limited to younger men. Although the rates increased for blacks, black men had lower age-adjusted rates of prostatectomy than whites in all years of the study. CONCLUSION The SEER data show a clear trend toward more aggressive treatment, especially prostatectomy. However, the proportion of black men who received prostatectomy was substantially lower than that of white men and this disparity does not appear to be changing.
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Affiliation(s)
- L Harlan
- National Cancer Institute, Bethesda, MD
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Boice JD, Blettner M, Kleinerman RA, Engholm G, Stovall M, Lisco H, Austin DF, Bosch A, Harlan L, Krementz ET, Latouret HB, Merril JA, Petters LJ, Schulz MD, Wactawski J, Storm HH, Björkholm E, Pettersson F, Bell CM, Coleman MP, Fraser P, Neal FE, Prior P, Choi NW, Hislop TG, Koch M, Kreiger N, Robb D, Robson D, Thomson DH, Lochmüller H, von Fournier D, Frischkorn R, Kjørstad KE, Rimpela A, Pejovic MH, Kirn VP, Stankusova H, Pisani P, Sigurdsson K, Hutchison GB, MacMahon B. Radiation dose and breast cancer risk in patients treated for cancer of the cervix. Int J Cancer 1989; 44:7-16. [PMID: 2744900 DOI: 10.1002/ijc.2910440103] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The relationship between breast cancer and radiation treatment for cervical cancer was evaluated in an international study of 953 women who subsequently developed breast cancer and 1,806 matched controls. Radiation doses to the breast (average 0.31 Gy) and ovaries (average 32 Gy) were reconstructed for exposed subjects on the basis of their original radiotherapy records. Overall, 88% of the breast cancer cases and 89% of the controls received radiation treatment [relative risk (RR) = 0.88; 95% confidence interval (CI) = 0.7-1.2]. Among women with intact ovaries (561 cases, 1,037 controls), radiotherapy was linked to a significant 35% reduction in breast cancer risk, attributable in all likelihood to the cessation of ovarian function. Ovarian doses of 6 Gy were sufficient to reduce breast cancer risk but larger doses did not reduce risk further. This saturation-type response is probably due to the killing of a critical number of ovarian cells. Cervical cancer patients without ovaries (145 cases, 284 controls) were analyzed separately because such women are at especially low natural risk for breast cancer development. In theory, any effect of low-dose breast exposure, received incidentally during treatment for cervical cancer, should be more readily detectable. Among women without ovaries, there was a slight increase in breast cancer risk (RR = 1.07; 95% CI = 0.6-2.0), and a suggestion of a dose response with the RR being 1.0, 0.7, 1.5 and 3.1 for breast doses of 0, 0.01-0.24, 0.25-0.49 and 0.50+ Gy, respectively. However, this trend of increasing RR was not statistically significant. If low-dose radiation increases the risk of breast cancer among women over age 40 years, it appears that the risk is much lower than would be predicted from studies of younger women exposed to higher doses.
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Affiliation(s)
- J D Boice
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892
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