Biomedical subjects

Arne Nysted

Publications and source records attributed to Arne Nysted.

3 recordsLinked to original sources

PubMed2006

Success predictors of adjuvant chemotherapy in node-negative breast cancer patients under 55 years.

BACKGROUND: Adjuvant systemic chemotherapy (ASCT) in lymph node-negative breast (LN-) cancers improves survival. The majority of (LN-) patients receive ASCT when the St. Gallen criteria or its modifications are used, as accurate identifiers which patients benefit from ASCT are lacking. This may imply over-treatment in many patients. AIM: To evaluate which patients or primary tumor factors predict ASCT success. MATERIAL AND METHOD: Retrospective analysis by single and multivariate survival analysis of clinical and tumor characteristics in (LN-) breast cancers <55 years, related to ASCT (n=125) or-not (n=516). RESULTS: The two patient groups did not differ in age, tumor diameter, grade, type, number of mitoses and other factors. Fourteen-year survival for the ASCT and non-ASCT patients was 83% and 74% (Hazard Ratio=HR=0.33; p<0.0001, 9% absolute=12% relative difference). Subgroup analysis showed that the recurrence-free survival=RFS of ASCT treated vs. non-treated patients differed in patients with grade 1 cancers (p=0.008), grade 2 cancers (p=0.004), grades 3 (p=0.02), tumors under and >or=2 cm (p=0.001 and 0.0002), oestrogen receptor-positive or -negative tumors (p=0.003,0.04), MAI < 10 and >or=10 (p=0.005,0.003) and fibrotic focus absent (p=0.002). With multivariate analysis the most important predictor of ASCT effect was the MAI. In patients with slowly proliferating tumors (MAI <3) no advantage was found between patients treated-or-not with adjuvant chemotherapy (RFS=92% and 91%, p=0.13, p=0.63 for overall survival), contrasting those with MAI >or=3 (p=0.0001; HR=0.32, 95% CI 0.18-0.58). CONCLUSION: MAI is the strongest predictor of adjuvant systemic chemotherapy success. In patients with MAI < 3 (31% of all patients), ASCT does not improve survival.

Adult↗

PubMed2005

[Thyroid surgery in Rogaland].

BACKGROUND: Thyroid surgery is performed at both hospitals in Rogaland county. In this retrospective study we compare clinical features, including preoperative diagnostics, type of surgery, and recorded postoperative complications. MATERIALS AND METHODS: Between 1994 and 1998, 380 patients (89% women) underwent thyroid surgery. Data were retrieved from hospital records and surgical notes. Non-parametric methods were employed for statistical analysis. RESULTS: The annual operative incidence per 100,000 inhabitants was 20.5; there was no significant difference between the two hospitals. Median age was 45 years (range 14-85). Two thirds of the procedures were done at Rogaland Central Hospital (SiR). At Haugesund Hospital (HS) 31% of the 120 patients were operated in the department of ear-nose-throat diseases. Ultrasound of the thyroid gland was requested more often at HS, whereas thyroid scintigraphy was more frequently done at SiR. Fine needle aspiration cytology was performed on 80% of the patients, including non-representative samples in 13% at HS and 8% at SiR, respectively. Hemithyroidectomy was the most frequently performed operation. The operative mortality was zero. Postoperative complications were few: permanent hypoparathyroidism was encountered in two (0.5%) patients and unilateral permanent vocal cord paralysis in five (1.1%) patients. INTERPRETATION: Our results are in accordance with national and international standards. Observed differences in preoperative diagnostics are most likely explained by different traditions among general practitioners and different access to imaging modalities. Implementation of updated guidelines for referral and work up of this group of patients are warranted.

Adolescent↗

PubMed2003

[Radiotherapy after breast-conserving surgery in the treatment of breast cancer: early results from a non-university hospital in Norway].

BACKGROUND: In 1998 the first radiotherapy unit located outside a university hospital in Norway was established at Rogaland Central Hospital. MATERIAL AND METHODS: Results from 222 consecutive patients treated between June 1999 and March 2002 are presented. Median time to follow up was 25 months (range 8-41). All patients underwent a lumpectomy combined with a complete axillary dissection or a sentinel node biopsy. The entire breast was irradiated using 6MV photon energy to a total dose of 50 Gy. RESULTS: As of October 2002, there has not been registered any local breast failures. Three patients developed distant metastases and subsequently died from their disease. Contralateral breast cancer has occurred in one patient. The relative number of patients treated with breast conservation therapy, as compared to the total number of patients operated, has not changed after a unit of radiotherapy was established locally. INTERPRETATION: Our findings show that radiotherapy after breast-conserving surgery can be performed safely in a non-university hospital such as Rogaland Central Hospital.

Adult↗