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Sorbye H, Knappskog S, Grob T, Venizelos A, Amstutz U, Hjortland G, Lothe I, Kersten C, Hofsli E, Sundlov A, Elvebakken H, Garresori H, Couvelard A, Svensson J, Perren A. 890MO Mutation spectrum in liquid versus solid biopsies from advanced digestive neuroendocrine carcinoma patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1016] [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: 11/15/2022] Open
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2
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Liposits G, Ryg J, Skuladottir H, Winther S, Möller S, Hofsli E, Shah CH, Poulsen Oestergaard L, Berglund A, Qvortrup C, Osterlund P, Glimelius B, Sorbye H, Pfeiffer P. 410P Prognostic value of baseline ECOG performance status, frailty phenotype, and geriatric screening tools (G8 and VES-13) in vulnerable older patients with metastatic colorectal cancer: The randomized NORDIC9-study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.548] [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: 11/27/2022] Open
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Larsen SG, Goscinski MA, Dueland S, Steigen SE, Hofsli E, Torgunrud A, Lund-Iversen M, Dagenborg VJ, Flatmark K, Sorbye H. Impact of KRAS, BRAF and microsatellite instability status after cytoreductive surgery and HIPEC in a national cohort of colorectal peritoneal metastasis patients. Br J Cancer 2022; 126:726-735. [PMID: 34887523 PMCID: PMC8888568 DOI: 10.1038/s41416-021-01620-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 10/18/2021] [Accepted: 10/29/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients with metastatic colorectal cancer (mCRC) carrying BRAF (mutBRAF) or KRAS mutation (mutKRAS) have an inferior prognosis after liver or lung surgery, whereas the prognostic role in the context of peritoneal metastasis (PM) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been less investigated. METHODS In total, 257 patients with non-appendiceal PM-CRC were included from the Norwegian National Unit for CRS-HIPEC. RESULTS In total, 180 patients received CRS-HIPEC with Mitomycin C, 77 patients received palliative surgery only. In the CRS-HIPEC group, mutBRAF was found in 24.7%, mutKRAS 33.9% and double wild-type 41.4% without differences in survival. MSI was found in 29.3% of mutBRAF cases. Patients with mutBRAF/MSI had superior 5-year survival compared to mutBRAF with MSS (58.3% vs 25.2%, P = 0.022), and better 3-year disease-free survival (DFS) compared to mutKRAS (48.6% vs 17.2%, P = 0.049). Peritoneal Cancer Index and the number of lymph node metastasis were prognostic for OS, and the same two, location and gender prognostic for DFS in multivariate analysis. CONCLUSIONS PM-CRC with CRS-HIPEC patients has a surprisingly high proportion of mutBRAF (24.7%). Survival was similar comparing mutBRAF, mutKRAS and double wild-type cases, whereas a small subgroup with mutBRAF and MSI had better survival. Patients with mutBRAF tumours and limited PM should be considered for CRS-HIPEC.
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Affiliation(s)
- S. G. Larsen
- grid.55325.340000 0004 0389 8485Section for Surgical Oncology, Norwegian Radium Hospital, Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway
| | - M. A. Goscinski
- grid.55325.340000 0004 0389 8485Section for Surgical Oncology, Norwegian Radium Hospital, Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway
| | - S. Dueland
- grid.55325.340000 0004 0389 8485Department of Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - S. E. Steigen
- grid.412244.50000 0004 4689 5540Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway
| | - E. Hofsli
- grid.52522.320000 0004 0627 3560The Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - A. Torgunrud
- grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - M. Lund-Iversen
- grid.5510.10000 0004 1936 8921Department of Clinical Pathology, University of Oslo, Oslo, Norway
| | - V. J. Dagenborg
- grid.55325.340000 0004 0389 8485Section for Surgical Oncology, Norwegian Radium Hospital, Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway
| | - K. Flatmark
- grid.55325.340000 0004 0389 8485Section for Surgical Oncology, Norwegian Radium Hospital, Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway ,grid.55325.340000 0004 0389 8485Department of Tumor Biology, Institute for Cancer Research, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - H. Sorbye
- grid.7914.b0000 0004 1936 7443Department of Oncology, Haukeland University Hospital and Department of Clinical Science, University of Bergen, Bergen, Norway
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Hicks RJ, Dromain C, de Herder WW, Costa FP, Deroose CM, Frilling A, Koumarianou A, Krenning EP, Raymond E, Bodei L, Sorbye H, Welin S, Wiedenmann B, Wild D, Howe JR, Yao J, O’Toole D, Sundin A, Prasad V. ENETS standardized (synoptic) reporting for molecular imaging studies in neuroendocrine tumours. J Neuroendocrinol 2022; 34:e13040. [PMID: 34668262 PMCID: PMC11042683 DOI: 10.1111/jne.13040] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/29/2021] [Accepted: 08/31/2021] [Indexed: 11/27/2022]
Abstract
The European Neuroendocrine Tumor Society (ENETS) promotes practices and procedures that aim to improve the standard of care delivered to patients diagnosed with or suspected of having neuroendocrine neoplasia (NEN). At its annual Scientific Advisory Board Meeting in 2018, experts in imaging, pathology and clinical care of patients with NEN drafted guidance for the standardised reporting of diagnostic studies critical to the diagnosis, grading, staging and treatment of NEN. These included pathology, radiology, endoscopy and molecular imaging procedures. In an iterative process, a synoptic reporting template for molecular imaging procedures was developed to guide personalised therapies. Following pilot implementation and refinement within the ENETS Center of Excellence network, harmonisation with specialist imaging societies including the Society of Nuclear Medicine, European Association of Nuclear Medicine and the International Cancer Imaging Society will be pursued.
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Affiliation(s)
- RJ Hicks
- Neuroendocrine Service, the Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - C Dromain
- Lausanne University Hospital, Department of Radiology and University of Lausanne, Lausanne, Switzerland
| | - W W de Herder
- Erasmus MC, Department of Internal Medicine, Section of Endocrinology, Rotterdam, The Netherlands
| | - FP Costa
- Centro de Oncologia of Hospital Sírio Libanês, Sao Paulo, Brazil
| | - C M Deroose
- University Hospitals Leuven, Nuclear Medicine and KU Leuven, Department of Imaging and Pathology, Nuclear Medicine & Molecular Imaging, Leuven, Belgium
| | - A Frilling
- Imperial College London, Department of Surgery and Cancer, Hammersmith Hospital, London, United Kingdom
| | - A Koumarianou
- National and Kapodistrian University of Athens, Hematology Oncology Unit, 4th Department of Internal Medicine, Athens, Greece
| | - EP Krenning
- Erasmus MC, Cyclotron Rotterdam BV, Rotterdam, The Netherlands
| | - E Raymond
- Medical Oncology, Hôspital Paris Saint-Joseph, Paris, France
| | - L Bodei
- Memorial Sloan Kettering Cancer Center, Department of Radiology, Molecular Imaging and Therapy Service, New York, USA
| | - H Sorbye
- Haukeland University Hospital, Department of Oncology and Department of Clinical Science, Bergen, Norway
| | - S Welin
- Endocrine Oncology, Uppsala University Hospital, Uppsala, Sweden
| | - B Wiedenmann
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D Wild
- University of Basel Hospital, Department of Radiology and Nuclear Medicine, Basel, Switzerland
| | - JR Howe
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - J Yao
- University of Texas M.D. Anderson Cancer Center, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, Houston, Texas, USA
| | - D O’Toole
- St. James’s and St. Vincent’s University Hospitals & Trinity College Dublin, Dublin, Ireland
| | - A Sundin
- Department of Surgical Sciences, Uppsala University, Radiology and Molecular Imaging, Uppsala University Hospital, Uppsala, Sweden
| | - V Prasad
- Department of Nuclear Medicine, University Ulm, Ulm Germany
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Osterlund P, Kinos S, Pfeiffer P, Salminen T, Kwakman J, Frödin JE, Shah C, Sorbye H, Ristamäki R, Halonen P, Soveri L, Heervä E, Ålgars A, Bärlund M, Hagman H, McDermott R, O’Reilly M, Röckert R, Liposits G, Kallio R, Flygare P, Teske A, van Werkhoven E, Punt C, Glimelius B. Continuation of fluoropyrimidine treatment with S-1 after cardiotoxicity on capecitabine- or 5-fluorouracil-based therapy in patients with solid tumours: a multicentre retrospective observational cohort study. ESMO Open 2022; 7:100427. [PMID: 35798468 PMCID: PMC9291631 DOI: 10.1016/j.esmoop.2022.100427] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/23/2021] [Accepted: 12/18/2021] [Indexed: 12/14/2022] Open
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Butt B, Stokmo H, Ladekarl M, Mitkina Tabaksblat E, Sorbye H, Revheim M, Hjortland G. 1108P Folfirinox in the treatment of advanced gastroenteropancreatic neuroendocrine carsinomas. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.190] [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: 10/20/2022] Open
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7
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Osterlund E, Muhonen T, Ristimäki A, Kytölä S, Kuopio T, Halonen P, Kallio R, Soveri L, Heervä E, Sundström J, Keinänen M, Ålgars A, Ristamäki R, Sorbye H, Pfeiffer P, Pulkkanen K, Nunes L, Salminen T, Lamminmäki A, Isoniemi H, Glimelius B, Osterlund P. SO-13 KRAS-G12C mutations in a Nordic cohort of 1441 metastatic colorectal cancer patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.037] [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: 10/20/2022] Open
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8
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Liposits G, Eshoj H, Möller S, Winther S, Skuladottir H, Jesper R, Hofsli E, Poulsen L, Shah C, Berglund Å, Qvortrup C, Osterlund P, Glimelius B, Sorbye H, Pfeiffer P. SO-15 Quality of life and physical functioning in older patients with metastatic colorectal cancer receiving palliative chemotherapy: The randomized NORDIC9-study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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9
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Siesing C, Larsson A, Petersson A, Nodin B, Sorbye H, Aasebo K, Qvortrup C, Pfeiffer P, Pontén F, Glimelius B, Eberhard J, Jirström K, Karnevi E. 485P Link between PODXL and the EGFR axis in metastatic colorectal cancer and in vitro: Implications for improved treatment stratification. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.596] [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: 11/25/2022] Open
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10
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Osterlund E, Isoniemi H, Kytölä S, Kononen J, Pfeiffer P, Soveri L, Keinänen M, Sorbye H, Nunes L, Salminen T, Nieminen L, Halonen P, Ålgars A, Sundström J, Kallio R, Ristamäki R, Lamminmäki A, Heervä E, Kuopio T, Glimelius B, Ristimäki A, Osterlund P. SO-22 Atypical non-V600E BRAF (aBRAF) mutations as a prognostic and predictive factor in real-life metastatic colorectal cancer patients from the Nordic countries. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.037] [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: 10/23/2022] Open
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11
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Falk P, Severin M, Guren MG, Österlund P, Hofsli E, Giwercman A, Eberhard J, Sorbye H. Sex hormones and sperm parameters after adjuvant oxaliplatin-based treatment for colorectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.033] [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: 11/12/2022] Open
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12
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Schou J, Sztupinszki Z, Johansen J, Nielsen D, Glimelius B, Qvortrup C, Sorbye H, Jensen BV, Pfeiffer P. High circulating miR-1247 is a marker for poor prognosis in patients with metastatic colorectal cancer treated with chemotherapy and cetuximab. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.101] [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: 11/12/2022] Open
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13
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Pfeiffer P, Bjerregaard J, Qvortrup C, Sorbye H, Glimelius B, Kersten C. Updated results of NORDIC 8, a randomised trial of cetuximab every 2 weeks with FOLFIRI or cetuximab with alternating FOLFIRI/FOLFOX in patients with RAS and BRAF wild type metastatic colorectal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.027] [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: 11/13/2022] Open
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14
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Pfeiffer P, Glimelius B, Winther S, Qvortrup C, Yilmaz M, Berglund À, Vistisen K, Kersten C, Liposits G, Sorbye H. Randomised trial of cetuximab every 2 weeks with FOLFIRI or cetuximab with alternating FOLFIRI/FOLFOX in patients with RAS and BRAF wild type metastatic colorectal cancer: Nordic 8 results. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.014] [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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15
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Hamfjord J, Guren TK, Dajani O, Johansen JS, Glimelius B, Sorbye H, Pfeiffer P, Lingjærde OC, Tveit KM, Kure EH, Pallisgaard N, Spindler KLG. Total circulating cell-free DNA as a prognostic biomarker in metastatic colorectal cancer before first-line oxaliplatin-based chemotherapy. Ann Oncol 2019; 30:1088-1095. [PMID: 31046124 DOI: 10.1093/annonc/mdz139] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Metastatic colorectal cancer (mCRC) is a heterogeneous disease where prognosis is dependent both on tumor biology and host factors. Total circulating cell-free DNA (cfDNA) has shown to harbor prognostic information in mCRC, although less is known about the biological correlates of cfDNA levels in this patient group. The primary objective was to evaluate the prognostic value of pretreatment cfDNA in patients receiving the first-line oxaliplatin-based chemotherapy for mCRC, by using a predefined upper limit of normal (ULN) from a cohort of presumed healthy individuals. The secondary objective was to model cfDNA levels as a function of predefined tumor and host factors. PATIENTS AND METHODS This was a retrospective post hoc study based on a prospective multicenter phase III trial, the NORDIC-VII study. DNA was purified from 547 plasma samples and cfDNA quantified by a droplet digital PCR assay (B2M, PPIA) with controls for lymphocyte contamination. Main clinical end point was overall survival (OS). RESULTS cfDNA was quantified in 493 patients, 54 were excluded mainly due to lymphocyte contamination. Median cfDNA level was 7673 alleles/ml (1050-1 645 000) for B2M and 5959 alleles/ml (555-854 167) for PPIA. High cfDNA levels were associated with impaired outcome; median OS of 16.6 months for levels above ULN and 25.9 months for levels below ULN (hazard ratio = 1.83, 95% confidence interval 1.51-2.21, P < 0.001). The result was confirmed in multivariate OS analysis adjusting for established clinicopathological characteristics. A linear regression model predicted cfDNA levels from sum of longest tumor diameters by RECIST, the presence of liver metastases and systemic inflammatory response as measured by interleukin 6 (F(6, 357) = 62.7, P < 0.001). CONCLUSION cfDNA holds promise as a minimally invasive and clinically relevant prognostic biomarker in mCRC before initiating first-line oxaliplatin-based chemotherapy and may be a complex entity associated with tumor burden, liver metastases and systemic inflammatory response. TRIAL REGISTRATION ClinicalTrials.gov, NCT00145314.
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Affiliation(s)
- J Hamfjord
- Department of Oncology, Oslo University Hospital, Oslo; Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo
| | - T K Guren
- Department of Oncology, Oslo University Hospital, Oslo; K. G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway.
| | - O Dajani
- Department of Oncology, Oslo University Hospital, Oslo
| | - J S Johansen
- Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - B Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - H Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - P Pfeiffer
- Department of Oncology, Odense University Hospital, Odense; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - O C Lingjærde
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo; Department of Computer Science, University of Oslo, Oslo
| | - K M Tveit
- Department of Oncology, Oslo University Hospital, Oslo; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo; K. G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway
| | - E H Kure
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Oslo; Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Bø in Telemark, Norway
| | - N Pallisgaard
- Department of Pathology, Zealand University Hospital, Roskilde
| | - K-L G Spindler
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Winther S, Skuladottir H, Hofsli E, Shah CH, Yilmaz M, Österlund P, Berglund Å, Glimelius B, Qvortrup C, Sorbye H, Pfeiffer P. NORDIC9: A randomized phase II trial comparing first-line palliative full-dose monotherapy (S-1) with reduced dose-combination therapy (SOx) in older and frail patients with metastatic colorectal cancer (mCRC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Hamfjord J, Guren T, Dajani O, Glimelius B, Sorbye H, Pfeiffer P, Christoffersen T, Lingjærde O, Tveit K, Kure E, Pallisgaard N, Spindler K. Total circulating cell-free DNA (cfDNA) as a prognostic biomarker in metastatic colorectal cancer prior to first-line oxaliplatin-based chemotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.025] [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: 11/13/2022] Open
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18
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Kjellman M, Welin S, Knigge U, Gronbaek H, Sorbye H, Thiis-Evensen E, Thyregod Jørgensen M, Johanson V, Schalin-Jäntti C, Myrenfors P, Ström T, Becker K, Belusa R. Plasma protein fingerprinting and machine learning for the diagnosis of small intestinal neuroendocrine tumors: The nordic NET biomarker group EXPLAIN study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx368.035] [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: 11/13/2022] Open
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19
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Galleberg R, Knigge U, Tiensuu Janson E, Vestermark L, Haugvik SP, Ladekarl M, Langer S, Grønbæk H, Österlund P, Hjortland G, Assmus J, Tang L, Perren A, Sorbye H. Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas. Eur J Surg Oncol 2017; 43:1682-1689. [DOI: 10.1016/j.ejso.2017.04.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/07/2017] [Accepted: 04/21/2017] [Indexed: 01/17/2023] Open
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Angelsen JH, Horn A, Sorbye H, Eide GE, Løes IM, Viste A. Population-based study on resection rates and survival in patients with colorectal liver metastasis in Norway. Br J Surg 2017; 104:580-589. [DOI: 10.1002/bjs.10457] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/29/2016] [Accepted: 11/14/2016] [Indexed: 12/13/2022]
Abstract
Abstract
Background
Detailed knowledge about the proportion of patients with colorectal liver metastases (CLM) undergoing resection is sparse. The aim of this study was to analyse cumulative resection rates and survival in patients with CLM.
Methods
For this population-based study of patients developing CLM during 2011–2013, data were extracted from the Norwegian Patient Registry and the Cancer Registry of Norway.
Results
A total of 2960 patients had CLM; their median overall survival was 10·9 months. Liver resection was performed in 538 patients. The cumulative resection rate was 20·0 per cent. The cumulative resection rate was 23·3 per cent in patients aged less than 40 years, 31·1 per cent in patients aged 40–59 years, 24·7 per cent in those aged 60–74 years, 17·9 per cent in those aged 75–79 years and 4·7 per cent in patients aged 80 years or more (P < 0·001). In multivariable analysis, resection rate was associated with age, extrahepatic metastases, disease-free interval and geographical region. Overall survival after diagnosis of CLM was affected by liver resection (hazard ratio (HR) 0·54, 95 per cent c.i. 0·34 to 0·86), rectal cancer (HR 0·82, 0·74 to 0·90), metachronous disease (HR 0·66, 0·60 to 0·74), increasing age (HR 1·32, 1·28 to 1·37), region, and extrahepatic metastases (HR 1·90, 1·74 to 2·07). Three- and 4-year overall survival rates after hepatectomy were 73·2 and 54·8 per cent respectively.
Conclusion
The cumulative resection rate in patients with CLM in Norway between 2011 and 2013 was 20 per cent. Resection rates varied across geographical regions, and with patient and disease characteristics.
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Affiliation(s)
- J-H Angelsen
- Department of Acute and Digestive Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - A Horn
- Department of Acute and Digestive Surgery, Haukeland University Hospital, Bergen, Norway
| | - H Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - G E Eide
- Centre for Clinical Research, Department of Research and Development, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - I M Løes
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - A Viste
- Department of Acute and Digestive Surgery, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Winther S, Østerlund P, Berglund Å, Glimelius B, Qvortrup C, Sorbye H, Pfeiffer P. NORDIC9: A randomized phase II trial exploring treatment of older patients with metastatic colorectal cancer (mCRC) by comparing full dose monotherapy (S-1 followed by irinotecan) with reduced combination regimen (S-1/oxaliplatin followed by S-1/irinotecan). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.149] [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: 11/13/2022] Open
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22
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Garcia-Carbonero R, Sorbye H, Baudin E, Raymond E, Wiedenmann B, Niederle B, Sedlackova E, Toumpanakis C, Anlauf M, Cwikla JB, Caplin M, O'Toole D, Perren A. ENETS Consensus Guidelines for High-Grade Gastroenteropancreatic Neuroendocrine Tumors and Neuroendocrine Carcinomas. Neuroendocrinology 2016; 103:186-94. [PMID: 26731334 DOI: 10.1159/000443172] [Citation(s) in RCA: 375] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- R Garcia-Carbonero
- Medical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain
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Winther S, Zubcevic K, Amna S, Qvortrup C, Jensen H, Sorbye H, Pfeiffer P. P-276 S-1 and oxaliplatin (SOx) in older Western patients with metastatic colorectal cancer (mCRC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Sorbye H, Dragomir A, Sundstrom M, Pfeiffer P, Thunberg U, Bergfors M, Aasebo K, Eide G, Ponten F, Qvortrup C, Glimelius B. O-014 High BRAF mutation frequency and marked survival differences in subgroups according to KRAS/BRAF mutation status and tumor tissue availability in a prospective population-based metastatic colorectal cancer cohort. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv235.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Tanis E, Nordlinger B, Mauer M, Sorbye H, van Coevorden F, Gruenberger T, Schlag PM, Punt CJA, Ledermann J, Ruers TJM. Local recurrence rates after radiofrequency ablation or resection of colorectal liver metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983. Eur J Cancer 2014; 50:912-9. [PMID: 24411080 DOI: 10.1016/j.ejca.2013.12.008] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 12/07/2013] [Accepted: 12/10/2013] [Indexed: 01/03/2023]
Abstract
AIM The aim of this study is to describe local tumour control after radiofrequency ablation (RFA) and surgical resection (RES) of colorectal liver metastases (CLM) in two independent European Organisations for Research and Treatment of Cancer (EORTC) studies. BACKGROUND Only 10-20% of patients with newly diagnosed CLM are eligible for curative RES. RFA has found a place in daily practice for unresectable CLM. There are no prospective trials comparing RFA to RES for resectable CLM. METHODS The CLOCC trial randomised 119 patients with unresectable CLM between RFA (±RES)+adjuvant FOLFOX (±bevacizumab) versus FOLFOX (±bevacizumab) alone. The EPOC trial randomised 364 patients with resectable CLM between RES±perioperative FOLFOX. We describe the local control of resected patients with lesions ≤4 cm in the perioperative chemotherapy arm of the EPOC trial (N=81) and the RFA arm of the CLOCC trial (N=55). RESULTS Local recurrence (LR) rate for RES was 7.4% per patient and 5.5% per lesion. LR rate for RFA was 14.5% per patient and 6.0% per lesion. When lesion size was limited to 30 mm, LR rate for RFA lesions was 2.9% per lesion. Non-local hepatic recurrences were more often observed in RFA patients than in RES patients, 30.9% and 22.3% respectively. Patients receiving RFA had a more advanced disease. CONCLUSIONS LR rate after RFA for lesions with a limited size is low. The local control per lesion does not appear to differ greatly between RFA and surgical resection. This study supports the local control of RFA in patients with limited liver metastases. Future studies should evaluate in which patients RFA could be an equal alternative to liver resection.
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Affiliation(s)
- E Tanis
- EORTC Headquarters, Brussels, Belgium.
| | - B Nordlinger
- Department of Surgery, Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hopitaux de Paris, Boulogne-Billancourt, France
| | - M Mauer
- Department of Statistics, EORTC Headquarters, Brussels, Belgium
| | - H Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - F van Coevorden
- Department of Surgery, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - T Gruenberger
- Department of Surgery, Medical University Vienna, Vienna, Austria
| | - P M Schlag
- Department of Surgery, Robert-Roessle-Klinik, Humboldt-Universitat Berlin, Berlin, Germany
| | - C J A Punt
- Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J Ledermann
- UCL and UCL Hospitals Comprehensive Biomedical Research Centre, University College London, London, United Kingdom
| | - T J M Ruers
- Department of Surgery, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
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Ruers T, Tanis E, Nordlinger B, Mauer M, Sorbye H, van Coevorden F, Gruenberger T, Schlag P, Punt C, Ledermann J. PG 8.2 Surgery versus radiofrequency ablation (Lessons from the CLOCC trial). Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70029-2] [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: 10/25/2022]
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Sorbye H, Mauer M, Gruenberger T, Glimelius B, Poston G, Rougier P, Schlag P, Bechstein W, Primrose J, Walpole E, Nordlinger B. PG 8.3 Recurrence patterns after resection of liver metastases. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70030-9] [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: 10/25/2022]
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Sorbye H, Cvancarova M, Qvortrup C, Pfeiffer P, Glimelius B. Age-dependent improvement in median and long-term survival in unselected population-based Nordic registries of patients with synchronous metastatic colorectal cancer. Ann Oncol 2013; 24:2354-60. [PMID: 23704193 DOI: 10.1093/annonc/mdt197] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In metastatic colorectal cancer (mCRC) trials, median survival has increased from 6 months to above 20 months during the previous decades. Uncertainty exists in how this survival improvement has translated to the general mCRC population. PATIENTS AND METHODS Survival data from patients with synchronous mCRC were collected from the Norwegian (1980-2008), Swedish (1996-2008) and Danish (2001-09) cancer registries. RESULTS A total of 29 628 patients were identified. From 1980-1985 to 2006-2008, median survival increased from 5 to 10 months for Norwegian patients. Three-year survival increased from 7% to 21% and 5-year survival from 4% to 9%. For patients <60 years, median survival was doubled to 16 months, 3-year survival increased fourfold up to 28% and 5-year survival threefold up to 14%. Similar improvements were seen in Sweden and Denmark. In all countries, the improved outcome was seen especially for younger patients and much less for patients >75 years of age. CONCLUSION An increase in median and long-term survival over time was found in unselected population-based registries of patients with synchronous mCRC. The improved outcome in survival was especially seen in younger patients, raising concerns over our ability to adapt available treatment options for elderly patients.
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Affiliation(s)
- H Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Denmark.
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Sorbye H, Welin S, Langer SW, Vestermark LW, Holt N, Osterlund P, Dueland S, Hofsli E, Guren MG, Ohrling K, Birkemeyer E, Thiis-Evensen E, Biagini M, Gronbaek H, Soveri LM, Olsen IH, Federspiel B, Assmus J, Janson ET, Knigge U. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): the NORDIC NEC study. Ann Oncol 2012; 24:152-60. [PMID: 22967994 DOI: 10.1093/annonc/mds276] [Citation(s) in RCA: 641] [Impact Index Per Article: 53.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As studies on gastrointestinal neuroendocrine carcinoma (WHO G3) (GI-NEC) are limited, we reviewed clinical data to identify predictive and prognostic markers for advanced GI-NEC patients. PATIENTS AND METHODS Data from advanced GI-NEC patients diagnosed 2000-2009 were retrospectively registered at 12 Nordic hospitals. RESULTS The median survival was 11 months in 252 patients given palliative chemotherapy and 1 month in 53 patients receiving best supportive care (BSC) only. The response rate to first-line chemotherapy was 31% and 33% had stable disease. Ki-67<55% was by receiver operating characteristic analysis the best cut-off value concerning correlation to the response rate. Patients with Ki-67<55% had a lower response rate (15% versus 42%, P<0.001), but better survival than patients with Ki-67≥55% (14 versus 10 months, P<0.001). Platinum schedule did not affect the response rate or survival. The most important negative prognostic factors for survival were poor performance status (PS), primary colorectal tumors and elevated platelets or lactate dehydrogenase (LDH) levels. CONCLUSIONS Advanced GI-NEC patients should be considered for chemotherapy treatment without delay.PS, colorectal primary and elevated platelets and LDH levels were prognostic factors for survival. Patients with Ki-67<55% were less responsive to platinum-based chemotherapy, but had a longer survival. Our data indicate that it may not be correct to consider all GI-NEC as one single disease entity.
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Affiliation(s)
- H Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Norway.
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Qvortrup C, Cvancarova M, Glimelius B, Pfeiffer P, Sorbye H. Age Dependent Increase in Median and Long-Term Survival in 29 628 Metastatic Colorectal Cancer (MCRC) Scandinavian Patients During the Past Two Decades. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33162-8] [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: 10/25/2022] Open
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Tanis E, Nordlinger B, Mauer M, Sorbye H, van Coevorden F, Gruenberger T, Punt C, Schlag P, Lederman J, Ruers T. 189. Local recurrence rates after RFA and resection of colorectal liver metastases – A descriptive analysis of EORTC CLOCC and EPOC databases. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.186] [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: 10/27/2022] Open
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Tveit K, Guren T, Glimelius B, Pfeiffer P, Sorbye H, Pyrhonen S, Kure E, Ikdahl T, Skovlund E, Christoffersen T. Randomized phase III study of 5-fluorouracil/folinate/oxaliplatin given continuously or intermittently with or without cetuximab, as first-line treatment of metastatic colorectal cancer: The NORDIC VII study (NCT00145314), by the Nordic Colorectal Cancer Biomodulation Group. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.365] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
365 Background: The role of anti-EGFR therapy in first-line treatment of metastatic colorectal cancer (mCRC) is not established. In the present study pts were randomized to FLOX or FLOX + cetuximab until progression or FLOX intermittently + cetuximab continuously. Methods: Treatment arm A: Nordic FLOX (q2w): oxaliplatin 85 mg/m2day 1, 5-FU bolus 500 mg/m2 and FA 60 mg/m2 day 1-2; B: FLOX + cetuximab, initial dose 400 mg/m2, then 250 mg/m2/week; C: FLOX for 16 weeks + cetuximab continuously, with FLOX added at progression. Primary endpoint was progression-free survival (PFS). Results: Between May 05-Oct 07, 571 pts were randomized, 566 pts evaluable in intention to treat (ITT) analyses. Median age was 61 (24-74). ECOG status: 0=67%, 1=29%, 2=4%. KRAS and BRAF mutation (mut) analyses were obtained in 498 (87%) and 457 pts (81%), respectively. 40% of tumors had KRAS mut, 12% had BRAF mut. Cetuximab combined with Nordic FLOX did not significantly improve RR, PFS or OS compared to FLOX. KRAS mutation was not predictive for cetuximab effect. OS was similar for patients treated with FLOX intermittently and cetuximab continuously as for patients treated until progression. BRAF mutation was a strong negative prognostic factor (median OS 7.6 vs. 20.4 mo). Conclusions: Cetuximab did not add significant benefit to the Nordic FLOX regimen in first-line treatment of mCRC, irrespective of KRAS-mut. [Table: see text] [Table: see text]
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Affiliation(s)
- K. Tveit
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - T. Guren
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - B. Glimelius
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - P. Pfeiffer
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - H. Sorbye
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - S. Pyrhonen
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - E. Kure
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - T. Ikdahl
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - E. Skovlund
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
| | - T. Christoffersen
- Oslo University Hospital, Oslo, Norway; Akademiska University Hospital, Uppsala, Sweden; Department of Oncology, Odense University Hospital, Odense, Denmark; Haukeland University Hospital, Bergen, Norway; Turku University Hospital, Turku, Finland; University of Oslo, Oslo, Norway
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Sorbye H, Mauer M, Gruenberger T, Glimelius B, Poston GJ, Schlag PM, Rougier P, Primrose JN, Walpole ET, Nordlinger B. Predictive factors for the effect of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC phase III study 40983). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Sorbye H, Köhne CH, Sargent DJ, Glimelius B. Patient characteristics and stratification in medical treatment studies for metastatic colorectal cancer: A proposal for standardization of patient characteristic reporting and stratification. Ann Oncol 2007; 18:1666-72. [PMID: 17660495 DOI: 10.1093/annonc/mdm267] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [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: 11/15/2022] Open
Abstract
BACKGROUND Prognostic factors have the potential to determine the survival of patients to a greater extent than current antineoplastic agents. Despite this knowledge, there is no consensus on, first, what patient characteristics to report and, second, what stratification factors to use in metastatic colorectal cancer trials. PATIENTS AND METHODS Seven leading oncology and medical journals were reviewed for phase II and III publications reporting on medical treatment of metastatic colorectal cancer patients during 2001-2005. One hundred and forty-three studies with 21 214 patients were identified. The reporting of patient characteristics and use of stratification was noted. RESULTS Age, gender, performance status, metastases location, sites and adjuvant chemotherapy were often reported (99-63%). Laboratory values as alkaline phosphatase, lactate dehydrogenase and white blood cell count, repeatedly found to be of prognostic relevance, were rarely reported (5-9%). Stratification was used in all phase III trials; however, only study centre was used with any consistency. CONCLUSION There is considerable inconsistency in the reporting of patient characteristics and use of stratification factors in metastatic colorectal cancer trials. We propose a standardization of patient characteristics reporting and stratification factors. A common set of characteristics and strata will aid in trial reporting, interpretation and future meta-analyses.
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Affiliation(s)
- H Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Norway.
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Nordlinger B, Sorbye H, Collette L, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein W, Walpole E, Gruenberger T. Final results of the EORTC Intergroup randomized phase III study 40983 [EPOC] evaluating the benefit of peri-operative FOLFOX4 chemotherapy for patients with potentially resectable colorectal cancer liver metastases. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.lba5] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
LBA5 Background: The 5-year survival after resection of colorectal cancer liver metastases is 30% but recurrence is common. This study evaluates the benefit of combining peri-operative chemotherapy and surgery for patients with initially resectable liver only metastases from colorectal cancer (LM). Methods: Between September 2000 and July 2004, 364 pts with up to 4 LM were randomized between peri-operative FOLFOX4 (oxaliplatin 85mg/m2 and LV5FU2), 6 cycles before and 6 cycles after surgery, (CT), and surgery alone (S). The primary endpoint was progression free survival (PFS) with the goal to increase median PFS by 40% (HR=0.71). Safety was a secondary endpoint (already reported at ASCO 2005). PFS results are reported at the 2-sided 0.0434 significance level (adjusting for one interim analysis). Results: Baseline characteristics were similar in both arms. Eleven of 182 pts were ineligible in each arm, mostly for more advanced disease. In the CT arm, a median of 6 pre-op cycles were delivered and 151 patients were resected. 115 pts (63%) received post-op CT, with a median number of 6 cycles and a relative dose intensity of 79% to 86%. In the S arm, 152 pts were resected. Due to the nature of the trial, evaluation of resectability (relevant for eligibility) was based on pre-op imaging, but 31/182 pts (CT arm) and 30/182 pt (S arm) could not undergo resection. There were 2 (S arm) and 1 (CT arm) deaths after surgery. At a median follow-up of 3.9 years, 254 PFS events were reported (240 in eligible pts) and the results are as shown in the table . Conclusions: Peri-operative FOLFOX4 chemotherapy improved PFS over surgery alone in patients whose metastases were actually resected. The benefit was slightly diluted when also pts considered resectable on imaging but eventually not resected were taken into account. FOLFOX4 given peri-operatively is safe and does not prevent the pts from undergoing surgery. [Table: see text] [Table: see text]
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Affiliation(s)
- B. Nordlinger
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - H. Sorbye
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - L. Collette
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - B. Glimelius
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - G. J. Poston
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - P. M. Schlag
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - P. Rougier
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - W. Bechstein
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - E. Walpole
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
| | - T. Gruenberger
- Hopital Ambroise Pare, Boulogne Cedex, France; Haukeland Hospital - University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool University Hospital, Liverpool, United Kingdom; Robert- Roessle-Klinik, Humboldt Universitaet, Berlin, Germany; Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France; Klinikum der J.W. Goethe Universitaet, Frankfurt am Main, Germany; Princess Alexandra Hospital - University Of Queens,
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Gruenberger T, Sorbye H, Debois M, Bethe U, Primrose J, Rougier P, Jaeck D, Finch-Jones M, Van Cutsem E, Nordlinger B. Tumor response to pre-operative chemotherapy (CT) with FOLFOX-4 for resectable colorectal cancer liver metastases (LM). Interim results of EORTC Intergroup randomized phase III study 40983. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3500] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3500 Background: After resection of LM, 5y survival is 30%, but cancer recurrence is frequent. The benefit of combining surgery and CT has not yet formally been proven. Methods: This study evaluates the value of pre- and postoperative CT in patients with potentially resectable liver metastases from colorectal cancer. Between September 2000 and July 2004, 364 patients were randomized between peri-operative FOLFOX4 (oxaliplatin 85mg/m2 and LV5FU2), 6 cycles before and 6 cycles after surgery (182 patients), and surgery alone (182 patients). The primary endpoint was progression free survival. The purpose of this analysis was to evaluate tumor response to pre-operative treatment and determine if CT induces a tumor size reduction. Results: Baseline characteristics were similar in both arms: median age: 62.5 yrs, prior adjuvant CT: 41.8%, 1 to 3 metastases: 92.3%, T3 or T4: 80.8%. In the CT arm, 97.7% of the patients were documented to have completed pre-operative CT (81.5% received 6 preoperative cycles). 28.9% of the patients who started pre-operative CT required a dose reduction. Of all patients entered in the trial, 88.3% and 94.9% underwent surgery in the CT and surgery arms, respectively. Resection was achieved in 95.6% of the patients operated (84.4% of all patients) in the CT arm, and 89.2% of the patients operated (84.7% of all patients) in the surgery arm. As previously reported, preoperative chemotherapy was safely administered. From imaging data (CT scan), median sum of largest diameters of lesions was 45 mm [Q1-Q3:28.0–70.0] (both arms) before treatment and decreased to 30 mm [Q1-Q3: 15.0–55.0] after CT (median relative difference of 29.7%). At pathological examination, median sum of largest diameters of lesions was 34.5 mm [Q1-Q3:20.0–53.0] in the CT arm and 45 mm [Q1-Q3: 29.0–69.0] in the surgery arm. Conclusions: CT scan measurements were consistent with those performed at pathological examination. Pre-operative CT with 6 cycles of FOLFOX4 resulted in a decrease in diameter of lesions. Since size of metastases at time of surgery is known to have an impact on survival, it is possible that preoperative chemotherapy will improve survival. Survival data should be available at the end of 2006. No significant financial relationships to disclose.
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Affiliation(s)
- T. Gruenberger
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - H. Sorbye
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - M. Debois
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - U. Bethe
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - J. Primrose
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - P. Rougier
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - D. Jaeck
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - M. Finch-Jones
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - E. Van Cutsem
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
| | - B. Nordlinger
- University of Vienna, Vienna, Austria; Haukeland Hospital—University of Bergen, Bergen, Norway; EORTC Data Center, Brussels, Belgium; Southampton General Hospital, Southampton, United Kingdom; C.H.U. Ambroise Pare, Boulogne-Billancourt, France; Hôpital Universitaire Hautepierre, Strasbourg, France; Bristol Royal Infirmary, Bristol, United Kingdom; U.Z. Gasthuisberg, Leuven, Belgium
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Nordlinger B, Sorbye H, Debois M, Praet M, Glimelius B, Poston GJ, Schlag PM, Walpole ET, Bechstein W, Gruenberger T. Feasibility and risks of pre-operative chemotherapy (CT) with Folfox 4 and surgery for resectable colorectal cancer liver metastases (LM). Interim results of the EORTC Intergroup randomized phase III study 40983. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3528] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- B. Nordlinger
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - H. Sorbye
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - M. Debois
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - M. Praet
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - B. Glimelius
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - G. J. Poston
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - P. M. Schlag
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - E. T. Walpole
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - W. Bechstein
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
| | - T. Gruenberger
- Hosp Ambroise Pare, Boulogne, Cedex, France; Haukeland Hosp - Univ of Bergen, Bergen, Norway; EORTC Data Ctr, Brussels, Belgium; Akademiska Sjukhuset, Uppsala, Sweden; Royal Liverpool Univ Hosp, Liverpool, United Kingdom; Robert-Rössle-Klinik, Humbolt Univ, Berlin, Germany; Princess Alexandra Hosp, Brisbane, Australia; Klin der J. W. Goethe Univ, Frankfurt, Germany; Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria
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